Anatomy of a Literature Search Part 1 Webinar March 13, Prepared by Deb Monkman, PABC Clinical Librarian

Transcription

1 + Anatomy of a Literature Search Part 1 Webinar March 13, 2013 Prepared by Deb Monkman, PABC Clinical Librarian 1

2 + 2 What town are you Webinaring from tonight? Please type in the chat box to everyone!

3 + Purpose: Database Anatomy & 3 Physiology Learn how a bibliographic biomedical database (EBSCO Medline or CINAHL) works

4 + Survey Says. 4 Less than half of you have searched Medline & CINAHL (66% & 33%) Mixed group! About 25% are comfy with searching while the other 75% range from very uncomfy to neutral Biggest needs: working with results, setting up Alerts, etc. - will be in Part 2 next week 33% private 40% public 25% both

5 + The Reality of Searching for 5 Physiotherapy Research It s easy to find medical treatment (drug therapy, surgery, etc) of a disease or condition, e.g., medical management for hip replacement BUT It s harder to find physiotherapy (less research published, not indexed as well, may be a line in a medical paper physiotherapy recommended, maybe not as specific as you d like e.g., exercise program for post-surgical treatment of hip replacement) Search both Medline and CINAHL for best coverage of PT Use both keywords and subject headings [see online tutorials] Don t forget me a resource for you!

6 + Learning Objectives: 6 By the end of the Webinar, you will be able to describe how to: 1. Write a clinical question using PICO 2. Access EBSCO Medline and CINAHL on the PABC elibrary 3. Do a keyword search using EBSCO Medline 4. Do a subject heading search using EBSCO Medline 5. Do a combined keyword and subject heading search 6. Use Boolean logic and, or, not 7. Narrow or broaden a search In part 2, we learn: how to apply limits, how to tease out physiotherapy-specific literature, how to set up alerts, and how to search both Medline and CINAHL together

7 Review: Covered in Absolute Beginner Webinar + watch all 5 PABC elibrary tutorials FREE Via e-hlbc Google PEDro Rehab+ PubMed OVID Medline & EBMR, including Cochrane Library With fulltext EBSCO Medline, CINAHL, & PsycINFO With fulltext Continuum of databases to learn to search

8 + A note about Rehab Reference 8 Centre (RRC) via CPA New Jan 2013 freely available to CPA members RRC is great for: Clinical reviews on a topic Exercise handouts Patient education For lit searching (articles, guidelines) use PABC s Medline & CINAHL (RRC does not have Medline and CINAHL) PABC has more full-text journals (from several different sources) RRC has Rehab & Sports Medicine Source, which PABC does not have, but there is much duplication with Medline & CINAHL

9 + A note for public practice 9 members All health authorities and their hospital library services have the ehlbc (the Electronic Health Library of BC), to which PABC also subscribes Hospital libraries will have access to MORE journals than PABC and will provide inter-library loan/document delivery services = your best bet for getting articles! VIHA is the only health authority that we are aware of that also has access to Rehab Reference Centre

10 Asking a Clinical Question

11 + Process of evidence-informed practice Step 1: Formulate a well-built question tutorial DEB Step 2: Find articles and other evidence-based resources that answer the question View all tutorials Step 3: Critically appraise the evidence to assess its validity (JOURNAL CLUB) see Alison s Journal Clubs and worksheets Step 4: Apply the evidence ALISON Step 5: Re-evaluate the application of evidence and areas for improvement

12 + Formulate a well-built clinical 12 question using PICO PABC tutorial Population: What age? Paeds, adults or elderly What diseases or conditions? Hip clicking, tennis elbow How long? Acute or chronic Intervention: What type of treatment? Stretching, exercise, LASER, lymphatic drainage Comparison: Another type of intervention, wait and see, surgery, no treatment Outcome: Pain, range of motion, strength

13 + Anatomy of a Citation 13 Major & Minor Subject headings = CINAHL Headings or MeSH (Medical Subject Headings) Subheading = physiology, etiology, rehab, therapy, drug therapy, etc.

14 + Clinical Question example: tennis 14 elbow & LASER Is low-level LASER effective for improving function (pain, grip strength) in patients with acute tennis elbow?

15 + What are all the possible keywords 15 for the various search concepts? Use the Worksheet to plan your search Tennis elbow Elbow tend?nitis/oses Elbow tendinopath* Lateral epicondylitis Acute Grip strength Pain Low-level laser* Low intensity laser* Low power laser* Laser therap* LLLT

16 + What does Truncation mean? 16 Tendinitis Tendonitis Tendinosis Tendinoses Truncate to: [this is what you type in] Tend* - picks up all the possible endings (but also tendon Or Tend?n* - picks up variant spellings Or Tend?nit* or tend?nos* might work out best

17 + Nikki s worksheet: What is the best 17 conservative treatment for FAI? 1. My clinical question is What physical or conservative therapies reduce pain and improve function in adults with FAI 2. The PICO is Population: adults with FAI Intervention: physio, conservative, non surgical Comparison: surgery, physio Outcome: improve function, reduce pain 3. The database I will use is Medline & CINAHL

18 + Nikki s worksheet: cont The limits I want are highest levels of evidence (RCTs, systematic reviews, metaanalyses) 2005 to present 5. The concepts are (1) FAI and (2) physio/non surg/conservative 6. Keywords for FAI are femoracetabular, femoroacetabular, femoral acetabular, femoroacetabular 7. Keywords for physio specific types of physio (e.g., exercise, manual therapy). Physical therapy/ies, physiotherapy/ies, non surgical, non operative, conservativ* 8. Subject headings are TO BE LOOKED UP!

19 + How do I make my searches MORE 19 RELEVANT? Answer = Use PICO and the worksheet to get clear on what you re looking for Suggestions to get clear: - Google/Google Scholar what terms are used? - Quick PubMed search - EBSCO search in TITLE field

20 Select a Database - EBSCO CINAHL & Medline

21 How to select a database: Covered in Absolute Beginner Webinar + watch all 5 PABC elibrary tutorials FREE Via e-hlbc Google PEDro Rehab+ PubMed OVID Medline & EBMR, including Cochrane Library With fulltext EBSCO Medline, CINAHL, & PsycINFO With fulltext Continuum of databases to learn to search

22 + EBSCO Medline & EBSCO CINAHL 22 Medline largest database of biomedical research, indexes many physiotherapy journals CINAHL largest database of nursing and allied health research (Cummulative Index of Nursing & Allied Health Literature), indexes many physiotherapy journals Journals found in Medline overlap with journals found in CINAHL but some are unique, so it s important to search BOTH databases Learn one interface and link to full-text articles (but use A-Z Journals List to find more)

23 Keyword searching BASIC: Hands-on

24 + Exercise 1 & 2: Keyword searching 24 in EBSCO Medline (The Googly way) Login to EBSCO Medline (Exercise 1) Basic search: (Exercise 2) [Click on Basic Search ] Elbow tendinopathy and laser. Explore the results Then try tennis elbow and laser. Explore those results how many more? Now try lateral epicondylitis and laser Explore the areas of the screen what can you do? Try to limit What would be the best SUBJECT HEADING to search for this topic? Hint: look at a citation to see the subject headings

25 + Now move to the ADVANCED 25 search screen and explore Tennis elbow or elbow tend?nit* or elbow tend?nos* or lateral epicondylitis AND Laser Tennis elbow - as a subject AND Laser*

26 What is Boolean logic? Using and, or, not in ADVANCED Handson

27 + Advanced Search Author 27

28 + Boolean Logic And, Or, Not 28 ( Boolean Operators ) Use and to find ALL these different concepts together in one article Systematic review or clinical trials Pilates Use or to combine similar concepts Low back or lumbar or [specific muscles] Age Reduce pain or increase function

29 + Exercise 3: Keyword Advanced 29 Search in EBSCO Medline + Results Advanced search: [Click on Advanced Search ] Pilates and low back Put at least one result in your folder Add to folder results in your folder to yourself

30 Subject Heading Search in Medline/CINAHL in 3 STEPS: (1) Explode, (2) Major Concept & (3) Subheadings

31 + For adults with FAI 31 what is the best conservative/physical therapy (compared to surgery) for improving function?

32 + If you re not sure how to start Search for your terms in the TITLE field this ensures the articles retrieved will be highly relevant. THEN look at subject headings

33 + Why use subject headings? You don t have to type in all the keywords! 33 Sean John Combs = Puff Daddy = P Diddy = Diddy = Puffy, etc Subject heading = Diddy Femoral acetabular impingement, femoroacetabular impingement, femoracetabular impingement, etc Subject heading in Medline (MeSH) = Femoracetabular impingement

34 + Demo & Exercise # 4 34 Search in MESH Headings and do separate searches for each one. Start with FAI This is a 3 step process: Find the subject heading femoral acetabular impingement Step 1 = Should I Explode the subject heading to include all the more specific types? Not an option in this case Step 2 = Should I make it a Major Concept? I will not in this case. Step 3 = Do I need to add a Subheading to be more specific? E.g., rehabilitation. I will not in this case. Then search for it. Start again with the next term physiotherapy

35 + Medline let s use subject headings what is the tree for FAI? CLICK ON MeSH 35 Click on it there are no narrower terms in the Tree so we cannot Explode

36 + Medline using subject headings how do I select a Subheading for rehabilitation? 36 Subheadings create a more specific SUBJECT HEADING for example, REHABILITATION of FAI. In this case, we Include All Subheadings. This is a way of getting more relevant results but may be too restrictive at times

37 + Medline Finally, click on Search Database to do the subject headings search 37 Search each term separately look for FAI as a subject heading, using explode, major concept and subheadings as appropriate Also, search for FAI as a keyword:

38 + Medline search each term separately and then combine using AND, OR (or NOT) 38

39 + We have just searched for the 1 st term (FAI) as a subject heading and a keyword in Medline. Whew! 39 The next step is to search for the next term, physiotherapy. NOT Googly! VERY precise!

40 + Let s search Physical Therapy in 40 the same way Go the MeSH Physical Therapy The most appropriate term is Physical Therapy Modalities Do you want to Explode it? (YES!) Do you want to make it a Major Concept? (probably not) Are any subheadings relevant? (not in this instance) Search it and then go to the Search History, and combine it with other terms using AND, OR Femoracetabular impingement AND physical therapy modalities+ (where + means explode)

41 + Explode Physical Therapy 41 Modalities (then click on SEARCH DATABASE)

42 Let s supplement Subject Headings with KEYWORDS

43 + Keyword searches 43 Think of all the relevant spellings and terms Use truncation - * at the end of a word, or $ or? In the middle of a word Remember to or like concepts together

44 Let s combine Subject Headings & keywords using AND, OR (sometimes NOT ) the Boolean Operators

45 + 45 Keyword Search = 95 Subject Search = 6

46 + Now What? 46 Go through the same process in CINAHL as well!

47 Tips & Tricks

48 + 48 Tip: Remember to Clear previous searches, then start a new one

49 + 49 Tip: CINAHL Headings and MeSH Headings may be different

50 + What are the CINAHL Headings? 50 Are they different from MeSH? FAI is NOT a heading in CINAHL! There is a CINAHL heading for HIP INJURIES, but it may be too broad (not specific enough) Use the keywords for FAI and don t use a subject (CINAHL) Heading Physical therapy is the CINAHL Heading (instead of Physical Therapy Modalities, which is the MeSH heading). Explode it.

51 + Useful physiotherapy subject 51 headings (check for explosions+) CINAHL Headings Physical fitness+ Therapeutic exercise+ Physical therapy modalities+ Orthoses+ Laser therapy, low-level Athletic injuries+ Arthroplasty, replacement, knee Balance, postural Low back pain Medline Medical Subject Headings (MeSH) Physical fitness Exercise therapy+ Physical therapy+ Orthotic devices+ Laser therapy+ Athletic injuries+ Arthroplasty, replacement, knee Postural balance Low back pain

52 + Subject Heading Explosions! 52 CINAHL Headings Medline Medical Subject Headings (MeSH) Therapeutic exercise+ Exercise therapy+ - Abdominal exercise - Motion therapy, continuous passive - Aerobic exercises+ - Muscle stretching exercises ---Aquatic exercises -Resistance training - Back exercises -Pylometric exercise - Breathing exercises+ Hydrotherapy --- various terms - Closed kinetic chain exercises - Conditioning, cardiopulmonary - Many more

53 + Tip: Handy subheadings for 53 subject headings Athletic injuries -- prevention & control Any condition (e.g., osteoarthritis) rehabilitation, surgery Any treatment (e.g., therapeutic exercise) -- contraindications, adverse effects

54 + Ways to get less (narrow your 54 results) Use subject heading, e.g., Therapeutic exercises Select the Major Concept subject heading Add a Subheading to the subject heading Osteoarthritisrehabilitation Use limits (year, age group, publication type, full-text) Add more concepts using AND, e.g., electrotherapy AND manual therapy articles discussing both treatments NOT out irrelevant concepts, e.g., low-level laser NOT acupuncture Use a more specific term, e.g., sacrotuberous ligament Search in Title (then see how it s indexed and search again)

55 + Ways to get more (broaden your 55 results) Use keywords plus subject headings, e.g., tennis elbow or tendinopathy or tendinitis or tendinoses Think of synonyms or similar concepts, e.g., back* or lumbar or thoracic or cervical or spine or spinal or disc or disk or pelvis or sacrotuberous ligament Truncate to pick up alternate spelling, e.g., tendin* will search -itis, opathy, opathies, osis, oses, etc. Use a more general term, e.g., knee instead of ACL Add more related terms using OR, e.g., manual therapy OR mobilisation* OR mobilization* OR manipulation* OR maitland OR mulligan etc.

56 + Very Important Tip about Search 56 Results! When you search results to yourself (or I them to you) Log on to the members site > Clinical Library > Library Databases & Journals > Databases --- this will authenticate you Go back to your and click on the links they should open in EBSCO (no password)

57 To be covered in Part 2 (A Sneak Peak): Limits - Years, Full-text, Publication types, Age groups

58 + But where did the LIMITS go??? 58 Click on Advanced Search Hold down Control to select more than one

59 To be covered in Part 2: A sneak peak: Searching EBSCO Medline and CINAHL together

60 + Working with Multiple Databases CINAHL & MEDLINE 60 Keyword search + use both CINAHL Headings & MeSH: e.g., CINAHL uses Adhesive Capsulitis Medline uses Bursitis

61 To be covered in Part 2: a sneak peak Set up an Alert

62 + Save Searches / Alert Search 62 History > Save /Alert > login

63 + 12. How to get the full-text? 63 Webinar on this special topic! May be linked to your search results. If not: 1. Check A-Z Journals List to see if it s one of the full-text journals we have 2. Google to see if it s freely available 3. Ask me I can access other sources

64 Recap!

65 + Recap: 65 Write a clinical question using PICO and select a database (view tutorials on website) Access EBSCO Medline & CINAHL on the PABC elibrary Do a keyword and subject heading search using EBSCO CINAHL (CINAHL Heading, explode, major concept, subheading) Use Boolean logic and, or, (not) Work with search results by sorting, adding to folders, displaying, printing, ing

66 + Recap cont but more to come in 66 part 2: Apply limits to a search Search Medline & CINAHL together but note subject headings will be different so check them first Create a search alert (or save your search permanently) Tips for physiotherapy searching

67 + Homework? 67 Watch all 5 videos (Library Services > Tutorials & Training) Practice using subject headings along with keywords Ask me

68 + Questions? Thanks! You will receive a POST-TEST & EVALUATION! The recording on the webinar can be found in the Clinical Library on the members site