MEDLINE and Embase. Swiss Biomedical Librarians Basel, September 10th Dieuwke Brand Wolters Kluwer. The Netherlands

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MEDLINE and Embase characteristics, search strategies, and advanced search options Swiss Biomedical Librarians Basel, September 10th 2015 Dieuwke Brand Wolters Kluwer The Netherlands

Agenda, part 1 1. Information about MEDLINE and Embase 2. Status of MEDLINE records 3. Embase and its MEDLINE supplement 4. Evidence-based medicine 5. Structured searching 6. A search in MEDLINE 2

MEDLINE: MEDLARS online MEDLARS: MEDical Literature Analysis and Retrieval System The MEDLARS database could only be searched by a mainframe computer Online interactive searching was not yet possible Since 1974 (1973?) MEDLINE! Online interactive searching 3

MEDLINE MEDLINE pure (records with controlled terms) Scope: Medicine (in a broad sense) Producer: National Library of Medicine (U.S.A.) Content: Descriptions of journal articles (records) with controlled terms Period: 1946 (1902) now Journals: > 5,600 journals Total: > 22 million records Increase: > 800,000 records/year Languages: 91% English 0.1% Norwegian 0.2% Dutch 1.2% German 1.7% Chinese (languages: 2000-current) 4

MEDLINE on Ovid Records with controlled terms. MEDLINE Records that do not (yet) have controlled terms - CTs will be added. In-Data-Review. In-Process - CTs will never be added. PubMed-not-MEDLINE Records with/without old controlled terms. OLDMEDLINE 5

MEDLINE on Ovid Records with controlled terms. MEDLINE [PubMed - indexed for MEDLINE] Records that do not (yet) have controlled terms - CTs will be added. In-Data-Review [PubMed - in process]. In-Process [PubMed - in process] - CTs will never be added. PubMed-not-MEDLINE [PubMed] Records with/without old controlled terms. OLDMEDLINE [PubMed OLDMEDLINE] PubMed s [PubMed - as supplied by publisher] is not available in MEDLINE on Ovid 6

MEDLINE record In recent records, Keyword Headings are authors keywords 7

The oldest MEDLINE record 8

PubMed-not-MEDLINE record 9

OLDMEDLINE record Keyword Headings in OLDMEDLINE: - old subject headings - uppercase - all Major/Focus (with an *) - translated into MeSH Headings 10

Former OLDMEDLINE record See MEDLINE Database Guide Field: Journal Subset 11

Status in MEDLINE/Ovid 12

NLM-Page about status in PubMed http://www.ncbi.nlm.nih.gov/books/nbk3827/table/pubmedhelp.t.status_subsets/ 13

Embase: Excerpta Medica Database Embase pure (without MEDLINE supplement) Scope: Medicine (in a broad sense) Producer: Elsevier (Amsterdam) Content: Descriptions of journal articles (records) with controlled terms Period: 1974 (1908) - now Journals: > 5,000 journals Total: > 19 million records Increase: > 1 million records/year Languages: 92.4% English 0.03% Norwegian 0.3% Dutch 1.9% German 1.4% Chinese (languages: 2000-current) 14

Embase: Excerpta Medica Database Embase from 1974 Embase Classic 1947-1973 Since 2010: MEDLINE supplement is added to all Embase versions! Embase/Ovid, Embase/DIMDI, Embase.com etc. Keep in mind! The MEDLINE supplement consist of records with Controlled Terms The Original MeSH SHs are converted to Emtree SHs 15

Embase record (Copyright Elsevier) 16

Embase record (Copyright MEDLINE) 17

Embase from 1974 More than dan 7500 journals Embase-unique: > 2000 MEDLINE-unique: > 2500 Overlap: > 3000 More than 29.1 million records > 19.5 million from Embase > 9.6 million from MEDLINE 18

Journals in Embase (> 7500) MEDLINE supplement (yellow): 9,611,416 Time period 1902 now; substantially from 1940 MEDLINE supplement 2500 js. Overlap E-M, available as Embase records: 3000 js. Embase unique 2000 js. } 5000 Total Embase (blue + green): 19,543,523 Time period 1908 now; substantially from 1973 19

Publication years Embase and MEDLINE 20

Strengths of Embase 1. More information than MEDLINE on - Drugs - Pharmacology and pharmaceutics - Conferences 2. Richer indexing than MEDLINE (this can also be a disadvantage) Conference abstracts since 2009 They are indexed automatically (incl. Major terms) 21

MEDLINE and/or Embase? When to perform an additional search in Embase? 1. When completeness is important - Systematic review - PhD thesis - Drug industry 2. When MEDLINE gives zero/few records 22

Embase: information from Elsevier http://www.elsevier.com/ data/assets/pdf_file/0016/92104/embase-indexing-guide-2015.pdf 23

Embase: information from Elsevier 24

Embase: information from Elsevier 25

Embase: information from Elsevier 26

Coverage of MEDLINE in Embase http://cdn.elsevier.com/assets/pdf_file/0017/127331/coverage-of-medline-in-embase.pdf This is a white paper by Ian Crowlesmith, May 2011, with more information than the Indexing Guide 27

28

Evidence-based medicine Sacket DL et al. BMJ. 1996 Jan 13;312(7023):71-2. (MEDLINE 8555924.an.) 29

First article evidence-based medicine (MEDLINE 1404801.an.) More than 30 authors! 30

Evidence-based medicine Benefits of EBM Improves health care practice Improves patient outcomes Lowers health care costs But EBM is also criticized Sometimes it is called cookbook medicine Most therapies are NOT evidence based (and yet can be good therapies ) 31

Evidence-based medicine Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials Gordon C S Smith, Jill P Pell BMJ. 2003 December 20; 327(7429): 1459 1461. (MEDLINE 14684649.an.) BMJ Christmas issue 32

The 5 steps of evidence-based medicine 33

Levels of evidence Highest levels: Scientific publications 34

Structured searching - Formulate a search question - Analyze the different element - Choose appropriate database(s) - Collect search terms for every element - Combine the search terms within an element with OR - Combine the elements with AND - Consider the search results - Reformulate if necessary - Print / Download / Mail the records before searching during searching - Save the search history (including database/time period) Repeatable, controllable, reliable 35

Structured searching A way of online searching with a plan following a scheme with a final report Synonyms: conceptual searching systema2c searching Systematic searching Searching for systematic reviews 36

Systematic reviews Systematic reviews exhaustively search for, identify, and summarise the available evidence that addresses a focused clinical question, with particular attention to methodological quality. BMJ. 330(7482):68, 2005 Jan 8. (MEDLINE 15619601.an) Searching multiple resources (computerized and print) without language restrictions 37

Example of question and elements Q: What is the influence of pesticides on fertility? Elements: Pesticides: pesticide pesticides Fertility: fertility separate pesticides fertile Subject Headings and truncation can provide assistance Within an element Between elements OR AND Boolean operators and Venn diagrams Boole: 1815-1864 38

Combinations within/between elements Within an element: Between elements: OR AND AND Element 1 Element 2 39

Importance of Subject Headings 1. Synonyms 2. Narrower Terms 3. Referrals to related terms 4. Homonyms Mercury (Metal vs Planet) 5. Abstracts with sentences like... did not include diabetic patients in this study...... on the other hand... 40

Subject Headings: 1. Synonyms Kidney disease(s), renal disease(s), When a database producer selects one of these terms as a Subject Heading, and adds this Subject Heading to the relevant records, searching with that Subject Heading is sufficient but in most searches, free text searching can expand search results (especially when not all records in the database contain Subject Headings) 41

Subject Headings: 2. Narrower Terms Kidney Diseases Nephritis Glomerulonephritis Glomerulonephritis, IGA When you are interested in Kidney Diseases, you are also interested in (Glomerulo)Nephritis and Glomerulonephritis, IGA With explode, you can search for Kidney Diseases and all of its Narrower Terms in an OR combination MEDLINE indexers have to index as specific as possible! 42

How would you search for this topic? Q: What is the influence of pesticides on fertility? Database: MEDLINE 43

Subject Headings: 3. Related Terms Antonyms should be considered as search terms! reliability/unreliability of memory Embase Scope Note for fertility 44

Main Search Page of MEDLINE 45

Basic Search in MEDLINE 46

Basic Search in MEDLINE scroll 47

Basic Search in MEDLINE 2 steps! 48

Basic Search in MEDLINE 49

Basic Search versus Advanced Search Basic Search - Suitable search mode for an initial exploration - Simple, Google-like searching - May help in finding some new search terms Advanced Search - Best search mode for structured searching - Assistance in finding Subject Headings - Explode of Subject Headings - Major Subject Headings - Boolean combinations - Selection of search fields 50

Advanced Search: first element Always start with the most important element! When it gives a low number of records, you could skip further searching. 51

Mapping of pesticide 52

Tree of MEDLINE Pesticides has Narrower Terms, so Explode is necessary! 53

Subheadings (not obliged) 54

First term of the 2 nd element: fertility 55

Mapping of fertility Fertility has 2 Narrower Terms 56

2 nd term of the 2 nd element: infertility 57

2 nd term of the 2 nd element: infertility Infertility has Narrower Terms Where is Infertility, Female? 58

2 nd term of the 2 nd element: infertility Explode of Infertility searches for this MeSH Term and áll of its NTs: Infertility, Male ánd Infertility, Female ánd the NT s of Infertility, Male 59

Boolean combinations 60

7 records out of the first 10 (of 859) A limit to humans is necessary! 61

Limit to Humans Will free text search add relevant records? 62

Expanded search: free text added 63

Non-relevant records Truncation was too broad... 64

More restricted truncation 65

Limiting the search to Focus SHs *3 means: exp Pesticides (set 3) is limited to Focus 66

Limiting the search to Focus SHs 67

Limiting to Focus SHs plus titles 68

Summary of all attempts 1. MeSH Headings 231 2. MeSH Headings plus.ti,ab,kf. 887 3. Idem, with *3-truncation 570 4. Focus MeSH Headings 83 5. Focus MeSH Headings plus titles 101 69

Agenda, part 2 Embase items 7. Emtree versus MeSH 8. Candidate terms 9. Limits in Embase Ovid items 10. Truncation 11. Adjacency 12...dedup 13. OR/5-20 14. Transfer of a search strategy 15. Analysis of authors, journals, etc. Extra 16. (Dis)advantages of MEDLINE/Ovid compared to Pubmed 70

Emtree versus MeSH When an Embase Subject Heading has more than 1 position in Emtree, its Narrower Terms are the same in all positions This is different from the situation in the MeSH tree in MEDLINE So Embase does not have a Context button 71

MeSH tree in MEDLINE Ovid 72

Candidate terms in Embase Indexers may find that concepts discussed in articles are not adequately covered by an existing Emtree term. In such cases new so-called candidate terms may be proposed. Indexers who propose candidate terms are expected to assign a broader umbrella term to cover the new concept at a higher level. 73

Candidate terms in Embase Candidate term, added in 2013 74

Candidate terms in Embase 75

Limits in Embase How to limit in general? 1. Add a new element with AND 2. Use Focus Subject Headings (instead of Subject Headings) 3. Search in titles (instead of.ti,ab..mp..af.) 4. Use Limits 76

Limits in Embase 77

Additional Limits in Embase 78

Additional Limits in Embase Do not use this limit! It does not do what you expect from it >5.3% Lancet is a MEDLINE journal But Lancet also is an Embase journal! The collection of MEDLINE journals varies over time 79

Truncation in Ovid * or $ 0, 1, or more characters behind a root adolescen* pollut* # exactly 1 character wom#n organi#ation? 1 or 0 character(s) colo?r engine? *3 or??? up to 3 characters fertil??? fertil*3 Important in free text searching!!! 80

Adjacency: sequence and distance of words Adjacency is important in free text searching!!! Blank: sequence fixed adjn sequence free n-1 words in between 117 184 129 81

Adjacency: sequence and distance of words 117 adj2 not adj1 184 adj3 not adj2 129 adj4 not adj3 In most cases, adj3 gives good additional information Words in between can be stopwords (with, and) 82

Dot dot commands The only dot dot commands I use are:..ps (for making a nice Search History)..dedup n (for example:..dedup 5) for deduplication in single database searching 83

..ps (Print Screen) and..dedup Normal Search History..dedup 5..ps Search History 84

First removed record (after dedup) In this case, the Embase record was removed... 85

OR/n-m Smart Ovid combinations 86

Same search in PubMed 87

Transfer of an Ovid search strategy History Jumpstart http://demo.ovid.com/demo/ovidsptools/ 88

History Jumpstart 89

History Jumpstart 90

History Jumpstart 91

History Jumpstart http://ovidsp.ovid.com/ovidweb.cgi?t=js&csc=y&d=oemezd&page=main&news=n&id=&password=&search=exp+pesticide/%0aexp+fertility/%0aexp+infertility/%0a1+and+(2+or+3)%0alimit+4+to+human 92

Analysis of authors, journals, etc. scroll 93

Analysis of authors, journals, etc. Highest ranked authors: Altshul L. and Chen X. 94

Advantages of Ovid/MEDLINE compared to PubMed 1. Truncation 2. Adjacency 3. Searches like (cancer* or neoplas* or tumor* or tumour* or ).ti,ab.kf. 4. Selection of some Narrower Terms of a MeSH Heading 5. Combinations like OR/2-20 6. Self selected combinations of e.g.therapy subheadings exp Neoplasms/dh,dt,rt,su,th 7. You can search several databases with the same Ovid language 8. Ovid has filters for Subject, Author, Journal (kind of frequency analysis) 9. When removing one or more sets from the Search History - a warning is given when more sets will be affected - sets are renumbered 10. Options with set numbers: set 10 = (cancer* or neoplas* or tumor* or tumour* or ).ti,ab,kf. 10.ti.à (cancer* or neoplas* or tumor* or tumour* or ).ti. set 12 = exp Neoplasms/ec[Economics] *12 à exp *Neoplasms/ec 95

Advantages of PubMed compared to Ovid/MEDLINE 1. Transfer of a search strategy (to a customer) 2. Mapping to subheadings In PubMed, economics is mapped to: "economics"[subheading] OR "economics"[all Fields] OR "economics"[mesh Terms] In MEDLINE/Ovid, economics is mapped to: Economics.fs is not included in economics.mp 3. MEDLINE/Ovid does not contain status PubMed as supplied by publisher 4. PubMed is free 5. PubMed Help gives nice NLM information, e.g. list and tree of subheadings, strategy of Systematic Review limit 6. Different branches in the Tree are all shown on the same MeSH page; in Ovid the (rather unknown) Context button has to be used 7. PubMed contains comments in PubMed Commons. MEDLINE/Ovid does not 96

PubMed Commons 97

Extra NLM Announces (weekly e-mail newsletter) http://www.nlm.nih.gov/listserv/emaillists.html 98

Extra From the newsletter (6 May 2015) http://www.nlm.nih.gov/bsd/medline_lang_distr.html http://www.nlm.nih.gov/bsd/authors1.html 99

Questions?