Support Unit for Research Evidence (SURE)

1. Support Unit for Research Evidence (SURE) Mala Mann March 2009 University Health and Medical Librarians Group (UHMLG)Spring Forum

2. Outline SURE Profile • Our expertise • Our projects

3. Support Unit for Research Evidence (SURE) • Nationally recognised unit established to support and produce research to assist evidence based practice and policy • Specialised skills in: • Advanced literature searching • Critical appraisal • Summarising research evidence • Teaching of these skills within the University and in Wales

4. Evidence-based practice The use of current best evidence in making decisions about the care of individual patients. It involves integrating clinical expertise with the best available clinical evidence from systematic research.

5. SURE team • Hilary Kitcher • Mala Mann • Fiona Morgan • Helen Morgan • Lesley Sander • Rowland Somers • Ruth Turley • Alison Weightman (Director)

6. Advanced Literature Searching • Building complex search strategies for electronic databases, using: • Boolean logic (combining search terms with OR, AND, or NOT) • Wildcards or truncation • Limits to refine a search

7. 1 prosperity.mp. (363) 2 wealth.mp. (4139) 3 unemploy$.mp. (7600) 4 poverty.mp. (21355) 5 earning$.mp. (1971) 6 low pay.mp. (49) 7 salary.mp. (1850) 8 debt$.mp. (1979) 9 arrear$.mp. (16) 10 social class.mp. (23746) 11 socio-economic.mp. (8891) 12 socioeconomic.mp. (83015) 13 social security.mp. (6987) 14 social welfare.mp. (6254) 15 social mobility.mp. (610) 16 housing tenure.mp. (132) 17 home own$.mp. (163) 18 house own$.mp. (13) 19 renter.mp. (7) 20 car own$.mp. (82) 21 overcrowd$.mp. (1251) 22 income.mp. (37143) 25 family conflict.mp. (387) 26 poor housing.mp. (163) 27 educational attainment.mp. (1616) 28 educational achievement.mp. (403) 29 deprivation.mp. (41158) 30 inequalit$.mp. (7500) 31 financial hardship.mp. (104) 32 social position.mp. (359) 33 damp housing.mp. (38) 34 social isolation.mp. (9350) 35 social exclusion.mp. (199) 36 social network$.mp. (2730) 37 decision latitude.mp. (236) 38 social relationship$.mp. (1480) 39 effort-reward.mp. (113) 40 job opportunit$.mp. (174) 41 promotion prospects.mp. (27) 42 social gradient.mp. (135) 43 family breakdown.mp. (46) 44 family conflict.mp. (387) 45 social conflict.mp. (178) Social determinants for cancer

8. 46 neglect.mp. (7494) 47 social interaction.mp. (2940) 48 vulnerable group$.mp. (759) 49 social adversity.mp. (65) 50 social cohesion.mp. (138 51 poor environment.mp. (93) 52 social contacts.mp. (673) 53 social attachment$.mp. (97) 54 social integration.mp. (965) 55 emotional ties.mp. (37) 56 perceived inadequacy.mp. (22) 57 civic communit$.mp. (5) 58 domestic violence.mp. (3744) 59 engagement in community.mp. (3) 60 social stigma.mp. (296) 61 social capital.mp. (418) 62 social status.mp. (2220) 63 family status.mp. (271) 64 single parent.mp. (1513) 65 sole parent.mp. (9) 66 lone parent.mp. (35) 67 divorce.mp. (4268) 68 marital separation.mp. (61) 69 ethnic$.mp. (59718) 70 refugee$.mp. (5355) 71 good nutrition.mp. (303) 72 household composition.mp. (164) 73 family composition.mp. (184) 74 crowding.mp. (4126) 75 school performance.mp. (1198) 76 school attendance.mp. (463) 77 housing condition$.mp. (1117) 78 benefit recipient$.mp. (11) 79 household type.mp. (37) 80 housing design.mp. (27) 81 employment status.mp. (1983) 82 economic inactivity.mp. (8) 83 social housing.mp. (91) 84 access to health care.mp. (1878) 85 access to services.mp. (525) 86 community participation.mp. (984) 87 social environment.mp. (26711) 88 Social disadvantage.mp. (237) 89 *"Public Housing"/ (370) 90 property own$.mp. (46) 91 racial$.mp. (12725) 92 sociodemographic.mp. (9350) 93 inequit$.mp. (1698) 94 disadvantaged.mp. (3422) 95 Immigrant$.mp. (7999) 96 Rental.mp. (243) 97 affluen$.mp. (1820) 98 Rented.mp. (166) 99 Salaries.mp. (11250)

9. 100 Shift work.mp. (1052) 101 Social disparit$.mp. (89) 102 Social effect$.mp. (360) 103 Uninsured.mp. (5085) 104 social inclusion.mp. (76) 105 or/1-104 (351713) 106 exp Controlled Clinical Trials/ (53225) 107 exp Random Allocation/ (59871) 108 exp Double-Blind Method/ (93163) 109 exp Single-Blind Method/ (11128) 110 ((singl$ or doubl$ or trebl$ or tripl$) adj5 (blind$ or mask)).ti,ab. (88154) 111 (control$ adj (trial$ or stud$ or evaluation$ or experiment$)).mp. (419822) 112 randomi?ed.hw,ti,ab,pt. (336615) 113 (cohort: or survey: or qualitativ: or cross section: or case stud: or evaluat: or audit: or longitudinal: or questionnaire:).ti,ab. (1757661) 114 (case stud: or evaluat: or audit: or longitudinal: or questionnaire:).ti,ab. (1453166) 115 exp Meta-Analysis/ (7588) 116 meta-analys$.ti,ab. or metaanalys$.ab,ti. or meta analys$.ab,ti. (17210) 117 Cochrane.ab,sh,ti. (8158) (review$ or overview$).ti. or review$.pt. or (synthes$ adj3 (literature$ or research or studies or data)).ab,ti. (1361158) 119 pooled analys$.ab,ti. or ((data adj2 pool$) and studies).mp. (3068) 120 ((hand or manual or database$ or computer$) adj2 search$).ab,ti. (10520) 121 ((electronic or bibliographic$) adj2 (database$ or data base$)).ab,ti. (2627) 122 ((review$ or overview$) adj10 (systematic$ or methodologic$ or quantitativ$ or research$ or literature$ or studies or trial$ or effective$)).ab. (148334) 123 census$.mp. (10083) 124 registry.mp. (22497) 125 registries.mp. (30974) 126 follow up stud$.mp. (356983) 127 or/106-126 (3598245) 128 neoplasm$.mp. (1486462) 129 malignan$.mp. (273106) 130 Polycythemia Vera.mp. (3927) 131 Myeloproliferative Disorder$.mp. (4717) 132 cancer$.mp. (611077) 133 exp neoplasms/ (1830218) 134 tumo?r$.mp. (951252) 135 Myelodysplastic Syndrome$.mp. (9373) 136 Immunoproliferative Disorder$.mp. (133) 137 or/128-136 (2145924) 138 105 and 127 and 137 (13438)

10. 139 138 not (Algeria$ or Egypt$ or Liby$ or Morocc$ or Tunisia$ or Western Sahara$ or Angola$ or Benin or Botswana$ or Burkina Faso or Burundi or Cameroon or Cape Verde or Central African Republic or Chad or Comoros or Congo or Djibouti or Eritrea or Ethiopia$ or Gabon or Gambia$ or Ghana or Guinea or Keny$ or Lesotho or Liberia or Madagasca$ or Malawi or Mali or Mauritania or Mauritius or Mayotte or Mozambiq$ or Namibia$ or Niger or Nigeria$ or Reunion or Rwand$ or Saint Helena or Senegal or Seychelles or Sierra Leone or Somalia or South Africa$ or Sudan or Swaziland or Tanzania or Togo or Ugand$ or Zambia$ or Zimbabw$ or China or Chinese or Hong Kong or Macao or Mongolia$ or Taiwan$ or Belarus or Moldov$ or Russia$ or Ukraine or Afghanistan or Armenia$ or Azerbaijan or Bahrain or Cyprus or Cypriot or Georgia$ or Iran$ or Iraq$ or Israel$ or Jordan$ or Kazakhstan or Kuwait or Kyrgyzstan or Leban$ or Oman or Pakistan$ or Palestin$ or Qatar or Saudi Arabia or Syria$ or Tajikistan or Turkmenistan or United Arab Emirates or Uzbekistan or Yemen or Bangladesh$ or Bhutan or British Indian Ocean Territory or Brunei Darussalam or Cambodia$ or India$ or Indonesia$ or Lao or People's Democratic Republic or Malaysia$ or Maldives or Myanmar or Nepal or Philippin$ or Singapore or Sri Lanka or Thai$ or Timor Leste or Vietnam or Albania$ or Andorra or Bosnia$ or Herzegovina$ or Bulgaria$ or Croatia$ or Estonia or Faroe Islands or Greenland or Liechtenstein or Lithuani$ or Macedonia or Malta or maltese or Romania or Serbia$ or Montenegro or Slovenia or Svalbard or Argentina$ or Belize or Bolivia$ or Brazil$ or chile or Chilean or Colombia$ or Costa Rica$ or Cuba or Ecuador or El Salvador or French Guiana or Guatemala$ or Guyana or Haiti or Honduras or Jamaica$ or Nicaragua$ or Panama or Paraguay or Peru or Puerto Rico or Suriname or Uruguay or Venezuela or developing countr$ or south America$).ti,sh. (11890) • 140 limit 139 to (humans and English language and yr="2001 - 2006") (5315)

11. The process of systematically examining research evidence to assess its validity, results and relevance before using it to inform a decision Critical Appraisal “The medical literature can be compared to a jungle. It is fast growing, full of dead wood, sprinkled with hidden treasure and infested with spiders and snakes.” Peter Morgan, Scientific Editor, Canadian Medical Association

12. Summarising the Evidence Making a summary of the research papers appraised; Summarising the methodology and quality of the individual studies and pooling the results.

13. Learning, Teaching & Research Support • Teaching database searching • Critical appraisal training • Supporting systematic reviews and other research projects • Supporting researchers with grant applications Evidence based information literacy skills:

16. Centre for Health and Environmental Research Population health effects associated with chronic low level exposure to environmental toxicants (2004) National Institute for Health and Clinical Excellence (NICE) Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children (2006)http://www.nice.org.uk/CG043 Systematic and other reviews: terms and definions used by UK organisations and selected databases. Systematic review and Delphi survey (2006) http://www.nice.org.uk/niceMedia/docs/systematic%20reviews%20v5%20FINAL.pdf Welsh Assembly Government Identification of determinants of health indicators for cancer, child health and older people’s health(2008) Information support for NICE guidance including: Workplace & physical activity Health inequalities Mental health and the workplace Children and physical activity Needle exchangeIdentification of determinants of health indicators for cancer, child health and older people’s health (2007) Clinical Engineering Device Assessment and Reporting (CEDAR) Techniques for the treatment of varicose veins (2008) Wales Centre for Health How effective are Health Impact Assessment and Participatory Action Research as tools for public engagement? (2008) Completed Projects

18. Guidelines to inform Government recommendations

19. http://new.wales.gov.uk/topics/health/ocmo/research/gain/socialdeterminants/?lang=enhttp://new.wales.gov.uk/topics/health/ocmo/research/gain/socialdeterminants/?lang=en

21. National Library for Health Oral Health Specialist Library • Repository of oral health research • methodically identified • critically appraised • summarised • Rapid access to published evidence • best available • quality checked

24. Systematic Reviews of Physical Aspects of Child Protection • This work has directly informed clinical practice in the • Royal College of Radiology/Royal College of Paediatrics and Child Health standards for radiological investigations of suspected abuse • NICE maltreatment guideline • NHS direct • Advice and guidance to Dental Practitioners http://www.cpdt.org.uk/ • Production of series of leaflets for all practitioners based on review results • Informed a primary research agenda • Direct influence on practice via our own website visited by 6000 people month from across all disciplines internationally http://www.core-info.cardiff.ac.uk/

25. Leaflet produced with NSPCC

26. Collaboration between local health and local government agencies for health improvement (Cochrane Protocol) Intensive Care Monitor Current Awareness Journal Systematic Reviews of Physical Aspects of Child Protection Oral Health Specialist Library Cochrane Public Health Review Group Literature searching for systematic review on vascular disease Factors that explain the risk of unplanned hospital admission – a systematic review Older People’s Wellbeing Monitor for Wales: Evidence Review SURE current projects

29. Centre for Health and Environmental Research National Public Health Service Welsh Assembly Government Wales Centre for Health Welsh Institute of Rural Health Departments within Cardiff University Universities within UK eg Bristol, University College London Centre for Evidence Based Dentistry National electronic Library for Health National Institute for Health & Clinical Excellence Centre for Reviews and Dissemination Virtual Centre for Improving Oral Health The Cochrane Information Retrieval Methods Group SURE Collaborations

30. Finally… “Information is a source of learning. But unless it is organised, processed, and available to the right people in a format for decision making, it is a burden, not a benefit.” William Pollard The Soul of the Firm. Grand Rapids: Zondervan Publishing House 2000

31. Thank you www.cardiff.ac.uk/insrv/sure mannmk@cf.ac.uk