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Literature searching. A literature search identifies relevant information sources that are used to answer clinical questions. The objective of literature searches. Primarily to find journal articles Other useful sources:
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Literature searching A literature search identifies relevant information sources that are used to answer clinical questions
The objective of literature searches • Primarily to find journal articles • Other useful sources: • Books, conference proceedings, book chapters, theses, government documents, and websites Evidence-based Chiropractic
Defined searches are a must • Because of the vastness of some databases, searching can be a daunting task • e.g., PubMed lists 4,800 biomedical journals • More than 15 million citations • Vague searches may produce an unmanageable number of articles • Searching PubMed for “headache” 37,147 Evidence-based Chiropractic
Search and retrieval systems • Databases can be searched quickly and easily when focused search strategies are utilized • The best results occur when the search is carefully planned in advance • Less likely to miss important articles • A great deal of time can be saved Evidence-based Chiropractic
Databases • A database is a collection of data that is organized in such a way that it is quick and easy to search for and retrieve specific information using a computer • Databases used in EBP contain bibliographic data from journal articles, books, reviews, etc. • Can be accessed from a remote source using an Internet connection Evidence-based Chiropractic
Databases are organized • Fields • Single bits of information • e.g., title, author, journal name etc. • Records • Collections of fields • e.g., the complete citation • Files • Groups of records Evidence-based Chiropractic
Example PubMed record Authors Title of article Lisi AJ, Cooperstein R, Morschhauser E. An exploratory study of provocation testing with padded wedges: can prone blocking demonstrate a directional preference? J Manipulative Physiol Ther. 2004 Feb 27 (2) 103-8 Name of journal Year & month Volume Issue Pages Evidence-based Chiropractic
To search a database • Enter specific terms that correspond to any of the fields in a record • Author names • Words found in the title • The journal’s volume and issue numbers • Most databases also permit text word searches that look for terms used in the abstract or list of key words Evidence-based Chiropractic
Narrow down the search • Enter combinations field items • For instance • A PubMed search using the term “low-back” produces more than 12,500 citations • When “low-back” is combined with “treatment,” 7,869 citations result • When both terms are combined with “manipulation,” the search results are narrowed down to 508 citations Evidence-based Chiropractic
Databases essential to EBP • There are numerous databases to choose from • Each database has a specific emphasis • Consequently one must be familiar with several of them to perform a complete search • Especially pertaining to chiropractic • The following are of interest to chiropractic and CAM practitioners Evidence-based Chiropractic
PubMed • Includes over 15 million citations • Citations are from MEDLINE and additional life science journals • MEDLINE alone has nearly 13 million records from 1966 to the present. • Includes links to many full text articles and other related resources • http://PubMed.gov Evidence-based Chiropractic
Index Medicus • The online counterpart of Index medicus is MEDLINE • Vol. 41, 2000 was the last printed edition of Index medicus • Is an extensive list of journals that is compiled by the National Library of Medicine (4,098 listed in 2004) • PubMed provides free Internet access to this vast collection of information Evidence-based Chiropractic
CAM on PubMed • Searches the PubMed database to locate CAM-related citations • Can be accessed from PubMed by choosing “Limits” and then “Complementary Medicine” from the “Subsets” menu • There are over 270,000 citations in the PubMed CAM subset • http://www.nlm.nih.gov/nccam/camonpubmed.html Evidence-based Chiropractic
To get to CAM on PubMed Select Select Evidence-based Chiropractic
Manual Alternative and Natural Therapy Index System (MANTIS) • Addresses all areas of alternative medical literature • References from more than 1,400 journals • The largest index of peer reviewed articles for several disciplines including • Chiropractic, osteopathy, homeopathy, and manual medicine • http://www.healthindex.com Evidence-based Chiropractic
Index to Chiropractic Literature (ICL) • Indexes all chiropractic peer-reviewed journals cover-to-cover, and others topically • ICL is indexed by the Chiropractic Library Consortium, which is a group of health science librarians from chiropractic colleges throughout the world • http://www.chiroindex.org Evidence-based Chiropractic
Cumulative Index to Nursing and Allied Health (CINAHL) • Covers nursing and allied health literature from 1982 to the present • Includes citations from 2,593 journals • Also covers biomedicine, alternative and complementary medicine, consumer health and health sciences librarianship • http://www.cinahl.com Evidence-based Chiropractic
AMED • Includes resources in three subject areas • 1) Several professions allied to medicine • 2) Complementary medicine • 3) Palliative care • AMED covers articles from about 596 journals, many not indexed by other sources • http://www.bl.uk/collections/health/amed.html Evidence-based Chiropractic
The Cochrane Library • Consists of eight evidence-based databases that deal with the effects of health care interventions • Provides regularly updated information and evidence to support health care decisions • Cochrane systematic reviews are full text • http://www.thecochranelibrary.org Evidence-based Chiropractic
The Cochrane databases Evidence-based Chiropractic
Multiple database searches • It is usually necessary to search more than one database in order to cover an EBC topic adequately • PubMed has limited coverage of chiropractic journals • However, many relevant articles are found in journals that are not indexed in the chiropractic specific databases (i.e., MANTIS and ICL) Evidence-based Chiropractic
Obtaining copies of articles • Databases sometimes provide links to full-text articles • They typically only generate the article’s citation, including abstract • Copies of the full-text can be ordered directly from the publisher or obtained from a biomedical library Evidence-based Chiropractic
Loansome Doc • Available through PubMed • Articles can be ordered within the PubMed website • Articles are delivered through a nearby DOCLINE library • Must first establish with a relationship with a DOCLINE library • http://www.nlm.nih.gov/loansomedoc/loansome_home.html Evidence-based Chiropractic
PubMed searching • Search using keywords, text words, or subject headings • PubMed looks for entered keywords or text words in each of the possible fields of a record • e.g., author, title, abstract, journal name, volume, issue, date, etc. Evidence-based Chiropractic
Search dropdown list Features bar Query box Sidebar Evidence-based Chiropractic
PubMed homepage • Search terms are typed into the Query box • The Search drop-down list is typically left in its default position • The MeSH database can be searched from the Search drop-down list orusing a link in the sidebar Headache Evidence-based Chiropractic
PubMed sidebar The tutorial is excellent Link to the MeSH Database Clinical Queries link Evidence-based Chiropractic
PubMed sidebar (cont.) • The Clinical Queries link permits searches designed to answer clinical questions • Topics can be searched by clinical study categories (e.g., therapy, diagnosis, prognosis, etc.) • Or to only search for systematic reviews Evidence-based Chiropractic
PubMedClinical Queries search Search term Select study category Evidence-based Chiropractic
MANTIS • The MANTIS High Clinical Relevancy option is similar to PubMed’s Clinical Queries • High Clinical Relevancy limits a search to articles that involve clinical trials or case reports Evidence-based Chiropractic
MANTIS advanced search page MANTIS Advanced search screen Search term High Clinical Relevancy check box Evidence-based Chiropractic
PubMed Basic Search mode • Simply enter search terms in the Query box and click Go • PubMed produces a list of retrieved citations • Stopwordsare ignored by PubMed • e.g., the, and, because, thus, etc. • They don’t add or detract anything from the search results Evidence-based Chiropractic
Search results for chiropractic Click to see full citation Check box then click Display Evidence-based Chiropractic
Select format for display view Sort records by option Results can be sent Evidence-based Chiropractic
Multiple checkboxes • More than one record can be viewed at the same time by selecting the checkboxes next to the desired citations • Select a drop-down menu choice to set the display format • PubMed keeps track of checkboxes and displays all checked records when requested by clicking Display Evidence-based Chiropractic
Advanced PubMed search tactics • Limits • Click the Limits tab on the Features bar • Select the limiting search criteria from the screen that appears Evidence-based Chiropractic
More limit criteria Evidence-based Chiropractic
Limits (cont.) • Searching with limits will only retrieve articles that meet the limiting criteria that are set • Selecting from the Type of article menu limits searches to specific publication types • e.g., meta-analyses, clinical trials, case reports, editorials, etc. Evidence-based Chiropractic
Limits example • A search using the terms carpal tunnel syndrome without limits yields 5,728 citations―far too many to contend with • Whereas only 15 are retrieved when the following limits are set • English • Clinical Trial • Complementary Medicine Evidence-based Chiropractic
Field tags • Used to refine searches by forcing the query to consider specific search fields • Results are very similar to what is achieved using Limits • Thus, field tags are optional in PubMed • Some think field tags are easier to use and prefer them • Limits function is only partial in MANTIS Evidence-based Chiropractic
Field tags (cont.) • Field tags are placed within brackets after search terms • Does not matter how many spaces between the search term and the field tag • Does not matter whether upper or lower case letters are used • To usefield tags • Enter the search term in the query box followed by a field tag within brackets Evidence-based Chiropractic
Common PubMed Field Tags Evidence-based Chiropractic