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Database Search.

First aid guide to medical database search.
by

Sam awami

on 12 April 2016

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Transcript of Database Search.

Database Search.
Samiha Alawami
Consultant Feto-Maternal Medicine.
Diploma in Research Methodology.
IAFH-NGHA Dammam.

GOAL!
Thank you!
Steps in Database search.
Choose a database.
It is all about:
The question!
Your Needs!


Define the question!


Formulating a clearly focused clinical question
Construct a search strategy.
Boolean Logic
Truncation
Wildcards
Subject headings
Keyword searching
Where do I start?
Richardson, W. S., Wilson, M. C., Nishikawa,
J., & Hayward, R. S. A. (1995). The
well-built clinical question: A key to
evidence-based decisions. ACP Journal
Club, 123, A12-13.
Formulate a clearly focused question.
Construct a search strategy.
Choose a database.
Expand your search.
Limit your search.
Change approaches as necessary.
Aim for a sensitive and specific Search.

P.I.C.O. Model for Clinical Questions

P
Patient, Population, or Problem
How would I describe a group of patients similar to mine?

I
Intervention, Prognostic Factor, or Exposure
Which main intervention, prognostic factor,
or exposure am I considering?

C
Comparison or Intervention (if appropriate)
What is the main alternative to compare
with the intervention?

O
Outcome you would like to measure or achieve
What can I hope to accomplish, measure,
improve, or affect?

What type of question are you asking?
Diagnosis, Etiology/Harm, Therapy, Prognosis,
Prevention

Type of study you want to find
What would be the best study design/methodology?

'P I C O' examples
Interventions

A 28-year-old male presents with recurrent furunculosis (skin boils) for past 8 months; these episodes have been treated with drainage and several courses of antibiotics but keep recurring.
He asks if recurrences can be prevented.

Question:
‘In patients with recurrent furunculosis, do prophylactic antibiotics, compared to no treatment, reduce the recurrence rate?’



P
Population/patient = patients with recurrent furunculosis

I
Intervention/indicator = prophylactic antibiotics

C
Comparator/control = no treatment

O
Outcome = reduction in recurrence rate of furunculosis

Frequency or rate

Mabel is a 6-week-old baby at her routine follow-up. She was born prematurely at 35 weeks.
You want to tell the parents about her chances of developing hearing problems.


Question:
‘In infants born prematurely, compared to those born at full term, what is the subsequent lifetime prevalence of sensory deafness?'



P
Population/patient = infants
I
Intervention/indicator = premature

C
Comparator/control = full-term

O
Outcome = sensorial deafness

General search strategies
Medical search strategies
Recognize the knowledge gaps with Clinical Expertise.
Patient oriented.

MeSH™
Medical subject heading.
The NLM controlled vocabulary thesaurus used for indexing articles for PubMed
Four Criteria for Choosing Information Resources
Well-built Clinical Questions

“Background” questions
Ask for general knowledge about a disorder.

Have two essential components:
A question root (who, what, where, when,why , how) with a verb.

A disorder, or an aspect of a disorder.

Examples:
What causes babesiosis?
When do complications of actue pancreatitis usually occur?

Well-built Clinical Questions – cont’n.

“Foreground” questions

Ask for specific knowledge about managing patients with a disorder.

Have four (or three) essential components:
Patient and/or problem.
Intervention
Comparison intervention (if relevant)
Clinical outcomes.

Example:
In older patients with heart failure from isolated diastolic dysfunction,
does adding digoxin to standard diuretic and ACE inhibitor treatment yield enough reduction in morbidity and/or mortality to be worth its adverse effects?

Babesiosis is an infectious disease caused by protozoa of the genus Babesia.
Decide YOUR needs
Modify Practice
Research Purpose
Categories of Clinical information Resources
Choose a database.
Patient oriented.
Decide YOUR needs
Modify Practice
Research Purpose
Categorization of Representative Examples of Information Resources Readily Available
Construct a search strategy.
Conducting a simple search.
Bibliography
Users Guide To The Medical Literature By: Gordan Guyatt et al.
Evidance Based Medicine By: Kameshawar Prasad
L.V. Jones."How to perform a literature search"Current Paediatrics (2004) 14, 482–488
McGrath."Before You Search the Literature: How to Prepare".NEWBORN & INFANT NURSING REVIEWS, SEPTEMBER 2012
file:///E:/EBM/Formulating%20the%20Evidence%20Based%20Practice%20Question%20A%20Review%20of%20the%20Frameworks.pdf
http://libguides.mit.edu/c.php?g=175963&p=1160804http://libguides.mit.edu/c.php?g=175963&p=1160804
http://libguides.mit.edu/c.php?g=175963&p=1160804
http://fcorpet.free.fr/Denis/Research-Health-Information-Medecine.html
http://www.library.illinois.edu/bix/pdf/genguide/searchtips.pdf
http://www.berkeleycitycollege.edu/wp/library/2011/04/04/databasesearchtips/
http://en.wikipedia.org/wiki/Wildcard_character
http://journals.lww.com/ajnonline/Fulltext/2010/05000/Evidence_Based_Practice,_Step_by_Step__Searching.24.aspx
http://www.quote-coyote.com/quotes/authors/s/william-shakespeare/quote-7379.html
http://learntech.physiol.ox.ac.uk/cochrane_tutorial/cochlibd0e604.php
http://researchguides.uic.edu/content.php?pid=232200&sid=1921076
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839740/
https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144
http://hsl.lib.umn.edu/biomed/help/boolean-operators
http://www.nlm.nih.gov/bsd/disted/pubmedtutorial/020_quiz_c.html
http://www2.uncp.edu/home/alewine/lib1000_module3/mobile_pages/lib1000_module34.html
http://toonlet.com/archive?m=s&a=1&i=54121
http://library.udel.edu/instruction/tutorials/engl110/articles1/articles5/
http://blogs.lib.utexas.edu/undergraduates/2010/11/21/tip-jar-post-6-using-google-scholar-to-find-articles-in-the-ut-libraries/
http://tomfishburne.com.s3.amazonaws.com/site/wp-content/uploads/2011/12/111205.powerpoint.jpg
Saab, Dahlia Search strategies PPT, with permission.

Tips for Working With a Librarian
Be clear about what you want to find out.

Give the purpose of the search.

If the purpose of the search is an assignment, be sure to
know the requirements of the assignment or bring a copy
of the requirements with you.

Create a list of related terms or key words for the main
terms of your search.

If the disease or condition is complex, try to explain it in
simple language.

If you have done some searching on your own and found
any articles that you feel are related to your topic, bring
them to your meeting with the librarian.

Be prepared to spend some time, and be open to adjusting your search and a second session with the librarian. A search is a process, and to obtain good results, it will take some time.
Is the search needed for current or incoming patient?
Is it ongoing research or a class assignment?
The purpose will help to determine the types and scope of articles and sources.
Because of the way the World Wide Web is financed, the results that come up first in a search can be related to the advertising and not the most important to your search.

If you are going to use materials from the Web, it is important to evaluate them appropriately.

Find out who wrote the information. Are they an appropriate expert in the field of interest?

Are there disclosures on the Web site?

Do they tell you their affiliations or reveal their conflicts of interest?
Why Not Rely on Google?
'P I C O' examples

Interventions

A 28-year-old male presents with recurrent furunculosis (skin boils) for past 8 months; these episodes have been treated with drainage and several courses of antibiotics but keep recurring. He asks if recurrences can be prevented.

To convert this to an answerable question, use the P I C O method as follows :


Question:
‘In patients with recurrent furunculosis, do prophylactic antibiotics, compared to no treatment, reduce the recurrence rate?’


P Population/patient = patients with recurrent furunculosis
I Intervention/indicator = prophylactic antibiotics
C Comparator/control = no treatment
O Outcome = reduction in recurrence rate of furunculosis
35 years old woman, term twin pregnancy, wants to know whether a planned cesarean section or planned vaginal delivery is associated with improved outcome, specifically mortality.
All of you.
KAU
KFNGH
McMaster university
IAFH
Faculty Development Program/American University of Beirut.
Truncation (Wildcards)
Use an asterisk (*) to replace zero to many characters at the end of a word.  
Example: bacter* retrieves bacteria, bacterium, bacteriophage, etc.  
MeSH [mh] or [majr]
NLM’s Medical Subject Headings are terms that describe the subject of each journal article indexed in MEDLINE.

[mh]retrieves all articles indexed with a term;

[majr] retrieves all articles for which the term has been marked as a major subject.

Example:
asthma [majr] AND child [mh] AND english [la]  

Important note: Searching on MeSH terms will exclude “records in process,” as they have not yet been indexed with MeSH.
Explode Feature  
Searching on MeSH terms automatically includes all terms that are are logical subsets of that term.
For example, vision disorders includes blindness.
To turn off automatic explosion, use the tag [mh:noexp].
"Users Guide To The Medical Literature By:
Gordan Guyatt et al.2008"
Keyword vs. MeSH
MeSH searches for concept (includes variation of spelling)

Keyword searches the exact word entered

Example: “Pediatrics”
As a MeSH: looks for pediatrician, paediatrics, etc…
As a keyword: looks for pediatrics only

Quotation Marks (“ ”) are used when looking for a specific phrase.

The words between quotation marks will be searched as a whole not taken separately

Example: “Eastern Mediterranean Region” will look for results containing these three words
consecutively and in the correct order.

Example 3

What is the prevalence of nargileh smoking among adults in KSA?
Advanced search
Example 1
We are interested in searching for risk factors for meningitis during the Hajj Season in KSA
Example 2
What are the risk factors for Type 1 Diabetes in the Gulf Countries?
(results since 2008)

hookah, narghile, nargileh, sheesha, shisha, chicha, calean, kalian, water pipe, hubble-bubble, hubbly-bubbly
samalawami@gmail.com
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