Title: ACP Journal Club. CINAHL -- allied health and nursin
1CHMC PGY-1 FP Residents
- Evans Whitaker, MD, MLIS
- Norris Medical Library
- 2003 Zonal Ave.
- Los Angeles, CA 90089-9130
- ewhitake_at_usc.edu, 323 442 1128
2Background questions
- USC grad? Familiar with Norris home page?
- Are you comfortable with electronic resources
ebooks, ejournals? - How comfortable are you with EBM?
- What did you think of the UMASS EBM online
tutorial/quiz? - Are you comfortable with MEDLINE searching? What
interface have you used (PubMed, Ovid)? Do you
know what MeSH means? - Have you used EndNote or RefWorks?
3Outline for Today
- Access to USC resources
- Lightning tour of Norris Resources
- EBM Primer and Sources
- MEDLINE Ovid and a little PubMed
- Miscellany
4Access to USC Resources
5USC Proxy Server
6General Information
- For biomedical information make Norris Medical
Library your home base (http//www.usc.edu/nml )
-- bookmark it! - By beginning your information seeking at the
Norris homepage you will have full-text access to
everything to which USC subscribes.
7Tour of Norris Homepage
8Moving from Left to Rightthe Key Points
- Journals
- All USC eJournals lists every electronic
journal in the USC system - Books/Multimedia
- Databases
- Ovid MEDLINE --
- PubMed _at_USC --
- Other USC Databases A-Z
- ERIC education database
- PsycInfo
- Sociological Abstracts
- Wilson Education Full Text
- Key Resources for portal for selected sources
for various groups - eResources ? Search eResources database ? drop
down box ? choose Education. This leads to a
hodge-podge of ebooks, databases, websites, etc. - Research and Development Resource Base
(http//128.100.115.20/) bibliographic database,
source of Continuing Education Knowledge
Translation, Interprofessional Literature, and
Faculty Development. - Catalogs
- HELIX -- Norris Medical and Wilson Dental
Libraries - ADVOCAT -- USC Law Library
- HOMER -- All other USC libraries
- Quicklinks -- many common resources listed in
drop down menu.
9Clinical Information Resources
- Designed for rapid information finding, fast
enough for clinical work - UpToDate
- ACP Pier
- Essential Evidence, nee InfoRetriever
- Clinical Evidence (evidence based)
- Epocrates pharmacy, drug interactions
- LexiComp pharmacy, drug interactions
10Books
- Electronic books will be the most practical for
you - Two sources
- HELIX the Norris Library Catalog (best for
known book - Multi Ebook Search (from the QuickLinks menu)
searches within gt700 ebooks
11Journals
- Electronic journals
- Two sources
- All USC eJournals as it sounds
- HELIX Medical library catalog
12EBM Resources
- OVID
- Cochrane Database of Systematic Reviews
- ACP Journal Club
- Database of Abstracts of Reviews of Evidence
(DARE) - Clinical Evidence (search for title)
- National Guideline Clearinghouse
- TripDatabase
- SumSearch
- User's Guides to the Medical Literature
- How to Read a Paper
13MEDLINE
- Ovid MEDLINE
- PubMed (use PubMed_at_USC to get full-text links)
14EBM Resources
15Evidence-Based Medicine
- Simple concept use the best information
available to take care of your patients - It is a formalization of good practices in
information finding, evaluation, and application - EBM has appeared on the scene in the last 15
years or so due to a combination of factors
computers and changing healthcare environment. - Process begins and ends with the patient
16EBM step by step
- 5 Steps
- Formulate search (PICO, searchable question)
- Track down the best information (in
- Evaluate results (Assess methodology and
statistics) - Apply results to practice
- Reevaluate effectiveness
17Background and Foreground
18Background and Foreground
- Relevant in choice of materials
- Background
- Texts, review articles might be best source
- Foreground
- Primary research literature is best source
19Evidence Pyramid
Source http//library.downstate.edu/EBM2/2100.htm
20The Evidence Pyramid
- Those layers nearest the top are the preferred
information in EBM - Many questions in medicine do not have answers,
many do not have systematic reviews, meta
analyses, RCTs, or even cohort studies. - Means we have to make use of the best available
information.
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22PICO
- Assists formulation of the clinical question.
- Grown from the EBM movement of the last 15 years.
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24Evaluate Results
- I am no biostatistician, I have used the
simplified approach of Trisha Greenhalgh, MD when
I have had to analyze a paper. - Her common sense recommendations are (at least
somewhat) realistic for a practicing primary care
physician.
25MEDLINE and its two avatars
26Ovid and PubMed
- Ovid
- commercial product that includes multiple
databases, and the option of subscribing to full
text of books and journals. - PubMed
- US governmental bibliographic database
- collaboration of National Library of Medicine
(NLM), National Center for Biotechnology
Information (NCBI), and the National Institutes
of Health (NIH). It is free to use and is the
only database of its size and scope in the world.
27PubMed and MEDLINE
- OvidSP -- different interface and search engine,
same contents as MEDLINE.
MEDLINE is a subset of PubMed. The 2 million
article difference includes articles both
articles that are being processed and will move
into MEDLINE, and articles which will never be
included in MEDLINE (e.g., outside the scope of
the database). (18.6/16.8 as of 08/14/08)
28Pros and Cons of Ovid MEDLINE
- Pros
- Easier to learn than PubMed
- Automatic mapping of search terms works better
than PubMed - Basic search can be used at the speed of clinical
medicine - Basic and Advanced search modes work well
together - Cons
- Expensive
- After leaving an academic medical center unlikely
to have access
29What Else is in Ovid?
- EBM (the three below and others)
- Cochrane Database of Systematic Reviews
- DARE (Database of Abstracts of Reviews of
Effects) - ACP Journal Club
- CINAHL -- allied health and nursing database
- Ovid Healthstar contains citations to the
published literature on health services,
technology, administration, and research. - Health and Psychosocial Instruments (HAPI) --
information on measurement tools for healthcare - Books _at_ Ovid (almost 400 books)
30How to search OvidSP Basic
- Natural language search engine
- Keep include related terms checked
- Can combine and limit searches
- Good for a few good articles
- Useful as a way to find the right words for
Ovid Advanced Search - Can use at the speed of clinical medicine
31OvidSP Basic things to know and tips
- A good place to start
- Searches yield 500 or more hits
- Good stuff in the first 20-30. If nothing
relevant is found in that group, reformulate
search or move on to Advanced - Based on our experience at NML, use keywords
without AND, OR, or punctuation. Seems to
retrieve the smallest, most focused set of results
32Advanced Ovid Search
- Default at Norris Medical Library.
- Resembles previous versions of Ovid.
- Steps in a search
- Enter search concepts one at a time. Ovid
translates the users terms into MeSH terms. User
may choose MeSH terms, explode, focus, and apply
sub-headings. - Combine concepts
- Limit results as a last step
33Advanced Ovid Search -Tips
- Subheadings narrow searches.
- Do not use subheadings unless they match your
needs. - Do not overuse subheadings not all concepts
need them, and few concepts need more than one or
two. - Limits narrow searches.
- Do not overuse limits, try to apply them once at
the end of devising your search. - Learn to use the MeSH tree and scope notes
34Formulate your question
- Many of the same concepts that apply to EBM also
apply to Ovid searching. - First, you identify the information need.
- Define the clinical question.
- Define the searchable clinical question,
identify constituent parts of CQ, remove
extraneous details. - Choose the most appropriate information source in
which to begin your search it might be a book! - Enter your search terms.
- Review results and reformulate search if
necessary.
35Searches to try.
- Basic ice cream headache
- Basic and Advanced selenium and prostate cancer
prevention - Advanced use of antibiotics for common cold
- Others of our devising
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37Miscellany
38How to keep up with the information deluge.
- eTOCS (JAMA)
- MyNCBI and Ovid Personal Account
- UpToDate-Whats New
- Faculty of 1000 Medicine
39How to organize what you have (or will) receive
- EndNote/EndNoteWeb
- RefWorks
- others
40The elephant in the room
- GoogleScholar -- Advanced Preferences
- GS is good for preliminary exploration of an
unfamiliar topic. Yields good terms to use in
more valid and authoritative search engines. - GS will also occasionally find full text of an
article in a journal to which USC does not
subscribe.
41Scirus.com
- A search engine devoted to scientific websites.
Easy to use. Higher overall quality of sites than
GS. - Can set preferences to link to USC full-text
- Independent product of publishing giant
Elsevier. I have not seen evidence of bias. - Worth a look when exploring a topic.
42Tips
- Norris as home page, use proxy server.
- Sign up for a free account with Ovid to save
searches and annotate articles. - Sign up for a free MyNCBI account, you can save
PubMed searches, collect articles, and have
alerts emailed to you about new articles from
saved searches. - Sign up for free eTOCS for those journals whose
contents you want to scan regularly. - Sign up for free Web-of-Knowledge/EndNote
accounts. This is a nice way to store, organize,
and use citations found in your research.
Consider Connotea as well. - Consider classes at your local library in PubMed,
OvidSP, EndNote, etc.
43Final Exam
- DIAGNOSIS
- 1. MRI for breast cancer screening, should this
be our method of choice? - 2. PSA variations PSA velocity, PSA density,
free PSA ratios do these add value to prostate
cancer screening? - TREATMENT
- 3. Low back pain patients -- how effective (to
decrease pain) are chiropractic and acupuncture
therapies? Are there studies that compare these
modalities? - 4.Operative vs. non-operative treatment for acute
Achilles tendon ruptures which is better?
44Thanks for your attention
- Let us know if you have questions!!