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WORK ON COMPUTERS Winter Semester : List of Topics

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Title: WORK ON COMPUTERS Winter Semester : List of Topics


1
WORK ON COMPUTERSWinter Semester List of Topics
  1. Medical literature as a resource for evidence
    based medicine. An overview.
  2. Biomedical literature resources and hierarchy of
    evidence.
  3. MEDLINE - the most important biomedical database.
    PubMed online training.
  4. MEDLINE - sample searches. Search strategy tips,
    Boolean operators, working with search results.
    MeSH, links to fulltext articles.

2
CLINICAL QUESTION FOR TODAYAuthor Prof. V.
Mihál, MD, PhD.
  • Vaccination for prevention
  • of otitis media
  • in children

3
Topic 1 ConsolidationGoogle Search Document
Types
4
(No Transcript)
5
Self-study Assignment 1
  • Identify types of first 40 documents, eg.
  • Company websites
  • Journal articles
  • Fulltext version
  • Bibliographic record only
  • Bibliographic record abstract
  • Database
  • Educational material (universities, professional
    societies)
  • Patents
  • Patient information
  • Library catalogs
  • Business information (eg.pharmaceutical
    companies)
  • Others (specify)

6
Quality of Internet Resources
  • eEurope 2002 Quality Criteria for Health related
    Websites
  • Communication from the Commission to the Council,
    the European Parliament, the Economic and Social
    Committee and the Committee of the Regions

7
European CommissionQuality Criteria for Health
Related WebsitesPublished 2002
  • 1. Transparency and Honesty
  • Provider of site - including name, physical
    address and electronic address of the person or
    organisation responsible for the site
  • Purpose and objective of the site
  • Target audience clearly defined (further detail
    on purpose, multiple audience could be defined at
    different levels).
  • Sources of funding for site (grants, sponsors,
    advertisers, non-profit, voluntary assistance).

8
European CommissionQuality Criteria for health
Related Websites
  • 2. Authority
  • Clear statement of sources for all information
    provided and date of publication of source.
  • Name and credentials of all human/institutional
    providers of information put up on the site,
    including dates at which credentials were
    received.

9
European CommissionQuality Criteria for health
Related Websites
  • 3. Updating of information
  • Clear and regular updating of the site, with date
    of up-date clearly displayed for each page and/or
    item as relevant.
  • Regular checking of relevance of information.

10
European CommissionQuality Criteria for health
Related Websites
  • 4. Privacy and data protection
  • 5. Accountability (user feedback, trustworthy
    linking to other websites, editorial policy)
  • 6. Accessibility (general findability,
    searchability, readability, usability, etc.).

11
Journal Articles Categories
  • Original articles / clinical research results
  • Randomized controlled trials
  • Cohort studies
  • Case reports case series
  • Editorials, letters to editor, comments.
  • Reviews / secondary research
  • Critically appraise contents methodology of
    published original studies (gt2) to help readers
    orientate in the never-ending information
    explosion..

12
Pyramid of Evidence
13
Original ArticlesRandomized Controlled Trials
14
Original ArticlesRandomized Controlled Trial
Example
  • Fireman B. et al. Impact of the pneumococcal
    conjugate vaccine (PCV) on otitis media.
    Pediatric Infectious Diseases Journal 2003
    2210-16.
  • InstitutionKaiser Permanente Vaccine Studies
    Center, Oakland, CA, USA.
  • Objectives
  • To examine impact of PCV on incidence of otitis
    media to assess if effectiveness of the vaccine
    wanes after after age 24 months and varies by
    race, sex or season.
  • Design, setting, participants
  • 1995 1998
  • 37 868 children were randomized (allocated by
    random) to receive
  • PCV vaccine
  • OR
  • Control vaccine
  • Follow-up until April 1999
  • Intervention
  • Primary series at 2, 4 and 6 months booster at
    12 to 15 months.
  • Results
  • Control children averaged 1.8 otitis visits/year
  • PCV vaccinees had fewer otitis visits in every
    age group, sex, race and season.
  • PCV vaccine reduced
  • otitis visits by 7.8

15
Original ArticlesCohort Studies
16
Original ArticlesCohort Study Example
  • T.Heikkinen et al. Influenza vaccination in the
    prevention of acute otitis media in children.
  • American Journal of Diseases of Children 1991
    145(4)445-448.
  • Institution Department of Pediatrics, University
    of Turku, Finland.
  • Objectives
  • We studied a new approach to the prevention of
    acute otitis media through the administration of
    influenza vaccine
  • Participants
  • Group of vaccinees 187 day-care center children
    aged 1 to 3 years before the influenza A epidemic
    of 1988-1989.
  • Comparison group 187 unvaccinated children of
    similar age and background.
  • Follow-up
  • During the 6-week study period, influenza A
    infection was diagnosed
  • in 5 (3) of 187 vaccinees, and
  • in 29 (16) of 187 controls.
  • Acute otitis media developed in 3 (60) of 5
    vaccinees with influenza A infection compared
    with
  • 18 (67) of 27 controls (excluded were two
    children with a double viral infection).
  • Outcome
  • The incidence of acute otitis media associated
    with influenza A was reduced by 83 in the
    vaccinees.
  • The total number of children with acute otitis
    media in the vaccine group was 35,
  • compared with

17
Original ArticlesCase Reports Case Series
18
Review ArticlesDefinition
  • Review articles in medical journals summarize
    large amounts of information on a particular
    topic
  • ..a useful and popular source of information for
    doctors.
  • some review articles reflect the personal
    opinions of the author more than the body of
    knowledge about a topic.
  • Experts have proposed guidelines for how authors
    should write review articles in order to avoid
    personal bias.
  • ..authors should address a focused question,
  • describe how they searched for and evaluated
    information,
  • identify gaps in knowledge,
  • estimate risks and benefits of recommended
    treatments.

Annals of internal Medicine 1999131(12)947.
19
Types of Reviews
  • Traditional (narrative)
  • Systematic Meta-analysis
  • (selection of articles according to
    pre-determined criteria statistical analysis)

20
Traditional (Narrative) Reviews
  • Frequently found in many journals
  • Often broad in scope
  • Book chapter
  • Usually based on incomplete data
  • Do not use systematic methods
  • identify
  • assess
  • synthesize

INFORMATION
21
Systematic Reviews Main Features
  • Focus on a specific clinical question and conduct
    an extensive literature search to identify
    studies with sound methodology.
  • Studies are reviewed, assessed, and the results
    summarized according to the pre-determined
    criteria of the review question.

22
Systematic Reviews Meta-Analysis
Statistical methods
Statistical methods
23
Bibliographic DatabasesPathway to Journal
Articles
  • MEDLINE / PubMedService of US National Library
    of Medicine
  • URL http//www.pubmed.com
  • is an easy and free place to search for
    answers to foreground questions, and it offers
    links to a growing number of free full-text
    articles.
  • Size gt18 million records
  • Retrospective since 1950 until present
  • LinkOut feature --- access to fulltext articles
  • through external providers (publishers, info
    brokers)

24
Use of Boolean Operators
  • Allows you to combine search terms to better
    focus your search
  • AND Combines terms to limit your search as
    both(all) concepts must be present in all
    retrieved articles.
  • Example otitis media AND vaccin
  • OR Widens your search as either term can be
    present in all retrieved articles
  • Example otitis media OR middle ear inflammation
  • NOT Limits your search by excluding a concept as
    one term must be present and the second term must
    not be present
  • Example otitis media NOT chronic

25
What is Truncation / Wildcard
  • PubMed finds all terms that begin with a given
    text string
  • Represented by the asterisk (), sometimes
    referred to as a wildcard.
  • Example
  • vaccin
  • PubMed retrieves vaccine, vaccines, vaccination,
    vaccinated, vaccinee(s),,,,,,,,,

26
PubMed Search StrategyProblem/Disease
  • http//www.pubmed.com
  • Step 1
  • otitis media OR middle ear inflammation OR
    middle ear infection
  • Limits Title

27
Enter One or More Search Terms Use Features Tabs
Click on Limits
28
Choose Limits Title
1. Scroll Down
2. Select Title
3. Press Go
29
Step 1 Results otitis media/title
Display Format
Summary
30
Display Format Summary Record Structure
  • Author(s)
  • Schmelzle J, Birtwhistle RV, Tan AK.
  • Article title
  • Acute otitis media in children with tympanostomy
    tubes.
  • Journal
  • Can Fam Physician. 2008 Aug54(8)1123

Volume
Page(s)
Issue
31
PubMed Search StrategyIntervention/Exposure
  • Step 2
  • vaccin
  • Limits Title/Abstract

32
Step 2 Clear Search Box Limits Box
33
Enter New Search Term(s), Choose Limits
1. Scroll Down
2. Select Title/Abstract
3. Press Go
34
Step 2 Results vaccin/Title-abstractD
isplay Format Summary
35
PubMed Search StrategyCombine Searches
  • Step 3
  • 1 AND 2
  • Choose additional limits
  • Ages
  • Birth-23 months
  • Type of article
  • eg. Randomized Controlled Trials
  • Etc.

36
Step 3 Clear Search Box Limits BoxClick on
History
Click on History
37
Step 3 HistoryClick Query for More Options
2. Click on Preview
Click query for more options.
38
Combine Searches, eg. 1 AND 2
Click on Preview
39
Results of Step 3 otitis media x vaccinChoose
Age Limits
Click on Limits
40
Age LimitsBirth-23 months Pre-school 2-5 years
41
Age Limits Applied Results
42
PubMed
  • To Be Continued
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