Lecture 11: Evidence Evaluation: Searching Literature

Question 1

What are the types of information sources?

Answer 1

• Drug monographs/textbooks
• Evidence summaries
• Systematic reviews
• Guidelines
• Primary literature

Question 2

What is a drug monograph?

Answer 2

Outline basic information about drugs (indications, administration, adverse effects, etc)

Sources include:
● CPS
● LexiComp (includes AHFS, Martindale)
● Stockley’s
● NatMed Pro (formerly Natural Medicines - for
supplements)

Question 3

What are evidence summaries?

Answer 3

Several resources summarize available evidence in a
concise way. Great for background and exploring what
other literature exists on a general topic.

Ex.
- UpToDate
-DynaMed
-BMJ Best Practice

Question 4

What is a systematic review?

Answer 4

Systematic reviews search for all relevant studies and
appraise them to answer a research question

Question 5

What is a meta-analyses

Answer 5

Meta-analyses pool data from individual studies and perform statistical analyses on the combined results

Question 6

What are guidelines?

Answer 6

Make recommendations on how to provide optimal care.

The strength of evidence found in guidelines varies. Some include a systematic review search, but many don’t. Many are published as journal articles, but some are only found
on organizations’ websites

• Good source: Trip Database

Question 7

What is primary literature?

Answer 7

For many questions, you’ll need to search the primary journal literature to find a complete, specific, up to date answer.

Question 8

What is the best place to search for primary literature?

Answer 8

The best place to search for primary literature is a specialized database such as Medline.

Question 9

Before starting a literature search what kind of question should you develop?

Answer 9

PICO

• Among P does I compared with C affect O

Question 10

P - PICO

Answer 10

Patient/population

Question 11

I - PICO

Answer 11

Intervention/exposure

Question 12

C - PICO

Answer 12

Comparator

Question 13

O - PICO

Answer 13

Outcome

Question 14

What does PICO help you identify

Answer 14

Main concepts to search in a database

Question 15

Do PICO: An overweight, older male patient asks you if you think he
should ask his doctor about starting a statin. He’s heard they increase the risk of developing diabetes, which concerns him since he has a family history of diabetes

Answer 15

P = older men; overweight; family history of diabetes

I = statins (including individual drugs)

C = no statin

O = risk of developing diabetes vs benefit of reduced CV
risk

Question 16

What are the most important parts to include in PICO

Answer 16

• P and I
  or
• I and O

Question 17

What are the database search steps

Answer 17

1. Search for one PICO concept at a time
2. Combine synonyms for each PICO concept with OR
   ex. statins or HMG CoA reductase
   inhibitors
3. Combine different PICO concepts with AND. Use brackets to control order of operations:
   (statins OR HMG CoA reductase
   inhibitors) AND diabetes

Question 18

What is Medline

Answer 18

The most commonly used database to search for medical journal literature.

Question 19

How many journals does Medline include

Answer 19

About 5600

Question 20

Who adds data to articles in Medline

Answer 20

Experts to make searching easier

Question 21

What sources is Medline available

Answer 21

Through PubMed, Ovid, and other sources

Question 22

Where is it easier to find useful MeSH terms? Ovid Medline or PubMed

Answer 22

In Ovid Medline than PubMed

Question 23

Where is it simpler to search for articles on classes of drugs? Ovid Medline or PubMed

Answer 23

Ovid Medline

Question 24

Where is it easier to do complex searches with multiple concepts?

Answer 24

Ovid Medline

Question 25

What source requires a subscription, what source is open access and free to anyone?

Answer 25

PubMed free, Ovid Medline needs subscription

Question 26

What are MeSH terms?

Answer 26

Medical Subject Headings are around 25, 000 terms that are used to label articles

• They help you find more relevant results (ex. Cardiovascular Diseases)

Question 27

What terms are similar to MeSH in PubMed

Answer 27

Pharmacological Action and Supplementary Concept

Question 28

What does keywork searching do?

Answer 28

When you do a keyword search, the database looks for an exact match for that word or phrase in the title, abstract, and a few other places (not the full text of the article)

Question 29

What will be missed if you search for your idea only as a keyword?

Answer 29

Searching for your idea only as a keyword will miss relevant articles that use a synonym or misspelling of the words you search.

Question 30

What are MeSH strengths

Answer 30

• Finds articles on topic, no matter the exact words used
• Can also find more specific, related ideas
• Subheadings can help focus your search

Question 31

What are Keyword Strengths?

Answer 31

Some articles don’t have MeSH terms
* Some ideas don’t have MeSH terms

Question 32

How many concepts of PICO should you search at a time, why?

Answer 32

1 because Ovid Medline will suggest MeSH terms for the keyword you type in

Question 33

Clicking on a link for a MeSH will take you to a screen called?

Answer 33

Tree - Should you if there are more specific terms you can search using the Explode box

Question 34

How do subheadings help?

Answer 34

• Helpful for focusing your search

Question 35

Reading a search history; exo, mp, *, adj3

Answer 35

exp = exploded MeSH term. / indicates MeSH term.
.mp = keyword search. “Many places” searched for exact match of search term.
* = finds different word endings
adj3 = finds words within 3 words of each other (number can be any you choose)

Question 36

What are some tips for better keyword searches?

Answer 36

different possible word endings
● generic and brand names
● North American/UK spellings
● acronyms
● antonyms (eg mental disorders instead of mental health; falls
instead of balance)

Question 37

What are some literature databases besides Medline?

Answer 37

EMBASE
● CINAHL
● Web of Science