Searching for Medical Information

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Searching for Medical Information

• How (and why) to Find Medical Information Without
  Using Google
• Sharon Leslie, MSLS, AHIP
• Practice of Pharmacy I, September 2009

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Objectives

• Know where to look for medical literature
• Know how to look for medical literature

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Basics

• Where to Find Books?
• OPAC (Online Public Access Catalog)
• Books and e-books only - no articles!
• Where to Find Articles?
• Online Databases or Print Collection

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Part of GaIN Database
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Drug Info NOT article databases
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Where to Search?

• Google
• Unfiltered haystack approach
• Doesnt reach deep web content
• Google Scholar
• Unknown content coverage from all research fields
• Unknown frequency of updating
• Some full-text
• Medline
• Controlled vocabulary
• Current, quality information from biomedical
  sources
• Abstracts and/or full-text often provided

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What is Medline?

• A database that indexes biomedical journals

Life sciences
Physician assistant
Veterinary medicine
Dentistry
Bioengineering
Behavioral sciences
Nursing
Pharmacy
Occupational therapy
Medicine
Chemistry
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Medline

• Used to be called Medlars (Medical Literature
  Analysis and Retrieval System Online)
• Contains over 19 million journal citations from
  over 5,000 journals, in 37 languages, from 1948
  onward
• 2,000 - 4,000 citations are indexed weekly

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What is Indexing?
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How are you going to keep up?

• In the last yeararticleson drug therapyhave
  been indexedin Medline.

28,880
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Example
H1N1 (Influenza A Virus, H1N1 Subtype)
introduced on Medline in 2006
Since 2006, 1,039 articles on H1N1 have been
added to Medline
45 of these (471 articles) were added in 2009
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Medline can be searched using

• NLMs PubMed search engine
• OR
• Commercial vendors like Ovid, EBSCO, etc. who
  lease the data

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MedlinePubMed vs. Ovid

• PubMed is and can be accessed from
  anywhere.
• Automatic term mapping.
• Allows some linking to full-text articles.
• PubMed searches all of Medline at once.
• Contains genetics molecular biology info from
  NCBI.
• Gets current info immediately.

• Ovid is by subscription only.
• Automatic term mapping.
• Allows some linking to full-text articles.
• Medline at Ovid is divided into sub-databases.
• Has lag-time.

free
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Anatomy of a Journal Citation
First Author

• Calhoun DA, Smith RL. Use of single-pill
  combination therapy in the evolving paradigm of
  hypertension management. Expert Opin
  Pharmacother. 200910(12)1869-74.

Year, Volume, Issue, Page Numbers
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Develop a Search Strategy

• What is a search strategy?
• A plan for locating the information you need.
• A search statement is the actual string of words
  you type in the search box(es) of a database.

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Why Do You Need To Know How To Build A Search
Strategy?

• To be able to effectively and efficiently search
  the medical literature and retrieve pertinent
  information.

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Steps for Developing a Search Strategy

• Create a question
• Select the appropriate literature source
• Search using the best search terminology
• Find and evaluate your results

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Step 1 Create a Question
P.I.C.O.
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Step 1 Create a Question
Example One of your elderly patients has
osteoarthritis. Youre concerned about the
long-term effects of acetaminophen. Should you
switch her to NSAIDS?
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Step 1 Create a Question
Example One of your elderly patients has
osteoarthritis. Youre concerned about the
long-term effect of acetaminophen. Should you
switch her to NSAIDS?
P Among patients with osteoarthritis
I does the use of Acetaminophen
C or NSAIDS
O have fewer adverse effects?
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Step 2 Select Appropriate Literature Sources

• Primary medical literature
• Original studies, published in peer-reviewed
  pharmacy and medical journals (NEJM, AJHSP, JAMA)
• Secondary medical literature
• Indexing sources e.g. Medline, IDIS
• Tertiary medical literature
• Summary sources that discuss the primary works
  e.g. text books, review articles, news articles,
  internet sites

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Step 3 Search Using Best Search Terms Using
MeSH and Limits

• Medical Subject Headings
• A controlled vocabulary produced by the National
  Library of Medicine and used for indexing,
  cataloging, and searching for biomedical and
  health-related information and documents

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Step 3 Search Using Best Search Terms Using
MeSH and Limits

• Synonyms for diseases/conditions
• Drug names (brand, generic)
• Study population (age, gender)
• Type of publication (review, original research,
  etc.)
• Date of publication
• Language
• (Items in red may be limiters)

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What is MeSH?

• a short video

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Boolean Operators - AND


AND NARROWS Tells the database that you only
want articles that contain ALL of the search terms
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Boolean Operators - OR

OR EXPANDS Tells the database that you want all
articles that contain EITHER of the terms
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Boolean Operators - NOT
AIDS
NOT EXCLUDES Tells the database that you do not
want any articles that contain a certain term
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Joining Boolean Operators
(smoking OR nicotine) AND cancer
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Boolean Logic

• In some databases you can combine search
  statements by using Boolean operators.

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Truncation Symbol Uses root of the word

• Example pharm
• Finds pharmacology, pharmacy, pharmaceutical,
  etc.
• Example injur
• Finds injured, injury, injuries, etc.

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Wildcard Symbol Allows for multiple spellings
of a word

• Example sulur
• Will find sulphur and sulfur
• Example orthopdic
• Will find orthopedic and orthopaedic

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Other Search Operators

• Proximity operators
• Near (n)
• Ex Prozac n3 adverse effects
• Stop words
• and, if, or, the, a, for

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Step 4 Find and Evaluate Your Results
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Step 1 Formulate a Question
Example One of your elderly patients has
osteoarthritis. Youre concerned about the
long-term effect of acetaminophen. Should you
switch her to NSAIDS?
P Among patients with osteoarthritis
I does the use of Acetaminophen
C or NSAIDS
O have fewer adverse effects?
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Step 2 Select the appropriate literature source
Example One of your elderly patients has
osteoarthritis. Youre concerned about the
long-term effect of acetaminophen. Should you
switch her to NSAIDS?
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Step 3 Search Using Best Search Terms Using
MeSH and Limits
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Other Examples

• Author search
• Clinical queries
• Clipboard
• My NCBI collections

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What If There Is No Full-text Link?

• Check the journals page for holdings
• L
• Swilley Interlibrary Loan (ILL)

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RECAP Steps For Developing A Search Strategy

• 1. Create a single question

2. Select the appropriate literature source
3. Search using best search terminology
4. Find and evaluate your results
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Suggestions

• Register for My NCBI write down your user name
  and password
• Register for Loansome Doc

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Go to Swilley Librarys Pharmacy Page. Click on
Course Guides for PHA 371. Complete the linked
tutorials BEFORE the labs.

• September 29th (now)
• Short Quiz
• October 13th Lab Quiz
• Complete PubMed Tutorial
• Complete Ovid Tutorial
• Complete IDIS Web Tutorial
• November 3rd Lab Quiz
• Review GaIN Resources
• (MD Consult, StatRef!, Access Medicine)