Post on 17-Mar-2018
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Anatomy of a Literature Search
Part 1 Webinar – March 13, 2013
Prepared by Deb Monkman, PABC Clinical Librarian
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What town are you
Webinaring from tonight?
Please type in
the chat box to
everyone!
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+ Purpose: Database Anatomy &
Physiology
Learn how a
bibliographic
biomedical
database (EBSCO
Medline or
CINAHL) works
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+ Survey Says….
Less than half of you have searched
Medline & CINAHL (66% & 33%)
Mixed group! About 25% are comfy
with searching while the other 75%
range from very uncomfy to neutral
Biggest needs: working with results,
setting up Alerts, etc. - will be in Part
2 next week
33% private – 40% public – 25% both
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+ The Reality of Searching for
Physiotherapy Research
It’s easy to find medical treatment (drug therapy, surgery, etc) of a
disease or condition, e.g., medical management for hip
replacement ……… BUT
It’s harder to find physiotherapy (less research published, not
indexed as well, may be a line in a medical paper “physiotherapy
recommended,” maybe not as specific as you’d like – e.g., exercise
program for post-surgical treatment of hip replacement)
Search both Medline and CINAHL for best coverage of PT
Use both keywords and subject headings [see online tutorials]
Don’t forget me – a resource for you!
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+ Learning Objectives: By the end of the Webinar, you will be able to describe how to:
1. Write a clinical question using PICO
2. Access EBSCO Medline and CINAHL on the PABC eLibrary
3. Do a keyword search using EBSCO Medline
4. Do a subject heading search using EBSCO Medline
5. Do a combined keyword and subject heading search
6. Use Boolean logic – and, or, not
7. Narrow or broaden a search
In part 2, we learn: how to apply limits, how to tease out
physiotherapy-specific literature, how to set up alerts, and
how to search both Medline and CINAHL together
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Google PEDro
Rehab+ PubMed
EBSCO
Medline,
CINAHL,
& PsycINFO
With full-text
OVID Medline &
EBMR, including Cochrane
Library
With full-text
Continuum of databases to learn to search
Via e-HLbc FREE
Review: Covered in Absolute Beginner Webinar + watch
all 5 PABC eLibrary tutorials http://www.youtube.com/user/BCPhysio#p/search/4/pdy5W5OzqGM
+ A note about Rehab Reference
Centre (RRC) via CPA
New Jan 2013 – freely available to CPA members
RRC is great for:
Clinical reviews on a topic
Exercise handouts
Patient education
For lit searching (articles, guidelines) – use PABC’s Medline &
CINAHL (RRC does not have Medline and CINAHL)
PABC has more full-text journals (from several different sources)
RRC has Rehab & Sports Medicine Source, which PABC does not
have, but there is much duplication with Medline & CINAHL
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+ A note for public practice
members
All health authorities and their hospital library
services have the eHLbc (the Electronic Health
Library of BC), to which PABC also subscribes
Hospital libraries will have access to MORE
journals than PABC and will provide inter-library
loan/document delivery services = your best bet
for getting articles!
VIHA is the only health authority that we are aware
of that also has access to Rehab Reference Centre
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+
1. Asking a
Clinical Question
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+ Process of evidence-informed practice
Step 1: Formulate a well-built question – tutorial
Step 2: Find articles and other evidence-based resources that answer
the question – View all tutorials
Step 3: Critically appraise the evidence to assess its validity (JOURNAL
CLUB) – see Alison’s Journal Clubs and worksheets
Step 4: Apply the evidence
Step 5: Re-evaluate the application of evidence and areas for improvement
DEB
ALISON
+ Formulate a well-built clinical
question using PICO PABC tutorial http://www.youtube.com/user/BCPhysio#p/u/1/pdy5W5OzqGM
Population:
What age? Paeds, adults or elderly
What diseases or conditions? Hip clicking, tennis elbow
How long? Acute or chronic
Intervention:
What type of treatment? Stretching, exercise, LASER, lymphatic
drainage
Comparison:
Another type of intervention, wait and see, surgery, no treatment
Outcome:
Pain, range of motion, strength
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+ Anatomy of a Citation
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Major & Minor Subject
headings = CINAHL
Headings or MeSH (Medical
Subject Headings)
Subheading = physiology,
etiology, rehab, therapy,
drug therapy, etc.
+ Clinical Question example: tennis
elbow & LASER
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Is low-level LASER effective
for improving function (pain,
grip strength) in patients with
acute tennis elbow?
+ What are all the possible keywords
for the various search concepts?
Use the Worksheet to plan your
search
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Tennis elbow
Elbow tend?nitis/oses
Elbow tendinopath*
Lateral epicondylitis
Grip strength
Pain
Low-level laser*
Low intensity laser*
Low power laser*
Laser therap*
LLLT
Acute
+ What does “Truncation” mean?
Tendinitis
Tendonitis
Tendinosis
Tendinoses
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Truncate to: [this is
what you type in]
Tend* - picks up
all the possible
endings (but also
tendon
Or
Tend?n* - picks up
variant spellings
Or
Tend?nit* or
tend?nos* might
work out best
+ Nikki’s worksheet: What is the best
conservative treatment for FAI?
1. My clinical question is… What physical or
conservative therapies reduce pain and improve
function in adults with FAI
2. The PICO is…
Population: adults with FAI
Intervention: physio, conservative, non surgical
Comparison: surgery, physio
Outcome: improve function, reduce pain
3. The database I will use is… Medline & CINAHL
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+ Nikki’s worksheet: cont…
4. The limits I want are…
highest levels of evidence (RCTs, systematic reviews,
metaanalyses)
2005 to present
5. The concepts are… (1) FAI and (2) physio/non surg/conservative
6. Keywords for FAI are… femoracetabular, femoroacetabular,
femoral acetabular, femoroacetabular
7. Keywords for physio… specific types of physio (e.g., exercise,
manual therapy). Physical therapy/ies, physiotherapy/ies, non
surgical, non operative, conservativ*
8. Subject headings are… TO BE LOOKED UP!
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+ How do I make my searches MORE
RELEVANT?
Answer = Use PICO and the
‘worksheet’ to get clear on what
you’re looking for
Suggestions to get clear:
- Google/Google Scholar – what terms are
used?
- Quick PubMed search
- EBSCO search in “TITLE” field
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2. Select a
Database - EBSCO
CINAHL & Medline
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Google PEDro
Rehab+ PubMed
EBSCO
Medline,
CINAHL,
& PsycINFO
With full-text
OVID Medline &
EBMR, including Cochrane
Library
With full-text
Continuum of databases to learn to search
Via e-HLbc FREE
How to select a database: Covered in
Absolute Beginner Webinar + watch all 5 PABC eLibrary
tutorials http://www.youtube.com/user/BCPhysio#p/search/4/pdy5W5OzqGM
+ EBSCO Medline & EBSCO CINAHL
Medline – largest database of biomedical
research, indexes many physiotherapy journals
CINAHL – largest database of nursing and allied
health research (Cummulative Index of Nursing &
Allied Health Literature), indexes many
physiotherapy journals
Journals found in Medline overlap with journals
found in CINAHL but some are unique, so it’s
important to search BOTH databases
Learn one interface and link to full-text articles
(but use A-Z Journals List to find more)
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3. Keyword searching –
BASIC:‘Hands-on’
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+ Exercise 1 & 2: Keyword searching
in EBSCO Medline (The “Googly”
way) Login to EBSCO Medline (Exercise 1)
Basic search: (Exercise 2) [Click on ‘Basic Search’]
Elbow tendinopathy and laser. Explore the results
Then try tennis elbow and laser. Explore those results – how many
more?
Now try lateral epicondylitis and laser
Explore the areas of the screen – what can you do? Try to limit
What would be the best SUBJECT HEADING to search for this
topic? Hint: look at a citation to see the subject headings
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+ Now move to the ADVANCED
search screen and explore…
Tennis elbow or elbow tend?nit* or elbow tend?nos* or
lateral epicondylitis
AND
Laser
Tennis elbow - as a subject
AND
Laser*
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4. What is “Boolean
logic”?
Using and, or, not
in ADVANCED ‘Hands-
on’
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+ Advanced Search – Author
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+ Boolean Logic And, Or, Not
(“Boolean Operators”)
Pilates
Low back or lumbar or [specific muscles]
Reduce pain or increase
function Age 15 – 85
Systematic review or
clinical trials
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Use ‘or’ to combine
similar concepts
Use ‘and’ to find ALL
these different
concepts together in
one article
+ Exercise 3: Keyword ‘Advanced
Search’ in EBSCO Medline + Email
Results
Advanced search: [Click on ‘Advanced Search’]
Pilates and low back
Put at least one result in your folder – ‘Add to folder’
Email results in your folder to yourself
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+
5.
Subject Heading Search in
Medline/CINAHL in 3 STEPS:
(1) Explode,
(2) Major Concept &
(3) Subheadings
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+ For adults with FAI
what is the best
conservative/physical
therapy (compared to
surgery) for improving
function?
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+ If you’re not sure how to start...
Search for your terms in the TITLE field – this
ensures the articles retrieved will be highly
relevant. THEN look at subject headings
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+ Why use subject headings? You don’t have to type in all the keywords!
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Sean John Combs = Puff Daddy
= P Diddy = Diddy = Puffy, etc
Subject heading = Diddy
Femoral acetabular impingement,
femoroacetabular impingement,
femoracetabular impingement, etc
Subject heading in Medline (MeSH) =
Femoracetabular impingement
+ Demo & Exercise # 4 Search in MESH Headings and do separate searches for each
one. Start with FAI
This is a 3 step process: Find the subject heading femoral
acetabular impingement
Step 1 = Should I ‘Explode’ the subject heading to include all the
more specific types? Not an option in this case
Step 2 = Should I make it a ‘Major Concept’? I will not in this case.
Step 3 = Do I need to add a ‘Subheading’ to be more specific?
E.g., rehabilitation. I will not in this case.
Then search for it. Start again with the next term – physiotherapy
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+ Medline – let’s use subject headings – what is
the tree for FAI? CLICK ON MeSH
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Click on it – there are
no narrower terms in
the ‘Tree’ so we cannot
‘Explode’
+ Medline – using subject headings – how do I
select a Subheading for rehabilitation?
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Subheadings create a more specific SUBJECT
HEADING – for example, REHABILITATION of FAI. In
this case, we Include All Subheadings.
This is a way of getting more relevant results – but
may be too restrictive at times
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+ Medline – Finally, click on ‘Search Database’
to do the subject headings search
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Search each term separately – look for FAI as a subject
heading, using explode, major concept and subheadings
as appropriate
Also, search for FAI as a keyword:
√
+ Medline – search each term separately and
then combine using AND, OR (or NOT)
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+
The next step is to search for
the next term, physiotherapy.
NOT Googly! VERY precise!
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We have just searched for the 1st
term (FAI) as a subject heading
and a keyword in Medline.
Whew!
+ Let’s search Physical Therapy in
the same way
Go the MeSH – Physical Therapy
The most appropriate term is Physical Therapy Modalities
Do you want to Explode it? (YES!)
Do you want to make it a Major Concept? (probably not)
Are any subheadings relevant? (not in this instance)
Search it… and then go to the Search History, and combine it with
other terms using AND, OR
Femoracetabular impingement AND physical therapy modalities+
(where + means explode)
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+ Explode Physical Therapy
Modalities (then click on SEARCH
DATABASE)
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+
6.
Let’s supplement Subject
Headings with KEYWORDS
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+ Keyword searches
Think of all the relevant spellings and
terms
Use ‘truncation’ - * at the end of a
word, or $ or ? In the middle of a word
Remember to ‘or’ like concepts
together
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+
7.
Let’s combine Subject
Headings & keywords using
“AND”, “OR” (sometimes
“NOT”) the ‘Boolean
Operators’
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+ 45
Keyword Search = 95
Subject Search = 6
+ Now What?
Go through the same process in
CINAHL as well!
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+
8.
Tips & Tricks
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Tip: Remember to Clear previous
searches, then start a new one
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+
Tip: CINAHL Headings and MeSH
Headings may be different
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+ What are the CINAHL Headings?
Are they different from MeSH?
FAI is NOT a heading in CINAHL!
There is a CINAHL heading for HIP INJURIES, but
it may be too broad (not specific enough)
Use the keywords for FAI and don’t use a subject
(CINAHL) Heading
Physical therapy is the CINAHL Heading (instead
of Physical Therapy Modalities, which is the MeSH
heading).
Explode it.
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+ Useful physiotherapy subject
headings (check for explosions+)
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CINAHL Headings Medline Medical Subject
Headings (MeSH)
Physical fitness+ Physical fitness
Therapeutic exercise+ Exercise therapy+
Physical therapy modalities+ Physical therapy+
Orthoses+ Orthotic devices+
Laser therapy, low-level Laser therapy+
Athletic injuries+ Athletic injuries+
Arthroplasty, replacement, knee Arthroplasty, replacement, knee
Balance, postural Postural balance
Low back pain Low back pain
+ Subject Heading Explosions!
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CINAHL Headings Medline Medical Subject Headings
(MeSH)
Therapeutic exercise+ Exercise therapy+
- Abdominal exercise - Motion therapy, continuous passive
- Aerobic exercises+ - Muscle stretching exercises
---Aquatic exercises -Resistance training
- Back exercises -Pylometric exercise
- Breathing exercises+ Hydrotherapy
--- various terms
- Closed kinetic chain exercises
- Conditioning, cardiopulmonary
- Many more…………
+ Tip: Handy subheadings for
subject headings
Athletic injuries -- prevention & control
Any condition (e.g., osteoarthritis)–
rehabilitation, surgery
Any treatment (e.g., therapeutic exercise)
-- contraindications, adverse effects
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+ Ways to get less (narrow your
results)
Use subject heading, e.g., Therapeutic exercises
Select the Major Concept subject heading
Add a Subheading to the subject heading – Osteoarthritis-
rehabilitation
Use limits (year, age group, publication type, full-text)
Add more concepts using AND, e.g., electrotherapy AND manual
therapy – articles discussing both treatments
NOT out irrelevant concepts, e.g., low-level laser NOT acupuncture
Use a more specific term, e.g., sacrotuberous ligament
Search in Title (then see how it’s indexed and search again)
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+ Ways to get more (broaden your
results)
Use keywords plus subject headings, e.g., tennis elbow or
tendinopathy or tendinitis or tendinoses
Think of synonyms or similar concepts, e.g., back* or
lumbar or thoracic or cervical or spine or spinal or disc or
disk or pelvis or sacrotuberous ligament
Truncate to pick up alternate spelling, e.g., tendin* will
search -itis, opathy, opathies, osis, oses, etc.
Use a more general term, e.g., knee instead of ACL
Add more related terms using OR, e.g., manual therapy OR
mobilisation* OR mobilization* OR manipulation* OR
maitland OR mulligan etc.
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+ Very Important Tip about Search
Results!
When you email search results to yourself
(or I email them to you)…
Log on to the members site > Clinical
Library > Library Databases & Journals >
Databases --- this will “authenticate” you
Go back to your email and click on the links
– they should open in EBSCO (no password)
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+
9. To be covered in Part 2
(A Sneak Peak):
Limits - Years, Full-text,
Publication types,
Age groups
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+ But where did the LIMITS go???
Click on “Advanced Search”
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Hold down
Control to
select more
than one
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10. To be covered in Part 2:
A sneak peak:
Searching EBSCO
Medline and CINAHL
together
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+ Working with Multiple Databases
CINAHL & MEDLINE
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Keyword search + use both
CINAHL Headings & MeSH:
e.g., CINAHL uses Adhesive
Capsulitis
Medline uses Bursitis
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11. To be covered in Part 2:
a sneak peak –
Set up an Alert
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+ Save Searches / Alert – ‘Search
History’ > Save… /Alert > login
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+ 12. How to get the full-text?
Webinar on this special topic!
May be linked to your search results. If not:
1. Check A-Z Journals List to see if it’s one of
the full-text journals we have
2. Google to see if it’s freely available
3. Ask me – I can access other sources
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+
13. Recap!
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+ Recap:
Write a clinical question using PICO and select
a database (view tutorials on website)
Access EBSCO Medline & CINAHL on the PABC
eLibrary
Do a keyword and subject heading search using
EBSCO CINAHL (CINAHL Heading, explode, major
concept, subheading)
Use Boolean logic – and, or, (not)
Work with search results by sorting, adding to
folders, displaying, printing, emailing
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+ Recap cont… but more to come in
part 2:
Apply limits to a search
Search Medline & CINAHL together –
but note subject headings will be
different so check them first
Create a search alert (or save your
search permanently)
Tips for physiotherapy searching
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+ Homework?
Watch all 5 videos (Library Services >
Tutorials & Training)
Practice using subject headings along with
keywords
Ask me
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Questions? Thanks! You will receive a POST-TEST & EVALUATION!
The recording on the webinar can be found in
the Clinical Library on the members site
√