EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics School of Population Health
PubMed 101 Using PubMed to find research evidence in quickest possible time-future proof your searching! Get this lecture ppt from CECIL and on “Normal View” find all the step-by step instructions
Medline • widely available on different platforms eg, OVID or PubMed • produced in USA. (National Library of Medicine) • premier electronic source for biomedical literature • contains mostly US/UK journals • 4000 / 10,000 published worldwide • http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed
Tip Number 1 GOOGLE PUBMED!
MeSH 1 • Medline Subject Headings (MeSH terms) are assigned to each article. • Provide consistent way to retrieve articles • MeSH “a controlled vocabulary organised in a tree structure” • index = like chapter headings in a text book • Major Subject Headings (eg Leg) • Subject Headings (eg knee) • Subheadings (eg cruciate ligament) • Each new paper is “tagged” by NLM librarians using MeSH terms representing the key things about each study (eg rct ligament surgery)
CLINICAL SCENARIO A 65 yr old woman with stable angina and on HRT for 8 years comes to see you. She has read a magazine article about the possible harms of Hormone Replacement Therapy (HRT) on heart disease. She • Is a non-smoker. • Has a BMI of 25 • Has no menopausal symptoms Should her prescription for HRT be stopped?
Reframe into PECOT question Among postmenopausal women with angina or other coronary heart disease (P), Does hormone replacement therapy (HRT) (E), Compared to no HRT (C) , affect the risk of further CHD events (eg MI, bypass surgery) (O) over the next 5 years (T) ?
HRT EXAMPLE AND AND AND
MeSH 2 • Explode retrieves all articles with that MeSH term or a term beneath it on the tree eg explode “leg” retrieves all articles tagged with either leg, hip, thigh, knee, ankle, foot • Restrict (orFocus) restricts search to those articles where the specified MeSH term is the major focus. • Previous indexing -Subject Headings change over time – may need to check “old” headings as well as MeSH term
Introducing PubMed TABS • HISTORY • Gives you a summary of what you have searched, limits or filters used and number of articles retrieved
LIMITS • Limits your search eg; to particular study types, population groups studied, or language
“Clinical Queries” searches for you by applying a filter for specific study types
Highlight the search terms, copy (Ctrl-C) and paste (Ctrl-V) into Clinical Queries dialogue box