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Questions & answers about database searching.

Bibliographic databases such as RNdex, CINAHL, and MEDLINE help you find current clinical practice information beyond what is available in textbooks and reference manuals. There are many options for accessing these information resources, including some that are convenient and affordable for students. By learning basic search principles and techniques for searching these databases, you can save yourself time and be more successful in locating the information you need. Important search skills include being able to identify the component parts of your search topic, locate relevant subject headings in a database thesaurus, and use logical connectors to combine topic components. The better your skills at searching for information, the easier your study and research assignments will be. The information seeking skills you learn now will be applicable in the future too, as information resources evolve and as your learning needs change. Developing competence in database searching will help prepare you for a rich life of learning as you pursue your career as a nursing professional.

Computer User Training↗

Information retrieval in digital libraries: bringing search to the net.

A digital library enables users to interact effectively with information distributed across a network. These network information systems support search and display of items from organized collections. In the historical evolution of digital libraries, the mechanisms for retrieval of scientific literature have been particularly important. Grand visions in 1960 led first to the development of text search, from bibliographic databases to full-text retrieval. Next, research prototypes catalyzed the rise of document search, from multimedia browsing across local-area networks to distributed search on the Internet. By 2010, the visions will be realized, with concept search enabling semantic retrieval across large collections.

Abstracting and Indexing↗

Interactive Query Workstation: standardizing access to computer-based medical resources.

Methods of using multiple computer-based medical resources efficiently have previously required either the user to manage the choice of resource and terms, or specialized programming. Standardized descriptions of what resources can do and how they may be accessed would allow the creation of an interface for multiple resources. This interface would assist a user in formulating queries, accessing the resources and managing the results. This paper describes a working prototype, the Interactive Query Workstation (IQW). The IQW allows users to query multiple resources: a medical knowledge base (DXplain), a clinical database (COSTAR/MQL), a bibliographic database (MEDLINE), a cancer database (PDQ), and a drug interaction database (PDR). Descriptions of each resource were developed to allow IQW to access these resources. The descriptions are composed of information on how data are sent and received from a resource, information on types of query to which a resource can respond, and information on what types of information are needed to execute a query. These components form the basis of a standard description of resources.

Artificial Intelligence↗

A systematic approach to medical decision-making of uncommon clinical pictures: a case of ulcerative skin lesions by palm tree thorn injury and a one-year follow-up.

In clinical practice, the clinician is challenged with symptoms and/or signs at times apparently insoluble by diagnostic and/or therapeutic means. We propose that in these cases, we have to use an EBM approach in which evidence may be looked up in every available clinical report and bibliographic databases are used for searching that evidence. We report on a case of ulcerative skin lesions apparently insoluble by expert dermatologists following a conventional diagnostic and therapeutic process. We use this case report for illustrating a systematic approach to resolve diagnostic and therapeutic questions using a bibliographic database search (like MEDLINE and EMBASE). Both a systematic approach to bibliographic databases and a critically appraised topic on case reports (or case series) are needed to 'rehabilitate' low-level evidences (that is a case report or case series) to a higher level when we approach decision-making of uncommon clinical pictures. We demonstrate the possibility of using bibliographic databases to search and retrieve useful information for decision-making of uncommon clinical pictures. The method we have proposed can be applied in every area of the world, especially in rural areas. Finally, an Internet-shared database of uncommon clinical pictures with critically appraised topics could be useful in saving more time.

Adult↗

Problems with indexing and citation of articles with group authorship.

CONTEXT: It is not known whether articles with group authorship (ie, with a research group name listed as the author) are difficult to identify or whether use of group authorship may lead to problems with citation. METHODS: To examine ways in which reports of controlled trials with group authorship are indexed and citations counted in bibliographic databases, we conducted a cross-sectional study in January 2000. We identified 47 controlled trials funded by the National Eye Institute and 285 associated articles. Between January and August 2000, we searched PubMed and Science Citation Index (SCI) and recorded the citation practices for these articles. Our main outcome measures were ways in which trial reports were listed in PubMed and SCI and number of citations to each report by type of authorship. RESULTS: Of the 285 published reports identified, 126 (44%) had group authorship, 109 (38%) had modified group authorship (listing individual names plus the name of the research group), and 50 (18%) had named authors only. In PubMed, no group authors were listed in the author field (per MEDLINE rules); in SCI, group-authored reports generally were incorrectly attributed (first name on investigator list [35.3%], first name on writing committee [25.5%], contact name [16.7%], anonymous [16.7%], and other [5.9%]). Using the SCI general search, we identified citations to 16.7% of group-authored reports, compared with citations to 96.9% of reports with modified group authorship and 93.9% of citations to reports with named authors only. Other systematic search methods found that more than 98% of group-authored reports actually had been cited and that group-authored reports were cited more than other reports. CONCLUSIONS: Indexing systems are not optimally adapted to group authorship. We recommend that indexing services change their practices to include group authors in the author field to help correct the problem.

Abstracting and Indexing↗

Identification of randomized controlled trials in systematic reviews: accuracy and reliability of screening records.

A study was conducted to estimate the accuracy and reliability of reviewers when screening records for relevant trials for a systematic review. A sensitive search of ten electronic bibliographic databases yielded 22 571 records of potentially relevant trials. Records were allocated to four reviewers such that two reviewers examined each record and so that identification of trials by each reviewer could be compared with those identified by each of the other reviewers. Agreement between reviewers was assessed using Cohen's kappa statistic. Ascertainment intersection methods were used to estimate the likely number of trials missed by reviewers. Full copies of reports were obtained and assessed independently by two researchers for eligibility for the review. Eligible reports formed the 'gold standard' against which an assessment was made about the accuracy of screening by reviewers. After screening, 301 of 22 571 records were identified by at least one reviewer as potentially relevant. Agreement was 'almost perfect' (kappa>0.8) within two pairs, 'substantial' (kappa>0.6) within three pairs and 'moderate' (kappa>0.4) within one pair. Of the 301 records selected, 273 complete reports were available. When pairs of reviewers agreed on the potential relevance of records, 81 per cent were eligible (range 69 to 91 per cent). If reviewers disagreed, 22 per cent were eligible (range 12 to 45 per cent). Single reviewers missed on average 8 per cent of eligible reports (range 0 to 24 per cent), whereas pairs of reviewers did not miss any (range 0 to 1 per cent). The use of two reviewers to screen records increased the number of randomized trials identified by an average of 9 per cent (range 0 to 32 per cent). Reviewers can reliably identify potentially relevant records when screening thousands of records for eligibility. Two reviewers should screen records for eligibility, whenever possible, in order to maximize ascertainment of relevant trials.

Databases, Bibliographic↗

Information resources useful in forensic toxicology.

This paper addresses information resources available to forensic toxicologists. The approach taken here is to discuss those resources found useful in problem solving situations. First, attempt to obtain information from someone familiar with the problem. This is generally the most efficient mechanism to use. The next most efficient mechanism is to search the published literature, electronically using bibliographic databases, if possible. The least efficient method of obtaining information is to go into the laboratory and generate the desired information. In many situations, however, the problem must be solved, or the information confirmed, in the laboratory. Suggested sources of information have been listed in the appendices. These are not intended to be exhaustive, but rather to stimulate and direct the access to information resources.

Databases, Bibliographic↗

Simplified search strategies were effective in identifying clinical trials of pharmaceuticals and physical modalities.

BACKGROUND AND OBJECTIVES: Assess the efficacy of simplified search strategies and identify the best electronic bibliographic database for clinical trials in the field of musculoskeletal disorders and pain. METHODS: Clinical trials within selected reviews from the Cochrane Back, Musculoskeletal, and PaPaS Review Groups were searched using MEDLINE, EMBASE, CINAHL, and CENTRAL to identify which database included the highest percentage of trials. Simplified search strategies for each review were devised and compared to the original, more complex strategy for sensitivity, specificity and precision. RESULTS: Individually, MEDLINE, and EMBASE included 90 and 89% of the relevant studies respectively, and 94% when combined. CENTRAL contained 87% and CINAHL 31%. Generally, simplified search strategies (two to four lines) had higher specificity than the original strategies (approximately 27 lines). Sensitivity was also high, but varied according to intervention. Super simple search strategies (one to two lines) proved as sensitive, but were slightly less specific, depending on the intervention. Both simple and super simple search strategies were often more precise than the original. CONCLUSION: Simplified search strategies are an effective, efficient way to search for clinical trials. They work best when the intervention is a pharmaceutical or a well-defined physical treatment. Their sensitivity, however, is not adequate for conducting systematic reviews.

Anti-Inflammatory Agents, Non-Steroidal↗

Bibliographic information retrieval in the field of artificial nutrition.

The enormous amount of data available for clinical and research purposes has made information searching a complex task. We have designed a study to determine which bibliographic databases provide appropriate information for the field of artificial nutrition. Of the 149 databases consulted in the preliminary search, 15 were found to contain an appreciable number of titles related to our field. As a general result, we found that MEDLINE had the largest number of titles but other databases oriented toward more specific topics contained references that were unique to them. The results show that an exhaustive search for any topic concerning artificial nutrition must be done on MEDLINE, EMBASE and Current Contents (75% productivity). These can be complemented with others according to their specialization in the subject to be treated. To obtain productivity over 75%, from five to seven databases must be consulted, according to the item under study.

Databases, Bibliographic↗

A network of web multimedia medical information servers for a medical school and university hospital.

Modern medicine requires a rapid access to information including clinical data from medical records, bibliographic databases, knowledge bases and nomenclature databases. This is especially true for University Hospitals and Medical Schools for training as well as for fundamental and clinical research for diagnosis and therapeutic purposes. This implies the development of local, national and international cooperation which can be enhanced via the use and access to computer networks such as Internet. The development of professional cooperative networks goes with the development of the telecommunication and computer networks and our project is to make these new tools and technologies accessible to the medical students both during the teaching time in Medical School and during the training periods at the University Hospital. We have developed a local area network which communicates between the School of Medicine and the Hospital which takes advantage of the new Web client-server technology both internally (Intranet) and externally by access to the National Research Network (RENATER in France) connected to the Internet network. The address of our public web server is http:(/)/www.med.univ-rennesl.fr.

Artificial Intelligence↗

Health economic evaluations: how to find them.

OBJECTIVES: The aim of this study was to demonstrate the best way of identifying all relevant published health economic evaluation studies, which have increased in number rapidly in the past few decades. Nevertheless, health technology assessment projects are often faced with a scarcity of relevant studies. METHODS: Six bibliographic databases were searched using various individually adapted strategies. The particular example involves the cost-effectiveness of diagnosing gastroesophageal reflux disease. Inclusion and exclusion criteria were formulated. RESULTS: After irrelevant studies and duplicates had been excluded, sixty-eight abstracts were reviewed. We chose forty-one of them as relevant for full-text review, which identified fourteen papers as having met the inclusion criteria. Most of the relevant studies were identified by searching the National Health Service Economic Evaluation Database (NHS EED) and PubMed databases. CONCLUSIONS: A search in NHS EED, by means of the Cochrane Library or the Center for Reviews and Dissimination, along with a supplementary search in PubMed, is generally an appropriate, cost-effective strategy. However, because "cost-effectiveness" is not consistently indexed with Medical Subject Heading terms in PubMed, all economic search terms need to be used to fully identify the relevant references.

Cost-Benefit Analysis↗

Subject strengths and weaknesses of four current-awareness services on diskette.

This paper reports on a comparison of four current-awareness services on floppy disk: CURRENT CONTENTS ON DISKETTE--LIFE SCIENCES, CURRENT CONTENTS ON DISKETTE--CLINICAL MEDICINE, MEDICAL SCIENCE WEEKLY and REFERENCE UPDATE. The four differ considerably not so much in the number of journals as in the subject emphasis of journal titles covered. Like most bibliographic databases the area of particular interest to the individual or organization will dictate which of these services is the best choice. For many subspecialties the differences are too big to ignore; subject strengths and weaknesses are discussed in this article since many (end)users will depend on the advice of medical librarians.

Data Collection↗

The Cochrane Collaboration: the role of the UK Cochrane Centre in identifying the evidence.

This paper attempts to explain why systematic reviews of randomized controlled trials, based on as high a proportion as possible of the relevant studies, are so important in generating reliable information for evidence-based decision making within health care. The preparation, maintenance and dissemination of such reviews is the challenge which has been taken up by the Cochrane Collaboration. The first phase of data collection is the identification of relevant studies. Currently, bibliographic databases are inadequate for this task. MEDLINE searches identify on average only about half of the relevant studies, and until 1994 there were no suitable indexing terms in EMBASE to identify randomized controlled trials. Co-operation between the Cochrane Collaboration and both the National Library of Medicine and Elsevier, however, is already transforming this situation. From January 1994 a new indexing term has been added to EMBASE to help identify randomized controlled trials. From January 1995 a new indexing term will be added to MEDLINE to help identify controlled trials where the method of allocation to treatment or control cannot be described with certainty as being randomized. Also from January 1995 an additional 20,000 reports will be identifiable as randomized controlled trials in MEDLINE. Progress during the first 2 years of the Cochrane Collaboration has been encouraging, but much remains to be done if users of health services are to benefit from the evidence-based health care which they deserve.

Abstracting and Indexing↗

A comparison of the coverage of clinical medicine provided by PASCAL BIOMED and MEDLINE.

The bibliographic databases PASCAL BIOMED and MEDLINE, available both at SilverPlatter, were compared for their coverage of clinical medicine. The main objective of the study was to identify the information in PASCAL BIOMED that is supplementary to MEDLINE. In PASCAL BIOMED and MEDLINE 10 searches were performed, all limited to publication year 1996. Search profiles in PASCAL BIOMED were free text only, while in MEDLINE they were mainly composed of MeSH headings, with additional free text. Search results were analysed for numbers of (relevant) references retrieved, unique and duplicate references, precision and uniqueness ratio. Also the presence of abstracts in both databases, and the abstract language and the presence of English descriptors and identifiers in PASCAL BIOMED were studied. MEDLINE contained more relevant information than PASCAL BIOMED on nearly all topics studied. The precision of the PASCAL BIOMED searches varied from 29 to 87% (median = 68%) and of the MEDLINE searches from 20 to 91% (median = 66%). The uniqueness ratio in PASCAL BIOMED varied from 0 to 33% (median = 20%) and in MEDLINE from 28 to 83% (median 37%). Considering the numbers of relevant and unique references retrieved, MEDLINE performed better than PASCAL BIOMED. Yet a sizeable proportion of the relevant references were unique to PASCAL BIOMED. Probably PASCAL BIOMED would have performed better if lists of descriptors had been accessible in the database, preferably with support to trace them.

Clinical Medicine↗

Views of Australian and New Zealand radiation oncologists and registrars about evidence-based medicine and their access to Internet based sources of evidence.

In order to determine the views of Australian and New Zealand (ANZ) radiation oncologists and registrars about evidence-based medicine (EBM) and their access to, and use of, Internet-based EBM resources such as MEDLINE and the Cochrane Library, a self-administered postal survey was sent out in December 2000. A total of 191 of 243 practicing ANZ radiation radiation oncologists (138) and registrars (53) responded (78.6% response rate). The main outcome measures were: (i) views about EBM and its promotion; (ii) previous EBM training; (iii) extent of Internet access and level of MEDLINE use and access to online medical journals; (iv) awareness of the Cochrane Library and other EBM resources; and (v) self-assessment of common EBM technical terms. The results of the survey found that most (82.7%) indicated a positive view of themselves towards the current promotion of EBM. However, significantly fewer perceived their colleagues were as positive (chi2 = 35.2, d.f. = 1, P < 0.001). Most (84.8%) considered research findings 'useful' in day-to-day management of patients. The majority (70.2%) of respondents never had attended an EBM course; however, most indicated interest in such training. The majority (73.8%) reported having accessed MEDLINE or another bibliographic database in the previous month. Seventy-seven respondents (40.3%) reported that, in the past month, a literature search/article had influenced their practice. Only a minority (28.3%) used the Cochrane Library. Self-assessment of most of the 12 EBM terms was generally high. For radiation oncologists, past attendance at an EBM course was significantly associated with a better overall self-assessment of these 12 terms (chi2 = 10.59, d.f. = 1, P = 0.001). These findings reveal strong support for EBM among ANZ radiation oncologists and registrars with most regularly accessing the Internet for evidence. However, lack of awareness of some relevant EBM related resources, particularly the Cochrane Library, remains a challenge. Our findings invite a concerted effort by those promoting EBM to ensure clinicians have both the skills and knowledge to practice EBM.

Attitude of Health Personnel↗

SALUS: online co-operation between South Australian health libraries.

The establishment of the South Australian Health Libraries Consortium led to the development of the SALUS project which enabled the online delivery of core health, clinical information and bibliographic databases with full-text resources across South Australian government health services. This was the first venture of Australian health librarians to create an online consortium. This article discusses the policy and management issues surrounding the implementation of the SALUS project and its influence on the evolution of the health Libraries Consortium over several years. Lessons learned during this process included: the necessity to plan well ahead yet to remain flexible in implementing those plans, to avoid procedure becoming more important than improvization during planning, to be willing to take well judged risks on occasions, and to be fully aware of changing circumstances in the project's funding and political environment. The importance of securing influential advocates outside of the participating libraries to support continued project funding is also considered.

Cooperative Behavior↗

User-controlled mapping of significant literatures.

We apply a version of our web-based literature-mapping system to PNAS for 1971-2002, as indexed by the National Library of Medicine and the Institute for Scientific Information. Given a single input term from a user, a medical subject heading, a cocited author, or a cocited journal, PNASLINK rapidly displays views in which that term and the other 24 terms that most frequently co-occur with it in a bibliographic database are interrelated in ways suggesting fruitful combinations for document retrieval. The interrelationships are produced by two algorithms, pathfinder networks and Kohonen-style self-organizing maps. PNASLINK displays are themselves interactive interfaces that can retrieve documents from digital libraries (e.g., PNAS Online). This style of visualizing knowledge domains is called "localized" because it does not attempt to map the indexing of literatures in full but concentrates on the top terms in an "associative thesaurus" reflecting user interests. It also permits swift remappings, as the user recognizes terms worth pursuing. PNASLINK is illustrated with maps drawn from the literature of population genetics. Some comparative and evaluative comments are added, one from a domain expert indicating that the face validity of the system may be tempered by insufficient specificity in the indexing terms being mapped.

Databases, Bibliographic↗

BEME Guide no 3: systematic searching for evidence in medical education--Part 1: Sources of information.

Searching for evidence to inform best practice in medical education is a complex undertaking. With very few information sources dedicated to medical education itself, one is forced to consult a wide range of often enormous sources--and these are dedicated to either medicine or education, making a medical education search all the more challenging. This guide provides a comprehensive overview of relevant information sources and methods (including bibliographic databases, grey literature, hand searching and the Internet) and describes when they should be consulted. The process of constructing a search is explained: identifying and combining core concepts, using Boolean algebra and search syntax, limiting results sets, and making best use of databases' controlled vocabularies. This process is illustrated with images from search screens and is followed by numerous examples designed to reinforce skills and concepts covered. The guide has been developed from the ongoing experience gained from the systematic searches conducted for the Best Evidence Medical Education Collaboration, and concludes by looking ahead to initiatives that will shape future searching for medical education evidence.

Benchmarking↗