Cochrane Library

Table of Contents Review of Prior Lessons: Evidence Pyramid Using the Cochrane Library –Purpose of the Cochrane LibraryPurpose of the Cochrane Library –Access the Cochrane Library through the ATSU PortalAccess the Cochrane Library through the ATSU Portal –Search the Cochrane LibrarySearch the Cochrane Library Advanced Search MeSH Search Search History Saved Searches

Brief Review: Evidence Pyramid The best evidence is located at the top of the pyramid.

Which of the following does NOT describe all systematic reviews? comprehensively synthesizes information from several other articlescomprehensively synthesizes information from several other articles uses a selection criteria in the inclusion/ exclusion of articlesuses a selection criteria in the inclusion/ exclusion of articles critically appraises material from various other articles uses statistical methods to combine all of the data from different articlesuses statistical methods to combine all of the data from different articles

That is correct. Continue Review section anywayReview section anyway Meta analyses use statistical methods to combine all of the data from different articles, but not all systematic reviews are meta-analyses.

Sorry. Continue Review section Uses statistical methods to combine all of the data from different articles is the correct answer. It is often misunderstood, but not all systematic reviews are meta-analyses, which do employ statistical techniques to combine all data. Many systematic reviews use meta-analytic techniques to combine some data when certain conditions are met.

The Purpose of the Cochrane Library Collection of databases of articles which serve as a basis for your clinical treatment decisions with Cochrane Reviews containing systematic reviews.

Try it Yourself: Access the Cochrane Library (Video) View movie as: –QuickTime (.mov)QuickTime (.mov) –Flash (.swf)Flash (.swf) Double-click on video for full- screen mode.

Try it Yourself: Access the Cochrane Library (Text) Type in the address bar of your internet search engine (Internet Explorer, etc.). Enter your username and password. Click Library on the left. Then click KCOM Library. Click Online Medical Resources. Finally click Cochrane LibraryCochrane Library

Advanced Search MeSH Search Search History Saved Searches Cochrane Search Tools:

Top of Advanced Search

Bottom of Advanced Search

Search Boxes Drop-down boxes include primary operators and fields. Use these to construct your search. –Do not forget about the order of operation as discussed in the lesson on PubMed (and further discussed later).

Restrict by Study Type Check-boxes allow one to specify what types of studies to look for. –If All of The Cochrane Library is checked or multiple checkboxes are checked, the categories are separated and are accessible by tabs across the top.

Record Status and Date Range Can restrict by various statuses And within a range of dates

Search Results At first it may appear only to have found a few articles, but the Cochrane Library is a compilation of databases. It only shows articles from one at a time. Use the tabs above to view others.

Your patient is a 32-year-old male construction worker with acute low back pain, who wants to prevent it from worsening. He refuses spinal manipulative therapy and alternative medicine treatments. Try it Yourself: Scenario

Form a relevant question according to the procedures in Step 1 with respect to the patient and his preferences.Step 1 Now its time to do a literature search. Use Advanced Search to seek the best available evidence to improve his current condition and prevent its recurrence. Try it Yourself: Steps 1 & 2

Now step out of your comfort zone for a moment. Use some of the search features you typically ignore. Try typing in wildcards (*) to increase results and phrases surrounded by quotation marks () to decrease results. –Note: These are used in the Cochrane Library searches just as they were in PubMed. Try it Yourself: Step 2

How drastically did each of these affect your search results? What helpful features do each of these offer? How could you use these more effectively? Try it Yourself: Thinking about Step 2

MeSH Search

These are the terms from the U.S. National Library of Medicines controlled vocabulary Advantages: –Provide a way of finding articles treating the same topics while using different synonymous words –Arranged hierarchically, allowing one to choose broader or more precise terminology as needed MeSH/Medical Subject Headings:

Go to MeSH Trees –Locates hierarchies of MeSH terms that contain that word. (If that word is not a MeSH term, the thesaurus is searched.) Thesaurus –Retrieve all MeSH descriptors containing that word –Finds MeSH terms corresponding to that word Definition –Defines MeSH terms Exploring MeSH/Medical Subject Headings:

Search History View

View syntax used for previous Advanced Searches. Take more control over your searches using the Search for box at the top. Include operators that do not have drop-down boxes. Search History:

AND –Conjunction/Include both words OR –Disjunction/Include one word or the other (possibly both) NOT –Exclusion/Do not include the word Do not need to be capitalized, but still a good habit –Unlike PubMed Cochrane Search Operators:

* (Asterix) –Wildcard/Truncation/Replaces a string of letters hyp*thermia retrieves both hypothermia and hyperthermia. ? (Question mark) –Wildcard/Replaces a single letter analys?s retrieves both analysis and analyses. () (Parentheses) –Controls order in which operations are applied # (Pound Sign) (followed by number) –Recalls a numbered search from your search history More Search Operators:

(Quotation Marks) –Phrase/Include if the exact phrase is included (No variants) NEAR/ (followed by a number) –Proximity/Include if words are {number} words apart NEXT –Proximity/Include if word stems follow each other, separated by a space or a dash –May be more useful than (quotation marks) when you still need to include plurals or other operators Example: colorectal NEXT *noma* retrieves entries on colorectal adenomas and colorectal carcinoma Even More Search Operators:

You can also search by abstract (:ab), author (:au), keywords (:kw), source (:so), title (:ti), publication type (:pt), tables (:tb), or DOI (:doi). Combine these by placing commas between each field. (Only one : (colon) is needed.) Example: –"hepatocellular carcinoma":ti,ab,kw Cochrane Fields:

Spacing defaults to AND Stemming accounts for the many common spelling variants and most plurals –For example tumour retrieves tumour, tumor, tumours, and tumors. –Can use * (asterix) to be sure to retrieve these alternatives Not sensitive to capitalization Accented character not matched to unaccented forms Cochrane Searches:

Did you retrieve unexpected results from your search? –Try using parentheses around your search terms. –Then see if you understand the order in which certain operations are applied. Helpful with site-specific operations Think of some simple searches that may help us determine this. Try them out. Ways to Determine Order of Operations:

Example: word 1 AND word2 OR word3 could be interpreted in 2 ways: –((word1 AND word2) OR word3) –(word1 AND (word2 OR word3)) This makes a big difference when word1 does not retrieve any articles and word3 retrieves many. –The 1 st would show many while the 2 nd would show none. Determining Order of Operations:

Try this out by typing gibberish for word1, any word for word2, and a common term for word3. –Which interpretation did the search engine use? Which operation gets applied first? AND or OR? Try it Yourself: Determining Order of Operations

Now using Search History, access your previous searches. Copy and paste some of the syntax into the Search for box above. Then alter these queries to try out the search operators you just learned about. What effects did these have? How can these help you become more efficient? Try it Yourself: Using Search History

Saved Searches View

You can save searches and sequences of searches and rerun them at a later time. –While Search History is cleared between sessions, Saved Searches remain. –You can rerun these as needed or use a series of searches as a template, which you can edit for more specific searches. Saved Searches

Links to Other Websites and Hands-On Activities The Cochrane Library User Guide From Suny Downstate Medical Center –Applying EBM to Online SearchesApplying EBM to Online Searches

Congratulations! You have successfully completed this lesson. The End