Medical advisor: V. Mihál, Prof., MD, PhD. Head of Palacký University Paediatric Department PhD Programme 2013/2014 Palacký University Faculty of Medicine and Dentistry, Olomouc Exploiting Literature Databases English Version Course teacher & developer: J. Potomková, Ph.D. Palacky University Medical Library & Institute of Medical Biophysics Medical advisor: V. Mihál, Prof., MD, PhD. Head of Palacký University Paediatric Departmentl E-learning materials in Czech

Course Structure Introduction –Contacts –Usefull links –Electronic information resources at Palacký University Olomouc Remote access Clinical case, research question, PICO Information retrieval using multiple resources –Theory –Interactive online training Discussion, exercise Conclusion.

Contacts Jarmila Potomková, PhD. Palacký University Medical Library, Director Institute of Medical Biophysics, Senior Lecturer Vladimír Mihál, Prof., MD., PhD. Palacký University & Teaching Hospital Department of Paediatrics, Head Palacký University Medical Library, Website – Knihovna –Vzdělávání(Training) --- DSP „QAKOM“ – e-learning portal for PhD programmes Kurzy/B001/Czech version

Useful Links Palacký University Library, Olomouc Online public access catalog Research Library, Olomouc National Medical Library, Prague – Fee-based registration for remote database access – Bibliographia Medica Čechoslovaca National Library of Medicine (USA) – Book catalog – Database MEDLINE WorldCat WorldCat is the world's largest network of library content and services. WorldCat libraries are dedicated to providing access to their resources on the Web, where most people start their search for information. Search Engines - General search - Scientific articles only - Book content for reading only

Electronic Information Resources at Palacký University ABC, faculties, fields Medical databases Knihovna LF Databáze –Free (PubMed –IP-recognition Palacký University network (eg. Dynamed Teaching Hospital Olomouc (eg. UpToDate –Remote access VPN (Virtual Private Network) Shibboleth / eduID Terminal Server For more details feel free to contact: Mr. Tomáš Kopečný, network administrator

Clinical case (scenario) Research Question Formulation, PICO Format

Clinical Case (author: V. Mihál) A boy, 2 years old Acute otitis media; Fever, earache; Visit to a paeditrician´s office; Pharmacological anamnesis No ATBs in the past 6 months; No pneumococcal vaccination; Mother wants to know whether antibiotics (eg. amoxicillin) should be precscribed immediately………

Formulation of a PICO Question Before Search Patient(s)/problem/population – Otitis media in infants (birth - 2 years) Intervention/exposure – Immediate antibiotic therapy (eg. amoxicilin) Comparison – Pain killer – placebo – watch-and-see Outcome – Effect of the selected intervention

Search terms, keywords „ Minimum Information Principle“ P (Acute) otitis media - AOM Middle ear inflammation Middle ear infection(s) I Antibiotic(s) Antimicrobial Antibacterial Amoxicillin Analgesics Placebo Wait/Watch-and-see

Electronic library catalogs Internet search engines Professional databases

Electronic Library Catalogs (1) National Medical Library, Prague, Czech R. /Medvik Navigation, functions: Search Medvik/ Advanced All Fields -- MeSH: otitis media Search Date/ descending ? MeSH = Medical Subject Headings (thesaurus)

Electronic Library Catalogs (2) National Library of Medicine, Bethesda, USA/LocatorPlus Navigation and functions: LocatorPlus / Find Books …. Advanced Menu Search otitis media phrase/Title AND antibiotic antibiotics any of these/Title Search Sort results /Publish date descending Detailed view Ctrl+F/otitis/Hledej

Electronic Library Catalogs (3) International Joint Catalog Worldcat Navigation, functions: Advanced search Title/ otitis media Keyword/ antibiotics Year/ Content/ Thesis/Dissertation Search

Search Engines

Medical Websites Quality eEurope 2002: Quality Criteria for Health related Websites Communication from the Commission to the Council, the European Parliament, the Economic and Social Committee and the Committee of the Regions Free access

Medical Websites Quality Basic Criteria Transparency and Honesty Authority Privacy and data protection Updating of information Accountability Accessibility

INTERNET Deep Search Engines : Scholar Google Navigation and functions: Advanced Search Phrase: otitis media At least one of the words: antibiotic antibiotics antimicrobial amoxicillin Occurrence: article title Date: Journal articles Cited by Related articles Versions Citační ohlasy

Professional Medical Databases : selection MEDLINE/PubMed Bibliographic database with fulltext links Free access DynaMed Point-of-care EBP knowledgebase Institutional licence, IP-recognition UpToDate EBP knowledgebase Institutional licence, IP-recognition COCHRANE LIBRARY –Systematic reviews –Institutional licence, IP-recognition

MEDLINE/PubMed Advanced Search

MEDLINE/PubMed „Gold Standard “ for niomedical and health saciences Coverage: >5000 journals published in the USA a 80 other countries 23 mill. > 23 mill. records, retro since 1950 All records have English abstracts irrespective of original language MEDLINE/PubMed Summary + abstract + MeSH terms Fulltext links from providers LinkOut – More Resources Free Licence/subscription Absent /some archival materials

Search Tools Boolean Operators AND, OR, NOT Documents must contain at least two (or more) search terms  otitis media AND antibiotics Documents must contain any (or all) of search terms  otitis media OR middle ear inflammation Documents must not contain search terms  otitis media NOT surgery

PubMed: Search Strategy URL: Advancedhttp:// Search Builder functions Boolean operators OR, AND, NOT Truncation/wildcards * Step #1 Title: otitis media (search term occurs in article title) OR Title/abstract: middle ear inflammation (search term occurs in article title or abstract) Add to History Step #2 Title: antibiotic* (search term occurs in article title) OR Title/abstract: antimicrobial* (search term occurs in article title or abstract) Add to History Step #3 History #1 AND #2 Search Show additional filters: Ages – Show: Infant birth-23 months

PubMed : Results Summary Abstract –Related articles –Send to : File (library fulltext services) –Article types, MeSH Terms (Medical Subject Headings) –Linkout – more resources –Free fulltext –Providers, publishers – fee, subscription –Absent

Send to == REMINDER: Additional text must contain your contact.

Knowledgebases for evidence-based practice (evidence based medicine – EBM) DynaMed UpToDate

Navigation and functions – IP-recognition within Palacký University network – Remote access A point-of-care reference tool with clinically-organized summaries for more than 3,200 topics, which monitors the content of medical journals and systematic evidence review databases through journal review services. Each article is evaluated for clinical relevance and scientific validity, and the new evidence is then integrated with existing content, with overall conclusions being drawn from the best available evidence. Example: otitis media antibiotics Search – Choose a summary from the list – Open the selected topic Search within text - keyword search – „Levels of evidence“ – validity – References including reviews and guidelines

Result : Acute otitis media (AOM) Treatment overview

Navigation and functions: – IP-recognition within Palacký University and Teaching Hospital networks – Remote access Evidence-based clinical summaries, regularly uptodated >8,000 criticallyx appraised topics8,000 criticallyx appraised topics 14 specialties > pages (text, graphics, PubMed links) Patient information Quarterly updates

New Search: otitis media antibiotics Search

Results: Acute otitis media in children: TreatmentAcute otitis media in children: Treatment

Find Answer to Our Research Question Summary and Recommendations The choice of initial treatment with antibiotics or observation depends upon the age of the child and the laterality and severity of illness: We recommend that children with AOM who are <6 months be treated with antibiotics We suggest that children with AOM who are between six months and two years be treated with antibiotics ATD. Boy, 2 years old, acute otitis media

Discussion, exercise Search for the same topic in the COCHRANE LIBRARY a database of systematic reviews. Free access to structures asbtracts Fulltext fee-based.

COCHRANE LIBRARY