Foundation Year 2 Generic Skills Medline Filters Workshop

Why PubMed? NHS Core Content currently uses Dialog Datastar This arrangement ceases 31 st March 2008 Training on current system therefore not practical New system not yet available for training purposes PubMed will continue to be accessible in future

What are MeSH? MeSH are Medical Subject Headings They help tackle the issue of synonyms in Medical Terminology Eg: To find papers addressing the topic of “kidney stones” A search for the phrases:“Renal Stones” “Renal Calculi” “Kidney Stones” “Kidney Calculi” etc, etc. Would be required as there may be uncertainty as to which term has been used.

What are MeSH? If MeSH searching is used all four terms “Map” to a single MeSH “Renal Stones” “Renal Calculi” “Kidney Stones” KIDNEY CALCULI “Kidney Calculi”(MeSH Term)

Medline Filters Why Bother? “..some, (the purists would say up to 99% of) published articles belong in the bin and should certainly not be used to inform practice.” Trisha Greenhalgh How to Read a Paper, BMJ Books, 2001

Medline Filters Types of Filters Therapy Prognosis Differential Diagnosis

Medline Filters Therapy Questions Concerned with treatments for a problem or condition. Covers drug treatments, surgical procedures, exercise and rehabilitation regimes, etc. Preferred study design= Randomised Controlled Trial

Medline Filters Prognosis Questions Determines what is likely to happen to someone once a disease is identified. Identifies possible outcomes. Preferred study design= Cohort Study

Medline Filters Differential Diagnosis Questions Demonstrates whether a new diagnostic test is valid (can it be trusted?) and reliable (will similar results occur each time it is used) Preferred study design= Cross Sectional Survey

Simple Medline Filters (Health Information Research Unit, McMaster University) Randomised Controlled Trials: Select “Randomized Controlled Trials” in Publication Type Cohort Studies General Search for “Cohort Studies” Cross Sectional Surveys: General search for “Sensitivity and Specificity”

Therapy Example What evidence is there regarding the use of Botulinum Toxin Type A in treating children (aged <18) with Cerebral Palsy?

Therapy Example P = Patient=Cerebral Palsy I = Intervention= Botulinum Toxin Type A C = Comparison= O = Outcome=------

Choose “Mesh Terms” from “All Fields” menu Type “cerebral palsy” into search box Click “Index” button Type “cerebral palsy” into search box Click “Go” button

PubMed displays the most likely MeSH term it can find, together with its subheadings. Alternative choices are displayed above.

Tick to select. Choose “”Search box with AND” from the “Send to” menu

AND, OR, NOT “ Boolean” commands are used to combine search sets together: ANDTo find papers occurring in two or more search sets ORTo find papers occurring in any of several search sets NOTTo find papers occurring in the first search set but not present in others

The next subject “Botulinum Toxin Type A” is entered Click “Go” Note – previous search elements are displayed on screen.

Tick to select. Then choose “”Search box with AND” from the “Send to” menu

Clear the Search Box. Click “PubMed” Search button

To add the remaining elements aspect to the search Click “LIMITS”

Due to our search question we are only interested in studies addressing patients who are aged under 18. In order to find the best research for our type of clinical question we need “Randomized Controlled Trials” Then click “GO”

Exercise 1 Prognosis Find papers dealing with the likelihood of stroke among patients in their 50’s experiencing Atrial Fibrillation. TIPS: Cohort Studies can be found by performing a general search for the term “cohort studies” For age limitation choose (Adults (45-64years)) in the “Age Groups” special term limit.

Exercise 2 Differential Diagnosis Find papers in English examining the role of Procalcitonin in the diagnosis of sepsis. TIPS: Studies addressing differential diagnosis questions are found by searching for the phrase “sensitivity and specificity”

Creating a Personal Account in PubMed It is possible to create a personal NCBI account for use in PubMed. This is useful because it makes it possible to: Create Current Awareness Alerts Save your search Additional personalised features are also planned for the future, including linking in e-journal and print journal holdings for your local NHS library.

Creating a Personal Account in PubMed

Fill in registration details (Remember your username and password) Click “Register”