1. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Finding Relevant Evidence Using Search Engines and Databases Susan Fowler Medical Library St. Louis Children’s Hospital SFowler22@wustl.edu 314-454-2768

2. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Outline Search Strategy Pulling Keywords from Your PICO Question Boolean, Truncation, and Wild Cards Hierarchy of Evidence and Study Design AACN Procedure Manual for Pediatric Acute and Critical Care National Guidelines Clearinghouse Cochrane Database of Systematic Reviews PubMed SLCH Medical Library Services Becker Medical Library Services

3. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine The Search Strategy Develop PICO question Identify keywords and terms from PICO Identify standardized subject headings Combine subject headings and keywords to narrow or broaden your search Evaluate your search results Revise the search in light of your results

4. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Pulling Keywords from Your PICO Question What are the main topics of your PICO? Brainstorm – what other words could you use to describe your topic? What are some synonyms for the words you’ve come up with?

5. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Evaluate the Search Results Don’t be afraid if you have zero (0) or thousands of results, play around with search strategies – you wont break anything! Read the titles and abstracts of “hits” in your search to get a feel for their relevance Identify relevant MeSH and Keywords used to index particularly relevant “hits” If your search yields too many or too few hits, modify it and try again

6. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Revise the Search in Light of your Results Narrow the search by combining search terms and applying limits Broaden the search if the results are too limited by removing keywords and limits

7. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Boolean AND OR NOT

8. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Boolean strawberry AND vanilla AND chocolate Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic. Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.

9. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Boolean strawberry OR vanilla OR chocolate Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic. Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.

10. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Boolean and Nesting (strawberry OR vanilla) NOT chocolate Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic. Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.

11. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Truncation and Wild Cards Truncation is a searchable shortened form of a word. adolescen* will include adolescence adolescent adolescents, etc… Wild card characters are useful because of alternate spellings and other quirks in the English language. behavio?r, will include behaviour behavior Wom*n, will include women woman

12. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Hierarchy of Evidence and Study Design As you move up the pyramid the amount of available literature decreases, but increases in its relevance to the clinical setting.

13. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine AACN Procedure Manual for Pediatric Acute and Critical Care A print manual available in the reference section of the SLCH Medical Library This manual cannot be checked out but you are welcome to make free copies of practice guidelines Look up your topic in the Index, if it isn’t there, think of synonyms

14. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine National Guidelines Clearinghouse Freely accessible database of evidence-based clinical practice guidelines and related documents. Initiated by the AHRQ in partnership with the American Medical Association and America's Health Insurance Plans. Now maintained by the Agency for Healthcare Research and Quality (AHRQ) and the U.S. Department of Health and Human Services. If you have developed a good practice guideline, consider submitting it to the NGC

15. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Searching NGC http://www.guideline.gov/ Click Detailed Search

16. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine NGC Detailed Search Enter Keyword Sort Results by Publication Date

17. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine NGC Detailed Search cont… Limit search to age of target population.

18. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine NGC Search Example

19. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine NGC Pros Freely accessible practice guidelines that have undergone rigorous acceptance standards by the AMA, AHIP, AHRQ, and the U.S. Department of Health and Human Services Cons Limited content Limited search capabilities

20. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Cochrane Database of Systematic Reviews “Gold Standard” for systematic reviews Free database, but requires Wash U network access to access most content

21. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Accessing Cochrane http://becker.wustl.edu Choose Cochrane from Quick Links

22. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Cochrane

23. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Cochrane Search Example Enter search keywords

24. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Cochrane Search Example cont… You are only interested in Cochrane Reviews Click “Record” to view details of review and access full text if available.

25. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Cochrane Systematic Reviews Pros Compiled through rigorous standards Review process has already been done so you don’t have to Cons Limited content Limited search capabilities Access to most full-text content requires you to be on a Wash U networked computer

26. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed Created and maintained by the National Institute of Health (NIH) and the National Library of Medicine (NLM) Considered one of the most comprehensive databases of published scientific research articles Free database, but requires Wash U network access to access most content

27. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Accessing PubMed http://becker.wustl.edu Choose PubMed from Quick Links

28. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine MeSH = Medical Subject Headings Choose MeSH from Pull Down Menu

29. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine MeSH in PubMed Enter your search term

30. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed MeSH cont… Choose the most applicable MeSH term

31. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed MeSH cont… Use subheadings to further define your search. “analysis” should capture the concept of “monitoring”

32. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed MeSH cont… Click box for subheading or main MeSH term Send to Search Box

33. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed MeSH cont… Enter your second term, “Neonate.” Choose the topic that best suits your inquiry by reading the brief definitions.

34. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed MeSH cont… At this point, you have not searched the literature yet. You have built a search. Once you are satisfied with the search you have built, click “PubMed Search.”

35. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed Search Example Whoa! 1360 results! It is time to apply Limits.

36. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed Limits Click the “Limits” tab

37. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed Limits cont… For Practice Guidelines, always limit to “Humans,” “English,” and “Type of Article”

38. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed Search Example

39. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine PubMed Pros Freely accessible database Strong search capabilities Cons Vast amount of data requires application of limits Some content will require Wash U Network access or inter-library loan

40. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine SLCH Medical Library 24/7 hour Badge Access Online access to a vast online collection via (4) Wash U Networked Computers (4) BJC Networked Computers Journals, Books, and Databases Free Copying and Printing Free Fax Citation Assistance Bibliographic Instruction Free Interlibrary Loan Literature Searches Reference Questions Collection Development – Is there a book, journal, online resource that you think should be available at the library? Ask for it!

41. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Bernard Becker Medical Library Becker welcomes your requests SLCH employees have Borrowing Privileges Articles, send requests to ill@medicine.wustl.edu, let them know you work at SLCHill@medicine.wustl.edu Reference Assistance 314-362-7085 askreference@msnotes.wustl.edu Hours Mon-Thurs: 7:30 a.m. - 12:00 a.m. Friday: 7:30 a.m. - 10:00 p.m. Sat: 8:30 a.m. - 6:00 p.m. Sun: 12:00 p.m. - 12:00 a.m.

42. BERNARD BECKER MEDICAL LIBRARY Washington University School of Medicine Need Help? Contact a librarian, we are here to help! SLCH Medical Librarian Susan Fowler SFowler22@wustl.edu 314-454-2768 Becker Clinical Resources Librarian Will Olmstadt 314-362-4734 olmstadtw@wustl.edu