ALYSSA GREEN, MLISUNIVERSITY OF CALGARY

HEALTH SCIENCES LIBRARYJANUARY 5 , 2012

Searching the Cochrane Database of Systematic

Reviews

Agenda

OverviewGoalsIntroduction to systematic reviewsSystematic review sourcesCochrane Database of Systematic ReviewsScenarioPICO Basic search / ResultsBoolean logic / Special charactersAdvanced search / ResultsMy ProjectsConclusion and questions

Overview

Scope of presentation Information literacy concept Systematic reviews Information literacy skill Searching online medical

database

International Medical Graduates (IMGs) Trained outside Canada and US Must complete additional training

Offered at University of Calgary Difficulty with Canadian medical culture

Evidence-based medicine Literature searching

Goals

1. Understand how systematic reviews can answer clinical questions

2. Learn strategies for formulating answerable questions

3. Learn how to use Boolean logic to create queries

4. Learn to use the basic and advanced search in the Cochrane database of Systematic Reviews

Systematic Reviews

Key component of evidence-based medicine (EBM) Help healthcare team members make decisions

Studies that synthesize multiple primary studies

Limit errors and bias by following guidelines Rules for conducting literature searches Clearly defined selection criteria

Value of Systematic Reviews

Keep clinicians up-to-date

Provide guidelines for best practices

Are succinct, accurate summaries of results

Show whether findings are consistent

Save clinicians time and effort

Improve standards and safety

Systematic Review Sources

Medline/PubMed Limit searches to systematic reviews only

Clinical Evidence Systematic review source from BMJ

Cochrane Database of Systematic Reviews (CDSR) Cochrane reviews considered very thorough Access provided through OvidSP

Other online journals and databases

Cochrane Database of Systematic Reviews

Contains all Cochrane Reviews and Protocols Very thorough and reliable

Cochrane Reviews Focus on answering questions

Can antibiotics help in alleviating the symptoms of a sore throat?

Created by the Cochrane Review Group and peer-reviewed

Focus on effects of interventions for prevention, treatment, and rehabilitation

Assess diagnostic tests for specific populations/conditions

Updated regularly

Accessing the CDSR

Multiple ways to access the CDSR Through Library home page

Search “Cochrane” under Research Databases Through Health Sciences Library Page

Under “other point of care tools”

Subscription resource Library pays for access Access restricted to students

and faculty Can use from home or on

campus

Search Options

Scenario

Use a systematic review to find answers

Glenda, a 27 year old patient, is worried about getting sick before her upcoming exams. She wants to know if taking vitamin C will lower her chances of getting a cold.

PICO

Use PICO to formulate research questionsBreak scenarios into keywords and

componentsPICO Keyword

P = Patient or Problem ColdI = Intervention, therapy, or treatment

Vitamin C

C = Comparison (ex. placebo, the gold standard)

None

O = Outcome Prevention

Research Question

PICO research question For the common cold (P), how does Vitamin C (I)

compared to no treatment (C) impact prevention (O)?

Use a Cochrane Review to answer this question

Further simplify the question Does vitamin C prevent colds?

Basic Search

Useful for simple searchesCan search a complete topic or question

Basic Search- Results

Basic search browses full-text of each review

Results ranked by relevancy

859 results

Results don’t include all terms

Misses synonyms

Advance search is more precise

Formulating an Advanced Research Strategy

Revisit PICO keywords Vitamin C Cold Prevention

Brainstorm synonyms Vitamin C, ascorbic acid Cold, coryza Prevention, prophylaxis

Variant spellings Tumor, tumour

Boolean Operators

Used to combine words and phrases

AND links search terms together vitamin C AND cold

OR searches for one term or the other Prevention OR prophylaxis

NOT excludes the term from search results Cold NOT influenza

Brackets- ( ) links concepts together (cold OR coryza) AND (prevention OR prophylaxis)

Special Characters

Truncation- * truncates words to find variations Prevent* picks up prevent, prevents, prevention, etc.

Wildcards wom?n retrieves women, woman

Quotations- “ ” searches phrases, i.e. “vitamin c”

Next vitamin NEXT C

Near cold NEAR prevention

Sample Search

(“ascorbic acid” OR “vitamin c”) AND (prevent* OR prophylaxis) AND (cold OR coryza)

Advanced Search

Retrieves narrow, targeted resultsMore flexible and precise than basic search

Advanced Search- Results

12 results

Boolean operators tell database to return all search terms

Narrowed results while broadened search terms

Filter, sort, or view different results

Sample Review

My Projects

Transferable Skills

Can use Boolean operators with numerous resources OvidSP Databases

OvidSP’s evidence-based medicine reviews Online evidence-based medicine resources General medical databases Non-medical databases University of Calgary Library Catalogue through

Summon Toolbar

Conclusion

Systematic reviews are key to evidence-based medicine

Cochrane Database of Systematic Reviews is an important resource

PICO helps formulate research questions

Basic Search for simple queries

Boolean Logic and special characters allow for detailed searching

Advanced Search for refined searches

“My Projects” saves reviews, search strings, and other information

References

1. The Association of Faculties of Medicine of Canada. (2006). A Faculty Development Program for Teachers of International Medical Graduates. Ottawa, ON: Steinert, Y., & Walsh, A.

2. Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Haynes, R.B., & Richardson, W.S. (1996). Evidence based medicine: What it is and what it isn't. British Medical Journal, 312: (3), 71-72.

3. Cook, J.D., Mulrow, C.D, & Haynes, R.B., (1997). Systematic Reviews: Synthesis of Best Evidence for Clinical Reviews. Annals of Internal Medicine, 126(5), 376-380.

4. Mulrow, C.D. (1994). Systematic reviews: Rationale for systematic reviews. British Medical Journal, 309.

5. Delany, A., Bagshaw, S., Ferland, A., Laupland, K., Manns, B., & Doig, C. (2007). The quality of reports of critical care meta-analyses in the Cochrane Database of Systematic Reviews: An independent appraisal. Critical Care Medicine, 35(2), 589-594.

6. Higgins, J.P.T., & Green, S. (eds.). Cochrane Handbook for Systematic Reviews of Interventions. Retrieved from http://www.cochrane-handbook.org/. H

7. Centre for Evidence-Based Medicine: Toronto. (2012). Formulating Answerable Clinical Questions (Page 2). Retrieved from http://ktclearinghouse.ca/cebm/practise/formulate/tips2.