RAE ebook, Module 1, Topic 4 PDF

Preview

Summary

Download RAE ebook, Module 1, Topic 4 PDF

Description

Topic 4 — Acquiring the evidence Contents 4.0

Introduction and learning outcomes

4.1

Where are the databases? Which one should I use?

4.2

Database descriptions

4.3

Keyword or Subject Heading search?

4.4

Boolean operators AND and OR

4.5

Subject Headings, Subject Terms, MeSH (Medical Subject Headings)

4.6

This is how our search example would look in CINAHL using keywords and subject headings

4.7

Limiting results

4.8

This is how our search example would look in MEDLINE using keywords and subject headings

4.9

Finding the articles!

4.10

Referencing your sources

4.11

Using EndNote Multiple choice quiz

4.0 Introduction and learning outcomes In topic one of this module, you were introduced to the 5-step approach to evidence based practice (EBP). This topic will cover Step Two of the EBP approach: Acquire relevant evidence to answer the practice-related question.

You will learn how to conduct simple and complex searches in international online health databases to find the best evidence to answer your clinical question. Following on from Topic Three where you learned how to create a search strategy based on the PICO model, you will learn how to use this information to construct efficient search strategies using keyword and medical subject heading (MeSH) searches to ensure you retrieve accurate and useful search results.

This topic will explain the range of databases you will need to use, and demonstrate two different ways of searching, keyword and subject heading searching.

Click on the video Screenshot above or here to view the video introducing this topic — acquiring the evidence.

Key learning outcome Acquire evidence to answer different types of practice-related questions

Enabling outcomes You should be able to: •

Develop search strategies relevant to various practice-related questions

•

Implement these search strategies using different databases to collect evidence to address the questions

•

Implement simple and complex search strategies that use Boolean operators and truncation relevant to the database

•

Save searches, access the full text of relevant articles, and export the results to other applications e.g. EndNote

4.1 Where are the databases? Which one should I use? There are a range of databases to use for health sciences research; these are listed by subject area under the Databases tab on the Library home page. www.lib.latrobe.edu.au

All Health Sciences Practitioners must know how to conduct systematic searches of the medical literature to find the best evidence for patient care!

Databases are electronic indexing tools which will enable you to find a citation or reference that will usually lead you to the full text of a journal article. There are three types of databases: •

Citation databases, which contain the citation and occasionally the full text e.g. MEDLINE, CINAHL, Embase and PsycINFO

•

Full text databases, which contain the full text of the article attached to the record as a pdf e.g. ProQuest; and

•

Pre-appraised evidence databases, such as the Cochrane Library and Clinical Evidence (also full text databases)

The most useful databases for you as a Health Sciences student will be MEDLINE and CINAHL. Do NOT use Google or Google Scholar for best evidence; as there is no functionality to enable systematic searching.

4.2 Database descriptions MEDLINE provides authoritative medical information with seamless access to the latest bibliographic citations and author abstracts from more than 5,600 biomedical, health and life sciences journals. MEDLINE, a major international medical database, is updated daily and contains over 21.6 million citation records from 1948 to the present.

CINAHL is the authoritative and most in-depth resource for nursing and allied health professionals, students, educators and researchers (Cumulative Index to Nursing and Allied Health). This database indexes over 5,000 journals and contains over three million citations. Offering complete coverage of English-language nursing journals, this database covers nursing, biomedicine, consumer health and 17 allied health disciplines from 1982 to the present.

Joanna Briggs Institute EBP Database the Joanna Briggs Institute EBP Database allows you to search simultaneously, across a wide range of summarized and appraised full-text evidence, to inform your practice. This comprehensive range of resources includes over 3,000 records across seven publication types: Evidence Based Recommended Practices, Evidence Summaries, Best Practice Information Sheets, Systematic Reviews, Consumer Information Sheets, Systematic Review Protocols, and Technical Reports.

The Cochrane Library is an international, independent, not-for-profit organisation dedicated to making up-to-date, accurate information about the effects of health care readily available worldwide. Contributors work together to produce systematic reviews in full-text of healthcare interventions known as Cochrane Reviews which help practitioners make informed decisions about health care. These reviews are the most comprehensive, reliable and relevant source of evidence on which to base these decisions.

Clinical Evidence is a continually updated international source of the available full-text evidence on the effects of common clinical interventions. It summarises the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on searches and appraisal of the literature.

Embase is a major international biomedical and pharmacological database containing bibliographic records with citations and abstracts from biomedical articles, and is especially strong in its coverage of drug and pharmaceutical research, as well as clinical and experimental human medicine, public health and occupational health. Embase indexes over 7,500 peer-reviewed journals with over 22 million records from 1974 to the present.

PsycINFO covers the professional and academic literature in psychology and related disciplines including medicine, psychiatry, nursing, sociology, pharmacology, physiology and linguistics, dating back to 1806. This full-text database provides abstracts and citations in the psychological, social, behavioural and health sciences. Updated weekly, PsycINFO provides access to journal articles, books, chapters and dissertations.

ProQuest Health and Medicine provides in-depth coverage in full-text from over 1,500 publications with almost 1,300 available in full text. The journals cover all major clinical and healthcare disciplines, including medical sciences, immunology, pharmacy and pharmacology, nursing, physical fitness and hygiene, surgery and others.

ProQuest Nursing and Allied Health provides reliable healthcare information in full-text covering nursing, allied health, alternative and complementary medicine, and much more. This versatile database is designed to meet the needs of researchers at healthcare facilities as well as nursing and allied health programs at academic institutions. The database indexes more than 850 titles, with over 715 titles in full text, plus more than 12,000 full text dissertations representing the most rigorous scholarship in nursing and related fields.

ProQuest Social Services Abstracts covers subjects in full-text such as community and mental health services, crisis intervention, family and social welfare, gerontology, poverty and homelessness, professional issues in social work, social services in addiction, social work education, social work practice and violence, from 1979 to the present.

Sociological Abstracts index the international literature in sociology and related disciplines in the social and behavioural sciences. The full-text database provides abstracts of journal articles and citations from thousands of serial publications, and also provides abstracts of books, book chapters, dissertations and conference papers.

Informit Health offers full text publications that deliver authoritative research in health from Australia, New Zealand and the Asia Pacific region.

4.3 Keyword or Subject Heading search? There are two ways to search the databases, by keyword and subject heading: Keyword searches operate by searching for words in the title, abstract or full text of a journal article. You will retrieve more references but many will be less relevant.

Subject heading searches operate by finding topics, which will retrieve less references but these will be more relevant, therefore the result is a more precise search. For example, the subject heading Stroke also searches for the terms cerebral vascular accident (s) or cerebrovascular accident (s) or CVA (s) or strokes.

Keyword searches

Subject Heading searches (MeSH or Subject Term)

Fast and easy

Sometimes more time consuming to find the appropriate subject heading/term

Retrieves words found in the article

Retrieves topics or headings about the condition or topic

Finds more references, some of which More precision – results are usually very may be relevant or irrelevant

relevant

You can search by keyword or subject heading separately; or search a combination. In this module we will provide examples of keyword searching and combination (of keyword and subject heading) searching. Librarians will be running face to face classes as part of this subject, but the videos in this module will show you the process.

Search tips for Keyword searching: Most of the databases you will search are international with contributions from authors across the globe; therefore your searches need to account for variations in spelling, terminology and clinical descriptions: •

Spelling, there are many common examples: counselling or counseling, aging or ageing, paediatrics or pediatrics, and more.

•

Terminology e.g. car driver or automobile driver, community health nurse (AUS) or health visitor (UK) or neighbourhood nurse (US)

•

Medical terminology e.g. cerebral vascular accident or cerebrovascular accident

So how do you start a keyword search? Here is your search question: Is bed rest or exercise more effective for treatment of back pain in the elderly? Using the PICO format let’s create our search strategy:

P

I

C

O

Population

Intervention

Comparative

Outcome

Intervention Back pain in the

Exercise

Bed rest

elderly

Or

Or

Physical activity

Bedrest

Back pain Or Back ache Or Lower back pain

4.4 Boolean operators AND and OR Using the PICO map, we will search:

Pain relief

First, the population group back pain OR backache OR lower back pain Second, the concept of exercise OR physical activity Third, bed rest OR bed rest. After searching each concept, we will combine them with the Boolean Operator AND. Our search results will have all three concepts: back pain, exercise and bed rest.

In Keyword Searches use Truncation, wild cards and phrase searching Use the Truncation symbol * to increase search results e.g. child* will retrieve children, childhood, childless. In our example above we could use backache* (backache or backaches), low* back pain (low back pain or lower back pain), physical activit* (physical activity or physical activities) and more

Use the Wildcard symbol? if you are unsure of variations in spelling such as organi?ation will retrieve organisation or organization

Use the Wildcard symbol # in places where an alternate spelling may contain an extra character e.g. p#ediatric will retrieve paediatric or pediatric, and colo#r will retrieve colour or color

Use Quotation Marks to search for words as a phrase. Some common phrases used in health sciences are “quality of life” and “acquired brain injury”

The following video presents an overview of keyword searching in CINAHL

Click on the video Screenshot above or here to view the video — an overview of keyword searching in CINAHL. The following video presents an overview of keyword searching in MEDLINE

Click on the video Screenshot above or here to view the video — an overview of keyword searching in MEDLINE.

4.5 Subject Headings, Subject Terms, MeSH (Medical Subject Headings) Subject heading searching helps you determine how your topic is listed using the terms in the database. This is a more specific way of searching than using keywords. Subject headings can also be called controlled vocabulary or thesauri. In CINAHL you need to tick the box Select Subject Terms. Sometimes there will be a different heading in CINAHL and Medline for the same concept.

Medical Subject Headings (MeSH) are subject headings developed specifically by the U.S. National Library of Medicine to organise information in medicine and life sciences. MeSH headings are used in databases such as Medline and the Cochrane Library.

Subject Trees show how the subject or MeSH headings are organised in a hierarchy and the relationships between the terms. Broader terms are located at the top, with narrower terms towards the bottom.

In our back pain example, the broader term is Nervous System Diseases with narrower terms as follows: •

Neurologic manifestation o Pain 

Back pain 

Low back pain

Try out this example in CINAHL and MEDLINE: (remember to tick the box ‘Select subject terms’ in CINAHL) – Exercise •

click on ‘Exercise’ and look at the narrower terms: muscle stretching exercises, resistance training, running etc.

•

look at the Scope Note and see the description of the term at the top, and what it is used for – lots! See how using a subject heading would save you from searching all those keywords! Imagine a keyword search with all those words (synonyms)?

The following video presents an overview of how to search in Medline using Medical Subject Headings (MeSH)

Click on the video Screenshot above or here to view the video — an overview of how search in Medline using Medical Subject Headings (MeSH) The following video presents an overview of medical subject term searching in CINAHL

Click on the video Screenshot above or here to view the video — an overivew of medical subject term searching in CINAHL.

4.6 This is how our search example would look in CINAHL using keywords and subject headings

In the example above we have searched back pain or low back pain as a subject heading (S1). You can see the MH next to the search term. We then searched by keywords. Using OR we combined a subject term search with the keyword search to get the most comprehensive search result possible. Note the combination of sets using Search with AND - S3 and S6 and S9 4.7 Limiting results Now back to our question: Is bed rest or exercise more effective for treatment of back pain in the elderly? We currently have 77 search results, but we want to limit to elderly.

Underneath the search results screen on the left there are options to refine your results to peer-reviewed, English language and publication date. Click on Show More and scroll down to Age Groups and select Aged 65+, then search (now limits to 10 results). This is what the limit screen looks like. Note the options for peer-reviewed, English, date and age groups. If you search first on Medline, you can then remove duplicates by selecting Exclude MEDLINE records, see below.

4.8 This is how our search example would look in MEDLINE using keywords and subject headings (Click on Search History to display)

Click on the Limits, then Additional Limits, to filter by age group:

4.9 Finding the articles! There are four ways of obtaining the full text of the article, in the following order:

1. Sometimes the full article is attached to the record in the search results

2. If not, click on the black Full Text Finder to see if the full text is available

3. If there is no full text available, you can do a double check under the Journals tab on the Library home page. Enter the name of the journal (not the article), check if volume or year is held, then link through to the article.

4. If you still can’t find it, login to Document Delivery Services (under Quick Links on the Library home page) with your University username and password. We will order you a copy from another library; it usually takes 1-3 days and is delivered online. There is no charge for this service. Note that quotas for Undergraduate students are 10; Honors students 25; Masters and PhD students 100 per year.

4.10 Referencing your sources There are many reasons why you must cite your references in your essays: •

to support your arguments with evidence

•

to protect yourself against charges of plagiarism

•

to show that you have read widely and researched the topic

•

to enable the reader tolocate the sources referred to

You need to cite your source when you paraphrase from someone else’s work •

summarise another person’s ideas

•

use direct quotes

•

refer to the ideas or theories of another person’s work

In Health Sciences the APA 6th edition is the referencing style used. When referring to another work in your essay, you need to cite it in-text and list it in the references at the end of the document. Here is an example of an in-text reference citation for a journal article: •

Direct Quote: Parents smoking in their cars and in the family home “should be considered as intermediary factors in the pathway between parental and student smoking” (Glover et al., 2011).

•

Paraphrasing: Glover et al. (2011) report on the factors in the pathway

•

Reference list: Glover, M., Scragg, R., Min, S., Kira, A., Nosa, V., McCool, J., & Bullen, C. (2011). Driving kids to smoke? Children's reported exposure to smoke in cars and early smoking initiation. Addictive Behaviors, 36(11), 1027-1031. doi:10.1016/j.addbeh.2011.06.003

You can add the references manually using the Academic Referencing Tool available from the Library Home Page under Quick Links or from the following link: www.lib.latrobe.edu.au/referencing-tool/apa-6/ Or, use the EndNote program to manage your references (see next page)

4.11 Using EndNote •

When searching Library databases you will be able to save your results to EndNote

•

From EndNote you can insert your references into your essay text and a reference list is automatically created

•

Download a copy of EndNote from this guide: http://latrobe.libguides.com/endnote

•

Install the current La Trobe University APA6 version (instructions under Tab 5 in the guide)

•

The IT Service Desk in the Library on Level 1 can help if you have problems

The following video presents an overview of how to use EndNote

Click on the video Screenshot above or here to view the video — an overview of how to use EndNote

Exporting records from MEDLINE: 1. Open an EndNote li...