Finding the best evidence

1. Walk through one2. Do own searches

Learning through play Try all “buttons” Make lots of

“mistakes” Have fun

EBM and Systematic Review EBM (quick & dirty) Steps

Answerable Question Search Appraise

Apply

Time: 90 seconds < 20 articles This patient survives!

Systematic Review Steps

Answerable Question Search ++++ Appraise x 2 Synthesize Apply

Time: 6 months < 2,000 articles This patient is dead

Find a systematic review!!

Start up Start Explorer and enter

www.pubmed.gov Put on CAPS lock

So that AND and OR are in CAPITALS Start 2nd Explorer window, enter

www.tripdatabase.com

Using the question to guide searching

Scenario - You are interested in checking the hearing of elderly patients, and have heard that the ‘whispered voice test’ is good.

Question Population Indicator (intervention, test, etc) Comparator Outcome

Scenario - You are interested in checking the hearing of elderly patients, and have heard that the ‘whispered voice test’ is good.

Question Population – in elderly patients does Indicator – a ‘poor’ whispered voice test Comparator – a ‘normal’ whispered voice test Outcome – predict abnormal audiogram

1. Underline the key terms2. Number the order of importance from 1-43. Think of alternate spellings, synonyms, &

truncations

Using the question to guide searching

Scenario - You are interested in checking the hearing of elderly patients, and have heard that the ‘whispered voice test’ is good.

Question Population – in elderly patients does Indicator – a ‘poor’ whispered voice test Comparator – a ‘normal’ whispered voice test Outcome – predict poor hearing (audiogram)

1. Underline the (root of the) key terms2. Number the order of importance from 1-43. Think of alternate spellings, synonyms, &

truncations

1

2

3

Using the question to guide searching

* Means any other letters

AND means both terms required

Check the question type Check the

emphasis

Stepwise searching Search with #1 PICO item

Whisper* Then go to “Clinical Queries”: diagnosis

Whisper* (again) Add #2 PICO item

whisper AND (hear* OR audiogram)

Combining terms with Boolean operators – AND

chitosanweight

weight AND chitosan - has both terms

IN CAPITALS

Combining terms with Boolean operators – OR

chitosanweight

weight OR chitosan - has either term

Your tasks Search for the best single article

(systematic review or trial) for Your question from notes Your own question(s)

When you are finished Print just the abstract for each Write your search strategy on the

page

Boo-le-ans* AND = both terms OR = either term NOT = not this term (ADJacent, NEAR, … = AND +

close)

* George Boole (a man) is claimed to have invented “logic”

Where to the brackets go? If you want

cheese AND fruit

Which do you ask for? cheese AND (apple OR pear OR melon) (cheese AND apple) OR pear OR melon

What does PubMed do with if AND and OR? Cheese AND apple OR pear (Look at DETAILS tab)

General structure of search

(Population OR synonym 1 OR …) AND (Intervention OR synonym 1 OR …) AND (Comparator OR synonym 1 OR …) AND (Outcome OR synonym 1 OR …) AND

FILTER (for best study type)

MedlineEmbase

Cochrane Trials Registry

Comparing Databases

Medline = Pubmed, Webspirs, OVID, …

Search Cascade

Shortcuts

Meta-search engines www.tripdatabase.com Sumsearch Nelh

Other tips: Search on Title only

Eg [ti](Others are [au] - author; [so], [yr], …)

‘Related Articles’ button(PubMed)

previously identified study (PubMed)Look for the MeSH termsMeSH browser

Before you finish!

Print single most relevant abstract for each question – for both ‘set’ questions and your own questions