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Searching Medline. Janet West Principal Pharmacist Medicines Information Southern General Hospital NHS Greater Glasgow & Clyde. July 2007 course - participants responses. 12 questionnaires returned

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Searching Medline

Janet West

Principal Pharmacist Medicines Information

Southern General Hospital

NHS Greater Glasgow & Clyde

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July 2007 course - participants responses

  • 12 questionnaires returned

  • More than half have had formal training (during pre-reg, at university, during diploma/certificate, or by NHS library service)

  • Informal training in-house in MI service

  • Most participants use Dialog and a few use Pubmed in addition

  • Of the Dialog users most use Advanced search option

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Main issues/problems

  • Difficulty with limiting searches to a manageable number of hits

  • Use of the “tree” structure

  • Use of thesaurus mapping

  • Exploding and focussing – when to use

  • Difficulty with finding MeSH headings

  • Subheadings – when are they appropriate to use

  • Finding relevant articles e.g. about an adverse reaction to a particular drug as opposed to general info on its therapeutic use

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Session aims

  • To understand the concepts of a basic search strategy in Medline

  • To describe the MeSH thesaurus in detail so that you will be able to apply MeSH to use Medline efficiently

  • To carry out advanced Medline searches

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  • Searching basics – a refresher

  • What is Medline?

  • Medical Subject Headings (MeSH)

  • NLM’s MeSH browser

  • Dialog software – the basics

  • Worked examples

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Searching basics – a refresher

  • Large databases – electronic searching is essential

  • A controlled vocabulary or a thesaurus is necessary

  • A means of combining terms is also required e.g. BOOLEAN operators

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Boolean operators

  • A AND B

    A B

  • A OR B

    A B

  • A NOT B A B

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What is Medline?

  • Vast source of medical information

    • Medicine, Dentistry, Veterinary, Psychology

  • Covers

    • Clinical medicine, anatomy, pharmacology, toxicology, genetics, microbiology, pathology, environmental health, occupational medicine, psychology, biomedical technology

  • National Library of Medicine (USA)

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    • ~5000 journals indexed

      • (20,000 world wide)

      • 600 British

      • 70 Countries







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    Searching Medline

    • To use Medline effectively we must know how indexing works

    • Each article is assigned a number of MeSH terms

    • Articles indexed by 3 tier system

      • MeSH descriptor (MeSH heading)

      • MeSH qualifier (MeSH subheading)

      • Items mentioned (check tags)

      • Articles are indexed & then double checked by another indexer  must agree

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    Medical Subject Headings

    • Use MeSH thesaurus

      • Controlled vocabulary with ~23,000 descriptors

      • Each represents a single concept

      • Constantly changing

      • 600+ added per year

      • Up to ~ 20 MeSH per article (av. 10-12)

    • Tree structure

      • Hierarchal structure

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    • Open the Internet and type:

    • Click on “online searching of MeSH vocabulary”

    • Right click & then click on “create a shortcut”

    • Now click on “Navigate from tree top”

    NLM MeSH Browser

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    MeSH Examples

    • Kidney Failure

    • Depression

    • Chronic Fatigue Syndrome

    • PTSD

    • Fluoxetine

    NLM MeSH Browser

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    MeSH Headings

    • Explode

      • Includes everything below in the tree structure

    • Focus (Major)

      • Only includes articles where the MeSH heading (descriptor) is the main focus of the article

    NLM MeSH Browser

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    Quick questions…

    • What is the correct MeSH term to use for angina?

    • And if you exploded this term, what term(s) would you be also including in your search?

    NLM MeSH Browser

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    Subheadings (qualifiers)

    • Subheadings (qualifiers) refine your search

      • What aspect of the main heading is the author writing about or discussing?

      • Look at the definitions of the subheading e.g.:

        • Administration and Dosage

        • Adverse Effects

        • Analysis

        • Chemistry

        • Diagnostic use

        • Economics

        • History

    NLM MeSH Browser

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    Check Tags

    • All relevant articles are attached to the article

    • These are essentially used as “limit” functions

      • Human

      • Child

      • Adult

      • Aged

      • Male

      • Female

      • etc..

    • Type in “female” and look at annotation

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    Check tags

    Limits – publication types

    • If you want to search for papers that are meta analyses use the publication type limit function. Articles will then be meta-analyses

    • If you use the MeSH heading meta-analysis from tree E the articles you will get will be about meta-analysis as a study design(methods etc..)

    • Look at the MESH browser for definitions

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    Supplementary Concepts

    • Searches for substances that are not defined in MeSH (ie don’t have MeSH terms)

    • Supplementary chemical record

    • >30,000 substances undergoing clinical development – but not all will become commercially available medicines

    • Depending on software - search by CAS registry number and combine with text word search using OR (not necessary in Dialog)

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    Quick question…

    • What is directly above olanzapine in the MeSH tree?

    • What is its CAS registry number?

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    Medline & MeSH

    • Successful searching is finding correct indexing term

    • Avoid needle in hay stack searching

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    Dialog software

    • Open Internet and type:

    • Click “Athens users click here”

    • Right click & then click on “create a shortcut”

    • Enter Athens password

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    Dialog software

    • NHS England – access via Athens password

    • Use advanced search (avoid ‘easy search’)

    • Medline 1951 to date or 1996 to date

    • 3 options to search for terms:

      • Thesaurus mapping

      • Browse headings

      • Enter a term

    Dialog NHS

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    Dialog software

    • Don’t use punctuation e.g.

      • Fatigue syndrome, chronic in NLM MeSH

      • Fatigue syndrome chronic in Dialog

    • Subheadings

    • Tree structure

    • Limits

    • Show titles

    Dialog NHS

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    Worked example 1

    • Are there any recent papers about SSRIs or SNRIs being used in the treatment of Huntington disease?

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    Worked example 2

    • Are there any recent RCTs of the UK-available acetylcholinesterase inhibitors (galantamine, rivastigmine, donepezil) for Lewy Body Dementia?

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    Worked example 3

    • Are there any articles which discuss using high dose vitamin supplementation to treat autistic disorders ?

    • NB – remember that your enquirer’s way of describing what he is asking for may not necessarily be exactly how MeSH describes it….