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Searching Medline

This report summarizes participant responses from a July 2008 course led by Helen Rowlandson, Principal Medicines Information Pharmacist in London, focused on searching Medline effectively. With 17 questionnaires returned, it reveals that over half of participants have received formal training, showing strong informal training in-house. Common issues identified include excessive hits, relevance of search results, and challenges in accessing quality full-text articles. Key topics explored include the use of MeSH, search tools, and effective searching strategies to improve participant competencies in accessing medical literature.

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Searching Medline

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  1. Searching Medline Helen Rowlandson Principal Medicines Information Pharmacist London Medicines Information (Northwick Park) London

  2. July 2008 course - participants responses • 17 questionnaires returned • More than half have had formal training (during pre-reg, at university, during diploma/certificate, or by NHS library service) • Nearly all have had informal training in-house in MI service • Most participants have used Dialog and a few use Ovid or Pubmed • Only a few have starting using NLH regularly

  3. Main issues/problems • Searches produce too many hits - how do you narrow/limit your search down? • Searches produce irrelevant hits – how to you find relevant hits for your topic? • Difficulty finding good quality full text articles • Finding/deciding which are the relevant search terms to use –use of the MeSH browser/ MESH descriptors/MESH headings/thesaurus • Use of explode function

  4. National Library of Health (NLH) Interface Issues • Slow and crashes all the time • Thesaurus unavailable at times • Map to Thesaurus button is not automatically ticked • More hits with Dialog

  5. Plan • Searching basics – a refresher • What is Medline? • Medical Subject Headings (MeSH) • NLM’s MeSH browser • Searching tools • NLH software – the basics • Worked examples

  6. 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

  7. Boolean operators • A AND B A B A OR B A B A NOT B A B

  8. 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 • 5,000 journals indexed, 70 countries

  9. Searching Medline • Use indexing system - MeSH thesaurus • Controlled vocabulary with ~24,000 descriptors • Each represents a single concept • Tree structure - hierarchal • Constantly changing • 600+ added per year

  10. Medical Subject Headings • 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

  11. MeSH Browser • Open the Internet and type: http://www.nlm.nih.gov/mesh/MBrowser.html • Right click & then click on “create a shortcut” • Now click on “Navigate from tree top”

  12. MeSH Examples • Kidney Failure • Depression • Chronic Fatigue Syndrome • PTSD • Fluoxetine

  13. Searching Tools • 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

  14. 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?

  15. 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

  16. Check Tags • All relevant tags 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

  17. 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 as a topic’ 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

  18. 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 or free text

  19. Quick question… • What is directly above olanzapine in the MeSH tree? • What is its CAS registry number?

  20. Medline & MeSH Recap • Successful searching is finding correct indexing term • MeSH headings • Scope Notes • Focus/Explode • Subheadings/Check Tags • Supplementary concepts

  21. Accessing Medline? SILVER PLATTER PUBMED MEDLINE OVID NLH MEDSCAPE

  22. National Library for Health software • Open Internet and type: http://www.library.nhs.uk/Default.aspx • Log in using athens username and password” • Healthcare databases advanced search

  23. NLH software • Search one database at a time • Medline 1950 to date • 2 options to search for terms: • Thesaurus mapping • Browse headings

  24. NLH software • Major /Explode • Tree structure • Subheadings • Supplementary Concepts • Limits • Show titles

  25. Worked example 1 • Are there any recent papers about SSRIs or SNRIs being used in the treatment of Huntington disease?

  26. Worked example 2 • Are there any recent RCTs of the UK-available acetylcholinesterase inhibitors (galantamine, rivastigmine, donepezil) in Lewy Body Dementia?

  27. Worked example 3 • Are there any articles which discuss using high dose vitamin supplementation to treat autism? • NB – remember that your enquirer’s way of describing what he is asking for may not necessarily be exactly how MeSH describes it….

  28. ANY QUESTIONS?

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