If you have a rupee and I have 1; and we exchange = both will have rupee either.

But if you have 1 thought and you have 1 thought and we exchange = we will have 2 thoughts each.

Dr. Ganesh Divekar (M.B.B.S., M.B.A.)

Medical advisor – clinical researchSun Pharma Advanced Research Co. Ltd.

Biomedical Information

Retrieval / literature search

Disclaimer:

• Any views or opinions presented in this presentation

are solely those of the author and do not necessarily

represent those of the company.

• Second disclaimer.

True?????

• Man is known by the company he keeps.

• An academician / clinician is respected in

accordance with number of publications he/she has

or per research work he/she has conducted.

Other cases:

• 19 year old girl with swelling on face post slap.

• Adverse event reporting not as per CTCAE.

Gone are the days:

Few Things which will help:

• Emails and web ids are not case sensetive

• Emails are for others to remember

• Freeware and Shareware

• Free access and Open access

• Semantic web

• HON code

Free Access And Open Access:

What does mean by "open access"?

• "'open access' to the literature means its free availability on the public

internet, permitting any users to read, download, copy, distribute, print,

search, or link to the full texts of these articles, pass them as data to

software, or use them for any other lawful purpose, without financial,

legal, or technical barriers.

• Copyright in this domain, should be to give authors control over the

integrity of their work and the right to be properly acknowledged and

cited."

Semantic Web:

• The Semantic Web is an evolving extension of the World Wide Web in

which web content can not only be expressed in natural language, but

also in a form that can be understood, interpreted and used by

software agents, thus permitting them to find, share and integrate

information more easily.

• It derives from web founder Tim Berners-Lee's vision of the Web as a

universal medium for data, information, and knowledge exchange.

HON Code:

• HON's mission is to guide lay persons or non-medical users and

medical practitioners to useful and reliable online medical and health information.

HON provides leadership in setting ethical standards for Web site developers.

• The Health On the Net Foundation (HON), created in 1995, is a Non-

Governmental Organization

Literature review:

“… a systematic method for identifying,

evaluating and interpreting the work

produced by researchers, scholars and

practitioners.”FINK, A., 1998. Conducting literature research reviews: from paper to the internet. Thousand Oaks, CA:

Sage., p.3.

Why review the literature?

“…without it you will not acquire an

understanding of your topic, of what has

already been done on it, how it has been

researched, and what the key issues are.”

HART, E., 1998. Doing a literature review: releasing the social science research imagination, by E. Hart and M. Bond. London: Sage., p.1.

A good literature review…

• Goes beyond simply listing relevant literature

• Is a critical essay

• Assesses the range of literature available

• Is a critical summary of the literature

• Examines the background against which your own research is

set

• Forms a significant section of your dissertation

Doctors

Importance of problem statement

• Correct problem statement + best solution = best solution to correct problem.

• Incorrect problem statement + best solution = best solution to incorrect problem.

16Clinical research, SPARC

Dimensions of research

• Work done in past (what),

• How (safety and efficacy analysis),

• When (in recent times??),

• Why (requirement),

• By whom?

Relationship Of Review Of Literature To Theory, Research, Education And Practice

Research

PracticeEducation

Theory

Review of Literature

Purposes of Literature Review

1. Determines what is known about a subject, concept or problem

2. Determines gaps, consistencies & inconsistencies about a subject, concept or problem

3. Discovers unanswered questions about a subject, concept or problem

4. Describes strengths & weaknesses of designs, methods of inquiry and instruments used in earlier works

Purposes of Literature Review

5. Discovers conceptual traditions used to examine problems

6. Generates useful research questions or projects/activities for the discipline

7. Promotes development of protocols & policies related to nursing practice

8. Uncovers a new practice intervention, or gains support for changing a practice intervention

Steps of Searching the Literature

Determine concept/issue/topic/problem

Conduct computer (and/or hand) search

Weed out irrelevant sources before printing

Organize sources from printout for retrieval

Retrieve relevant sources

Conduct preliminary reading and weed out irrelevant sources

Critically read each source (summarize & critique each source)

Synthesize critical summaries

Search:

Pubmed:

Provides information regarding:

• Biomedical Journal database

• MeSH database

• Single citation matcher

• Pubmed central

Pubmed: Search Strategy Tips

• The Search strategy is a plan that helps you look for the information

you need.

• Identify the key concepts (Keywords)

• Determine alternative terms for these concepts, if needed

• Refine your search to dates, age groups, language, etc., as appropriate

• Practice helps. Strategies and styles will differ according to personal

choice and professional discipline.

Boolean Operators:

• LOGICAL OPERATORS

• Used to combine two or more Mesh terms and

• These are AND, OR, NOT

• All the Boolean operators must be used in upper case

• AND = Narrow

• OR = Expand

• NOT = Exclude

Boolean Operators:

Tags:

• To search by an author's name, enter the name in the format of last

name plus initials (no punctuation), e.g.smith ja, jones k.

• To search for an author in the author field when only the last name is

available, qualify the author name with the author search field tag [au],

e.g., smith[au].

• Use double quotes around the author's name with the author search

field tag [au] to turn off the automatic truncation, e.g., "smith j" [au].

Tags:

• To search the word in title use the search tag [ti] after the word

e.g. anemia[ti]

• To search by journal title either you enter journal titles in full

e.g., molecular biology of the cell;

Dates entered using the format year [date field],

e.g., 1998 [dp]

• To enter a date range, insert a colon (:) between each date,

e.g., 1993:1995 [dp]

Tags:

• dna [mh] AND crick [au] AND 1993 [dp]

• (heat OR humidity) AND multiple sclerosis

• asthma/therapy [mh] AND review [pt] AND child, preschool [mh] AND english [la]

• arthritis NOT letter [pt]

Truncation:

• Finding all terms that begin with a given text string

• PubMed searches for the first 150 variations of a truncated term.

• Asterisk: Extends the search to all terms that start with the letters

before the asterisk. For example, dia* will include such terms as

diaphragm, dial, and diameter.

A search by subject: “mitochondrion evolution”

A search by authors: “Esser” [au] AND “martin” [au]

Paradigms of Medicine

Expert Based Evidence BasedPathophysiological reasoning Clinical Studies

Personal observation Best evidence available

Expert based guidelines Evidence based guidelines

EBM Question

• Patients: Acute Pulmonary Edema• Intervention: ACE Inhibitor• Comparison: Placebo• Outcome:

– Mortality– Intubation– Hemodynamic parameters– ICU/CCU admission

Background versus foreground information

• Case discussion: 27 year old woman with right lower quadrant (RLQ) abdominal pain

• Background information available from textbooks-– What typically presents as RLQ pain

– What is the clinical course of the different diagnoses

– Specifically, what is typical presentation of appendicitis

• Foreground information– How good is a CT scan for appendicitis?

Finding the Evidence

Steps of EBM-5 A’s

• Ask• Acquire• Appraise• Apply• Assess

Core of EBP

“Supposing is goodbut finding out

is better.”

Mark Twain

MEDLINEPlus

• Information on over 650 diseases and conditions

• Medical encyclopedia and dictionary• Information on prescription and

nonprescription drugs• Links to ClinicalTrials.gov• Links to news• Sponsored by the NIH – no ads

www.medlineplus.gov

The MEDLINEPlus Homepage

Prescribing information:

• Dailymed.com

ClinicalTrials.gov

• Information about federally funded and private human clinical trials

• Includes the trial’s– Purpose– Locations– Participant requirements– Phone number

ClinicalTrials.gov Homepage

NIC:

• IndMED

• MedIND

• OpenMED

• Union Catalogue of Biomedical Periodicals

IndMED :

• Database designed to provide quick and easy access to Indian

literature.

• IndMED – bibliographic database of 77 peer reviewed Indian biomedical

journals

• Free access from IMC site – http://indmed.nic.in

• Include non-MEDLINE journals

• Simple & Advanced mode of searching available

• Keyword(s) & free-text search

medIND:

• MedIND - resource of peer reviewed Indian biomedical literature

covering full text of IndMED journals.

• Designed to provide quick and easy access through searching or

browsing.

• Free access from http://medind.nic.in

• Covers full-text of select IndMED journals

OpenMED:

• OpenMED - open access international archive for Medical and Allied

Sciences.

• Authors / owners can self-archive their scientific and technical

documents.

• For this they need to register once in order to obtain a user id in

OpenMED system.

Union Catalogue of Biomedical Periodicals:

• Union Catalogue of Biomedical Periodicals – holdings data of over 180 biomedical libraries in the country

• Free access from http://uncat.nic.in

• Search by Journal name(s) / detail(s) or library name(s) / detail(s)

Google Scholar and RSS:

• This is to get updates about new additions to any of the website which

is RSS enabled in headlines format.

Google Scholar

• Google Scholar provides a simple way to search for scholarly literature. Search across many disciplines and sources: peer-reviewed papers, theses, books, abstracts and articles, from academic publishers, professional societies, preprint repositories, universities and other scholarly organizations.

Google Scholar

• Works best for Citations

• Restrictions to Content– Fee-based

– Often your Library already owns material

– We’re working on improving access

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Google Scholarhttp://www.scholar.google.com/

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Enables you to search specifically for scholarly literature, including peer-reviewed papers, theses, books, preprints, abstracts and technical reports from all broad areas of research.

What is Google Scholar?

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Google Scholar orders your search results by how relevant they are to your query, so the most useful references should appear at the top of the page

This relevance ranking takes into account the: full text of each article. the article's author, the publication in which the article appeared and how often it has been cited in scholarly literature.

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Google Book Search

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Google

• Images• Alerts • Groups

How many databases to search:

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Law of Diminishing Returns

No of Relevant References retrieved

No of Hours spent Searching

When do we reach this point?How do we best spend our time after reaching this point?

Retrieval Depends Upon:

• Topic/Subtopic• Indexing• Functionality of the Search Engine• Searcher• Resource Constraints: Time, Cost, Personpower• Time Period Covered (Improvements in

Indexing/Coverage) • Purpose (cp. quality studies for SRs versus references) • State of Information Retrieval Awareness/Knowledge

Towards a TriplePlus Protocol

Triple: Three key subject databases Plus•Follow up of references (and verify in MEDLINE)Plus•Specialist databases for certain types of literature (e.g. CCTR for Trials; CINAHL, Index to Theses for theses)Plus•Supplementary searching (Related Articles, Citation searching, Web searching etc)

Phunsukh Wangadu

87BE studies with oncology drugs

10/14/2012

Learning by doing.