Finding the Medical Evidence in the Neonatal Intensive Care Unit

August 4, 2010

Libraries

Shauna-Lee KonradClinical LibrarianChildren’s Hospital, LHSCShauna.konrad@lhsc.on.ca

Robin FeatherstoneClinical Medicine LibrarianWestern Libraries, UWOrfeathe@uwo.ca

Slides: www.slideshare.net/featherr

Agenda

• Hospital and University Library Services

• Off-site access to Western Libraries

• Get it @ Western & Pubget

• Basic Searching in PubMed

• Answering clinical queries using filtered and unfiltered sources

Library Services

University Library Hospital Libraries

www.lib.uwo.ca/programs/neonatalandperinatalmedicine/

http://intra.sjhc.london.on.ca/refer/library/http://www.lhsc.on.ca/priv/library/

Library Services

University Library Hospital Libraries

Robin Featherstonerfeathe@uwo.caExt: 86383

Brad Dishan (SJHC)Brad.dishan@sjhc.london.on.ca

Ext: 65727

Shauna-Lee Konrad (Children’s Hospital, LHSC)Shauna.Konrad@lhsc.on.caExt: 55145

• On-site assistance: Taylor Library • On-site assistance: St. Joseph’s Hospital, SJHC Victoria Hospital, LHSC

• Extensive electronic & print collections • Local reference collection

• Searching consultations (Educational) • Literature searches• Searching consultations

• Purchase requests • Interlibrary Loan

• Workshops & Instruction • Workshops & Instruction

Neonatal and Perinatal Medicine Resources

What information tools have you used?

Selected Neonatal & Perinatal Medicine Info

www.lib.uwo.ca/programs/neonatalandperinatalmedicine

Live Demo

www.schulich.uwo.ca

Off-Site Access

Why are they asking me to pay??

Proxy Server

129.100.*.*

Option A: Log in at www.lib.uwo.ca

Option B: Use the EZ Proxy button

Option C: Use customized bookmarks created with the EZ Proxy Link Generator: https://www.lib.uwo.ca/offcampus/ezform.html

How to log on

Accessing Full-Text

• Once logged in to the proxy server, look for the “Get it @ Western” button

Full-Text from PubMed

Remember to use the PubMed link from the library website.

Get it @ Western

Option 1: Link to Full-Text

Option 2: Check the catalogue

Full-Text from Pubget

Remember to use the Pubget link from the library website & to log in to the proxy server.

Exercise 1 – Finding Full-Text

• Access the PDF of the following article:

Thoresen M, Hellström-Westas L, Liu X, de Vries LS. Effect of hypothermia on amplitude-integrated electroencephalogram in infants with asphyxia. Pediatrics. 2010 Jul;126(1):e131-9. Epub 2010 Jun 21. PubMed PMID: 20566612.

Introduction to PubMed

How do I find the recent

literature on my topic?!?

Define the Search Topic

• Define your search topic in a single question or statement.

Is hypothermia effective for treating neonatal asphyxia?

Is dobutamine or dopamine more effective for treating hypotension in the neonate?

Analyse the Search Topic

Analyse your search topic:

• What are the primary concepts (2-3)?Is hypothermia effective for treating neonatal asphyxia?

• What are the limiters ?– Population (Newborn infants, birth – 1 month)– Publication type (i.e. RCT, Review)– Publication date (i.e. last 10 years)

Basic Searching in PubMed

• Search your primary concepts, separating each concept with AND.

• Click “Search”.

Combine Different Concepts Using AND

AND

• Combine different concepts

• Finds articles where both concepts are present.

Applying Limits

• Click the limits link to see the complete list of options.

1. Check the appropriate limits for your search.

2. Click “Search”.

Commonly used limits include:

• Type of Article

• Language

• Ages

• Publication Date

Exercise 2: Basic Searching

After morning rounds, a NICU fellow is wondering if there

are any recent articles on the use of probiotics for

preventing necrotizing enterocolitis in the newborn.

Search Strategy:

probiotics AND necrotizing enterocolitis

Exercise 3: Basic Searching

For a research project, you would like to find published RCTs on

whether dopamine or dobutamine is more effective for

treating hypotension in the neonate from the last 20 years.

Search Strategy:

dopamine AND dobutamine AND hypotension

Managing Search Results

• Save your searches.

• Change display settings.

• View your search results.

• Email or save your search results.

Clinical Queries in PubMed

• Use Clinical Queries to quickly find the best studies to answer your question.

Select the type of question that you want to answer.

Enter the key concepts for your clinical question.

Clinical Queries in PubMed

Exercise 4: Clinical Queries in PubMed

Use clinical queries to determine the role of lumbar puncture in determining sepsis in neonates.

Clinical Queries Strategy:

Lumbar puncture sepsis neonate

Diagnosis

Broad

Exercise 5: Clinical Queries in PubMed

Use clinical queries to find articles that discuss acceptable levels of oxygen to prevent retinopathy of prematurity.

Clinical Queries Strategy:

Oxygen levels retinopathy of prematurity

Etiology

Broad

Exercise 6 – Clinical Query

Do probiotics prevent necrotizing enterocolitis?

In groups, please search the following: 1. Cochrane Library2. PubMed (Clinical Queries)3. PubMed

Clinical Query: Search Results

Source Results

Cochrane Library 2 Cochrane Reviews 4 Other Reviews

PubMed 118 Citations

PubMed Clinical Queries (therapy/narrow)

18 Clinical Studies5 Systematic Reviews

EMBASE 239 Citations total

Level of Evidence Pyramid

Qualitative Studies

Trip searches both

Exercise 7 – Image Search

• You’re preparing for a presentation on necrotizing enterocolitis. Find some images or animations to add to your slides.

Caveat: Without breaking copyright

Medical Illustration © 2010 Nucleus Medical Media, Inc., www.nucleusinc.com

Recap

• Hospital Libraries for on-site assistance

• University Library for collections

• EZ Proxy to access UWO subscriptions

• Get it @ Western or Pubget for full-text access to articles

• Neonatal and Perinatal Medicine Program page for selected information tools

Questions? Comments?

Brad Dishan

Librarian

St. Joseph’s Health Care London

C0-108, x65727

Brad.dishan@sjhc.london.on.ca

Robin Featherstone

Clinical Medicine Librarian

Western Libraries

519-661-2111 x86383 rfeathe@uwo.ca

Shauna-Lee Konrad

Clinical Librarian

Children’s Hospital, LHSC

C3-300, x55145

Shauna.konrad@lhsc.on.ca