Poor QualityPoor Quality

Anyone can publish anything on the Internet Anyone can publish anything on the Internet We need to be careful not to degrade our work We need to be careful not to degrade our work

by using poor quality information.by using poor quality information.

Quality ?? Quality ??

How to evaluate Internet resources ??How to evaluate Internet resources ??

Who has access to the following Who has access to the following databasesdatabases? ?

General search General search engine:engine:

Pub-med Pub-med (Medline)(Medline)

Clinical EvidenceClinical Evidence CochraneCochrane Best EvidenceBest Evidence Best Treatment Best Treatment Trip databaseTrip database Bandolier Bandolier

EBM Guidelines:EBM Guidelines:NICENICESIGNSIGNPRODIGYPRODIGYOthersOthers

Aim & ObjectivesAim:Aim:

To create an awareness of To create an awareness of useful sites on websuseful sites on webs

At the end of the sessionAt the end of the session, , the participants would be the participants would be able to:able to:

ObjectivesUnderstand useful general search Understand useful general search

techniquestechniquesUse Use Med-lineMed-line data-base effectively data-base effectively Differentiate between Differentiate between primary and primary and

secondarysecondary sources of evidence sources of evidence Aware about use of secondary Aware about use of secondary

sources of evidencesources of evidenceUtilize the Utilize the KSU databasesKSU databases

ContentsContents

IntroductionIntroductionPrimary & Secondary sourcesPrimary & Secondary sourcesMed-line Data-baseMed-line Data-baseOther data-basesOther data-basesKSU DatabasesKSU DatabasesConclusionConclusion

General TermsGeneral Terms

URL’sURL’sUniform Resource LocatorUniform Resource LocatorThe web “address” that connects you The web “address” that connects you

with a websitewith a websiteGoes in the address bar. Goes in the address bar. Gives you information about the Gives you information about the

website.website.

Parts of a URLParts of a URLhttp://www.medicalteacher.org/http://www.medicalteacher.org/

home.htmlhome.html http://--hypertext transfer protocolhttp://--hypertext transfer protocol:: the language computers use to “talk” to one anotherthe language computers use to “talk” to one another

www—world wide web:www—world wide web: the body of information connected by the cables and the body of information connected by the cables and

computers of the Internetcomputers of the Internet

..medicalteacher—domain name:medicalteacher—domain name: the structured, alphabetic-based, unique name for a the structured, alphabetic-based, unique name for a

computer on a networkcomputer on a network

..org—org—top level domaintop level domain:: gives an idea of where the document is storedgives an idea of where the document is stored

//home—file name:home—file name: a folder within a websitea folder within a website

..html—hypertext markup language:html—hypertext markup language: the computer language used to format documentsthe computer language used to format documents

Top Level DomainsTop Level Domains.org—general noncommercial .org—general noncommercial

organizationorganization.edu—higher education.edu—higher education.gov—government agency.gov—government agency.com—commercial.com—commercial.mil—military.mil—military.net—computer network.net—computer network.k-12—elementary and secondary .k-12—elementary and secondary

schoolsschools

Searching the Searching the Net ??Net ??

Before you search, you Before you search, you need toneed to::

PreparePrepareOrganizeOrganizeCombineCombine

PreparePrepareWhat do you need to know about What do you need to know about

your topic?your topic?

Make a list of all the terms Make a list of all the terms connected with your topic.connected with your topic.

OrganizeOrganize Make a list of the words that are Make a list of the words that are

critical to your search.critical to your search.Exchange/add some words if Exchange/add some words if

needed.needed. Note terms that you don’t want Note terms that you don’t want

to see appear.to see appear. Discard the rest.Discard the rest.

CombineCombine

Use Use Boolean operatorsBoolean operators to combine to combine your most important terms.your most important terms.

Use AND to connect the terms you want to Use AND to connect the terms you want to see.see.

Use NOT to exclude terms you don’t want.Use NOT to exclude terms you don’t want. Use OR to include similar terms.Use OR to include similar terms. Use quotation marks around names or phrasesUse quotation marks around names or phrases Use lower case for all proper nouns, except for Use lower case for all proper nouns, except for

acronymsacronyms

Boolean OperatorsBoolean Operators

A A ANDAND B B

Boolean OperatorsBoolean Operators

A A OROR B B

Limit your keyword searchLimit your keyword search

Read the Read the directions for each directions for each search engine.search engine.

Use words like Use words like AND and OR to AND and OR to limit your search limit your search and get more and get more specified specified information.information.

ScenarioScenario

A 4-year-old child, brought by his A 4-year-old child, brought by his mother with history of fever of one mother with history of fever of one day. Clinically he was diagnosed to day. Clinically he was diagnosed to have acute otitis media. have acute otitis media.

We would like to give treatment??We would like to give treatment??

ExampleExample

ScenarioScenario

A A 4-year4-year-old -old childchild, brought by his , brought by his mother with history of mother with history of feverfever of one of one day. Clinically he was diagnosed to day. Clinically he was diagnosed to have have acute otitis mediaacute otitis media. .

We would like to give We would like to give treatmenttreatment????

ExampleExample

USEFULNESS OF MEDICAL USEFULNESS OF MEDICAL INFORMATIONINFORMATION????

((Relevance X validityRelevance X validity))

WorkWork

Examples of Examples of some Search some Search

Medline Medline searchsearch

ScenarioScenario

A 4-year-old child, brought by his A 4-year-old child, brought by his mother with history of fever of one mother with history of fever of one day. Clinically he was diagnosed to day. Clinically he was diagnosed to have acute otitis media. have acute otitis media.

We would like to give treatment??We would like to give treatment??

A case for searching answerA case for searching answer

ScenarioScenario

A A 4-year4-year-old -old childchild, brought by his , brought by his mother with history of mother with history of feverfever of one of one day. Clinically he was diagnosed to day. Clinically he was diagnosed to have have acute otitis mediaacute otitis media. .

We would like to give We would like to give treatmenttreatment????

ExampleExample

How to search for this How to search for this case ?case ?

SEARCHING FOR THE SEARCHING FOR THE EVIDENCEEVIDENCE

Medline searchMedline search

Let us look at OM question by medline

PubMedPubMedPubMed: Web-based retrieval system PubMed: Web-based retrieval system By the By the “National Center for “National Center for

Biotechnology Information” (NCBI)Biotechnology Information” (NCBI) at at the National Library of Medicine.the National Library of Medicine.

Updated weeklyUpdated weeklyContains approximately 13 million Contains approximately 13 million

citations citations Citations are taken from over 4,000 Citations are taken from over 4,000

journalsjournals

Type of Clinical QuestionType of Clinical Question

The questions : The questions : diagnosisdiagnosis,,prognosisprognosis, , treatmenttreatment, , iatrogenic harmiatrogenic harm, , quality of care, quality of care, or health economicsor health economicsetcetc

Identifying The EvidenceIdentifying The Evidence

• Primary Sources

• Secondary Sources

MedlineEmbase

Systematic Reviews

Clinical Guidelines

Where to Find the Best Where to Find the Best EvidenceEvidence? ?

Using Prefiltered sources

Best Evidence 5.lnk

Secondary Sources (Prefiltered)?

Focus on relevant information

Evaluate its validityCome up with valid conclusion for busy clinicians

Secondary sources of Secondary sources of EvidenceEvidence

Examples:Examples:

The Cochrane LibraryThe Cochrane Libraryhttp://www.cochrane.orghttp://www.cochrane.org

Review GroupsReview Groups

Acute respiratory infectionsAcute respiratory infections AirwaysAirways AnaesthesiaAnaesthesia BackBack Breast cancerBreast cancer Colorectal cancerColorectal cancer Consumers and Consumers and

communicationcommunication Cystic fibrosis and genetic Cystic fibrosis and genetic

disordersdisorders Dementia & cognitive Dementia & cognitive

improvement improvement Depression, anxiety & Depression, anxiety &

neurosisneurosis

Developmental, Developmental, psychosocial and learning psychosocial and learning problemsproblems

Drugs and alcoholDrugs and alcohol Ear, nose and throat Ear, nose and throat

disordersdisorders Effective practice and Effective practice and

organisation of careorganisation of care EpilepsyEpilepsy Eyes and visionEyes and vision Fertility regulationFertility regulation Gynaecological cancerGynaecological cancer HeartHeart Hepato-biliaryHepato-biliary

Clinical ScenarioClinical Scenario

A 40 year old A 40 year old smokersmoker, would like to , would like to quit quit smokingsmoking, he tried to do that, several , he tried to do that, several times , but he could not tolerate the times , but he could not tolerate the withdrawal symptoms. withdrawal symptoms.

Recently he read that some medications Recently he read that some medications are used to help smoker to quit. are used to help smoker to quit.

He would like your advise about this He would like your advise about this issue!issue!

Clinical ScenarioClinical Scenario

A A 40 year40 year old old smokersmoker, would like to , would like to quit quit smokingsmoking, he tried to do that, several , he tried to do that, several times , but he could not tolerate the times , but he could not tolerate the withdrawal symptoms. withdrawal symptoms.

Recently he read that some Recently he read that some medicationsmedications are used to help smoker to quit. are used to help smoker to quit.

He would like your advise about this He would like your advise about this issue!issue!

SECONDARY SOURCESSECONDARY SOURCES http://www.clinicalevidence.orghttp://www.clinicalevidence.org

SECONDARY SOURCESSECONDARY SOURCES A Unique SourceA Unique Source……

Produced by the BMJ Publishing Produced by the BMJ Publishing GroupGroup

Driven by Driven by questionsquestions It is It is updated every 6 months.updated every 6 months.

www.clinicalevidence.orgwww.clinicalevidence.org

Incomplete (230 topics)Incomplete (230 topics)

Clinical QuestionClinical Question

A 45-year-old asymptomatic man A 45-year-old asymptomatic man no risk factors, asking for the no risk factors, asking for the use of aspirin to reduce the use of aspirin to reduce the incidence of cardiovascular incidence of cardiovascular events.events.

BandolierBandolierhttp://http://

www.jr2.ox.ac.uk/www.jr2.ox.ac.uk/bandolierbandolier//

BandolierBandolierBandolier is an Oxford based

appraisal site with lots of good material.

Search for systematic reviews and abstract them

Include NNT tables & LHRhttp://www.jr2.ox.ac.uk/

Bandolier/

TRIP DatabaseTRIP Database

The TRIP Database searches >100 The TRIP Database searches >100 sites of high-quality medical sites of high-quality medical information.information.

The site is updated monthly.The site is updated monthly.http://www.tripdatabase.com/http://www.tripdatabase.com/

GuidelinesGuidelines

Evidence Based Evidence Based GuidelinesGuidelines

GuidelinesGuidelines

NICENICE : : http://www.nice.org.ukhttp://www.nice.org.uk//

KSUKSU

DATABASEDATABASE

Death CirtificateDeath Cirtificate

http://www.le.ac.uk/pathology/teach/http://www.le.ac.uk/pathology/teach/va/case_7/frmst.htmlva/case_7/frmst.html

http://people.mnhs.org/dci/search.cfm?bhcp=1http://people.mnhs.org/dci/search.cfm?bhcp=1 http://ssdi.rootsweb.com/http://ssdi.rootsweb.com/ http://www.cdc.gov/nchs/howto/w2w/w2welcom.htmhttp://www.cdc.gov/nchs/howto/w2w/w2welcom.htm http://death-response.chance.berkeley.edu/graduate/http://death-response.chance.berkeley.edu/graduate/

certificates.htmlcertificates.html http://www.adminvc.ucla.edu/appm/public/160.htmhttp://www.adminvc.ucla.edu/appm/public/160.htm http://www.knowledgestorm.com/search/keyword/Deathhttp://www.knowledgestorm.com/search/keyword/Death

%20Certificate/GAWJAN/Death%20Certificate/secname,ad/%20Certificate/GAWJAN/Death%20Certificate/secname,ad/ad2,i/ad3,g/ad5,g/ad6,iad2,i/ad3,g/ad5,g/ad6,i

http://jpubhealth.oxfordjournals.org/cgi/content/abstract/http://jpubhealth.oxfordjournals.org/cgi/content/abstract/12/2/11812/2/118

  

Conclusion ContConclusion Cont.. Be specific about your questions or Be specific about your questions or

search.search.

Practice using different sites for Practice using different sites for

searchsearch

Be familiar with some common sitesBe familiar with some common sites

Be familiar with secondary resourcesBe familiar with secondary resources

USEFULNESS OF MEDICAL USEFULNESS OF MEDICAL INFORMATIONINFORMATION????

((Relevance X validityRelevance X validity))

WorkWork

These Skills are enoughThese Skills are enough ?? ??These Skills are enoughThese Skills are enough ?? ??

We need to improve our searching skills??

Virtual Training SuiteVirtual Training Suite

http://www.vts.rdn.ac.uk

Virtual Training SuiteVirtual Training Suite

61 61 subject specificsubject specific online tutorials on Internet online tutorials on Internet Information skills.Information skills.

Authored by specialists with subject and Internet Authored by specialists with subject and Internet expertise.expertise.

Free to access (no need to register).Free to access (no need to register).

Take a light hearted approachTake a light hearted approach

Thank Thank YouYou

hamzaabg@gmailhamzaabg@gmail..

comcom