BDent3 - finding the best evidence - an update

www.library.usyd.edu.au

BDent3 – Searching for the Best Evidence – an Update

Westmead hospital22nd of August 2007

Jeremy Cullis Faculty Liaison Librarian (Dentistry)

Dentistry LibraryUniversity of Sydney

Email:[email protected]: http://www.dentistrylibrary.blogspot.com

Searching for the Best Evidence - an update

By the end of the session you will know:

• How to create an effective search strategy

• How to locate systematic reviews

• Use the Medline Clinical Queries filter to locate primary studies for your type of question

• Where to locate resources to help you appraise articles.


Creating a search Strategy is one of the most important steps

1. What is your clinical question? 2. What are the three or four key concepts in your

question?3. Are there any similar words (synonyms) that

describe each of the key concepts?4. Are there any specific keywords that could limit

your search?5. How are you going to combine these keywords

together to search?[Search Strategy, Internet for Dentistry and Oral Health Available at:

http://www.vts.intute.ac.uk/acl/tutorial?sid=1139338&op=preview&manifestid=210&itemid=12066, Accessed 16th of August, 2008]


Creating a Search Strategy:

Question Formulation:In patients with tooth discolouration would home bleaching compared to placebo lead to whiter teeth?

[taken from Asking Questions, Centre for Evidence-based Dentistry, Available at: http://www.cebd.org/?o=1029, Accessed: 17/08/07]

• Population: Patients with tooth discolouration• Intervention: Home bleaching• Comparison: Placebo• Outcome: Whiter teeth


• Any synonyms?

• Tooth discolouration or dental fluorosis• Home bleaching or peroxide

• Try keyword searches for abbreviations etc to add to your searches


• Combining your searches.

• Use AND to combine different concepts

Example: Tooth discolouration AND bleaching

• Use OR to combine like concepts

Example: peroxide OR tooth bleaching


Search Medline

Remember to:• Use Subject Headings (consider using

keywords to expand your search)• Search for one concept at a time• Check the Tree Display for narrower headings• Look for other relevant subject headings• Use the correct logic to combine searches• Use the limits – especially useful for locating

primary studies.


• Find a systematic review:

Search Medline then use the EBM Reviews Limit

• First term: Tooth discolouration• Second term: home bleaching


Image: Ovid Medline: http://gateway.tx.ovid.com.ezproxy2.library.usyd.edu.au/gw1/ovidweb.cgi?New+Database=Single|17&S=CDLLFPBMJNDDKDEONCJLACPJANPPAA00: Viewed 17/8/07




• To find a Primary Study, use the Ovid Medline Clinical Queries Limits to limit your subject search. • Limits for the Four question types:

• Therapy• Diagnosis• Aetiology• Prognosis

• 3 Levels of emphasis for each question:• Specificity (Narrowest)• Optimised• Sensitivity (Broadest)




If the using the Therapy [specificity] Clinical queries Limit doesn’t result in relevant articles try the Therapy [optimised] then the Therapy [sensitivity] filters to expand your results


Searching for the Best Evidence - an updateExample:



Image: The Cochrane Library http://http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME, Viewed: 20/8/07

Free Stuff:


Image: EviDents, http://medinformatics.uthscsa.edu/EviDents/ viewed 20/9/07

* PubMed search interface

Free stuff:


Articles – Dentistry EBP (All available online):• Sutherland, SE 2001, 'Evidence-based dentistry: Part I. Getting started.' Journal of

the Canadian Dental Association, vol. 67, no. 4, pp. 204-6.

• Sutherland, SE 2001, 'Evidence-based dentistry: Part II. Searching for answers to clinical questions: how to use MEDLINE', Journal of the Canadian Dental Association, vol. 67, no. 5, pp. 277-80.

• Sutherland, SE & Walker, S 2001, 'Evidence-based dentistry: Part III. Searching for answers to clinical questions: finding evidence on the Internet', Journal of the Canadian Dental Association, vol. 67, no. 6, pp. 320-3.

• Sutherland, SE 2001, 'Evidence-based dentistry: Part IV. Research design and levels of evidence', Journal of the Canadian Dental Association, vol. 67, no. 7, pp. 375-8.

• Sutherland, SE 2001, 'Evidence-based dentistry: Part V. Critical appraisal of the dental literature: papers about therapy', Journal of the Canadian Dental Association, vol. 67, no. 8, pp. 442-5.

• Sutherland, SE 2001, 'Evidence-based Dentistry: Part VI. Critical Appraisal of the Dental Literature: Papers About Diagnosis, Etiology and Prognosis', Journal of the Canadian Dental Association, vol. 67, no. 10, pp. 582-5.


Articles – EBM

• Guyatt, GH, Sackett, DL & Cook, DJ 1993, 'Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group', JAMA, vol. 270, no. 21, pp. 2598-601.

• ---- 1994, 'Users' guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group', JAMA, vol. 271, no. 1, pp. 59-63.

• Jaeschke, R, Guyatt, G & Sackett, DL 1994, 'Users' guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? Evidence-Based Medicine Working Group', JAMA, vol. 271, no. 5, pp. 389-91.

• Jaeschke, R, Guyatt, GH & Sackett, DL 1994, 'Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group', JAMA, vol. 271, no. 9, pp. 703-7.

• Laupacis, A, Wells, G, Richardson, WS & Tugwell, P 1994, 'Users' guides to the medical literature. V. How to use an article about prognosis. Evidence-Based Medicine Working Group', JAMA, vol. 272, no. 3, pp. 234-7.

• Levine, M, Walter, S, Lee, H, Haines, T, Holbrook, A & Moyer, V 1994, 'Users' guides to the medical literature. IV. How to use an article about harm. Evidence-Based Medicine Working Group', JAMA, vol. 271, no. 20, pp. 1615-9.

• Oxman, AD, Sackett, DL & Guyatt, GH 1993, 'Users' guides to the medical literature. I. How to get started. The Evidence-Based Medicine Working Group', JAMA, vol. 270, no. 17, pp. 2093-5.


Books• Hackshaw, AK, Paul, EA & Davenport, ES 2006, Evidence-based dentistry : an

introduction, Blackwell Munksgaard, Oxford. Call no. 617.6 123

• Clarkson, J 2002, Evidence based dentistry for effective practice, Martin Dunitz, London. Call no. 617.6 92

• Greenhalgh, T 2006, How to read a paper: the basics of evidence-based medicine, 3rd edition, Blackwell Publishing, Oxford. Call no. 616 248

Websites• New Zealand Dental Association 2005, Evidence-based Dentistry, viewed 17th of

August, 2007 <http://www.nzda.org.nz/pub/?id=69>.

Tools• The Cochrane Library http://www.nicsl.com.au/Cochrane/ viewed 21st August, 2007

• The Forsyth Institute, Center for Evidence-based dentistry, EviDents, viewed 20th of August, 2007 <http://medinformatics.uthscsa.edu/EviDents/>


Thanks!

Any questions?

Jeremy Cullis Faculty Liaison Librarian (Dentistry)

Dentistry LibraryUniversity of Sydney

Email:[email protected]: http://www.dentistrylibrary.blogspot.com

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BDent3 - finding the best evidence - an update