PHAS 7080: Medline Searching Tutorial

[intro music]>>NARRATOR: Medline is a key biomedical database
that you will use throughout your education and career to find information for assignments
and to guide you in providing high quality patient care. It indexes articles from over
5,400 journals from around the world in fields such as medicine, allied health, public health,
nursing, and dentistry.>>NARRATOR: This tutorial will introduce
you to the OVIDSP version of Medline. We will use the clinical question from our PICO worksheet
– for a 35-year-old black woman with gestational diabetes, will Glyburide, compared to insulin,
result in better glycemic control and fewer complications?>>NARRATOR: You can navigate to Medline through
the Evidence-based practice research guide included in our D2L course.>>NARRATOR: Use the sources for all disciplines
sub tab under searching for evidence, and then click Medline via OVID in the individual
studies box.>>NARRATOR: As you can see, Medline indexes
articles going all the way back to the 1940s. For this search we will select the 2010 to
present segment of the database.>>NARRATOR: In many health-related databases,
including Medline, it is most effective to search one topic or concept at a time – in
this case gestational diabetes, glyburide, and insulin – in order to take advantage of
advanced features of the search interface.>>NARRATOR: First we will enter gestational
diabetes into the search box, then you can either click search or I’ll press enter.>>NARRATOR: The software maps the phrase
to the medical subject heading or MeSH heading, diabetes, gestational. MeSH headings are controlled
vocabulary used to describe article contents in Medline and they help standardize article
retrieval when there is more than one way to express a concept.>>NARRATOR: Whether an author used gestational
diabetes, pregnancy-induced diabetes, or some other phrase in their article, diabetes, gestational
will be the MeSH heading assigned to describe it.>>NARRATOR: Click continue.>>NARRATOR: Each MeSH term has subheadings
that may be applied to limit results to particular aspects of the topic. You might for instance,
select drug therapy for this concept.>>NARRATOR: For now, I’m going to choose
all subheadings and click Continue.>>NARRATOR: This returns us to the main search
page where the search history indicates that set 1 includes just over 1900 references.>>NARRATOR: Next we’ll search Glyburide,
an oral hypoglycemic agent frequently used to treat women with gestational diabetes.>>NARRATOR: Once again I’ll type the drug
name in the search box, click Search, select All Subheadings and then Continue.>>NARRATOR: We will continue our search from
part 1 by typing insulin in the search box and clicking Search.>>NARRATOR: The software maps the term to
a number of MeSH headings that include the word insulin.>>NARRATOR: Another feature of Medline are
what are known as tree structures that provide a hierarchical listing of broader and narrower
subject headings when you click on a MeSH heading from the mapping page.>>NARRATOR: I’ll click on the word insulin
and scroll down the screen until we see a blue horizontal line. The tree shows that
insulin is a narrower term under the broader subject heading insulins.>>NARRATOR: Insulin, long acting, and insulin,
short acting also appear in the tree and have plus signs beside them that indicate there
are even narrower terms available.>>NARRATOR: We’ll click on the plus signs
to see them.>>NARRATOR: It is important to look at the
trees because when indexers assign subject headings to describe article content, they
are instructed to use the most specific terms available to them. So if an article only discusses
Isophane insulin, it will not have the broader term Insulin, long acting assigned to describe
it.>>NARRATOR: You can click in the boxes next
to individual narrower terms or if you click the Explode box to the right of a broader
term such as insulin, long acting, or insulin, short acting it will combine the terms with
OR and will broaden our search and make our retrieval more inclusive.>>NARRATOR: After making all appropriate
selections, I’ll click Continue and we will return to the main search page.>>NARRATOR: Now that we have sets representing
all of our concepts, we can select and then combine them. We’ll use AND so that we retrieve
only those references that include all of our concepts.>>NARRATOR: We learned in the PowerPoint
slides, that some study designs provide higher levels of evidence than others based on the
type of clinical question you are asking.>>NARRATOR: We are answering a therapy question,
so systematic reviews, meta-analyses, and randomized controlled trials should provide
the highest level of evidence.>>NARRATOR: We can limit our search results
to these and other kinds of studies.>>NARRATOR: While some of the commonly used
limits appear directly below the search box on the main search page, clicking Additional
Limits below them offers additional choices.>>NARRATOR: For this search select English
language and then scroll down to the Publication Types box.
Select meta analyses, randomized controlled trials, and systematic reviews while holding
the control key, then click Limit Search.>>NARRATOR: An alternative that requires
less memory is to use clinical queries filters. These filters automatically retrieve articles
with higher level study designs for different types of clinical questions, therapy, diagnosis,
etc.>>NARRATOR: There are three options for each
– sensitivity to retrieve a broader set of study designs, specificity with a more
limited number of study designs, and best balance which is a compromise between the
other options.>>NARRATOR: I’ll select sensitivity and
click Limit Search.>>NARRATOR: Our results appear on the main
search page and include randomized controlled trials, comparative studies, systematic reviews
and meta analyses.>>NARRATOR: Scroll down or click Display
to review your results – many have abstracts you can read to help determine their relevance.>>NARRATOR: Click in the boxes next to those
you think will be most helpful for your paper or for patient care.>>NARRATOR: Then click Keep Selected at the
top or bottom of the results list to create another set with just those references and
select All so that you can email, print or export them to reference management software
such as RefWorks that will allow you store and organize references, and generate bibliographies
in AMA and other styles.>>NARRATOR: Please see the RefWorks tutorials
in D2L for additional information.

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