Discusses the search process and EBP

1. Roy Brown, MLIS
Education and Research Librarian
Tompkins-McCaw Library, VCU Libraries
Database Basics:
Performing a Good Search

2. CONFIDENCE IN YOUR
SEARCHING SKILLS

3. WHAT MAKES A GOOD
SEARCH?

4. WHERE TO TURN WHEN
YOU NEED INFORMATION

5. Goals:
• Be aware of the process for doing an effective search
• Understand the difference between keyword and subject
heading searching
• Know how to use Boolean operators & limits
• Be able to identify appropriate databases for different information
needs
• Be able to better use PubMed & CINAHL (Friday)
Effective Searching = Less Time & Reading

6. Why do you need to search efficiently?
1979 estimated that 2 million articles were published in
biomedical literature annually and increasing. If a
practitioner were to attempt to keep up with literatrue by
reading 2 articles per day, in 1 year they would fall 55
centuries behind. Another way to put it would be that if
physicians were to read everyting of possible relevance,
they would need to read 5500 articles per day....
Haynes, R., McKibbon, K., Fitzgerald, D., Guyatt, G., Walker, C., & Sackett, D. (1986). How to keep up with the medical literature: why try to
keep up and how to get started. Annals Of Internal Medicine, 105(1), 149-153.
Physically impossible to read everything that is published
in that literature, which now means attempting to read
nearly 90,000 journals per year. Estimated that if you
read two articles a day every day, by the end of the year
you would be over a year behind in your reading.
Lawrence, D. (1997). Literature searching and critical appraisal of the literature for the practicing chiropractor. Chiropractic Technique, 9(4),
151-156.
Since 2005, between 2,000-4,000 completed references are
added each day to PubMed

7. Levels of Evidence
Evidence
Based
Practice
Guidelines
Meta- Analysis /
Systematic
Review
Critically Appraised Topics
[Evidence Syntheses]
Critically Appraised Individual
Articles
[Article Synopses]
Randomized Control Trials (RCT’s)
Cohort Studies / Cross-Sectional Study
Case Controlled Studies/
Case Reports
Reviews
Background Information / Expert Opinion
Filtered Information
Unfiltered
Information
EBP Objective:
Clinical Knowledge Bedside

8. THE SEARCH PROCESS
Tompkins-McCaw Library for the Health Sciences, VCU Libraries

9. The Search Process
2.
5. Evaluate
the Results
6. Good Results = Use the Data
• Bad = Start Over
3. Choose the appropriate
database(s) or resource for
your topic
4. Perform the
Search
1. Problem/ Construct
Question
Image: http://evidencebasedhealth.blogspot.com/
Formulate Your Search
Strategy
• Synonyms for Search Terms
• Subject Heading vs. Keyword
• Boolean Operators & Limits

10. THE SEARCH PROCESS
Step 1: Starts with Problem or Need for Information/
Developing a Clear Research Question
Tompkins-McCaw Library for the Health Sciences, VCU Libraries

11. The Search Process
2.
5. Evaluate
the Results
6. Good Results = Use the Data
• Bad = Start Over
3. Choose the appropriate
database(s) or resource for
your topic
4. Perform the
Search
1. Problem/ Construct
Question
Image: http://evidencebasedhealth.blogspot.com/
Formulate Your Search
Strategy
• Synonyms for Search Terms
• Subject Heading vs. Keyword
• Boolean Operators & Limits

12. The Problem……….
• Helping a older, female
patient to deal with the
pain or other issues related
to fibromyalgia
• Improve Quality of Life
Question - Brings Focus to Search of the Literature
Chronic Pain / Fatigue / Sleep Issues

13. Formulate Your Question
Question
Is therapeutic touch or guided
imagery more effective when
treating a patient with
fibromyalgia?
P
(Problem, Patient,
Population,
Program)
I
(Intervention)
C
(Comparison)
O
(Outcome)
T
(Type of
Question)
T
(Type of
Study)

14. Type of Question/ Best Type of
Study
Type of Question Best Type of Study
Therapy
How to select treatments to offer patients that do more good
than harm and that are worth the efforts and costs of using
them
Randomized Control Trial (RCT)
Prevention
How to prevent a disease or condition RCT/ Cohort Study / Case Control
Prognosis
How to estimate the patient's likely clinical course over time
and anticipate likely
complications of disease
Cohort Study/ Case Control/ Case Series or Case Report
Diagnosis
How to select and interpret diagnostic tests Blind RCT Compared to the Gold Standard
(best treatment/test for diagnosis)
Etiology/Harm
How to identify causes for disease RCT/ Cohort Study /Case Control
Cost analysis
Economic costs of all facets of a intervention or disease
treatment
Economic Analysis

15. PICO & Breaking Search Into Concepts
Main Concepts
Break Search in Groups/Concepts
15
Fibromyalgia | Guided Imagery & Therapeutic Touch
These concepts will be used to search the databases
Find Synonyms/ Related Terms for Concepts
Different Databases Use Different Terms
P
(Problem, Patient,
Population,
Program)
I
(Intervention)
C
(Comparison)
O
(Outcome)
T
(Type of
Question)
T
(Type of
Study)
Patient with
Fibromyalgia
Female
Older/Aged
Therapeutic
Touch
Guided
Imagery
Alleviating
the
symptoms of
Fibromyalgia
Therapy
RCT

16. What are some alternative terms…
• Guided Imagery
• Fibromyalgia
• Therapeutic Touch

17. Fibromyalgia Therapeutic
Touch
Guided Imagery
• Fibromyalgia
• Chronic Fatigue
Syndrome
• Diffuse Myofascial
Pain
• Fibromyalgia-
Fibromyostitis
Syndrome
• Postviral Fatigue
Syndrome
• Therapeutic Touch
• Massage
• Zone Therapy
• Reiki
• Guided Imagery
• Hypnosis
• Directed Reverie
Therapy
• Imagery(Psychotherapy)
Alternative Terms…

18. Ways to Find Alternative Terms/
Background Information
• Good Sources:
1. Point-of-Care Tools
• First Consult
• Up to Date
2. Government Sites
• Medline Plus
• PubMed Health
3. Controlled Vocab. Entry
Terms
4. Google Scholar Term/Concept
Mining

19. Google vs. Google Scholar
 main purpose of is to
hunt for text in Web
pages
 Displays results based
on Page Rank
 Does not really cover
information contained in
library catalogs, official
government documents,
phone books, etc.
• Indexes the full text of
scholarly literature across an
array of publishing formats
and disciplines
• Includes most peer-
reviewed online journals of
Europe and America's
largest scholarly publishers
• Tends to put weight on
citation counts when
displaying search results
Falagas, M. E., Pitsouni, E. I., Malietzis, G. A., & Pappas, G. (2008). Comparison of PubMed, scopus, web of science, and google scholar: Strengths and weaknesses The FASEB Journal :
Official Publication of the Federation of American Societies for Experimental Biology, 22(2), 338-342. doi:10.1096/fj.07-9492LSF
Vine, #., & Rita. (2006). Google scholar Journal of the Medical Library Association, 94(1), 97–9.
Wikipedia contributors.Google search Retrieved, 2012,

20. THE SEARCH PROCESS
Step 2: Formulating Your Search Strategy

21. The Search Process
2.
5. Evaluate
the Results
6. Good Results = Use the Data
• Bad = Start Over
3. Choose the appropriate
database(s) or resource for
your topic
4. Perform the
Search
1. Problem/ Construct
Question
Image: http://evidencebasedhealth.blogspot.com/
Formulate Your Search
Strategy
• Synonyms for Search Terms
• Subject Heading vs. Keyword
• Boolean Operators & Limits

22. KEYWORD SEARCHING
Tompkins-McCaw Library for the Health Sciences,
VCU Libraries

23. How to search…Keyword or Controlled
Vocab/Subject Heading?
Neoplasm
Pressure Ulcer
Contusion
Myocardial Infarction
 Cancer
 Bed Sores
 Bruise
 Heart Attack
V.A.P.
 Ventilator-Associated
Pneumonia
V.B.A.C.  Vaginal Birth After Cesarean

24. DESCRIBE THE
FOLLOWING ITEM

25. Person 1
• Aluminum Can
• Coke Can
• Can with
Condensation
• Soda Can
Person 2
• Pop Can
• Soda Can
• Can That is Sweating
• Red Aluminum Can
Person 1
• Aluminum Can
• Coke Can
• Can with
Condensation
• Soda Can
• Red Can
Person 2
• Pop Can
• Soda Can
• Can That is Sweating
• Red Aluminum Can
Describe This Can ……

26. Keyword
• Also called natural language searching
• Search for words or phrases found in title, abstract, or
other parts of articles
• Keyword searching used for
• New terminology
• Rare terms
• Other terms that have no related subject heading
• Spelling variations
• Truncation - Train*
• Trained, Trainer, Training, etc.
• Grouping Using “Guided Imagery”
• Use Quotation Marks
• Without Quotes – AND Terms Together
Perspective
Synonyms

27. WHERE THE
DATABASE SEARCHES
FOR KEYWORDS
In the Citation

28. All searched when searching by
keyword

29. All Places that are searched when
doing a keyword search in PubMed

30. SEARCHING WITH
SUBJECT HEADINGS/
CONTROLLED VOCABULARY
MeSH - PubMed
CINAHL Headings - CINAHL
Tompkins-McCaw Library for the Health
Sciences,
VCU Libraries

31. Pepsi Coke
Pop
Soda Soda
Pop
Subject Headings/ Controlled Vocabulary
• Controlled Vocabulary – Thesaurus
• Help to return results that directly
apply to subject of the search
• Hierarchy – Tree Structure
• Broad –Specific
• Minor / Major Heading
• Major Heading - Focuses your search
results to returning articles that
specifically address the topic
• PubMed – have stars beside them
• CINAHL – Divided into Major & Minor
Headings
• Scope Note – Term Definition
Soft
Drink

32. Examples of Hierarchy
PubMed CINAHL

33. May need to move backward in order to move
forward……

34. Good Choice
• Broad
• Commonalities
between people
Issue: Breastfeeding practices of
adolescent mothers in Vietnam.
Too Broad
10
Articles
Tip: Sometimes Need to Back Up to Move
Forward

35. WHERE THE
DATABASE SEARCHES FOR
CONTROLLED VOCABULARY/
SUBJECT HEADINGS
In the Citation

36. Subject Heading Field in CINAHL

37. Subject heading field in PubMed

38. BOOLEAN
OPERATORS/
COMBINING TERMS
AND, OR, NOT
Tompkins-McCaw Library for the Health
Sciences,
VCU Libraries

39. Boolean Operators - AND
• Combines concepts
• Relationship
• Retrieves records that
contain BOTH terms
entered
Soda Pop Weight
Gain

40. Boolean Operators - OR
• Combines synonyms or
like concepts
• No Relationship
Necessary
• Retrieves records that
contain EITHER term
entered
Coke Pepsi

41. When Searching………..
Combining Terms Together
Group 1
Combine
Terms with OR
Group 2
Combine Terms
with OR
AND AND
Group 3
Combine Terms
with OR

42. Fibromyalgia Therapeutic Touch Guided Imagery
"Fibromyalgia“
[Subject Heading]
OR
"Fatigue Syndrome,
Chronic“
[Subject Heading]
OR
Fibromyalgia
[Keyword]
OR
Chronic Fatigue
Syndrome
[Keyword]
“Therapeutic Touch “
[Subject Heading]
OR
Therapeutic Touch
[Keyword]
OR
Massage
[Keyword]
"Imagery
(Psychotherapy)“
[Subject Heading]
OR
Guided Imagery
[Keyword]
OR
Hypnosis
[Keyword]
Good Search – Combination of Subject
Headings and Keywords
AND AND

43. Keep in Mind – Doing A Good Search
Break Your Search into Concepts –
Don’t Marry Early/ Let Them Date!!!!
Start Your Search Broad and Then Focus – Don’t Put
Blinders on the Horse Too Soon !!
Be sure to come up with alternative or related
terms for your topic
Always search in at least two databases.
Use Controlled Vocabulary When Possible
MeSH/CINAHL Headings

44. WAYS TO INCREASE
OR DECREASE
RESULTS
Exploding, Subheadings, Limits
Tompkins-McCaw Library for the
Health Sciences,
VCU Libraries

45. Explode Option:
 Increases Number
Includes Chosen Term
and All of those Below it
in the tree
PubMed – Done
Automatically
CINAHL – Must
Choose to Explode A
Term

46. Subheadings

47. Using Limits
• Language
• Age Group
• Time Period/ Date
• Gender/Sex
• Publication Type
• Systematic Reviews
• Meta Analysis
• Randomized Control Trials
• Practice Guidelines
• Reviews

48. Not Finding Enough?
Ways to Expand Your Results
Finding Too Many Articles?
Ways to Focus Your Results
(Ways to Get More Articles)
Try To :
• Explode Your Terms
• Keyword Searching
• Look At Related or Citing
Articles
(Ways to Get Fewer Articles)
Try Using:
• Major Concept/Subject
• Subheadings
• Limits
Other Things to Think About…..

49. Selecting the Right Resource
• Research Guides
• Nursing Research Guide
• Important Databases
• PubMed/Medline (Free)
• CINAHL
• APA PsycNet/PsychInfo
• Cochrane Library
• TRIP Database (Free)
• National Guidelines
Clearinghouse (Free)
• PubMed Health (Free)
• Medline Plus (Free)
http://guides.library.vcu.edu/nursing
Evidence
Based
Practice
Guidelines
Meta- Analysis /
Systematic
Review
Critically Appraised
Topics
[Evidence Syntheses]
Critically Appraised Individual
Articles
[Article Synopses]
Randomized Control Trials (RCT’s)
Cohort Studies / Cross-Sectional Study
Case Controlled Studies/
Case Reports
Reviews
Background Information / Expert Opinion
Filtered Information
Unfiltered
Information

50. Quick Review….
1. What is the advantage of using subject headings/controlled
vocabulary over keywords when doing a search?
3. What is one way you could decrease the number of articles
you get in a search when using subject headings/controlled
vocabulary?
2. Will truncation increase or decrease the amount of articles
you in get in a search?

51. Break Time…………

52. If You Need Help……..
• Get in touch with Me…..
Roy Brown, MLIS
Education and Research Librarian
Tompkins-McCaw Library, VCU Libraries
rebrown2@vcu.edu / Ph. 804-828-1592

53. Filtered Information
Unfiltered Information