Hi everyone -kia ora from New Zealand
I've been following this dialogue with great interest as we have been subtly changing our search teaching for students and clinicians and currently doing a wee investigation a little bit along the lines of that suggested by Martin Dawes so would be very interested in being involved.
Although our students have access to many databases now (but not all that have been indicated in these e-mails) we are trying to future proof their experience for the real world. We differentiate between searching techniques- systematic review-type searching vs getting the pragmatic best that you can (most appropriate/relevant literature) in a few minutes.
For the latter, an understanding of the best types of studies to answer their clinical question and 5S is essential. We always start grounded in the clinical problem - reframe into PECOT components and now teach students to go to PubMed first(because its free) and find the MeSH term/s linked to their PECOT components. From there we use the MeSH terms in Clinical Queries and the same terms (without the [MeSH]suffix) in Cochrane, Google, TRIP, Clinical Evidence etc.
Intuitively it makes sense to us but we're uncertain.
Currently exploring the following....
P- 10-20 clinical questions (some of ours, some from Oxford CEBM Workbook, some from Paul Glasziou) and each question reframed into component PECOT terms
Exposure 1- Using MeSH database construct a search in the SEARCH BOX and then copy and paste MeSH term/s holus bolus with suffix into Clinical Queries plus appropriate study filter AND use same MeSH terms without the [MeSH]suffix in other databases (Cochrane, TRIP)
Exposure 2- use MeSH terms in the same way but without the [MeSH]suffix in Clinical Queries +study filter AND same in other databases (Cochrane,TRIP)
Control - key words (what I would use naturally in a clinical situation) in Clinical Queries and other databases (Cochrane,TRIP)
Outcome - this is really hard to determine - but for this n of 1 study thought I'd go for what yields the most consistent results/ least frustrating search hits to answer my question in the least time. eg; yields not only the relevant SR, HTA appraisal, guideline or best publication design for my question but it is high on the list/immediately in my face.
Time- time it takes to do the search and what I have to wade through to get my answer/s
... glad for any feedback
Regards
Sue
Dr Sue Wells
Senior Lecturer Clinical Epidemiology
Section of Epidemiology and Biostatistics
School of Population Health
Tamaki Campus
University of Auckland
PO Box 92-019
Auckland
09 3737 599 ext 82463
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Dean Giustini
Sent: Wednesday, 20 February 2008 7:16 a.m.
To: [log in to unmask]
Subject: Re: Google vs Trip/Cochrane
Hi Irina et al,
Search cascades are useful for information professionals but I question
their usefulness for busy clinicians. Also, the therapy cascade in the
attachment is not complete, and UK-biased. It doesn't include the major
databases to which we all have access; BMJ's Clinical Evidence can be
helpful, indeed, but it is not indexed in MEDLINE (though it is searchable
in Google).
All of this reaffirms my position that searching for evidence is a
complex and occasionally (often?) frustrating experience for clinicians.
Is there one rubric that helps for most questions? one meta-search tool I
would recommend if a clinician had six minutes to search? Is there a
single source of information that I would rely on in the event I had the
same harried physician in front of me who needed answers, now?
The simple answer is no. Context is important. The question or information
need has to be matched to a source. As your cascade suggests, domain is
important and can take you in numerous directions. Are the tertiary tools
like Clinical Evidence, FirstConsult and Cochrane indispensible? Sure, but
not everyone has a subscription to these proprietary tools.
Until we can figure out a way to make medical information/evidence open
access this is the landscape we will have to work within. my two cents!
Dean Giustini, UBC biomedical branch librarian
Diamond Health Care Centre and Vancouver Hospital
Vancouver BC, Canada V5Z 1M9
blog: weblogs.elearning.ubc.ca/googlescholar
On Tue, 19 Feb 2008, Irina Ibraghimova wrote:
> Last year (after participating in Oxford workshop for EBM teachers in 2006)
> we started to use Search cascades (that was presented at once of the
> sessions by Sharon Straus). They are based on 5S approach (Haynes RB. Of
> studies, syntheses, synopses, summaries, and systems: the "5S" evolution of
> information services for evidence-based health care decisions. ACP Journal
> Club. 2006 Nov-Dec;145:A8). It depends on the audience - we are working
> with practitioners who have to find quick answer to a particular question
> and who have access to a lot of EBM resources for free (developing
> countries). First we provide an overview of main types of resources - then
> they have to find an answer to their question of interest - and make their
> own conclusions which of the EBM resources are more appropriate - it really
> worked... But I would like to here comments on this approach from the list.
>
> Some examples of those search cascades are in the attachment
>
>
>
> Thanks,
>
> Irina Ibraghimova
>
> Coordinator, Medical Information Resources
>
> American International Health Alliance
>
> [log in to unmask]
>
>
>
>
>
> From: Evidence based health (EBH)
> [mailto:[log in to unmask]] On Behalf Of Dr. Carlos Cuello
> Sent: Monday, February 18, 2008 7:21 PM
> To: [log in to unmask]
> Subject: Re: Google vs Trip/Cochrane, and the promise of mahalo - i use
> looknow.com
>
>
>
> An excellent idea. And even further, we could use strategies instead (or at
> the same time with) the search engines alone. I personally use a strategy
> instead of a single search engine (as most of us do I think). Maybe thats
> why TRIP is the most efficient search engine. I use the one I learned @
> Oxford
>
>
> http://www.cebm.net/index.aspx?o=1527
>
> Dependign of the type of question -
> Intervention: Cochrane - DARE - CENTRAL - pubmed clinical queries
> Other type of question: pubmed clinical queries (with caution because we are
> entering a zone of DOEs)
>
> Cheers
>
>
>
>
>
>
> --
> Carlos A. Cuello-García, MD, Doctoral Candidate
> Director, Centre for Evidence-Based Practice-ITESM
> Cochrane-ITESM coordinator. Professor of Paediatrics and Clinical Research
> Avda. Morones Prieto 3000 pte. Col. Doctores. CITES 3er. piso,Monterrey NL,
> México. CP64710 Phone. [+52](81)8888-2154 y 2141
> www.cmbe.net
>
> The content of this data transmission must not be considered an offer,
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