Martin, in a response to your thought-provoking idea (and to stimulate further discussion), I am arguing that the approach you illustrated is a classic case of what is known in decision-making literature on bias as "availability heuristics" [the probability of recall of information of interest is judged but the ease with which it can be assessed and not by its relevance or methodological rigor (="truth")]. Hence, you started your search with Uptodate (a resource which is better known for its excellent marketing than its critically-appraised content). This is not a criticism of what you have done- I do the same- it is just to show that we (i.e. EBM) is a long way from practicing what we are preaching: using time-consuming search to uncover reliable evidence is not happening even among us who are strong proponent of EBM. (For example, I have spent last several years cataloging high-quality evidence in oncology, and still am using resources such as Uptodate, since my database is relatively small to answer all my questions, and going routinely to PubMed is often a grueling exercise). Thus, in reality we are using whatever is available to us or we call consultants (which may or may not provide us a solid EBM advice, as we discussed it here several months ago).
would be interested in your further thoughts
ben
Benjamin Djulbegovic, MD,PhD
Professor of Oncology and Medicine
H. Lee Moffitt Cancer Center & Research Institute
at the University of South Florida
Department of Interdisciplinary Oncology
SRB #4, Floor 4, Rm #24031 (Rm# West 31)
12902 Magnolia Drive
Tampa, FL 33612
Editor: Cancer Treatment Reviews (Evidence-based Oncology Section)
http://www.harcourt-international.com/journals/ctrv/
e-mail:[log in to unmask]
http://www.hsc.usf.edu/~bdjulbeg/
phone:(813)979-7202
fax:(813)979-3071
-----Original Message-----
From: Martin Dawes, Dr. [mailto:[log in to unmask]]
Sent: Wednesday, September 08, 2004 3:02 PM
To: [log in to unmask]
Subject: Re: Google better than MEDLINE?! how about some Bayes??
What do you mean by the word "better"?
1. You have a question or several interlinked questions.
2. What is the probability that there is a published answer?
3. If the probability is low that an answer exists which database when
searched would be most likely to exclude an answer existing if your
search is negative.
4. If the probability is high that an answer exists which database would
be most likely to rule in that an answer exists (and provide the
answer).
So this morning I saw a woman with Sjogrens who was complaining of
gastritis.
Q1. Does sjogren's cause gastritis?
Q2. In a woman with Sjogren's what is the probability that the gastritis
is caused by Sjogren's?
The pre-search probability of an answer to Q1 and Q2 existing, as judged
by the resident and I, was moderate. I decided that if the answer to Q1
was not in a text book then the answer to Q2 & Q1 probably is not going
to exist as the syndrome is not new. I decided on Uptodate as an easy
reference. Q1 answer exists and is positive. Therefore Q2 probably
exists (the post search probability is higher than the pre search
probability) and I will now look on Medline.
A sub process of this approach is "which search terms include or exclude
an answer existing within certain databases".
Bayesian approaches to searching???
Anyone interested in developing this further??
Martin Dawes
Acknowledging a discussion with Pierre Pluye
-------------------------------------
Chair Family Medicine
McGill University
515-517 Pine Avenue West
Montreal, Quebec
H2W 1S4
Canada
Tel 514 398 7375 ext 0227
Fax 514 398 4202
-----Original Message-----
From: Evidence based health (EBH)
[mailto:[log in to unmask]] On Behalf Of Djulbegovic,
Benjamin
Sent: Wednesday, September 08, 2004 2:38 PM
To: [log in to unmask]
Subject: Re: Google better than MEDLINE?!
Tanya, as strange as it seems to be, but some of my students have been
using Google and anecdotally they were able to locate certain types of
the studies sooner than using MEDLINE (PubMed). I actually wonder if
anyone compared Google with MEDLINE?
thanks for this timely message
best
ben
-----Original Message-----
From: Feddern, Tanya [mailto:[log in to unmask]]
Sent: Wednesday, September 08, 2004 2:30 PM
To: [log in to unmask]
Subject: Google better than MEDLINE?!
***cross-posted***
Hello, everyone. I'd like your thoughts on this. I learned that
supposedly a Missouri occupational therapy professor, who's also an
author and journal editor, advocated using Google and Dogpile (instead
of MEDLINE) to find article citations for evidence-based practice.
Obviously, she doesn't know about the powerful features of specialized
literature databases such as the PubMed or Ovid software for searching
MEDLINE. If she did, she wouldn't be using Google to find evidence for
patient care (nor suggesting this in an invited lecture).
Unfortunately, this idea is probably being picked up by others.
Have any of you heard of other respected faculty telling students and
healthcare professionals to use Google instead of MEDLINE? How did you
address that? Please feel free to forward this. I will summarize to
the list(s).
Take care,
Tanya
Tanya Feddern, MLIS, AHIP, MOT, OTR/L
http://www.geocities.com/nqiya/EBMbib.html
http://www.geocities.com/nqiya/index.html
Evidence-Based Medicine Assistant Professor; Reference & Education
Services
Librarian University of Miami School of Medicine, Louis Calder Memorial
Library
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