Ovid MEDLINE for KSOM Y1

Pamela M. Corley, MLS, AHIPAdrian Follette, MLISEvans Whitaker, MD, MLISJanis Brown, MLS, AHIPNorris Medical LibraryUniversity of Southern CaliforniaLos Angeles, CA 90089-9130

Melissa Just, MLIS, EdDDirector, Graff LibraryCity of Hope Hospital1500 East Duarte RoadDuarte, California 91010

Administrative Notes Introduction to personnel Synchronize clickers

“Go”, “4”, “1”, “Go”, “1/A” to test ASK QUESTIONS! Personal Librarian program – new this year.

Contact your “personal librarian” with information questions.

You can work with any of us, but this program gives you a designated contact.

Student last name

Personal Librarian Email Phone

AhnFecht Pamela Corley pcorley@usc.edu (323) 442-1125

Fernandez Lee Eileen Eandi eeandi@usc.edu (323) 442-1133

LeongPenman Adrian Follette follette@usc.edu (323) 442-1972

PerrinYasmeh Evans Whitaker ewhitake@usc.edu (323) 442-1128

Personal Librarian Program

Additional Business This PowerPoint and the other documents that

go with the two sessions today will be posted to the Medical Student portal on the Norris Medical library website.

Fill out evaluation form; with your feedback we can continue to improve this presentation.

At the end of the session you will be asked to fill in emergency contact information on MyMedWeb site.

Introduction OvidSP – new product introduced February, 2008

Used for Literature Search Project -- Phases 1, 2, and 3 Enhanced features

Basic Search added Advanced Search similar to “old Ovid” Personal Account (free) allows user to save searches and

annotate articles This class and Literature Search Project 1, 2, and

3 will focus on MEDLINE searching. Other Ovid databases searched similarly

Level of experience?

4 Questions follow Vote with your clickers

Are you comfortable searching for medical information with Ovid MEDLINE or PubMed?

5%

37%

0%

16%

42%1. Very comfortable!

2. Yes

3. I can do it, but…

4. Not really

5. I am more comfortable at the dentist’s office!

Do you know how to use MeSH?

0% 0%5%

89%

5%

1. Always use MeSH when searching!

2. I know what it is but don’t use it

3. I may have heard the term…

4. Not familiar with it5. Yes, surgeons put it

in a hernia repair!

Are you familiar with the use of subheadings in MEDLINE searching?

0%

39%39%

22%

1. Yes, and I use them!

2. Yes.

3. Not really.

4. No.

Do you use the MeSH tree when searching?

0%

100%

0%

1. Yes

2. No, but I know what it is

3. I don’t know what that is

Ovid vs. PubMed Ovid

Commercial product, usually in academic libraries Multiple databases including MEDLINE Libraries subscribe to an information “package” -- the search engine plus

full text of books and journals PubMed

U.S. governmental bibliographic database Collaboration of National Library of Medicine (NLM), National Center

for Biotechnology Information (NCBI), and the National Institutes of Health (NIH)

Free to use, not easy to use well It is the only database of its size and scope in the world Estimated 40,000 biomedical journals world-wide, ~5,000 indexed in

MEDLINE ~18 x 106 citations in PubMed, 16.5 x 106 in MEDLINE

PubMed and MEDLINE OvidSP -- different interface and search

engine, same contents as MEDLINE

MEDLINE is a subset of PubMed.

The 1-2 million article difference is made up of both articles that are being processed and will move into MEDLINE, and articles which will never be included in MEDLINE (e.g., outside the scope of the database).

(18.2/16.8 as of 08/07/08)

Pros and Cons of Ovid MEDLINE Pros

Easier than PubMed, Advanced is good PubMed training Automatic “mapping” of search terms is more effective

than equivalent function in PubMed Basic search can be used at the speed of clinical medicine Basic and Advanced search modes work well together

Cons Expensive After your training, it is unlikely you will have access PubMed is more current; Ovid gets its material from PM

Other Ovid has a pay-per-use option

What Else is in Ovid? EBM (the three below and others)

Cochrane Database of Systematic Reviews DARE (Database of Abstracts of Reviews of Effects) ACP Journal Club

CINAHL -- allied health and nursing database Ovid Healthstar – “contains citations to the

published literature on health services, technology, administration, and research.”

Health and Psychosocial Instruments (HAPI) -- information on measurement tools for healthcare

Books @ Ovid (almost 400 books included)

Basic Ovid MEDLINE

How to search OvidSP Basic “Natural language” search engine Can combine and limit searches Good for:

locating a few good articles finding “the right words” for Advanced Ovid

Search

Ovid Basic – things to know and tips Searches yield 500 or more hits “Good stuff” is in the first 20-30. If nothing

relevant is found in that group, then reformulate search or move on to Advanced

Based on our experience at NML, use keywords without AND, OR, or punctuation. Seems to retrieve the smallest, most focused set of results

Advanced Ovid MEDLINE

Advanced Ovid Search Default at Norris Medical Library Good for a thorough, focused search Resembles previous versions of Ovid Steps in a search (see flow sheet in handouts)

Enter search concepts one at a time. Ovid translates the users terms into MeSH terms. User may choose MeSH terms, “explode”, “focus”, and apply sub-headings

Combine concepts (AND or OR) Limit results, e.g. English, humans, publication

types, publication years, etc.)

Definitions

Broaden/Narrow

MeSH

Focus

Explode

What is MeSH? Medical Subject Headings NLM indexers read papers, apply 5-10 agreed-

upon terms (“controlled vocabulary”) to describe the content of the papers

By looking up articles using MeSH terms you will find all the articles about a topic.

Remember…MEDLINE is a human enterprise and therefore contains human errors

Heart attack Myocardial infarction Coronary, Coronary occlusion Q wave, non-Q wave, transmural,

subendocardial All of the articles that use these variations are

discovered when you search under the MeSH term “myocardial infarction”

Myocardial infarction is separate from MeSH terms “angina” or “acute coronary syndrome”

Focus Intuitive Narrows your search Details: NLM personnel may label some

MeSH terms as main topics of an article. These topics are a “focus” of the article

MeSH tree/Explode Hierarchical structure of MEDLINE is similar to a

computer folder and file structure Pets

Dogs Boxers Labradors Chihuahuas

Cats Manx Siamese Persians

Explode broadens your search

Scope Notes Where ever you see

get more information

by clicking Scope Notes define terms

Advanced Ovid Search -Tips SUBHEADINGS narrow searches.

Do not use subheadings unless they match your needs. Do not overuse subheadings – not all concepts need

them, and few concepts need more than one or two. LIMITS narrow searches.

Do not overuse limits Apply them once at the end of devising your search

rather than using after each concept. Learn to use the “MeSH tree” and “scope notes”

The Search Process

Formulate your question This class is not about EBM or EBP, however many

of the same concepts apply. First, identify the “information need”. Define the clinical question, remove extraneous

details in order to make it “searchable”. Select concepts that will become search terms. Choose the most appropriate information source in

which to begin your search – it might be a book! Enter your search terms. Review results and reformulate search if necessary.

Identify, clarify your information need

Formulate the question

Break question into concepts, eliminate

extraneous

Enter term for Concept II

Combine concepts with AND or OR

Search

Print, save, email, or move results to

citation manager

Select best MeSH term

· “Explode”· Consider “Focus”· Consider Subheadings

Select best MeSH term

· “Explode”· Consider “Focus”· Consider Subheadings

Limite.g. humans, English, age, publication type

Evaluate ResultsIf necessary,

reformulate search

6 Steps to Better Advanced Ovid Searches

1.

2.

3.

4.

5.

6.

Enter term for Concept I

· Enter one concept per line · Remember to use scope notes and MeSH tree· “Explode” all concepts· “Focus” sparingly· Use Subheadings only when exactly match your search· Limit last!

No

tes:

Hands-On: Search 1 Your 63 y.o. patient brings in selenium 200

µg tablets. He had read that selenium helps to prevent prostate cancer.

He wants your advice before he starts taking selenium.

This is really two questions in one: Does selenium help prevent prostate cancer? Is selenium safe to take?

Search each question. What is your advice?

How to: Search 1 Main concepts:

Prostate cancer (prevention and control as subheading? Adverse effects as subheading?)

Selenium (therapeutic use as subheading?) Limits: English, human. Middle aged Male?

Hands-On: Search 2 62 y.o. male with history of MCA in 20s in which he

suffered a knee injury. Developed severe post-traumatic arthritis.

He is now scheduled to have total knee replacement. No other significant medical problems. What kind of preventive therapy would you

recommend to minimize his risk of blood clots in the leg veins post-operatively?

(Hint: total knee replacement is called Arthroplasty, replacement, knee)

How to: Search 2 Disease concept:

What is best term for blood clots in the leg? Subheading: Prevention and control?

Additional concepts: Knee joint replacement surgery (other possible

terms “orthopedic procedures” AND “knee”). Consider add “adverse effects” as subheading. “Post-operative complications”

Limits: English, humans. Middle age? Male?

Hands-On: Search 3 45 y.o. woman with depression, she has not

responded to several SSRIs. She continues with counseling, but is not making any substantial improvement.

You want to place her on other antidepressant types…either Wellbutrin, Effexor, or Cymbalta.

What can you find in the literature to predict your chances of pharmaceutical success?

How to: Search 3 Disease concept: Treatment resistant

depression Search as phrase or combine “depressive

disorder, major” (with “drug therapy” subheading) AND “drug resistance”

Additional concepts: treatment outcomes Limits: English, humans. Middle age?

Female?

Hands-On: Search 4

On your third year surgery rotation you have a patient in the hospital with Kaposi’s sarcoma of the rectum.

Your resident has not heard of this before. Do you have a reportable case?

GoogleScholar did not reveal anything.

How to: Search 4 How do you do this search? A simple way to approach this is to enter

“kaposis rectum” in basic search in Ovid. A few good articles appear in the first ten.

How to: Search 4 “Complete reference” shows the MeSH terms

for these good articles. You choose “neoplasm, rectal” and “sarcoma, Kaposi” this combination used on the 1950-current database reveals several articles, most of which appear pertinent.

You find to your dismay that your case is not unique enough to be reportable.

Final Exam (Time allowing)DIAGNOSIS 1. MRI for breast cancer screening, should this be our method

of choice? 2. PSA variations – PSA velocity, PSA density, free PSA

ratios – do these add value to prostate cancer screening?TREATMENT 3. Low back pain patients -- how effective (to decrease pain)

are chiropractic and acupuncture therapies? Are there studies that compare these modalities?

4. Operative vs. non-operative treatment for acute Achilles tendon ruptures – which is better?

Assignment Look at Literature Search Project handout. You will complete one of seven questions. Key points:

Use Advanced Ovid. Use MeSH, focus, explode, subheadings, and limits to get

full points on assignment Pick 5 relevant articles. Do not include comments, letters

to the editor, foreign language articles Include abstracts (default setting) Display your work and print it, save a copy for backup

Summary Ovid provides an easy-to-learn MEDLINE

search engine. Effective information finding and analysis are

important skills in modern medicine. Today’s session presented Ovid MEDLINE,

and provided search practice. Mastery of any skill requires practice and

thought; searching is no exception

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