Friday, May 05, 2017

Caves - the Leicester connection

There we were on a tour, by boat, of Speedwell Cavern in Castleton, and I was sure that the guide mentioned the University of Leicester, and Trevor Ford.  It was in connection with exploration to find out how deep the "Bottomless Pit" would have been before a lot of mining spoil was tipped into it in the 18th century.

So I conducted my own web based exploration.

Trevor Ford was a Senior Lecturer in Geology, starting when the University was still a University College, was had research and outside interests in Derbyshire, the Peak District and in caves and Blue John.

Dr Ford died earlier this year and you can read an obituary here.

He also identified a fossil fern found in Charnwood Forest, and, as it happens, was a student of geology in Sheffield.

Friday, April 21, 2017

Search strategy for chronic kidney disease

Chronic kidney disease?  Chronic kidney failure?   Chronic renal failure?

There are many ways to describe this (1).  After a few searches on the topic, I tried to come up with a Medline strategy.  I think it may include some conditions that Hsu and Chertow would not, but I have this:

1.            ((endstage or “end stage” or established or chronic or progressive) adj1 (renal or kidney) adj1 (failure or disease* or insufficienc*)).ti,ab
2.            (Chronic adj1 nephropath*).ti,ab
3.            (“Chronic uremia” or “chronic uraemia”).ti,ab
4.            (CKD or CKF or CKI or CRD or CRF or CRI).ti,ab
5.            (ESKD or ESRD or ESRF).ti,ab
6.            kidney diseases/ and chronic.ti,ab
7.            exp Renal insufficiency, chronic/ 
8.            Renal insufficiency/ AND chronic.ti,ab

9.            1 or 2 or 3 or 4 or 5 or 6 or 7 or 8

This is for Medline via HDAS.   

I started with terms I had used previously, and added terms used by colleagues at UHL, MeSH Used For, and terms used in strategies in First Consult, SIGN guideline 103 and NICE CG182.  I then asked people on lis-medical, and also had some further suggestions when I circulated the strategy there.

This, for the record, is the version dated 22nd June 2016 with tiny minor amendments made in April 2017 to remove some unnecessary full stops! 

(1) Hsu CY, Chertow GMChronic renal confusion: insufficiency, failure, dysfunction, or disease. Am J Kidney Dis. 2000 Aug;36(2):415-8.

Guidelines for comparing guidelines

This was asked at a writing workshop that  I led recently.   How do you go about comparing two guidelines?

Critical appraisal

Comparing is related to,  but not the same as, critically appraising a guideline, in which you are looking at guidelines individually.   Trisha Greenhalgh's very useful book How to read a paper has a chapter about appraising guidelines, with ten questions to ask about a clinical guideline.  There is also a systematic review of appraisal tools in this article in PLoS One by Ulrich Siering and colleagues.


The National Guidelines Clearinghouse has a "Compare" tool.    You choose the guidelines you want to compare, by ticking a box in the search results list.  Then you choose which sections you want to compare, and you can then see on screen or in a spreadsheet, those sections side by side.   It takes the sections as they are, which means that you may be comparing very differently arranged texts.

A PubMed search for comparison clinical guidelines finds some papers that compare guidelines for specific conditions.  It also finds many papers about comparing other things, not comparing actual guidelines.  The search worked much better once I had corrected comparision to comparison although the wrong spelling still found a handful of things!

Missing out the word clinical, so comparison guidelines, finds more (and more irrelevant things too, of course).

Searching more specifically, for example comparison guidelines valvular heart disease, would of course be a way forward.

A quick look at MeSH headings for something old enough to have them suggests:

Practice Guidelines as Topic/ 
Comparative Study/.  

Searching those headings (type in practice guidelines as topic comparative study) together finds a lot of relevant looking papers that I had not seen before, (as they did not use the word "comparison"), amongst other papers comparing decisions or results related to recommendations in guidelines.    Combine this search with a clinical area or subject.

Reporting guidelines

Comparing is related to reporting guidelines too.  The AGREE Instrument helps assess the methodology of a guideline.  This is in the Equator Network Library along with the RIGHT Statement for reporting practice guidelines and some other things.