Systematic review search filter for Ebsco APA PsycInfo

I needed one of these but couldn't find one.   I did find a multi-database filter for Ovid, including APA PsycInfo, from Canada's Drug Agency, CADTH, so modified it to use in EbscoHost.

I could find no relevant publication types to match line 1 of the original filter, so replaced it with a modification of line 17, and then omitted line 17, so my filter has 22 and not 23 lines.    I changed Ovid's adj3 into N2 (and changed any other adjn in the same way).

This is the result.   I have not validated or tested this filter, although the original one is labelled as having had "pragmatic" testing.

S1 MR (systematic review or meta analysis)

S2 DE "systematic review" OR DE "meta analysis"

S3 ((systematic* N2 (review* or overview*)) or (methodologic* N2 (review* or overview*)))

S4 ((quantitative N2 (review* or overview* or synthes*)) or (research N2 (integrati* or overview*)))

S5 ((integrative N2 (review* or overview*)) or (collaborative N2 (review* or overview*)) or (pool* N2 analy*))

S6 (data synthes* or data extraction* or data abstraction*)

S7 (handsearch* or hand search*)

S8 (mantel haenszel or peto or der simonian or dersimonian or fixed effect* or latin square*)

S9 (met analy* or metanaly* or technology assessment* or HTA or HTAs or technology overview* or technology appraisal*)

S10 (meta regression* or metaregression*)

S11 (meta-analy* or metaanaly* or systematic review* or biomedical technology assessment* or bio-medical technology assessment*)

S12 (medline or cochrane or pubmed or medlars or embase or cinahl)

S13 (cochrane or (health N1 technology assessment) or evidence report)

S14 (comparative N2 (efficacy or effectiveness))

S15 (outcomes research or relative effectiveness)

S16 ((indirect or indirect treatment or mixed-treatment or bayesian) N2 comparison*)

S17 (multi* N2 treatment N2 comparison*)

S18 (mixed N2 treatment N2 (meta-analy* or metaanaly*))

S19 umbrella review*

S20 (multi* N1 paramet* N1 evidence N1 synthesis)

S21 (multiparamet* N1 evidence N1 synthesis)

S22 (multi-paramet* N1 evidence N1 synthesis)

S23 S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11 OR S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20 OR S21 OR S22

Cinahl strategy for finding studies from the UK

This is based on the Medline filter in Ayiku, L. et al. (2017) ‘The Medline UK filter: development and validation of a geographic search filter to retrieve research about the UK from OVID Medline’, Health Information and Libraries Journal 34(3), pp.200-216.  That filter is discussed in another post.

I have tested it to see if it results in error messages (it does not) but it is not yet validated.  The Medline filter it is based on has been validated - see the article referenced above for details.

This Cinahl filter does not specify fields, so searches all fields.  In line S4, gb with no punctuation and g.b. with punctuation retrieve different results, so I have included both.

S1           (MH "United Kingdom+")

S2           (national health service* or nhs*)           

S3           (english not ((published or publication* or translat* or written or language* or speak* or literature or citation*) N4 english))

S4           (gb or g.b. or britain* or (british* not "british columbia") or uk or u.k. or united kingdom* or (england* not "new england") or northern ireland* or northern irish* or scotland* or scottish* or ((wales or "south wales") not "new south wales") or welsh*)    

S5           (bath or "bath's" or ((birmingham not alabama*) or ("birmingham's" not alabama*) or bradford or "bradford's" or brighton or "brighton's" or bristol or "bristol's" or carlisle* or "carlisle's" or (cambridge not (massachusetts* or boston* or harvard*)) or ("cambridge's" not (massachusetts* or boston* or harvard*)) or (canterbury not zealand*) or ("canterbury's" not zealand*) or chelmsford or "chelmsford's" or chester or "chester's" or chichester or "chichester's" or coventry or "coventry's" or derby or "derby's" or (durham not (carolina* or nc)) or ("durham's" not (carolina* or nc)) or ely or "ely's" or exeter or "exeter's" or gloucester or "gloucester's" or hereford or "hereford's" or hull or "hull's" or lancaster or "lancaster's" or leeds* or leicester or "leicester's" or (lincoln not nebraska*) or ("lincoln's" not nebraska*) or (liverpool not (new south wales* or nsw)) or ("liverpool's" not (new south wales* or nsw)) or ((london not (ontario* or ont or toronto*)) or ("london's" not (ontario* or ont or toronto*)) or manchester or "manchester's" or (newcastle not (new south wales* or nsw)) or ("newcastle's" not (new south wales* or nsw)) or norwich or "norwich's" or nottingham or "nottingham's" or oxford or "oxford's" or peterborough or "peterborough's" or plymouth or "plymouth's" or portsmouth or "portsmouth's" or preston or "preston's" or ripon or "ripon's" or salford or "salford's" or salisbury or "salisbury's" or sheffield or "sheffield's" or southampton or "southampton's" or st albans or stoke or "stoke's" or sunderland or "sunderland's" or truro or "truro's" or wakefield or "wakefield's" or wells or westminster or "westminster's" or winchester or "winchester's" or wolverhampton or "wolverhampton's" or (worcester not (massachusetts* or boston* or harvard*)) or ("worcester's" not (massachusetts* or boston* or harvard*)) or (york not ("new york*" or ny or ontario* or ont or toronto*)) or ("york's" not ("new york*" or ny or ontario* or ont or toronto*)))))

S6           (bangor or "bangor's" or cardiff or "cardiff's" or newport or "newport's" or st asaph or "st asaph's" or st davids or swansea or "swansea's")

S7           (aberdeen or "aberdeen's" or dundee or "dundee's" or edinburgh or "edinburgh's" or glasgow or "glasgow's" or inverness or (perth not australia*) or ("perth's" not australia*) or stirling or "stirling's")

S8           (armagh or "armagh's" or belfast or "belfast's" or lisburn or "lisburn's" or londonderry or "londonderry's" or derry or "derry's" or newry or "newry's")

S9           S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8 OR S9

S10         ((MH “Africa+”) OR (MH “America+”) OR (MH “Antarctic Regions”) OR (MH “Arctic Regions”) OR (MH “Asia+”) OR (MH “Australia+”) OR (MH “Pacific Islands+”)) NOT ((MH (“United Kingdom+”) OR (MH (Europe+”))

S11         S9 NOT S10

Finding health studies about the UK

I am often asked by undergraduate nursing and midwifery students, how to find UK studies.  I had got as far as thinking it was tricky, but is there anything that would help them?   An email to discussion lists told me about a filter NICE have developed and validated, which is in the excellent ISSG Search Filter Resource, which (rather to my embarrassment) I had not thought to check.  Look under "Geographic".

I was working recently with a student who needed to find other UK studies of heart valve disease, alongside a study they knew of.    Our searches, before we tried the NICE filter, were not even finding the known study.    This turned out to be because the (only five) MeSH terms did not include United Kingdom or England (the study was carried out in Oxfordshire, England).   The title and abstract also did not refer to location, only the full text did, and presumably not a section of the full text that the indexers had read.

The NICE filter demonstrates these difficulties - it includes MeSH, title and abstract words, and institutional addresses.  It includes city names as well as names for the home nations.   

The filter and paper that validates it are:

Ayiku L, Levay P, Hudson T, Craven J, Barrett E, Finnegan A and Adams R. The MEDLINE UK filter: development and validation of a geographic search filter to retrieve research about the UK from OVID MEDLINE. Health Information and Libraries Journal, 2017 34 (3): 200-216. 

(You might need a subscription or library access to read the paper, which is hyperlinked from the article title.  The filter itself is downloadable from the ISSG Search Filter Resource).

I have translated this filter to Cinahl, and the result is in another post.

I was worried that the filter would be too complicated for my undergraduates, but discussions with the lead author made me realise that if I made a "simpler" version, its performance would be unknown and it would not be validated.   So, I am not making a simpler version, instead I will tell them of the full filter, and tell them that if they change it, it will be less effective and efficient and they may lose valuable results.

The authors talk about searching for work related to a particular area of the UK, and have the example of searching for work relating to Greater Manchester.   I may work along those lines to develop a filter to find work relating to Leicester, Leicestershire, Rutland (neighbouring very small county, whose residents are often included in studies and practice relating to Leicestershire).    We don't think we have been asked about this, which is interesting, so we will see what people think!

Why use that database?

A module done by some of our students in nursing and midwifery involves an assignment, in which students need to find a peer reviewed paper to critically appraise.

One thing students have to do is choose a peer reviewed paper - see separate post "Is this peer reviewed?" for a discussion of that.

Another thing is to explain and justify their choice of databases.

Is "the librarian told me about it" or "we covered it in a library class" a good enough reason?     In the spirit of evidence based practice, where expert opinion (and I flatter myself) is at the base of the pyramid, I think it is not.

So, how to choose?

First, I think, is the idea that you would use a structured database like Cinahl or Medline, and not something simpler to use like Google Scholar or even Google, or even choosing a paper you saw in the media or social media.   

If you choose a structured database, you can conduct a structured, deliberate, search, having more control over what you are looking for.  You choose the words and phrases you will use, to increase the likelihood of finding papers on the precise subject you are interested in.    And you are using keywords, and not natural language searching, so you know how things are being found.   You know where the search is being done (titles, abstracts, keywords, or places you choose) and you know where the database is looking (a defined set of journals).

Then you choose the database on the basis of the subjects and types of material it covers.    For any topic in their subject (and I did give them this opinion in a class), Cinahl is the place to go, because it indexes a wider range of journals in nursing and allied health than other databases. 

But you could choose a second place, depending on your topic, as there are other databases that concentrate on related subjects. For us these are:

Mental health - APA PsycInfo

Medical practice, microbiology, genetics - PubMed (or Medline)

Childbirth, antenatal care, postnatal care, maternal health - MIDIRS (which we have as Maternity and Infant Care Database)

And if you want to venture outside the health literature, we have Web of Science and Scopus, which I think are useful for social science or education topics (and psychology as well).  Those two will also pick up conference material, and in Scopus' case, books.

All of this carries the warning that if you want literature published in the Global South, then you will need to look outside these "standard" databases into things like SciELO, African Journals Online and Global Index Medicus.  As I have documented elsewhere, the "standard" ones are not so good at indexing journals from the Global South (by which I mean Central and South America, Asia, Africa).

And for our students, there is the possibility of using NHS databases if you particularly wanted British journals about nursing (British Nursing Index) or material about health management (HMIC).  Or, since very recently, Social Policy and Practice for those subjects.

I did have a quick look in the books for arguments about database choice, and Helen Aveyard's Doing a literature review in health and social care (Aveyard, 2014, p.82) does say "for those undertaking a nursing-based literature review, CINAHL would be an appropriate start".  She goes on to list some of the other databases you might consider, and recommends talking to a librarian for advice and also, of course, to see what you have access to.    You, reading this post, may have other databases we do not have, and of course we may have access to things you do not.

Reference

Aveyard, H. (2014) Doing a literature review in health and social care: a practical guide. 3rd edn. Maidenhead, McGraw-Hill Education.

Speling, or you say caesarean, I say caesarian

I always mention in literature searching classes - if you don't find many results, check your spelling.   And my slide says speling, ha ha. 

It all started with a tweet from Janice Kung, Health Sciences Librarian, @janicekung, at the University of Alberta, pointing out the need to search for typos and spelling mistakes when searching the literature.  Tom Roper, retired health librarian, @tomroper, who I follow, replied, which is how I saw it, and included his video on the topic.  The video explores the reasons for some misspellings, including authors thinking a word is Latin in origin when it is Greek.   

One of Tom's examples is caesarean, which I have to admit is a word I always have to think about when spelling or searching.  Being midwifery librarian, it's a word I encounter quite often.

Another example mentioned by Megan Kennedy, @MeganSansH, also a Health Sciences Librarian at the University of Alberta, was the various spellings of Cinahl.

I had noticed before when searching that you sometimes retrieve results when you spell something incorrectly.   But I had not thought of the implications of that.   If you are doing a systematic review, shouldn't you therefore include typos and spelling mistakes?   What would you miss if you did not include accidental spelling variants?   How would you know what they were?

In Cinahl, yesterday: 

Cinahl - 48999 results

Cinhal - 664

Cinalh (not thought of that one before) - 34

In Ovid Medline, yesterday: 

Cinahl.ti,ab. - 36010

Cinhal.ti,ab. - 1069

Cinalh.ti,ab. - 46

What about caesarean?   Cinahl seemed to search caesarean when I searched for caesarian, finding the same number of results, so I looked just at Ovid Medline:

Ovid MEDLINE(R) ALL <1946 to February 03, 2022>

1 caesarean.ti,ab. 23038

2 cesarean.ti,ab. 44059

3 caeserean.ti,ab. 32

4 ceserean.ti,ab. 7

5 caesarian.ti,ab. 1436

6 cesarian.ti,ab. 474

7 caeserian.ti,ab. 12

8 ceserian.ti. 0 (I think when I did this yesterday there was one)

There may well be others.   To help find them all, I tried wildcards.  In Ovid: 

? stands for one character or none, and can be used in the middle of a word or at the end.

# stands for one character in the middle or at the end.

* stands for any number of characters at the end, as does $, and both can be qualified with a number, so *3 or $3 would find the word stem followed by up to three characters.

c#?s#r#an.ti,ab. finds 67579.

or/1-8 finds 67506, which means that term with wildcards finds an additional 73.   Some I can't explain, some are personal names like Cesarman and others are the Spanish word conservan.  

But I can see ceasarean, cessarian and casarean.  

We could truncate our wildcarded term, c#?s#r#an*.ti,ab., which finds 68360.

I think too much detail for most of my sessions, but worth a mention to anyone doing a systematic review.   

Oh yes, and then on the same day courtesy of Improbable Research, @improbresearch, brian injury.  A few other examples of this and brian damage, in Medline...  This one is just a typo, I am sure, not a word like caesarean whose spelling is difficult.

Finding qualitative research

One module I teach on sets an assignment where the students have to find a quantitative and a qualitative piece of research on the same topic.

Finding quantitative research in the three databases I show them needs them to choose a publication or study type and limit to that.   

Finding qualitative research is not quite so straightforward.    So here is a version of what I said to them.

CINAHL 

In the "Clinical Queries" limit (limiter), there are three Clinical Queries for Qualitative Research.  I've recommended they use the "Best Balance" one.  They need to find one piece of qualitative research, not everything.   

Maternity and Infant Care Database (MIDIRS)

For us (and perhaps other libraries) this is in Ovid, and under Limits > Additional Limits, there are two Publication Types, "Qualitative Research" and "Qualitative Study".  I don't know what the difference is so I have recommended they use both.

PubMed

There is no publication type filter, or clinical query for qualitative research.   I've recommended they search the words qualitative research as part of their strategy.   This maps to the MeSH term Qualitative Research.   (Interestingly just using the word qualitative does not).   

They are first years, so we don't talk about search filters.  But if we did, the ISSG Search Filters Resource has some for Cinahl but not for PubMed.   We don't look at Ovid Medline, but if we did, there are Ovid Medline filters there too.  

We mention APA PsycInfo (we have this through Ebsco) and it has a Methodology limit Qualitative Study.  

Fictional patients as literature search examples

Not simulated patients used in exams, but fictional patients as literature search topics.

I have used fictional patients for some years.   I looked back to see if I have ever given them names, and can't find any evidence of that.   That is good, as perhaps there is a danger the names would not be diverse.  

For the medical students who started in 2017, I had this:

"Your patient is a five year old with head lice.    Their parent asks if they should use an insecticide lotion to eradicate the lice.    Will this work, and better than the alternatives?   Are there any adverse effects?"  

and this

"Your patient is aged 70, and has arthritis.   They want to know which painkiller they should take.    What evidence can you find about painkillers in arthritis, their effectiveness and their side effects?"

I was pleased to see I had said "they" and "their".

For a reason I can't recall, I changed approach, so the first years who started in 2019 had this:

"Clinical trial of iron chelating agents in haemochromatosis in adults"

I think I prefer the original approach, so fictional patients might return for 2020's cohort, who I meet in February next year.  

My library (re)induction for fifth year medical students had a "scenario":

"You meet N, who has acute lung injury

While taking a history they mention they engage regularly in vaping

You’ve read about EVALI…

…and wonder if vaping is linked to acute lung injury?

Could N have EVALI?"

Also a they, and with a name that makes no assumptions about their gender, age, ethnicity.

For my session with the physiotherapists and nurses in 2018, I had a fictional patient (client) in mind when I looked at finding resources about exercises for people with vertigo.   Except they were not fictional, they were my Dad.    I did not tell the students, but I did tell one of the teachers (because I wanted some advice on what help Dad could get access to and how).  The teacher remembered when I used the same "fictional" patient (client) in 2019, and asked me how he was.

I don't know if I would have used him if he had had another health condition, like cancer, although I have definitely used examples in the past brought to mind by someone I knew, without ever telling anyone and certainly without telling that person.   Perhaps that raises more ethical questions.     Perhaps the cases in books of medical cases are similarly based on people known to the authors.

I think I told Dad I had used him as an example.   Certainly I passed on some information I found when testing my scenario, and I passed on my teaching colleague's advice on how to access the help that there might be.  

Dad sadly passed away in March this year.   I decided to keep the same example for this year's session, and I added a lovely photo of Dad on holiday in Shetland, a place he loved and visited many times with Mum.  I told the students that my fictional patient was not fictional, and was actually Dad.  I did take the photo out before sharing the slides in the VLE, though!

I like to think that Dad was happy to be an example used in teaching trainee health professionals.   He worked in education for years and years, and certainly had a positive impact on many students.   I remember many times as a boy walking into town with him, meeting someone who came over to say hello to Dad, and me asking who that was, to find out it was a student or former student.   And he was certainly happy to be involved in a research project as a patient.   So I hope he would be ok about appearing in undergraduate health education.   

PICSO: Population, Intervention, Control, Setting, Outcome

Things like this NICE manual talk about setting, when formulating a search question, and there is the SPICE scheme, where S is the setting.    But I am not sure I have seen a version of the PICO grid which includes setting.

If there is one, it would be good to know about it and you can tell me in the comments.&nbsp But if not, I may have just invented it.   But I can't claim the credit.   My eye was caught by a Guardian article today about whether face masks work to prevent the spread of COVID-19, and my eye was particularly caught because the author is Professor Trisha Greenhalgh of Oxford University, author of How to read a paper,  a staple of any reading list about critical appraisal.

Greenhalgh discusses how you would design a randomised trial to examine whether wearing a face mask prevents COVID-19 infection in others.   Read the article, it is very well worth reading, an exploration of trial design, philosophy of science, and what evidence is possible.

Greenhalgh writes:

"Let's therefore test, in all members of the general public (population), the impact of cloth face coverings (intervention) compared to no coverings (control) in public places (setting) for preventing infection in other members of the public (outcome)."

So I had the thought  - that is a scheme to use to plan a literature search, and to formulate an answerable question:

Population
Intervention
Control
Setting
Outcome

= PICSO

I then had the thought - isn't this PICOS?   But in PICOS, the S is Study design. 

So, PICSO is not the same as PICOS.    A PubMed search for PICSO finds a few things about "pressure-controlled intermittent coronary sinus occlusion", and one possibly two about "physiological contributions in spontaneous oscillations", and one where it might actually be PIC50, but nothing about literature searching or evidence based practice.  Indeed, PubMed asks "Did you mean picos?".   There are far more about picos, using PICOS with S as Study Design (and some about the Picos de Europa in Northern Spain).

C could be "comparison".

I've used this search example (admittedly not a very answerable question) with nursing and midwifery students:

Compression stockings to prevent deep vein thrombosis in middle aged hospital inpatients>

In the session, P = middle aged hospital inpatients, I = compression stockings, C = implicitly, no stockings; O = DVT

With PICSO:

P - middle aged people
I - compression stockings
C - no stockings
S - hospital
O - DVT

I think there is scope for PICSO as a search planning tool and as an alternative to PICO as a tool to help devise answerable questions.

Health and Psychosocial Instruments database (HAPI)

HAPI provides information on measurement scales, tests and checklists (henceforth referred to as “instruments”) in health and psychology.  The University of Leicester has access to itthrough Ovid.

Ovid’s own database guide is a thorough guide to the search fields and limits.    This post attempts to be a basic introduction to searching HAPI.

Ovid’s usual search syntax applies.    A search with no field name appended is carried out in the title (of the scale or of the article being indexed), source (the article being indexed), acronym, descriptors, measure descriptors, sample descriptors and  abstract.

Measure descriptors describe what the instrument measures, for example brain injuries or behaviour.

Sample descriptors describe the people to whom the instrument is administered, for example infants, head injuries.

Descriptors are taken from the Thesaurus of Psychological Index Terms and MeSH but not every reference seems to have them.

If you look at the Complete Reference, you will see a field “Reference”, which is where the instrument being used in the reference indexed in HAPI was published.    That reference may not be the first publication of the instrument, and may itself not be indexed in HAPI.

These fields can be searched using usual Ovid syntax, so coma.md. searches the Measure descriptor field.    A full list of field codes is in Ovid’s database guide.  There are others including Validity and Number of Questions.

There are limit tick boxes for Primary Source and Secondary Source.   

Primary Source is not always the original published source of the instrument.   But it is a source that contains the instrument.  A Secondary Source is a source that does not contain the instrument, but which describes how the instrument is used, and has some level of detail, including perhaps some questions.

So, Secondary Source will not find every article that has ever used the instrument.    To do that, you would need to use another database, perhaps Medline, using the name of the instrument as a freetext search (and that would not find everything), or Web of Science or Scopus, for articles that cite the reference of the original source.

As well as Primary and Secondary source, there are Review Source (articles that review instruments), Compendium Source (things like Mental Measurements Yearbook) and Translated Source (if you need a translation of an instrument).    These are under Limits > Additional Limits.

Example searches

A search for Neonatal Behavioral Assessment Scale (devised by T. Berry Brazelton, who passed away recently) finds 37 results.  One is a Primary Source, which is an article from 1981 which uses, and presumably lists, the scale.  32 are Secondary Sources.  Some, at least, in both categories, give a reference to the original publication in 1973.    However, the remaining four include the Mental Measurements Yearbook, which gives details of the 3^rd edition of the scale itself.   So, the reference in the HAPI item may not be the latest version of the instrument.

A search for Glasgow Coma Scale finds 334 items.   10 are primary sources, some of which are variants of the scale.   Some at least reference the original publication, as well as the source indexed for HAPI.   81 of the 334 are neither primary or secondary, but none of those are the original source, although many are versions in other languages.   None of the Primary Sources are the original publication either (but if you did not know when or where the scale was published, you might not know this), but perhaps enough of the items reference the same Lancet paper in 1974 to make you think that was the original.   A Google search for the scale finds the scale’s website, which references the same article.   HAPI started in 1985, so will not index this 1974 paper.

Finding fiction on health subjects

Ages ago my son and I watched David Walliams' Grandpa's great escape.   Grandpa is living with dementia and the film is a thought provoking portrayal of that and of how people living with it are treated.  


That made me think that fiction on health conditions could be useful for health students, as a way to get insights into living with a condition, and into life for carers.


Then I wondered how you might locate such fiction.


Here are some ways.


University of Leicester Library Search


(if you are not at the University of Leicester, your library may have an equivalent).



[name of condition] fiction


To find fiction itself, and articles about it.


I tried this with dementia and found some fiction, and also a 2005 article in the British Journal of Social Work about dementia in children's fiction.   


An old article, but that might not matter - you would need to check for more recent fiction, and check that the books referred to have not become culturally inappropriate in any way since (I am not suggesting this is the case).


You might find other, more recent, articles, by searching a citation database to see who had cited it.






PubMed


I searched PubMed for the same two terms.    Quite a lot comes up where the word "fiction" is used metaphorically - "fact or fiction", that sort of thing. 


But also there are relevant items, including at least one about dementia in the movies.  Those articles would hopefully lead you to actual fiction.


Try sorting by best match (you may see some best matches in a box at the top of the search results, if they are sorted in another way).


Try searching:


"Medicine in Literature"[Mesh] dementia

"Literature"[Mesh] dementia


Although, an article called "If They Were Real: Lessons Learned from Literary Characters With Dementia", was indexed under neither of these MeSH headings.


Literature[Mesh] may find articles discussing the nature of academic literature and also material about older literature (the classics, Shakespeare, that sort of thing).



For the movies, there is a MeSH heading Motion Pictures.


Cinahl


There is a subject heading Literature and another Books.   Both look helpful.  Cinahl will also show you citing articles, which finds one from 2012 that cited the 2005 one I allude to above.


Other search terms for "dementia" are of course available and using Alzheimer or Alzheimers may also help, in any database.

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 22^nd June 2016 with tiny minor amendments made in April 2017 to remove some unnecessary full stops! 

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

What's in a name?

You have waited a long time for this post, I notice!   I am sure you have had plenty to do while waiting.

In their article Chronic renal confusion, Chi-yuan Hsu and Glenn Chertow looked at the wide variety of terms used to describe the same level of kidney function, and the wide range of renal function described by the use of a term like "chronic renal failure".   They examined a sample of literature to reach their conclusions (1).

They argue that some terms should be dropped - a term like "chronic renal failure" has negative connotations for patients, and a term like "pre-dialysis" might discourage practitioners from attempting other sorts of treatment.   They argue for the use of "chronic renal insufficiency" instead. 

I am not sure people have been listening in the intervening 15 years!    Maybe it is too big an "ask".  There are still lots of terms for the same thing, and people do use terms interchangeably (their example is "chronic renal failure" and "end stage renal disease").

Their article shows two things:

1.  The wide variety of terms used to describe the same thing demonstrates why you need to include synonyms in a search.  This is particularly important if you are doing a systematic review, or other sort of systematic search.  You must try to use all the terms that authors might have used, however odd that usage might be.

2. It is important to review your search results, to remove those where the authors' definition of that condition does not match yours.   There is not a lot you can do in the search strategy to deal with this.

I think point 2 is the responsibility of the requestor of the search, or the reviewer of the results, and not the information specialist/librarian.

Point 1 is definitely the responsibility of the searcher, so often, the librarian, with help from the requestor or reviewers.

As an example, I devised a search strategy for chronic kidney disease, which is on the UHL Clinical Librarian Blog.

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

Commentary searching

"Commentary driving" is the technique of describing what you are doing and seeing as you are driving, and is a technique employed by instructors working to train the police, and as part of advanced driving tests.  It helps, it is said,  you use your eyes properly and improves your hazard perception.  Here, from driver trainer Chris Gilbert, is more information about the technique.  

What about commentary searching?   What about getting someone to describe what they are doing when they are searching, say, Medline, and why they are doing it?   Devising a mark scheme for this might be a bit of a challenge, but as a formative assessment?   Perhaps getting people in pairs to commentate on their search to each other?  And then to comment on each other's commentary?

Well, something to try in the new year, perhaps.

Reusing a search strategy

Other people's search strategies can be a useful source of search terms, and synonyms.   I wrote in an earlier post that you should not just reuse a strategy.  Using an existing strategy as a source of ideas is ok, but you need to understand how it works, and make sure that there is nothing missing. 

But, of course, you might be updating a review.  In which case, you would want to rerun the existing search.  I think these are the issues to look for, assuming that you are not changing the research question or topic of the review.

1.  Is there anything that should have been done differently?  Is there anything missing?  Is it ok to amend the strategy, just because you now see a better way to do it?    At the moment, I think this is a matter for your supervisor, tutor, or someone with more knowledge of systematic review methodology than me!

2.  Are there any new subject headings to include?   MeSH is updated annually, and perhaps since the search was first run, there is a new heading.  I think in these cases, it is ok to amend.   For example, there is a MeSH term Patient Handoff/.  It was first used in 2013.  If the original search predates that, it will not include the term, so you ought to add it.   What should you do to ensure you still find older references?  How are they indexed?   Checking MeSH (for example, in PubMed's MeSH database) may tell you. 

3.  Was the original search run in the same interface?   Perhaps it was run in Medline via Ebsco, and you have access to Medline via Ovid.  If this is the case, you need to translate the strategy and make sure that proximity operators and truncation are correct for the new interface.   I wrote an earlier post about this sort of thing.  It is also possible that the capabilities of the interface have changed since the search was first run, and this is a "translation" as well.

Translating search strategies

This post has been updated - look at the updated one instead.

Identifying search terms

For any literature search, you will need to identify your search terms.  What words or phrases are you going to search for?   What thesaurus terms are you going to choose?

If you are doing a detailed search for evidence for a systematic review, or doing a systematic search for some other reason, identification of search terms will include identification of synonyms, that is, alternative terms for the concept you are interested in.

Here are some possible ways to identify thesaurus and free text terms, and synonyms. 


Scoping search

Use a PICO grid or similar to identify the search concepts, and search for those.   For example:

Search question: antibiotics to treat otitis media in children under 5.

P - under fives with otitis media
I - antibiotics
C - no stated comparision
O - no stated outcomes

So, search for otitis media and antibiotics, and see what terms are used in titles and abstracts of the articles you find.

Existing strategies

An existing systematic review should include the search strategy used.  Don't feel you have to copy it (of course, if you are doing this exercise for a dissertation, assignment or thesis, you should not and must not copy it!), but it may give you useful terminology.

Background research

Use clues from any background reading you have done about the topic, textbooks, reputable websites, NICE Evidence Search for any clinical topic.

Drug information sources

The British National Formulary is included in NICE Evidence Search, but also try Electronic Medicines Compendium, the European Medicines Agency, and Drugs.com.  Include generic names (long acting insulin) and brand names (glargine), include classes of drugs (antibiotics) and specific types (penicillin).  eMC is a collection of drug information sheets and patient information leaflets.

“Used for” in thesauri 

In a search of Medline, Embase or Cinahl, you must identify relevant thesaurus terms.   Your scoping search will help you - in Ovid or the NHS interface, when you type in a search term, thesaurus terms are suggested to you.  But use the "scope note" and check the "used for" entries.  Articles using those terms in title or abstract will be indexed using the thesaurus term you are looking at.   Therefore, those "used for" entries are useful synonyms to include in your search.

Other people

If you are working on a research project as part of a team, then team members will have suggestions for search terms.   So will patients with that condition, and the team may be able to ask them.  If you are working on an assignment, dissertation or thesis, you may be on your own (although if you have a supervisor, ask if they can advise you).   It is worth talking to others, and checking that you understand the search keywords in the same way as them, and that you know what they mean. 

Known items

You looked at titles and abstracts of items that appeared in the results of your scoping search.  But have a look at the titles and abstracts, and full text, of items that you know about already, and items you find in your actual search.   And look at the titles of references in the bibliographies of relevant items.

MeSH on Demand

This is a National Library of Medicine service, which identifies MeSH terms in text that you enter.  I have not yet tried this, but it seems to have possibilities.  I have written a separate post about this.

George Boole

What do you do with Boolean operators?  Play Booles with them.

That's the awful joke out of the way, that I used some time back in a quiz to check that students remembered what we had covered in a previous session.

Google's Doodle yesterday marked the 200th anniversary of the birth of George Boole, born in Lincoln on 2nd November 1815, and appointed Professor of Mathematics at Queen's College Cork in 1849.  University College Cork's Library is named after him.

The Doodle links to resources about him (by searching for George Boole).  Here are a few:

George Boole 200 - a website from University College Cork, including a life of Boole, the opportunity to sign up for school resources, reproductions of exam papers set by Boole while a professor in Cork, and news and events.

Scientific American - a blog about the bicentennial. 

George Boole - page from MacTutor History of Mathematics Archive at the University of St. Andrews.

If you want a Halloween themed image of Boolean operators (BOOlean!), try this from Librarian Design Share. 

How much is enough?

Younger son's homework is to choose a country and find out about it.  He has a list of questions.  What is the climate like?   Does it rain?  Is it hot?   What animals live there?   What about the culture?

We found something about animals in "Planet Earth", a BBC related book he was given by a friend.  We found the names of three ("mountain monkey", kodkod, a small wild cat, and the pudu, the world's smallest deer, in case you want to guess which country it might be!).  

It was the weather that made me write this.   The country in question is so large that the climate in different parts of it is very different.  Some parts are very high, and cold, some parts are very far from the Equator and also a bit cold, but other parts are equatorial and tropical.   So what is the answer to the question on the sheet?  What would the answer be if the country was the UK?  Would it depend who you asked?  How much detail is required?   We went for an answer about how there was a range of climate, which is a way did not answer the question.

It made me think: how much detail was needed?   Was I thinking too hard about the question, which after all was designed for a 7 year old, not a *@ year old parent.  Was a quick to write sentence what was needed, even if it was not the whole story?  Was the point to be able to write something, or to realise that climate is different in different countries?

Then I thought, what about the level of detail needed when thinking about literature searching?   What a first year undergraduate needs to be able to do is different from a PhD researcher or systematic reviewer.   What a clinician looking for evidence for practice needs to find will be different from that systematic reviewer.  I think I knew this, but had not really thought about how it was ok not to go into detail or give what I, as an experienced searcher, thought was the complete answer.  An answer that enables people to do what they need to, at that time, is the one to look for.

The point of my son's question was not to test the knowledge or information finding powers of the parent, or to write a complete account, but to look for particular qualities in the student, which suggests that an answer incomplete to the parent is ok.

MeSH on Demand

Does MeSH on Demand have possibilities for identifying thesaurus terms for use in a search, as I wondered if in a previous post?

MeSH on Demand is here: http://www.nlm.nih.gov/mesh/MeSHonDemand.html.  There is information about it in this NLM Technical Bulletin article. 

As a first test, I entered this text:

The use of antibiotics to treat otitis media in children under 5. 

MeSH on Demand suggests:

Anti-Bacterial Agents
Antibiotics, Antitubercular 
Child
Dermatologic Agents
Humans
Otitis Media

There is a disclaimer that says that humans might have come up with different terms, and that MeSH on Demand might suggest terms that are not in the text, or miss ones that are.  It does not assume any prior knowledge of MeSH.

I would have come up with the first and last terms, and humans, although I think that would be included implicitly if you include an age group.  I would have chosen something more specific than Child.

If you explode the first term, Anti-Bacterial Agents, you would include Antibiotics, Antitubercular.  There is no advice that I can see from MeSH on Demand about exploding.  If you use PubMed, exploding would happen by default.  

I would not have come up (at least, until I had examined some search results) Dermatologic Agents, so that is interesting and I would explore that.

There is no guidance from MeSH on Demand about how to combine terms.   There is also nothing said about freetext terms that you might use.

As a second test, I input the abstract from an reference from PubMed, and the resulting list of suggested MeSH terms had a very small overlap with the actual terms applied to that reference.  Indexers do look at more than the abstract, so there may be ideas in the article headings, conclusions and tables and figures that are not in the abstract.   Interestingly, Philippines/ is suggested (it is mentioned in the abstract) but is not actually applied to the reference. 

And as a third test, I used a search involving a drug and a condition that I had used as an example before.  MeSH on Demand identified the disease MeSH term I had chosen, and a drug MeSH term I knew about but had rejected (as too broad), plus a MeSH Supplementary Concept (the idea of those was new to me, I have to say, and I am not yet sure how you search it in Ovid!) and a MeSH term for the part of the search I had decided to deal with by means of a publication type limit or filter.   So in this case, MeSH on Demand was useful as a source of ideas.

Post Ebola syndrome, and choice of search terms

On the BBC news recently was an interview with a survivor of Ebola, which made reference to "post Ebola syndrome".  A search of the web finds a lot of news items mentioning this term, a short Wikipedia page and an article from Medecins Sans Frontieres.  According to that MSF article, joint pain, eye problems and depression, among other things, can follow Ebola.

Another item found by a web search for "post Ebola syndrome" is this blog post on the H5N1 blog. It refers to an editorial in Lancet Infectious Diseases (the link in the blog post goes to the Lancet but here is the PubMed record):

Sequelae after Ebola virus disease: even when it's over it's not over.

Bausch DG.

Lancet Infect Dis. 2015 Apr 21. pii: S1473-3099(15)70165-9. doi: 10.1016/S1473-3099(15)70165-9.
PMID: 25910638

A search of PubMed for post ebola syndrome finds only 6 items, which are perhaps not the most relevant.  A search for ebola sequelae, taking the hint from this editorial, finds 89.   Among them is this, which is mentioned in that blog post:

Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study.

Clark DV, Kibuuka H, Millard M, Wakabi S, Lukwago L, Taylor A, Eller MA, Eller LA, Michael NL, Honko AN, Olinger GG Jr, Schoepp RJ, Hepburn MJ, Hensley LE, Robb ML.

Lancet Infect Dis. 2015 Apr 21. pii: S1473-3099(15)70152-0. doi: 10.1016/S1473-3099(15)70152-0.
PMID: 25910637

PubMed's Automatic Term Mapping maps post ebola syndrome to both relevant MeSH terms, virus and disease.  Searching for ebola sequelae does the same, but also to the subheading Complications.   This can be applied to the disease heading (Hemorrhagic Fever, Ebola), and effectively is a floating subheading with the virus heading (Ebolavirus).  Adding complications to the search (ebola (complications OR sequelae)) finds 89 as well.

However, using MeSH alone would find neither item from Lancet Infectious Diseases, as neither has been indexed yet. 

 

So, the literature searching lessons here - try alternative terms, try to identify the ones that are used in the medical literature and not just ones used in the general media, and try to find terms that make best use of PubMed's Automatic Term Mapping.