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Transcript of DETERMINANTS OF COMMUNITY HEALTH POWER SEARCHING Fall 2003 2003, Faculty of Medicine, University of...
DETERMINANTS OF DETERMINANTS OF COMMUNITY HEALTHCOMMUNITY HEALTH
POWER SEARCHINGPOWER SEARCHING
Fall 2003
2003, Faculty of Medicine, University of Toronto
GOALGOAL
To design search strategiesTo design search strategies
that find the best researchthat find the best research
OUTLINEOUTLINE
IntroductionIntroduction MEDLINEMEDLINE
practicepractice
PsycINFOPsycINFO practicepractice
Questions and discussionQuestions and discussion
STEPS IN A SEARCHSTEPS IN A SEARCH
Choose a databaseChoose a database
Formulate a search questionFormulate a search question
Identify primary topicsIdentify primary topics
Identify searchable termsIdentify searchable terms
Relate the conceptsRelate the concepts
FILTER!FILTER!
SELECTED DATABASESSELECTED DATABASES
MEDLINE, 1966-MEDLINE, 1966- CINAHL, 1983-CINAHL, 1983- PsycINFO, 1967-PsycINFO, 1967- Cochrane Library, 1995-Cochrane Library, 1995- EMBASE, 1974-EMBASE, 1974-
STEPS IN A SEARCHSTEPS IN A SEARCH
Choose a databaseChoose a database
Formulate a search questionFormulate a search question
Identify primary topicsIdentify primary topics
Identify searchable termsIdentify searchable terms
Relate the conceptsRelate the concepts
FILTER!FILTER!
ORIGINAL QUESTION:ORIGINAL QUESTION:
How can we improve our methadone How can we improve our methadone maintenance program?maintenance program?
FORMULATING A SEARCH FORMULATING A SEARCH QUESTIONQUESTION
precise, testableprecise, testable narrowly focusednarrowly focused phrase as a question or hypothesisphrase as a question or hypothesis
FORMULATING A SEARCH FORMULATING A SEARCH QUESTIONQUESTION
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
II
EE
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
heroin heroin addictionaddiction
II
EE
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
heroin heroin addictionaddiction
II intervention intervention or issueor issue
EE
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
heroin heroin addictionaddiction
II intervention intervention or issueor issue
methadonemethadone
EE
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
heroin heroin addictionaddiction
II intervention intervention or issueor issue
methadonemethadone
EE effect or effect or evaluationevaluation
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
heroin heroin addictionaddiction
II intervention intervention or issueor issue
methadonemethadone
EE effect or effect or evaluationevaluation
compliancecompliance
What factors affect compliance in a What factors affect compliance in a methadone maintenance program for methadone maintenance program for heroin addiction?heroin addiction?
FORMULATING A SEARCH FORMULATING A SEARCH QUESTIONQUESTION
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
heroin heroin addictionaddiction
II intervention intervention or issueor issue
methadonemethadone
EE effect or effect or evaluationevaluation
FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION
PP population or population or problemproblem
heroin heroin addictionaddiction
II intervention intervention or issueor issue
methadonemethadone
EE effect or effect or evaluationevaluation
effectivenesseffectiveness
What factors affect compliance in a What factors affect compliance in a methadone program for heroin methadone program for heroin addiction?addiction?
Is methadone an effective Is methadone an effective intervention for heroin addiction?intervention for heroin addiction?
FORMULATING A SEARCH FORMULATING A SEARCH QUESTIONQUESTION
STEPS IN A SEARCHSTEPS IN A SEARCH
Choose a databaseChoose a database
Formulate a search questionFormulate a search question
Identify primary topicsIdentify primary topics
Identify searchable termsIdentify searchable terms
Relate the conceptsRelate the concepts
FILTER!FILTER!
SEARCH TERMSSEARCH TERMS
PRIMARY TOPICSPRIMARY TOPICS
methadonemethadone heroin addictionheroin addiction effectivenesseffectiveness
SEARCHSEARCH TERMSTERMS
vary with each vary with each databasedatabase
STEPS IN A SEARCHSTEPS IN A SEARCH
Choose a databaseChoose a database
Formulate a search questionFormulate a search question
Identify primary topicsIdentify primary topics
Identify searchable termsIdentify searchable terms
Relate the conceptsRelate the concepts
FILTER!FILTER!
Is methadone an effective intervention Is methadone an effective intervention for heroin addiction?for heroin addiction?
SAMPLE SEARCH ASSIGNMENTSAMPLE SEARCH ASSIGNMENT
1.1. IDENTIFICATIONIDENTIFICATION
John Smith, Fitzgerald Academy John Smith, Fitzgerald Academy [email protected] [email protected]
Telephone 416-777-7777Telephone 416-777-7777Fax 416-778-5666Fax 416-778-5666
2.2. SEARCH QUESTIONSEARCH QUESTION
My field placement is with the Metropolitan Toronto My field placement is with the Metropolitan Toronto Detox Centre. We want to improve the Detox Centre. We want to improve the effectiveness of the methadone maintenance effectiveness of the methadone maintenance program for heroin addiction. Since compliance program for heroin addiction. Since compliance is a major factor affecting the program’s success, is a major factor affecting the program’s success, we want to focus specifically on barriers to we want to focus specifically on barriers to compliance. I therefore selected as my core compliance. I therefore selected as my core concepts compliance, methadone, and heroin concepts compliance, methadone, and heroin addiction. Rephrased as a question, my search addiction. Rephrased as a question, my search question becomes “What factors affect question becomes “What factors affect compliance in a methadone program for heroin compliance in a methadone program for heroin addiction?”addiction?”
3.3. SEARCH PLANNINGSEARCH PLANNING
DATABASEDATABASE
I decided to search in MEDLINE (Ovidweb), I decided to search in MEDLINE (Ovidweb), because it provides good coverage of the because it provides good coverage of the addictions literature. addictions literature.
PRIMARY TOPICSPRIMARY TOPICS
1.1. MethadoneMethadone
2. Heroin addiction2. Heroin addiction
3. Compliance3. Compliance
3. SEARCH PLANNING (cont’d)3. SEARCH PLANNING (cont’d)
RELATIONSHIP BETWEEN CONCEPTSRELATIONSHIP BETWEEN CONCEPTS
methadone AND heroin addiction AND compliance methadone AND heroin addiction AND compliance
QUALITY FILTERQUALITY FILTER
If the base set is large enough, I will narrow it down If the base set is large enough, I will narrow it down just to studies using questionnaires or surveys. just to studies using questionnaires or surveys. This will give me a subset that is research-based, This will give me a subset that is research-based, using the same type of instrument we want to use using the same type of instrument we want to use in our own study.in our own study.
4.4. DISCUSSIONDISCUSSION
When I typed methadone in Medline, it mapped to the When I typed methadone in Medline, it mapped to the MeSH heading methadone. I exploded methadone to MeSH heading methadone. I exploded methadone to pick up the narrower term, methadyl acetate. I then pick up the narrower term, methadyl acetate. I then typed my second concept, heroin addiction. This typed my second concept, heroin addiction. This mapped to the MeSH heading heroin dependence. I mapped to the MeSH heading heroin dependence. I clicked on the term to see the hierarchy of terms, and clicked on the term to see the hierarchy of terms, and decided to move up to the broader MeSH, opioid-decided to move up to the broader MeSH, opioid-related disorders. I exploded it to include heroin related disorders. I exploded it to include heroin dependence and morphine dependence. My third dependence and morphine dependence. My third concept, compliance, retrieved three terms, one of concept, compliance, retrieved three terms, one of which was patient compliance. The scope note for which was patient compliance. The scope note for patient compliance cited treatment refusal and patient patient compliance cited treatment refusal and patient dropouts as related terms.dropouts as related terms.
4.4. DISCUSSION (cont’d)DISCUSSION (cont’d)
I therefore created sets for all three terms, and I therefore created sets for all three terms, and combined them with OR, so that any of these terms combined them with OR, so that any of these terms would be picked up in the search. I then combined the would be picked up in the search. I then combined the sets for methadone, opioid-related disorders, and the sets for methadone, opioid-related disorders, and the various terms for patient compliance using AND. I various terms for patient compliance using AND. I limited this set to English and human to get a base set limited this set to English and human to get a base set of 41. For my quality filter, I selected the term data of 41. For my quality filter, I selected the term data collection, which can be exploded to include collection, which can be exploded to include questionnaires and surveys; I want articles using questionnaires and surveys; I want articles using these qualitative research tools. When I ANDed data these qualitative research tools. When I ANDed data collection with my base set, I retrieved a final set of collection with my base set, I retrieved a final set of five items. Most of the items in the final set appeared five items. Most of the items in the final set appeared to contain useful information relating to my question. to contain useful information relating to my question.
5.5. SEARCH STRATEGYSEARCH STRATEGY
Database: MEDLINE <1996 to October Week 4 2003>Database: MEDLINE <1996 to October Week 4 2003>
Search Strategy:Search Strategy:----------------------------------------------------------------------------------------------------------------------------------------------------------------1 exp METHADONE/ (834)1 exp METHADONE/ (834)2 exp Opioid-Related Disorders/ (1533)2 exp Opioid-Related Disorders/ (1533)3 1 and 2 (475)3 1 and 2 (475)4 limit 3 to (human and english language) (409)4 limit 3 to (human and english language) (409)5 Patient Compliance/ (3902)5 Patient Compliance/ (3902)6 Patient Dropouts/ (565)6 Patient Dropouts/ (565)7 Treatment Refusal/ (1034)7 Treatment Refusal/ (1034)8 5 or 6 or 7 (5303)8 5 or 6 or 7 (5303)6 4 and 8 (41)6 4 and 8 (41)7 exp data collection/ (130425)7 exp data collection/ (130425)11 6 and 7 (5)11 6 and 7 (5)
6.6. RESULTSRESULTS
<1><1>AuthorsAuthors Cushman P Jr.Cushman P Jr.TitleTitle Ten years of methadone maintenance treatment: some clinical Ten years of methadone maintenance treatment: some clinical
observations.observations.SourceSource American Journal of Drug & Alcohol Abuse. 4(4):543-53, 2002.American Journal of Drug & Alcohol Abuse. 4(4):543-53, 2002.
<2><2>AuthorsAuthors Morral AR. Belding MA. Iguchi MY.Morral AR. Belding MA. Iguchi MY.TitleTitleIdentifying methadone maintenance clients at risk for poor treatment Identifying methadone maintenance clients at risk for poor treatment
response: pretreatment and early progress indicators.response: pretreatment and early progress indicators.SourceSource Drug & Alcohol Dependence. 55(1-2):25-33, 2001 Jun 1.Drug & Alcohol Dependence. 55(1-2):25-33, 2001 Jun 1.
6. RESULTS (cont’d)6. RESULTS (cont’d)
<3><3>
AuthorsAuthors
Belding MA. McLellan AT. Zanis DA. Incmikoski R.Belding MA. McLellan AT. Zanis DA. Incmikoski R.
TitleTitle
Characterizing "nonresponsive" methadone patients.Characterizing "nonresponsive" methadone patients.
SourceSource
Journal of Substance Abuse Treatment. 15(6):485-92, 1999 Nov-Dec.Journal of Substance Abuse Treatment. 15(6):485-92, 1999 Nov-Dec.
<4><4>
AuthorsAuthors
Zanis DA. Woody GE.Zanis DA. Woody GE.
TitleTitle
One-year mortality rates following methadone treatment discharge.One-year mortality rates following methadone treatment discharge.
SourceSource
Drug & Alcohol Dependence. 52(3):257-60, 1999 Nov 1.Drug & Alcohol Dependence. 52(3):257-60, 1999 Nov 1.