Stephanie HolmgrenBiomedical LibrarianNIEHS LibraryJuly 24, 2012holmgren@niehs.nih.gov

Health InformationFinding Quality

On the Agenda

What’s out there – the good, the not-so-good (the bad, and of course, the ugly)

Prep-work before you search What’s your strategy? General search tips

Searching for Professional Literature Sources and Tips for PubMed

Searching the Web Finding the Good (using quality criteria) Tips for Google

Recommended Resources

What’s Out There?

Articles Valid and reliable study

Slight study design weakness

poor study design, bias, inappropriate statistical analysis

falsified data, plagiarism

Websites Reliable, accurate information meet quality criteria

Meet most but not all quality criteria

inaccurate or misleading information

fraudulent, hoaxes

Before you search..

What is your objective? Just need a few articles or want a more thorough search?

What type of information are you looking for? This determines the best resource(s) to use.

Think about your topic – what search terms will you use? Are there synonyms or other ways to express that concept? Use specific terms whenever possible.

Get to know the search language that the search engine or database uses

What’s Your Strategy?

Remember – GIGO garbage in, garbage out

Search Tips

Syntax PubMed Google

AND breast AND exposure breast exposure

OR diet OR nutritionbreast OR mammary

NOT heavy metals NOT mercury Heavy metals -mercury

Boolean combinations

Breast AND BPA OR phthalatesBreast AND (BPA OR phthalates)

Phrases “breast cancer”

Proximity (words near each other)

not available exposure AROUND(5) “breast cancer”

Truncation pubert*= puberty OR pubertal

No truncation

Today’s Example

1. Research Topic: Influence of diet on puberty and risk for breast cancer

2. Concepts Diet Puberty Breast Cancer

3. Text terms(synonyms, variations, plurals, …)

dietnutrition

pubert*maturationmenarche

breast OR mammaryCancer OR neoplas*

4. Limits humans, age range, publication date range, review article, English only, …

(diet OR nutrition) AND (pubert* OR maturation OR menarche) AND ((breast OR mammary) AND (cancer OR neoplas*))

Searching the Professional Literature

http://www.ncbi.nlm.nih.gov/pubmed/

• National Library of Medicine• Contains 20 million records – 98% journal articles• 5500 biomedical journals indexed

http://www.scirus.com/

• Elsevier• Searches scientific information available online

http://scholar.google.com/

• Google• Searches the Web for ‘scholarly’ information across all disciplines

PubMed

Search: Limits

Set limits to refine the search by the characteristics or time period you want

Reviewing the Results

Default setting• Summary format• 20 items per page• when PubMed added

Use “Display Settings” drop-down arrow to temporarily change the default.

Display of Results

Permanently change the display default in your My NCBI account.

Similar Items

On the Results page

On the article record

The Article Abstract

What is the research problem and why is it

important?

How did they conduct the study?

What did the researchers find?

What do the results mean?

Getting the Full-Text

Set Limits to:Free full text available

Public University library or local public library

Become a member; most offer interlibrary loan services (although some do require a fee)

Researcher‘s webpage or institutional repositories

Look at the researcher’s webpage for pre-print or final manuscript; may also be in the Institution’s repository - http://www.opendoar.org/ [directory of open access repositories]

Online Health Information

8 million Americans go online each day to search for health information

75% do not review the quality of the website

58% say the health search had an impact on a treatment decision, yet only 33% talked with doctor about what was found online.

Source: Fox S. Online Health Search 2006. Pew Internet & American Life Project.http://pewinternet.org/Reports/2006/Online-Health-Search-2006.aspx

Quality or not?

RYT Hospital Dwayne Medical Center

… specific for health websites

Finding the Good

Finding the Good: the WHO behind the website

Consider the Source

• Who is responsible for the website?.gov, .edu, .org, .com distinctions

Also, check the “About Us” page or note if a copyright statement indicates the publisher

• Is the contact information valid?

Credibility of authors

• Do they provide profile information on any of the content contributors?

• What are the credentials of the authors? Do they have medical backgrounds or speaking from personal experience?

Beware of bias • Is the site a commercial website? How do they receive funding?• Does the site have sponsors? Are they non-profit organizations or commercial companies?• Are advertisements clearly labeled?

Finding the Good: the WHAT behind the website

Find the purpose • What are the motives for creating the website? Does the website state a specific goal or purpose?

• Do they specify a target audience for their information – general public, patient, caregiver, physician or other health professional?

• Does the content match the intended audience in terms of language, readability, etc.?

Consider the Content

• What process/criteria are considered when adding content? Does the website have an Editorial Board? If so, what are the credentials of the members?

• How is information selected for inclusion?

• Is the information written in an impartial way or is it an opinion or testimonial? If facts are stated, are they supported with references?

• Do other websites you trust link to this site?

Check for Currency • When was the webpage last updated?

• Are the hyperlinks active and working?

Quick Search Tips for Google

Use more than one search engine – Try Bing, Yahoo, or Chrome Check out the Advanced Search feature – first, do a search, then click on the Settings icon and select Advanced Search

Search Tip Example

Google is not case sensitive BREAST = Breast = breast

Word order can matter Breast environment vs. environment breast

Force words to be near one another exposure AROUND(5) breast

Limit search to a specific website or ddomain (e.g., edu, gov, org)

“breast cancer” site:edu

Limit search term to being in the web address (URL) or webpage title

Allinurl: breast cancerAllintitle: breast environment

Limit search to a specific file type (e.g., pdf, ppt, xls, …)

Environment “breast cancer” filetype:ppt

Health Literacy

AMA – Health Literacyhttp://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/health-literacy-program.page

ATSDR Environmental Health Education for the Publichttp://www.atsdr.cdc.gov/emes/public/index.html

ATSDR Pediatric Environmental Health Toolkit Training Module http://www.atsdr.cdc.gov/emes/health_professionals/pediatrics.html

CDC Health Literacyhttp://www.cdc.gov/healthliteracy/

HHS – Health Literacy Online http://www.health.gov/healthliteracyonline/

NLM Health Literacy Information Resourceshttp://www.nlm.nih.gov/services/queries/health_literacy.html

Plain Language – Health Literacyhttp://www.plainlanguage.gov/populartopics/health_literacy/

Multilingual Resources

Stanford Health Library – Multilingual Health Information http://healthlibrary.stanford.edu/resources/foreign/Range of African, Asian, and European languages

Asian American Health: Materials in Asian Languages http://asianamericanhealth.nlm.nih.gov/AsianLang.htmlCambodian/Khmer, Chinese, Filipino/Tagalog, Hmong, Japanese, Korean, Laotian, South Asian, Thai, Vietnamese

Virginia Commonwealth University Cancer Center – Multilingual Cancer Resourceshttp://www.healthinformation.vcu.edu/multilingual-cancer-resources.htmlLinks to other websites with predominantly Spanish language versions

Cancer Council – Online Library Language http://www.cancersa.org.au/aspx/search_rl_lang.aspxArabic, Bosnian, Chinese, Croatian, Filipino, Greek, Italian, Khmer, Macedonian, Polish, Russian, Serbian, Somali, Spanish, Tigrinya, Turkish, Vietnamese

Breast Cancer and the Environment

Breast Cancer and the Environment: Scientific Evidence, Research Methodology, and Future Directions (Workgroup)

http://www.iom.edu/Activities/Environment/BreastCancerEnvironment.aspx

Breast Cancer and the Environment: A Life Course Approach (Report)

http://www.iom.edu/Activities/Environment/BreastCancerEnvironment.aspx

Of Mice and Women: modeling breast cancer and the environment (scientific glossary)

http://www.zerobreastcancer.org/research/miceandwomenglossary.pdf

State of the Evidence 2010:The Connection between Breast Cancer and the Environment (Report)

http://www.breastcancerfund.org/media/publications/state-of-the-evidence/

Government

Agency for Health Research and Quality: Practice Guidelines – Breast Cancer

http://www.guideline.gov/search/search.aspx?term=breast+cancer

CDC: Breast Cancer http://www.cdc.gov/cancer/breast/

Healthfinder.gov http://www.healthfinder.gov/

Medline Plus (National Library of Medicine)

http://www.nlm.nih.gov/medlineplus/breastcancer.html

National Cancer Institute: Breast Cancer

http://www.cancer.gov/cancertopics/types/breast

NIH Clinical Trials: Breast Cancer http://bethesdatrials.cancer.gov/breast_cancer/index.aspx

Women’s Health.gov: Breast Cancer

http://www.womenshealth.gov/breast-cancer/

Non-Profit Groups

American Cancer Society: Breast Cancer

http://www.cancer.org/Cancer/BreastCancer/index?ssSourceSiteId=null

Breast Cancer.org http://www.breastcancer.org/

Breast Cancer Action http://bcaction.org/

Breast Cancer Fund http://www.breastcancerfund.org/

Dr. Susan Love http://www.dslrf.org/index.asp

National Breast Cancer Foundation

http://www.nationalbreastcancer.org/

Oncolink: Breast Cancer http://oncolink.org/

Pink Ribbon http://www.pinkribbon.com/

Susan G. Komen for the Cure http://ww5.komen.org/

Zero Breast Cancer http://www.zerobreastcancer.org/

Non-Profits

TREATMENT & CARE

Breast Cancer Trials https://www.breastcancertrials.org/bct_nation/home.seam

BresDex (Breast Cancer Decision Explorer)

http://www.bresdex.com/

ClinicalTrials.gov http://clinicaltrials.gov/

National Comprehensive Cancer Network

http://www.nccn.com/files/cancer-guidelines/breast/index.html

National Quality Measures for Breast Centers

http://nqmbc2.org/certifiedCentersList.cfm

NCI Clinical Trials http://www.cancer.gov/clinicaltrials/search

NIH Clinical Trials: Breast Cancer http://bethesdatrials.cancer.gov/breast_cancer/index.aspx