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Tracking Down Studies: Going Around Obstacles

December 9th, 2009 by avatar

While I’ve spent a lot of time teaching about databases and indexes, they certainly are not the only way you can track down studies. In this final installment of the tracking down studies part of the Understanding Research series, I’ll show you how you can track down studies in other ways.

Last May I read an interesting blog post on Teri Shilling’s blog.

pfbblog

She posted about some research she’d read about in a magazine. The study had found that attending a childbirth class was the only significant predictor of whether or not a woman was satisfied with her childbirth experience.

Naturally, I wanted to know more, and being the “go straight to the source” type, I wanted to see the actual study. Teri had listed a few key pieces of information:

Study author = Angelina Arcamore

Study author’s place of work = Villanova University

Teri’s source: CBEreporter article written my Marsha Rehms

I started by asking Teri what she knew.

Askteri

Next I tried doing a search in EBSCO and PubMed for the author. Nothing. Tried searching for  the key words “Childbirth Education” and “satisfaction”. A few results, but nothing like what I was looking for.

Did a general Google searches for “Angelina Arcamore”, “CBEreporter” and for “Marsha Rehms”. Nothing helpful there.

So my only remaining clue was Villanova University. I went to their web site:

villanova

I searched their site for “Arcamore” and got nothing. Then I tried “childbirth education” and got a single hit:

Villanovahit

And voila! I found the faculty bio page of Angelina Arcamone!

Arcamonebio

Notice her name is actually spelled “Arcamone” instead of “Arcamore”! Somewhere along the way, a letter got misread as an r instead of an n. Very easy mistake.

So then I go back and do EBSCO, PubMed and Google Scholar searches for the correctly spelled name.

Still no results.

But remember how the faculty bio page had an e-mail address on it? Well, I decided to write to her and ask about the study. Within 24 hours she responded with a very nice e-mail:

Arcamoneresponse

While I found the information she sent me to be helpful, I am looking forward to seeing her study published!

Did you like this step-by-step of how I tracked down this study? You can find more articles like this on my web site.  If you have a study you’re having trouble finding and would like me to give it a try, send me an e-mail andrea [at] lythgoes [dot] net and I just might do it here on Science & Sensibility!

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Tracking Tools: Follow the Herd

November 29th, 2009 by avatar

This article is part of the Understanding Research series.

So you found a few good articles, but you wish you could have found more. Sometimes all it takes is finding one good study, and you can use that one to find more!

There are several ways to do this:

1. Most studies will have a section discussing the literature previously published on the topic. Dig up some of those studies using the information listed at the end. And then check the bibliographies of THOSE studies, too. In the research world, this is called “backwards chaining,” and works best with a more recent study. Sometimes you’ll get lucky and in the database you’ll see a list of the studies cited by the one you’re looking at, like this list of references connected with a study I found on EBSCO:

CitedReferences

2. Unless your study is brand spanking new, there’s a good chance someone else has cited it in a newer study. So as you’re searching, watch for places where you can see a list of studies that cite the one you’re reading. Google scholar nearly always includes a “Cited by” link under each search result. Meta-analyses and systemic reviews are GREAT finds if you can find one, as they tend to look at many studies all at once. This particular example of studies that cite the one I was interested in comes from EBSCO:

TimesCited

3. In the database where you found the study, look at the “related articles” that share key words with your article. Google Scholar and PubMed generally have excellent links to related articles. They may be articles that share keywords, authors, etc. with the study you are looking at. PubMed flags any articles that are a critique or review of another article as well.

PubMedRelatedArticles2

4. In most databases, the author’s name is a link. Clicking on it will search for any other articles by that author. Since researchers sometimes tend to focus on particular topics, you can often find similar studies. Sometimes this works very well – as in the case of someone like Susan Ludington-Hoe, who has published quite a bit on the topic of kangaroo care. She also has a very distinctive name. If you find a study by someone with a more common name, like say MJ Anderson, there may very well be more than one of those. You could revise those results or combine an author search with a keyword search in this case.

I’ve said it before in this series and I’ll say it again. The BEST way to get good at finding articles is practice, practice, practice! Try different indexes, try different approaches, and talk to a librarian for the tips and tricks!

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Advanced Tracking Tools: MeSH Keywords

November 3rd, 2009 by avatar

This article is part of our Understanding Research series.

MeSH – maybe you’ve seen it, that weird word that is always in caps, except for the little e. What is it and why should I care? Well, MeSH is an acronym for Medical Subject Headings, and in essence it is a way of having a standardized set of keywords that everyone uses to index research. It is run by the US National Laboratory of Medicine and is updated once a year.

It can be used a few different ways.

First, you can use it as a thesaurus to find out other terms you might use for your searching. So if you are searching for postpartum depression, you can enter that term here and find something that looks like this:

MeSH Descriptor PPD

You can see the official MeSH heading of “Depression, Postpartum” and below it several other Entry Terms that could be used as search terms. You can also see that before 1995, the indexing for postpartum depression was different than it is now. If you’re looking for studies older than 1995, using those as keywords may be helpful as well. (Though in this example, they are probably too broad!)

MeSH keywords are organized in a tree with similar keywords near them. By clicking on the “Concept View,” you can see how postpartum depression fits into two different areas, pregnancy and mental health:

MeSH Keyword Tree PPD

Searching the MeSH keywords can be an excellent way to find the generic and alternate brand names for drugs. Look at all the possible keywords that come up in a search for Cytotec:

MeSHCytotec

But where MeSH keywords really shine is within PubMed!

For example, if I wanted to find studies on the risks of induction of labor, I could do a simple PubMed search like this:

PubMed Induction Search

2440 results is a lot to slog through, and a quick scan of the first page of results shows things like a case report of a second trimester uterine rupture and an analysis of the risk factors for bladder injury during a cesarean section. So you’ve got a lot of stuff that really doesn’t apply to what you want to know.

So let’s try using MeSH! Click on the MeSH Database in the left hand sidebar and do a regular keyword search there.

PubMed MeSH Sidebar
In the MeSH database, I did a search for “Induction of Labor” and this is the MeSH result:

MeSH Induction

You can see that the MeSH keyword is a little different than my search, as the result is for Labor, Induced instead if Induction of Labor. The MeSH term is defined so you can ensure you’re at the right result. In this case there was only one MeSH keyword result, but it is possible to get multiple results and the definition can help you ensure you are looking at the correct one for your search.

Once you’re at the keyword entry that is the right one for your search, you can click on the “Links” in the upper right hand corner to complete a PubMed search for all articles that have this keyword. When I did this, I got 7,064 results – that’s 354 pages of citations to wade through, far more than I want to do. So I go back and try it again, this time using the “major topic” version of the PubMed search, so that I only get articles where induced labor is a major topic. This narrows it down to just under 4,800 results. Still too many!

But notice those subheadings just below the definition? Add a checkmark to the most applicable subheadings and then use the dropdown menu below to send these subheadings to the search box.

MeSHSendtoSearchbox

Your results will be limited by the subheadings you chose. Maybe you see more than one key word that fits what you want to know. Go ahead, click all the ones that fit.

For our example, I chose “Adverse effects” “Complications” and “mortality” as the three that I wanted to search. I can choose to add them to the search box with any of the major operators: AND, OR and NOT. I’m going to choose OR to get results that include any one of “Adverse effects” “Complications” and “Mortality.” I also checked the box that limited the results to major topics only.

MeSH Subheadings Results

Now I have 279 articles with the main topic of complications, adverse effects, or mortality in induction of labor! Much better than the 2,440 results we got before – far less to wade through, and they are much more on topic.

Next time: Using one great study as a tool to find more like it!

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Basic Tracking Skills: How to find what you’re hunting for

October 16th, 2009 by avatar

This is the third article in our Understanding Research series.

So you are at your index of choice. What now? You will need to use key words to search. The best way to learn to use key words effectively is to do a lot of practice searching. Some tips to help you get the most out of your practice:

1. Make sure you spell the words correctly. Seems almost silly that I would have to say it, but it is one of the most common mistakes.

2. Use quotation marks around phrases you want to search together. This can be a two-edged sword, though, as a search for “active management of labor” might miss a study that uses the phrasing “an active approach to labor management.”

3. Make use of the terms “and” “or” and “not”. If you wanted studies on smoking in pregnancy, you’d search for smoking AND pregnancy. The “or” command would be useful if you have similar terms you want to search at once, like hypertension OR high blood pressure. The “not” command can be used to eliminate unrelated results. For example labor NOT workforce. In some databases, you may need to capitalize these operators.

4. Don’t be too broad. If you’re looking for something on the risks of induction before 40 weeks, don’t just search “induction” because you’ll get a lot of results – and some won’t even have to do with labor! If you do find you get too many results, look for an option to refine your search to narrow the results to a manageable number. Often you’ll see a set of checkboxes where you can limit the results to a certain date range, only those with full text, or other criteria. Here is an example of the results limiting box found within EBSCO.

LimitResults

I’ve used the slider to show that I only want results published since the year 2000. When I click “update results” I’ll have refined my search so I have fewer results to look through.

5. Don’t be too specific. A search for induction risks labor 40 weeks gestation might eliminate a study titled “Timing of Elective Labor Induction at Term”.

6. If your first term doesn’t yield good results, try a different word that means the same thing. If birth location isn’t getting results, try place of birth. Or just start off using both terms with the “or” in between.

“birth location” OR “place of birth”

Also consider alternate spellings, like labor/labour or breastfeeding/breast feeding to see what comes up under each of those.

7. Finding little on Cytotec? Try searching “misoprostol” the generic name for the drug. Most published research will use the generic names for drugs since brand names can vary from country to country.

8. Use the medical lingo. I once got a call from a student who was frustrated beyond measure that she couldn’t find a single study to support her client in refusing a c-section for a baby that was estimated to weigh 9 pounds. “There’s GOT to be something!” Come to find out, she was searching for “big babies” and “c-section”. A search for macrosomia risks did turn up some helpful results.

9. Some (but not all) indexes will allow you to use the asterisk * symbol to truncate (or shorten) your search term. So if you want to do a search for something on episiotomy, you can search for “episiotom*” and the index will pull up anything with episiotomy, episiotomies, episiotomological, or any other word that starts with “episiotom-”. (OK, I admit, I made up the word “episiotomological”!) Be careful you don’t go too vague on this. A search for “epi*” will pull up episiotomy, epidural, epigastric, epistemology, epi-everything!

The best way to learn how to search is to practice, practice, practice. I find that it helps me to keep a running log of the terms I have tried to avoid repeating searches and to see things I may have missed. If you’re not finding what you want after several tries in one index, try another. If you are in a library building while you search, find a librarian and ask for help. Librarians can be great sources for the tips and tricks of searching!

Next week: Advanced Tracking Tools: MeSH Keywords

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Hunting Grounds: Where to look for studies

September 23rd, 2009 by avatar

Most research studies are published in professional journals. Some journals are published by a trade group or organization, such as JAMA: The Journal of the American Medical Association, or Lamaze International’s own Journal of Perinatal Education. Some journals are freestanding, independent of any organization. A good example of this is Birth: Issues in Perinatal Care.

Some journals are “peer reviewed”. This process involves both an editor and multiple independent experts reviewing manuscripts for publication and ensuring they meet minimum standards. While not a perfect process by any means, the peer-reviewed journals are generally considered to be higher quality and more reliable sources. This category includes most of the well-known and respected journals. Journals that are not peer reviewed have an editor making all the decisions, and this editor may or may not be impartial.

So how can you, as a childbirth professional, find studies on a topic you are interested in if you don’t have any idea when or in which journal an article may have been published?

There are many indexes out there that can come in handy for just this sort of thing. Let’s look at a few of  the most commonly used ones on the internet.

Google Scholar is a division of Google that you can find in the dropdown menu under “more” at the top of the page. The search will focus on academic articles and abstracts posted on the web.

Google Scholar

EBSCO is a service that provides access to multiple databases on a wide range of topics. EBSCO access often includes CINAHL, a great database for childbirth issues. While the public can’t access EBSCO directly, it is available through a variety of places. For example, I can use my library card to access EBSCO through the Salt Lake County Library System here. Don’t have a SL County library card? Try your local public library, they may offer it online or in person. Did you go to college? Check and see if your college provides online access to alumni. If you are a current college student, your school’s library will likely have access.  Even for those who are not current or former students, most college libraries allow free access if you come into the library. Hospital libraries may also allow some access. Call first to make sure!

PubMed A service of the U.S. National Library of Medicine that includes over 17 million citations from MEDLINE and other life science journals for biomedical articles back to the 1950s. PubMed includes links to full text articles and other related resources. Many articles on Pubmed have been assigned a Pubmed ID number, or PMID. If you see a citation that includes a PMID, just go to PubMed and type it in for quick access.

NLM Gateway Has many different indexes all in one place. A little trickier to use but can save time if you are proficient.

If you know where the study was published, you can try going directly to the web site of the journal that published it. Often this is the way to go when you read of a study in the paper or hear about it on TV. They might say “In a recent study published in the New England Journal of Medicine….”, making it very obvious to go and search there.

When you get to the index you want to use, you’ll do a search using the key words you think will best help you locate the articles you want. My next post will cover some tips and techniques for using key words effectively.

Search results usually come up with a list of citations showing the title, authors, date and place where it was published, and sometimes an abstract. The abstract is a short summary of the study that will give you an idea if this article is a good fit or not. If the abstract does not show during the initial search, you can usually view it by clicking on the article title.

Search Results

In this example, you can click on the title of the study to view the abstract. You could also click on the “Related Articles” to view citations of other studies on the same topic. This result also gives a link to where you can find the full text of the study for free. This will not always be the case, as some journals do not share full articles online for free. But some do!

The abstract alone may be all you need to know, or you may want to read the full study. You can find the full study by visiting the journal’s web site (where it still may not be free) or by visiting a library to use the library’s access to view it for free. If you don’t have a university or medical library near you, ask a librarian at the public library if they can obtain a copy for you using interlibrary loan or another service. In my experience, librarians really know the tricks to get articles you might need.

Next time: Using key words effectively!

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