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Research Methods: Searches & Systematic Reviews

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Slide deck for the Dent 610 graduate level course on research methods, 2018 version; collaboratively developed by Mark MacEachern, Patricia F. Anderson, and Tyler Nix.

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Research Methods: Searches & Systematic Reviews

  1. 1. Research Methods: Searches & Systematic Reviews Mark MacEachern I PF Anderson I Tyler Nix Informationists, Taubman Health Sciences Library, University of Michigan For Dentistry 610 I Nov. 6, 2018
  2. 2. Introduction
  3. 3. Objectives ● Understand the importance of literature searches ● Learn how to construct effective searches for research and clinical projects ● Learn data extraction and reporting resources
  4. 4. Why is it important to search well? ● Support evidence-based decision-making ● Avoid biases in research projects and clinical decisions ● Missed studies can undermine clinical decisions and research findings ● Save yourself time by leveraging resource features ● Keep current on new trends, developments
  5. 5. Evidence Pyramid Source: Sackett DL. Evidence-based medicine: how to practice and teach EBM.
  6. 6. Review Types ● Systematic Reviews ● Scoping Reviews ● Rapid Reviews Image: HLWiki: <http://hlwiki.slais.ubc.ca/index.php/Rapid_reviews>
  7. 7. Systematic Reviews "A systematic review is a formal research study. It follows a clear, predefined structure to find, assess, and analyze studies that have all tried to answer a similar question. The results of a systematic review can provide a reliable picture of what we know - and what remains uncertain." Source: <https://www.ncbi.nlm.nih.gov/pubmedhealth/what-is-a-systematic-review/>
  8. 8. Systematic Review Timeline Source: section 2.3.b of the Cochrane Handbook <http://handbook-5-1.cochrane.org/>
  9. 9. Rapid Reviews in Context: Time Systematic review Recommended time = 12 months Average or typical time = 23 months Rapid review Average or typical time = 6 months Can range from 1 month to a year
  10. 10. Rapid Reviews Are Different - How? ● SCOPE ○ type/number of questions; number of studies included ● COMPREHENSIVENESS ○ databases, hand searching, date, setting, languages, study types ● RIGOR ○ eliminate dual study selection and/or data extraction ● SYNTHESIS ○ limit or eliminate risk of bias testing, quality assessment of studies, quality assessment of evidence, analysis reduced to either quantitative or qualitative
  11. 11. Search Construction
  12. 12. What to expect? ● Expect the search to be iterative ● Expect 1000s of results ● Expect to search multiple databases ○ EMBASE, PubMed, Dentistry and Oral Sciences Source, PsycINFO, etc. ● Expect the search process to take awhile ● Expect to publish search strategy and search methodology ● Expect to consult someone with appropriate search expertise
  13. 13. Search construction 1. Identify search terms 2. Use Boolean 3. Term generation
  14. 14. 1. Identifying search terms Question/hypothesis: ● Real time ultrasonography and in implant and oral surgery What are the major concepts? Ultrasonography Ultrasound, ultrasonic, echography, etc Dental implants Types of implants, materials, implant names, etc. Oral surgery Surgery, surgeries, surgical, specific procedures, types of surgeries, etc.
  15. 15. 2. Boolean
  16. 16. 2. Boolean Concept 1 Ultrasonography OR Ultrasound OR Echography Concept 2 Dental implants OR Tooth implants OR Dental implantation AND
  17. 17. 2. Boolean Concept 1 Ultrasonography OR Ultrasound OR Echography Concept 2 Dental implants OR Tooth implants OR Dental implantation AND(ultrasonography or ultrasound or echography) AND (dental implants or dental implant or tooth implant or dental implantation)
  18. 18. 2. Boolean (what a final search looks like)
  19. 19. 3. Term generation Keywords Controlled vocabulary
  20. 20. 3. Term generation Keywords Controlled vocabulary What are they? ○ Literal search, looks for occurrences When to use? ○ Always, and when no vocabulary exists in database Examples ○ Google, PubMed
  21. 21. 3. Term generation Keywords Controlled vocabulary What are they? ○ Set of words or phrases used to describe concept ○ Dictionary of accepted terms for a database When to use? ○ Searching a database that has one Examples ○ MeSH & EMTREE
  22. 22. MeSH & MeSH Database
  23. 23. Finding MeSH Method Example MeSH Database Individual Article Search Builder
  24. 24. Finding MeSH Method Example MeSH Database Individual Article Search Builder MeSH Database: <https://www.ncbi.nlm.nih.gov/mesh/68017266>
  25. 25. Finding MeSH Method Example MeSH Database Torabinejad M, Anderson P, Bader J, Brown LJ, Chen LH, Goodacre CJ, Kattadiyil MT, Kutsenko D, Lozada J, Patel R, Petersen F, Puterman I, White SN. Outcomes of root canal treatment and restoration, implant-supported single crowns, fixed partial dentures, and extraction without replacement: a systematic review. J Prosthet Dent. 2007 Oct;98(4):285-311. Review. PubMed PMID: 17936128. MH - Cost-Benefit Analysis MH - Crowns MH - *Dental Implants, Single-Tooth MH - *Dental Prosthesis, Implant-Supported MH - Dental Restoration Failure MH - Dental Restoration, Permanent MH - *Denture, Partial, Fixed MH - Humans MH - *Root Canal Therapy MH - Survival Analysis MH - Tooth Extraction/*psychology MH - Treatment Outcome Individual Article Search Builder
  26. 26. Finding MeSH
  27. 27. Finding MeSH Method Example MeSH Database Individual Article Search Builder
  28. 28. Sentinel Articles (vs. Seminal)
  29. 29. What is a Seminal Article? Highly significant Influential Important By a leader in defining the research in the field “Key studies”
  30. 30. What is a Sentinel Article? (VALIDATION) Remember – purpose is for validating search, NOT proving you know the best articles on the topic (that would be seminal articles) On topic, not broader or narrower Well-indexed with appropriate terms Representative of citations that would be retrieved by a well-done search Each sentinel article must represent ALL desired concepts in the search Articles selected must meet ALL inclusion and exclusion criteria.
  31. 31. Choosing Sentinel Articles How many articles? 3-5. No more than ten. Verify appropriateness of selected sentinels. Neither very recent (current year) or old (before 1985) ● Articles old enough to have MeSH assigned. ● New enough to have complete indexing
  32. 32. MeSH Tips (What to do if there is NO HEADING) Earlier term mappings prior to assignment of a MeSH term are often: ● presenting symptom or diagnosis ● anatomical area TMJD Example: TMJD = temporomandibular joint disorder = (Temporomandibular joint [anatomical area] + ("myofacial pain" OR "Bone Diseases") [presenting symptom OR diagnosis] Image: Frank Gaillard. Normal anatomy of the Temporomandibular joint. 14 Jan 2009. <http://commons.wikimedia.org/wiki/File:Temporomandibular_joint.png>
  33. 33. MeSH & Sentinels Verify sentinel citations in MEDLINE Save file with full citations (abstract, MeSH headings, everything) Make duplicate file to process Analyse MeSH Terms ● retain topical terms ● retain methodology terms ● retain non-MeSH terms such as publication type and registry numbers (but separate from core concept terms) Image: <http://mesh.med.yale.edu/help>
  34. 34. Activity: MeSH
  35. 35. Team A vs. Team B: Searching Articaine+ TEAM A: Enter terms found into your team’s Google Doc: <http://bit.ly/Dent610TeamA> Search MeSH database for: ● Most important term ● MeSH headings ● Related terms ● MeSH Tree Structure: ○ Go up a level ○ Go down a level TEAM B: Enter terms found into your team’s Google Doc: <http://bit.ly/Dent610TeamB> Search for freetext keywords: ● Brainstorming ● Textbooks or articles ● Search Google or similar ● Search Google Scholar
  36. 36. Team A vs. Team B: Searching Articaine+ — FLIP! TEAM B: Enter terms found into your team’s Google Doc: <http://bit.ly/Dent610TeamB> Search MeSH database for: ● Most important term ● MeSH headings ● Related terms ● MeSH Tree Structure: ○ Go up a level ○ Go down a level TEAM A: Enter terms found into your team’s Google Doc: <http://bit.ly/Dent610TeamA> Search for freetext keywords: ● Brainstorming ● Textbooks or articles ● Search Google or similar ● Search Google Scholar
  37. 37. Discussion: Terms
  38. 38. Debrief 1. How is what your team found similar or different from what the other team found? Why do you think that is? 2. Which would you rather do first: Keyword searching, or MeSH term searching? Why? 3. Do you think you need lots of terms for EVERY topic you research? Why or why not?
  39. 39. Extra Ideas for Finding Terms ⃞ Plural forms ⃞ Alternate and variant terms mentioned in MeSH Browser ⃞ Abstract & title mining for equivalent terms ⃞ Other forms of main term (eg. Diabetes and diabetic) ⃞ British and American spellings (eg. Hematology and haematology) ⃞ Concepts of which this is a part ⃞ Concepts which create this concept when combined
  40. 40. Extra Ideas for Finding Terms ⃞ If clinical: Anatomical site (or region) + presenting symptom (eg: TMJD = Temporomandibular joint + Myofascial pain) ⃞ If clinical: Anatomical site (or region) + disease category (eg: TMJD = Temporomandibular joint + Bone diseases) ⃞ If clinical: Diagnostic criteria (eg. Diabetes and fasting plasma glucose or oral glucose tolerance test) ⃞ If clinical: Disease precursors, related conditions, or sequelae (eg: Dental caries and tooth demineralization.)
  41. 41. Extra Ideas for Finding Terms ⃞ If treatment: Anatomical site or system + specific modality ⃞ If pharmaceutical or chemical: chemical formula/symbols, registry numbers ⃞ If microorganisms: historical names, taxonomic groups ⃞ If materials: relevant ISO/ANSI standards and product identification numbers
  42. 42. Want to know what they did in the original? Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. J Am Dent Assoc. 2011 May;142(5):493-504. ● MEDLINE: (((exp Anesthesia, Dental/ OR (exp Anesthesia/ AND (exp Dentistry/ OR exp Stomatognathic system/ OR exp Stomatognathic diseases/))) AND (exp Carticaine/ OR septocaine.mp. OR ultracaine.mp. OR articaine.mp. OR carticaine.mp. OR Thiophenes/)) ● Embase: (((‘articaine’/exp OR articaine) OR (‘carticaine’/ OR carticaine) OR > (‘ultracaine’/exp” OR “ultracaine)” OR septocaine OR ‘thiophene > derivative’/de) AND (‘dentistry’/exp OR (‘mouth’/exp OR mouth)))
  43. 43. Build-A-Search
  44. 44. FRIAR/SECT F – Frame R - Rank by Relevance I - Irrelevant Search Concepts A - Alternates/Aliases (Term Generation) R - Review, Revise, Repeat
  45. 45. MEMORABLE, A Medline Search Strategy Development Tool
  46. 46. Data Extraction
  47. 47. Cochrane Data Extraction
  48. 48. Evidence Table Example● Levels of evidence ● Participant characteristics ● Study characteristics ● Intervention and outcome measurements ● Results ● Study limitations ● Inclusion/Exclusion criteria <http://www.aota.org/DocumentVault/AJOT/Template.aspx?FT=.pdf>
  49. 49. Data abstraction / extraction samples Cochrane: ● Forms: <http://endoc.cochrane.org/data-extraction-sheets> ● Elements: <http://www.cochrane.org/handbook/table-73a-che cklist-items-consider-data-collection-or-data-extrac tion> ● Cochrane CFGD November 2004 * (DOC): <http://cfgd.cochrane.org/sites/cfgd.cochrane.org/fil es/uploads/Study%20selection%20and%20%20extr action%20form.doc> More Cochrane: ● Data Extraction Template, 2011 (XLS): <http://www.latrobe.edu.au/chcp/assets/downloads /DET_2011.xls> ● Overview: <http://www.cochrane-pro-mg.org/Documents/Revi ewsheet-1-4-08.pdf> Other: ● CDC Data Abstraction Form: <http://www.nccmt.ca/uploads/registry/CDC%20To ol.pdf> ● Social science example (suicide) <http://www.cmaj.ca/content/suppl/2009/01/29/18 0.3.291.DC2/ssri-barbui-3-at.pdf>
  50. 50. Documenting / Reporting
  51. 51. Reporting The Equator Network <https://www.equator-network.org/>
  52. 52. Reporting Guidelines and standards for Systematic reviews PRISMA Cochrane Handbook National Academies of the Sciences
  53. 53. Reporting - PRISMA
  54. 54. Reporting - Cochrane Handbook ◻ See Cochrane Handbook ■ <http://handbook-5-1.cochrane.org/> ■ Section 6.6 ◻ “It should be borne in mind at the outset that the full search strategies for each database will need to be included in an Appendix of the review.”
  55. 55. Reporting - Cochrane Handbook ◻ See Cochrane Handbook ■ <http://handbook-5-1.cochrane.org/> ■ Section 6.6 ◻ In methods: ■ List all databases searched. ■ Note the dates of the last search for each database AND the period searched. ■ Note any language or publication status restrictions ■ List grey literature sources. ■ List individuals or organizations contacted.
  56. 56. Reporting - Cochrane Handbook ◻ See Cochrane Handbook ■ <http://handbook-5-1.cochrane.org/> ■ Section 6.6 ◻ In study flow diagram: ■ number of unique records identified by the searches; ■ number of records excluded after preliminary screening (e.g. of titles and abstracts); and ■ number of records retrieved in full text
  57. 57. Reporting - Cochrane Handbook PRISMA Checklist <http://prisma-statement.org/documents/PRISMA%202009%20checklist.pdf>
  58. 58. FAQ - Supplemental search strategies ● Examine the references of key studies and reviews ● Examine studies that have cited your key studies (Web of Science, Google Scholar) ● Contact authors, companies, orgs, societies, etc. ● Note journals that frequently publish relevant articles ● Search for ongoing trials (Clinicaltrials.gov) ● Search conference proceedings, abstracts (Scopus, Web of Science, Embase)
  59. 59. FAQ - Find Article Full-Text
  60. 60. FAQ - Save searches and email alerts ◻ PubMed emails you new citations as they enter the database ◻ Click ‘Create alert’ ◻ Use cases: ■ Table of contents ■ Research and clinical topic of interest ■ Keep track of colleague papers
  61. 61. Slides at: <http://slideshare.net/umhealthscienceslibraries/> Session guide: <http://guides.lib.umich.edu/dent610> Contact: Mark MacEachern: markmac@umich.edu Patricia F. Anderson: pfa@umich.edu Tyler Nix: tnix@umich.edu

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