PubMed TutorialPubMed TutorialAuthor: Gökhan Alpaslan DMD,Ph.DAuthor: Gökhan Alpaslan DMD,Ph.D

PubMed TutorialPubMed TutorialAuthor: Gökhan Alpaslan DMD,Ph.DAuthor: Gökhan Alpaslan DMD,Ph.D

e-vidente-vident

ObjectivesObjectives

Introducing Practitioner PubMedIntroducing Practitioner PubMed Searching for Systematic ReviewsSearching for Systematic Reviews Combining earch TermsCombining earch Terms MeSH SearchMeSH Search

OutlineOutline

What is PubMedWhat is PubMed SearchinSearchingg Clinical Queries Clinical Queries PICO ModelPICO Model PubMed Search PubMed Search Logic of Boolean Logic of Boolean Combining Search TermsCombining Search Terms What is MeSHWhat is MeSH MeSH SearchMeSH Search ReferencesReferences

OutcomeOutcome

Practitioner will;Practitioner will;Know Search ToolsKnow Search ToolsConstruct PICO modelConstruct PICO modelCombine Search TermsCombine Search TermsAble to Search in PubMed Search EngineAble to Search in PubMed Search Engine

PICO ModelPICO Model

PICO or PECO is aPICO or PECO is an acronym used to n acronym used to identify four primaryidentify four primary components of a wellcomponents of a well formulated clinical questionformulated clinical question..

P P = = Patient Population or Patient Population or Problem Problem

I I = = Intervention or Exposure Intervention or Exposure

CC = = Comparison Comparison

OO = = Outcome Outcome

PubMedPubMedhttp://www.ncbi.nlm.nih.govhttp://www.ncbi.nlm.nih.gov

What is PubMedWhat is PubMed Produced by NCBI, PubMed is part of the Produced by NCBI, PubMed is part of the Entrez Entrez retrieval system of related retrieval system of related

biomolecular databasesbiomolecular databases PubMed includes MEDLINE, a premier NLM biomedical database of worldwide PubMed includes MEDLINE, a premier NLM biomedical database of worldwide

journal literature in medicine, nursing, dentistry, veterinary medicine, public journal literature in medicine, nursing, dentistry, veterinary medicine, public health and the preclinical scienceshealth and the preclinical sciences

PubMed is an excellent database for finding some articles on most PubMed is an excellent database for finding some articles on most health/medicine topics.health/medicine topics.

PubMed citations come from more than 5,000 biomedical journals.PubMed citations come from more than 5,000 biomedical journals. PubMed has more than 21 million citations from the 1940's to the PubMed has more than 21 million citations from the 1940's to the

present. present. PubMed includes very recent articlesPubMed includes very recent articles and and updated each week. updated each week. Coverage is current as participating publishers submit electronic citations dailyCoverage is current as participating publishers submit electronic citations daily PubMed is free to anyone with internet access.PubMed is free to anyone with internet access. PubMed includes links to full text at publisher or library web sitePubMed includes links to full text at publisher or library web sitess

Combining similar termsCombining similar terms

Use Boolean operators to combine different Use Boolean operators to combine different termsterms

OROR use to combine different terms for use to combine different terms for the same the same conceptconcept

ANDAND to combine different conceptsto combine different concepts NOTNOT excludes concepts but must be used with excludes concepts but must be used with

caution to avoid excluding relevant caution to avoid excluding relevant itemsitems

Search limitsSearch limitsConsider search refinements to limit to specific Consider search refinements to limit to specific aspects oaspects of f a topic, such as:a topic, such as:

Meta-AnalysisMeta-Analysis ((quantitative summary quantitative summary combining results of independent studiescombining results of independent studies))

human or animal studieshuman or animal studies male or female subjectsmale or female subjects age groups, for example adolescents, infantsage groups, for example adolescents, infants time periodstime periods languageslanguages

Sample Case Scenario; PICO Sample Case Scenario; PICO Model Model

P P ProblemProblem/Patient/Patient

I I InterventionIntervention

CC Comparison Comparison

OO OutcomeOutcome

A patient has prescribed Zometa and A patient has prescribed Zometa and referred to your office by a fellow referred to your office by a fellow oncologist. Patient admitted to your office oncologist. Patient admitted to your office for his/her dental treatment.for his/her dental treatment.Some teeth need to be extracted, Some teeth need to be extracted, periodontal and endodontic treatment as periodontal and endodontic treatment as well. Finally prosthetic rehabilitation well. Finally prosthetic rehabilitation planned. planned. You are aware of Zometa related You are aware of Zometa related osteonecrotic lesions of the jaw bones osteonecrotic lesions of the jaw bones following dental interventions like tooth following dental interventions like tooth extraction. extraction. Is there a dental treatment guideline and Is there a dental treatment guideline and what is the best evidence based treatment what is the best evidence based treatment option for patients under biphosphanates. option for patients under biphosphanates.

LogicLogic of of BooleanBoolean

OR OR will search for articles containing any will search for articles containing any of the terms we chose. of the terms we chose.

Use ORUse OR to combine synonyms, alterative to combine synonyms, alterative spellings or related itemsspellings or related items

ANDAND will search for articles which contain will search for articles which contain all of the terms we haveall of the terms we have chosen.chosen.

Before startingBefore starting searchsearch consider consider;;

TThe keywordshe keywords OOther ways to spell the keywordsther ways to spell the keywords OOther words which mean the same thing ther words which mean the same thing

(synonyms)(synonyms) RRelated keywords elated keywords needneed to to be be includeincludedd LLimitsimits to applyto apply: : date, language, age date, language, age

group, publication typegroup, publication type

By adding terms and combining them with By adding terms and combining them with apropriate boolean practitioner will refine apropriate boolean practitioner will refine search. search.

In this particular example combining In this particular example combining terms “zometa”, “dental treatment”, terms “zometa”, “dental treatment”, “guidelines combined by AND.“guidelines combined by AND.

Therefore, the practitioner retrieved 4 Therefore, the practitioner retrieved 4 systematic reviews.systematic reviews.

MeSHMeSH Medical Subject Medical Subject Headings Headings MeSH is the standard terminology used by the MeSH is the standard terminology used by the

indexer and helps indexer and helps to to find articles on the topic, find articles on the topic, regardless of the exact wording used by the regardless of the exact wording used by the authors. authors. 

CControlled vocabulary of subject termsontrolled vocabulary of subject terms; it; it is is another feature built into PubMed to enhance another feature built into PubMed to enhance retrieval of best evidenceretrieval of best evidence..

What is MeSH?What is MeSH? MeSH is a vocabulary of subject headings and subheadingsMeSH is a vocabulary of subject headings and subheadings Subject terms are selected and approved for use by NLMSubject terms are selected and approved for use by NLM Each year subject headings are revised with additions and Each year subject headings are revised with additions and

deletionsdeletions Scope note indicate what is meant by the termScope note indicate what is meant by the term Used to describe the subject content of all publication types Used to describe the subject content of all publication types

in PubMed and in the in PubMed and in the llibrary catalogibrary catalogss Hierarchy of terms with broad and narrow termsHierarchy of terms with broad and narrow terms Items are indexed with the most specific MeSH term Items are indexed with the most specific MeSH term

availableavailable

AdvantagesAdvantages of of MeSHMeSH• Consistency in meaning of terms is maintained over Consistency in meaning of terms is maintained over

timetime• Synonyms are organized under one MeSH termSynonyms are organized under one MeSH term• Allows for both specific and comprehensive resultsAllows for both specific and comprehensive results• Cuts down on irrelevant retrievalCuts down on irrelevant retrieval

The MeSH controlled vocabulary is a distinctive The MeSH controlled vocabulary is a distinctive feature of MEDLINE. feature of MEDLINE.

ItIt imposes uniformity and consistency to the indexing imposes uniformity and consistency to the indexing of biomedicalof biomedical literature. literature.

MeSH terms are arranged in a hierarchical MeSH terms are arranged in a hierarchical categorized mannercategorized manner called MeSH Tree Structures and called MeSH Tree Structures and are updated annually.are updated annually.

Searching using MeSH allows you to overcome Searching using MeSH allows you to overcome problems of spelling andproblems of spelling and terminologyterminology;; especially especially when you might not be aware of differentwhen you might not be aware of different spellings or spellings or terminologyterminology..

Click on the term to view full record and access Click on the term to view full record and access PubMed search optionsPubMed search options for additional for additional information.information.

Subheadings describe specificSubheadings describe specificaspects of the subject.aspects of the subject. Click if apropriate. Click if apropriate.

Click to add to search builder Click to add to search builder

Tick out the aTick out the apppropriate box to bpropriate box to brroaden oaden or narrow the search for your interestor narrow the search for your interest

Practitioner easily retrieved a guideline for Practitioner easily retrieved a guideline for dental treatment in patients on dental treatment in patients on bisphosphanates by implementing bisphosphanates by implementing appropriate search terms in a short time in appropriate search terms in a short time in MeSH.MeSH.

ReferencesReferences1.1. Elliot AbtElliot Abt; ; TThehe B Basics of asics of EvidenceEvidence Based DentistryBased Dentistry

2.2. ADA ADA Policy on EvidencePolicy on Evidence Based DentistryBased Dentistry

3.3. SutherlandSutherland SS.; .; J Can Dent Assoc 2001; 67:204-6J Can Dent Assoc 2001; 67:204-6

4.4. McQuay HJ, Moore RA; Evidence-based resource McQuay HJ, Moore RA; Evidence-based resource for pain relief. Oxford:Oxford University Press, for pain relief. Oxford:Oxford University Press, 1988.1988.

5.5. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WSRichardson WS;; Evidence based medicine: what it Evidence based medicine: what it is and what it isn't. Bis and what it isn't. BMJMJ. 1996;312:71–72.. 1996;312:71–72.

6.6. UT Health Science Center; Oral Health Information UT Health Science Center; Oral Health Information Tutorial for Dental Public Heath Professionals.Tutorial for Dental Public Heath Professionals.