MLA 2015 - Sunrise seminar - A unique metod for fast, high-quality systematic searching

A unique method for fast, high-quality systematic searching

Wichor M. BramerErasmus MC

Rotterdam the NetherlandsMLA - Austin TX –May 18th 2015

handouts: bit.ly/mlabramer1

Research Question

Is exercise therapy an effective treatment for hip osteoarthritis

Simple search strategy:exercise therapy effectiveness hip osteoarthritis

PubMed 69 hits

Embase.com 1916

('hip osteoarthritis'/exp OR ((arthritis/de OR osteoarthritis/de) AND (hip/de OR 'hip pain'/exp)) OR (coxarth* OR ((hip OR cox) NEAR/6 (arthrit* OR arthrosis* OR arthroses* OR osteoarth* OR oa)) OR 'malum coxae senilis'):ab,ti) AND ('kinesiotherapy'/exp OR exercise/exp OR physiotherapy/exp OR 'conservative treatment'/de OR (kinesiotherap* OR kinesitherap* OR exercis* OR physiotherap* OR gymnastic* OR ((movement* OR motion OR manual OR phys* OR conservative* OR nonoperat* OR nonsurg* OR non-operative OR non-surgical OR paramedic* OR para-medical) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water OR management* )) OR ((muscle* OR muscul*) NEAR/3 (train*))):ab,ti)

Research question exhaustive search

Systematic searching

1. Examining the research question2. Identifying key terms

a. Thesaurus termsb. Free text terms

3. Creating a basic search strategy 4. Optimizing the basic strategy5. Translating the strategy between databases

The Research Question

Clear and focused

7

Clear and focused research questionHow can gist knowledge of patients be measured

Is scopic stabilisation better than Bristow Latarjet for treating an Anterior glenohumeral luxation with labrum injury (no ossale disorder) in a 20 YO rugby player for recurrent luxation or other Patient Related Outcome Measures

Dietary intake and cardiovascular disease

TOO VAGUE

TOO SPECIFIC

TOO BROAD

The Research Question

Clear and focusedWhich articles can answer the question?

Which articles can answer the question?

Facilitators and barriers in preconception care

evaluation studies of preconception care

Predictive factors for oronasal fistulas in children treated for clef lip

follow up studies of children treated for clef lip

The Research Question

Clear and focusedWhich articles can answer the question?Elements (Key Concepts):

- Watch our for Bias and Duplicates- Which elements to use in search?

Elements : Bias

Very specific characteristicsDuration of breastfeeding and intelligence

JudgementsPoor family functioning, harsh parenting and bullying behavior

Elements : Duplicates

Pre-eclampsia AND pregnant AND women

Lichtenstein therapy AND inguinal hernias

Which elements to use:Exercise therapy effective for hip osteoarthritis??

generalspecific

important

unimportant

Exercise therapy

Hip osteoarthritis

Treatment effectiveness

Exercise therapy

Hip osteoarthritis

Treatment effectiveness

Identifying thesaurus terms

One element One emtree term

Identifying thesaurus terms

One element One emtree termexercise therapy kinesiotherapy

One element More thesaurus terms (OR)

Identifying thesaurus terms

One element One emtree termOne element Multiple MeSH terms (OR)

prevention and control (Subheading) OR Preventive Medicine OR Preventive Health Services

Multiple elements One emtree term

Identifying thesaurus terms

One element One emtree termOne element Multiple MeSH terms (OR)

Multiple elements One emtree term('cancer mortality' OR (neoplasm AND mortality))(neoplasm OR 'cancer mortality') AND (mortality OR 'cancer mortality')

One element Multiple MeSH terms (AND)Bennett Fracture: (Fracture, Bone AND metacarpal bones AND thumb)Alcohol metabolites: alcohols/metabolism

Identifying free text words

Optimal sensitivity only by additionally searching in title / abstract:• Relevant, non-inverted terms from synonyms/

entry terms

Identifying free text words

Optimal sensitivity only by additionally searching in title / abstract:• Relevant, non-inverted terms from synonyms /

entry termsShoulder: glenohumeral joint- humeroscapular joint- scapulo humeral joint- scapulohumeral joint- articulatio humeri

• Relevant words / phrases from narrower terms

Identifying free text words

Optimal sensitivity only by additionally searching in title / abstract:• Relevant, non-inverted terms from synonyms /

entry termsShoulder: glenohumeral joint- humeroscapular joint- scapulo humeral joint- scapulohumeral joint- articulatio humeri

• Relevant words / phrases from narrower termsColorectal Neoplasms: Colonic cancer- Cancer of Sigmoid- Rectum tumor- Anal Neoplasms…etc…

Creating a basic search strategy

Build your query in WordCopy the query to the database to test itMake changes and translations in Word

The word document is simultaneously:- Supplementary file or the resulting article- Storage of search strategies for customers

Embase.com OvidSP PubMedBoolean AND, OR, NOTThesaurus /exp exp …/ [mh]---- Unexploded /de …/ [mh:noexp]Title / abstract ():ab,ti ().ab,ti. [tiab]Phrases ‘single quotes’ No quotes

needed“Double quotes” or *

Proximity NEAR/n ADJn Not possible: use AND or phrases

Standard syntaxExtended version (20 syntaxes in 7 databases) available upon request

Example

Research Question:Is exercise therapy an effective treatment for hip osteoarthritis

Elements:1. Hip osteoarthritis2. Exercise therapy3. (Treatment effectiveness)

DEMO

Example

Research Question:Is exercise therapy an effective treatment for hip osteoarthritis

Elements:1. Hip osteoarthritis2. Exercise therapy3. (Treatment effectiveness)

Hip osteoarthritis

()

Hip osteoarthritis

(''/exp)

('hip osteoarthritis'/exp)

Hip osteoarthritis

('hip osteoarthritis'/exp OR ():ab,ti)

('hip osteoarthritis'/exp OR (coxarth*):ab,ti)

('hip osteoarthritis'/exp OR (coxarth* OR (() NEAR/3 ())):ab,ti)

Hip osteoarthritis

('hip osteoarthritis'/exp OR (coxarth* OR ((hip OR cox) NEAR/3 (arth* OR osteoarth*))):ab,ti)

('hip osteoarthritis'/exp OR (coxarth* OR ((hip OR cox) NEAR/3 (arth* OR osteoarth*)) OR 'malum coxae senilis'):ab,ti)

Exercise therapy

Exercise therapy

('kinesiotherapy'/exp OR (kinesiotherap* OR kinesitherap* OR ((exercis*) NEAR/3 (technique* OR therap* OR treat*))):ab,ti)

Exercise therapy

('kinesiotherapy'/exp OR (kinesiotherap* OR kinesitherap* OR ((exercis* OR movement*) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet*)) OR ((muscle*) NEAR/3 (train*))):ab,ti)

Treatment effectiveness

Treatment effectiveness

('clinical effectiveness'/exp OR 'comparative effectiveness'/exp OR 'cost effectiveness analysis '/exp OR 'program cost effectiveness'/exp OR 'program effectiveness'/exp)

Treatment effectiveness

('clinical effectiveness'/exp OR 'comparative effectiveness'/exp OR 'cost effectiveness analysis '/exp OR 'program cost effectiveness'/exp OR 'program effectiveness'/exp OR ():ab,ti)

Treatment effectiveness

('clinical effectiveness'/exp OR 'comparative effectiveness'/exp OR 'cost effectiveness analysis '/exp OR 'program cost effectiveness'/exp OR 'program effectiveness'/exp OR (effectiv*):ab,ti)

Concept query('hip osteoarthritis'/exp OR (coxarth* OR ((hip OR cox) NEAR/3 (arth* OR osteoarth*)) OR 'malum coxae senilis'):ab,ti) AND ('kinesiotherapy'/exp OR (kinesiotherap* OR kinesitherap* OR ((exercis* OR movement*) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet*)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp OR 'comparative effectiveness'/exp OR 'cost effectiveness analysis '/exp OR 'program cost effectiveness'/exp OR 'program effectiveness'/exp OR (effectiv*):ab,ti)

152 hits

Creating a basic search strategy (summary)

• Type code in Word• Open an element with ()• For emtree terms type ''/exp and paste term• After pasting all emtree terms, type OR ():ab,ti within

that element once for free text words• Type single word synonyms first• Type (() NEAR/3 ()) somewhere in the document to

reuse• Copy (() NEAR/3 ()) into the ():ab,ti part search for

phrase variants, and add the words

Optimizing your strategy

Sort by relevance and check title / abstract and thesaurusAdd new relevant words to the search in Word

Temporarily change the syntax and check words:Per element, keeping the rest unchanged• (emtree) NOT (free text)• (free text) NOT (emtree)

DEMO

Step 3: optimizing your strategy

1. Check retrieved articles for relevant words

('hip osteoarthritis'/exp OR (coxarth* OR ((hip OR cox) NEAR/3 (arth* OR osteoarth*)) OR 'malum coxae senilis'):ab,ti) AND ('kinesiotherapy'/exp OR (kinesiotherap* OR kinesitherap* OR ((exercis* OR movement* OR motion OR manual) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp OR 'comparative effectiveness'/exp OR 'cost effectiveness analysis '/exp OR 'program cost effectiveness'/exp OR 'program effectiveness'/exp OR (effectiv*):ab,ti)

160 hits

Step 3: optimizing your strategy

1. Check retrieved articles for relevant words2. Temporarily change the syntax for one of the

elements into (emtree) NOT (free text)while keeping the rest unchanged

('hip osteoarthritis'/exp …) AND ('kinesiotherapy'/exp OR (kinesiotherap* OR kinesitherap* OR ((exercis* OR movement* OR motion OR manual) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp …)

('hip osteoarthritis'/exp …) AND ('kinesiotherapy'/exp NOT (kinesiotherap* OR kinesitherap* OR ((exercis* OR movement* OR motion OR manual) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp …)

('hip osteoarthritis'/exp …) AND ('kinesiotherapy'/exp OR (kinesiotherap* OR kinesitherap* OR exercis* OR physiotherap* OR ((movement* OR motion OR manual) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp …)

267 hits

Step 3: optimizing your strategy

1. Check retrieved articles for relevant words2. Temporarily change the syntax for one of the

elements into (emtree) NOT (free text)3. Temporarily change the syntax for one of the

elements into (free text) NOT (emtree)while keeping the rest unchanged

('hip osteoarthritis'/exp …) AND ('kinesiotherapy'/exp OR (kinesiotherap* OR kinesitherap* OR exercis* OR physiotherap* OR ((movement* OR motion OR manual) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp …)

('hip osteoarthritis'/exp …) AND ((kinesiotherap* OR kinesitherap* OR exercis* OR physiotherap* OR ((movement* OR motion OR manual) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp …) NOT 'kinesiotherapy'/exp

('hip osteoarthritis'/exp …) AND ('kinesiotherapy'/exp OR exercise/exp OR physiotherapy/exp OR (kinesiotherap* OR kinesitherap* OR exercis* OR physiotherap* OR ((movement* OR motion OR manual) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water)) OR ((muscle*) NEAR/3 (train*))):ab,ti) AND ('clinical effectiveness'/exp …)

355 hits

End Result – Systematic Review

('hip osteoarthritis'/exp OR ((arthritis/de OR osteoarthritis/de) AND (hip/de OR 'hip pain'/exp)) OR (coxarth* OR ((hip OR cox) NEAR/6 (arthrit* OR arthrosis* OR arthroses* OR osteoarth* OR oa)) OR 'malum coxae senilis'):ab,ti) AND ('kinesiotherapy'/exp OR exercise/exp OR physiotherapy/exp OR 'conservative treatment'/de OR (kinesiotherap* OR kinesitherap* OR exercis* OR physiotherap* OR gymnastic* OR ((movement* OR motion OR manual OR phys* OR conservative* OR nonoperat* OR nonsurg* OR non-operative OR non-surgical OR paramedic* OR para-medical) NEAR/3 (technique* OR therap* OR treat* OR isokinet* OR isomet* OR water OR management* )) OR ((muscle* OR muscul*) NEAR/3 (train*))):ab,ti)

1916 hits

Considerations

Explode a broad term or not?Start exploded, when many irrelevant results

appear, be more specificTruncate a term or not?

Truncate as much as possible, hardly noisePhrases or proximity?

Always proximity, easier and more sensitiveHow broad should proximity be?

Start with 3, increase with 3 andevaluate newly retrieved articles

Step 5: Translating the strategy between databases

Embase.com (Embase and Medline)Thorough optimization of thesaurus terms and title / abstract terms in search strategy

Macro and edit thesaurus

Medline (OvidSP)MeSH terms in PubMed / Optimization

Add extra terms Remove thesaurus

Cochrane library

Macro

Web-of-science

Macro

Scopus

Macro

PubMed publisher

[sb]

Macro and edit

thesaurus

CINAHL (EBSCO)

edit thesaurus

PsycINFO (OvidSP)

Macro and edit

Google Scholar

Macro and edit

Lilacs / Scielo / Eric / Clinical trials etc etc

DEMO

Success factors

• Optimization techniques • Macros for database translation• Single-line search strategies• Database choice and order• Direct feedback by researcher• Creating queries in Word• Computer literaracy• Experience (be pro active)

Contact details

E-mail: [email protected]: @wichorLinkedIn: nl.linkedin.com/in/wichorSlideshare: www.slideshare.net/wichor

Upcoming international workshops:June 2015 Edinburgh (UK) – EAHIL Workshop September 2015 Basel (CH) – AGMB Workshop

Further reading:• Bramer WM, Giustini D, Kramer BM, Anderson PF.

The comparative recall of Google Scholar versus PubMed in identical searches for biomedical systematic reviews: a review of searches used in systematic reviews. Syst Rev. 2013 Dec 23;2:115.

• Bramer WM, Holland L, Mollema J, Hannon T, Bekhuis T. Removing duplicates in retrieval sets from electronic databases: comparing the efficiency and accuracy of the Bramer-method with other methods and software packages (Eahil conference, Rome)

• Embase webinar : Systematic searching with Wichor Bramer (25 feb 2015)• Bramer WM, Pols DHJ, Bindels PJE, Bohnen AM. A fast, reliable and

objective method for creating thematic search filters in bibliographic databases [in process]

• Work in progress on coverage, retrieval and relevance ranking of the major databases for systematic reviews (>450 review searches; >100 finished; >4500 included references)

• Two articles in progress about this methodology (how to, and how well)

Single line approach or set numbers?Well structured?#1 brassica/exp#2 brassica*:ab,ti#3 broccoli:ab,ti#4 #1 OR #2 OR #3#5 neoplasm/exp#6 neoplas*:ab,ti#7 cancer*:ab,ti#8 tumor*:ab,ti#9 #5 OR #6 OR #7 OR #8#10 #4 AND #9#11 [animals]/lim#12 [humans]/lim#13 #11 AND #12#14 #11 NOT #13#15 #10 NOT #14

Unstructured?

(brassica/exp OR (brassica* OR broccoli):ab,ti) AND (neoplasm/exp OR (neoplas* OR cancer* OR tumor*):ab,ti) NOT ([animals]/lim NOT [humans]/lim)

What to do with subheadingsSeparate element(broccoli/de OR (broccoli* OR bassica*):ab,ti) AND (neoplasm/exp OR (cancer* OR neoplas*):ab,ti) AND (prevention:lnk OR prevention/exp OR (prevent*):ab,ti)

Combined element(broccoli/de OR (broccoli* OR bassica*):ab,ti) AND (neoplasms/exp/dm_pc OR ‘cancer prevention’/de OR ((cancer OR neoplasm) NEAR/3 (prevent*)):ab,ti)

Sensitive More hits : 345 (101 unique) Less chance of missing relevant articles Recommended for start For SRs highly recommended

Specific Less hits : 257 (13 unique) Higher chance of missing relevant

articles To reduce the number of hits Use proximity in free text

Why start in embase?Source: Unpublished research Bramer (5048 included references from 111 reviews)

Relevance ranking

Interface choiceEmbase.comPros- Very good relevance ranking

Cons- Translating between embase

and medline more complicated

- No wildcard (?) in truncation- Special characters not

normalized ( VO2max )

OvidSPPros- Equal syntax to medline

(OvidSP)

Cons- No relevance ranking on

complicated queries- Complex thesaurus interface

My advice: relevance ranking is very helpful during optimization. Problems are only minor. Start in embase.com and translate with macros

The databases I use:Database Used in % of SR

Embase.com 100%

Medline (OvidSP) 99%

(PubMed the other 1%)

Cochrane central 98%

Web-of-Science 95%

Google Scholar 92%

PubMed (publisher) 91%

Scopus 36%

Cinahl 25%

PsycINFO 19%

Others (proquest, sportdiscus, lilacs, scielo, eric, amed etc)

7%

Do you need to fully understand the research question?

What is the Cell contribution to chondroid / endochondreal / intramembranous bone formation

((('bone development'/de OR 'bone mineralization'/de OR 'bone maturation'/de OR ossification/de OR 'bone conduction'/de OR 'bone transplantation'/exp OR 'bone matrix'/exp OR 'bone growth'/exp OR 'bone remodeling'/de OR ((bone NEAR/6 (minerali* OR develop* OR format* OR synthesis* OR growth* OR graft* OR transplant* OR engineer* OR defect* OR matri* OR remodel* OR conduct* OR maturat*)) OR osteogen* OR ossificat*):ab,ti) AND (chondroid* OR transchondroid* OR enchondr* OR endochondr* OR intermembran* OR cartilagin* OR (inter NEXT/1 membran*)):ab,ti) OR 'enchondral ossification'/de) AND ('cell death'/de OR 'cell survival'/de OR apoptosis/de OR 'cell differentiation'/de OR 'cell fate'/de OR 'host cell'/de OR 'cell lineage'/de OR (((cell* OR msc OR osteoblast* OR osteocyte* OR osteoclast* OR preosteoblast*) NEAR/3 (death OR senescen* OR contribut* OR differentiat* OR fate OR plasticit* OR reprogram* OR donor* OR host* OR recruit* OR surviv* OR viabilit* OR lineage*)) OR apoptosis):ab,ti)

PICO?P 67 73%I 51 55%C 2 2%O 37 40%S 24 26%? 29 32%

PI 14PO 8PIS 7IO 6P? 6PIO 4P 4I? 4PS? 4PI? 3IOS 3I 3? 2PO? 2IO? 2

Embase.com syntax

()

(''/exp)

('hip osteoarthritis'/exp)

('hip osteoarthritis'/exp OR ():ab,ti)

('hip osteoarthritis'/exp OR (coxarth*):ab,ti)

('hip osteoarthritis'/exp OR (coxarth* OR (() NEAR/3 ())):ab,ti)

('hip osteoarthritis'/exp OR (coxarth* OR ((hip OR cox) NEAR/3 (arthrit* OR arthros* OR osteoarth*))):ab,ti)

Ovid (Medline) syntax

()

(exp ""/)

(exp "osteoarthritis, hip"/)

(exp "osteoarthritis, hip"/ OR ().ab,ti.)

(exp "osteoarthritis, hip"/ OR (coxarth*).ab,ti.)

(exp "osteoarthritis, hip"/ OR (coxarth* OR (() ADJ3 ())).ab,ti.)

(exp "osteoarthritis, hip"/ OR (coxarth* OR ((hip OR cox) ADJ3 (arthrit* OR arthros* OR osteoarth*))).ab,ti.)

PubMed syntax (not optimal)

()

(""[mh])

("osteoarthritis, hip"[mh])

(exp "osteoarthritis, hip"/ OR coxarth*[tiab])

(exp "osteoarthritis, hip"/ OR coxarth*[tiab] OR ((hip[tiab] OR cox[tiab]) AND (arthrit*[tiab] OR arthros*[tiab] OR …)))

(exp "osteoarthritis, hip"/ OR coxarth*[tiab] OR hip arthrit*[tiab] OR cox arthrit*[tiab] OR hip arthros*[tiab] OR cox arthros*[tiab] OR hip osteoarthrit*[tiab] OR …)

How well do the searches perform?

Benchmark This study# terms 46 54# databases 3 7# hits 1399 2224# includes 19 25precision 1.2% 2.0%

Benckmark: 93 systematic reviews from 2014 with an acknowledgement or co-authorship of a medical information specialist from another Dutch academic hospital.

Hausner, 2015 (13); Saleh, 2014 (17); Allen, 1999 (19); Gann, 2013 (47); Lyon, 2014 (9) [1-5] and unpublished data from London Health Sciences Centre in Canada (43)

0 5 10 15 20 25 30 35 40 45 500%

25%

50%

75%

100%

Meta-analysis (N=148)

Hours needed to create search strategy

Perc

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f Sys

tem

atic

Revi

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And the speed?

0 5 10 15 20 25 30 35 40 45 500%

25%

50%

75%

100%

Meta-analysis (N=148)

Bramer (N=258)

Hours needed to create search strategy

Perc

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f Sys

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Revi

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Hausner, 2015 (13); Saleh, 2014 (17); Allen, 1999 (19); Gann, 2013 (47); Lyon, 2014 (9) [1-5] and unpublished data from London Health Sciences Centre in Canada (43)

And the speed?