Dr' R' Rejikumar BHMS, MDHom

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Literature Review

• Dr. R. Rejikumar BHMS, MD(Hom)
• Lecturer, SKHMC
• State Joint Secretary, IHMA
• www.homoeopathyhome.com

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tributes to pioneers of Homoeopathy
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ACKNOWLEDGEMENTS

• Dr. Ravi. M. Nair , Former Advisor (Homoeo) ,
  Govt. of India
• Dr. V. M. Janakikutty, Principal Controlling
  Officer, GHMCT
• Dr. Mohan, Principal, SKHMC
• Dr. P. Muraleedharan, Rtd. Principal, GHMCC
• Dr. Nisha Paul, Superintendent, GHMCT
• Dr. S. Saveesh Kumar, Head, Dept. of Medicine,
  GHMCT
• Dr. Sajith Kumar, Asst. Prof, Dept. of Community
  Medicine, MCT
• Dr. Ravi Prasad Varma, Asst. Prof, Dept. of
  Community Medicine, MCT

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Why search medical
literature?

• Clarify your research idea and sharpen your
  research question
• Establish a theoretical framework for your study
• Find investigations similar to the one you are
  contemplating
• Learn from similar study designs

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Why search medical literature?

• Define your variables and terms clearly
• Identify useful methodologies and instruments
• Appreciate historical perspective
• To identify authorities or important contributors
  in the field

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Sources of medical literature

• Primary Sources Journal articles that report
  original work
• Print
• Electronic
• Secondary Sources
• Textbooks
• Monographs
• Review Articles
• Alternative Sources
• Government publications
• Doctoral dissertations
• Unpublished data

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Textbooks and monographs

• Textbooks
• Useful only for getting to know a topic
• One or few authors restricted viewpoint
• Information at least two years old
• Monographs
• Authors are usually authorities in the field
• Dated information

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Review articles

• Information is more current
• Authors are specialists in the area of study
• References provided are good sources of more
  reading material
• Organized search for journal articles of original
  research is a must

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Search for medical literature

• Traditional
• Index Medicus
• Year books
• Excerpta medica
• Electronic databases
• Medline
• Others
• World Wide Web

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The traditional library

• Browsing the shelves
• Catalogues or index cards
• Books have unique identity (ISBN)
• Books are permanent written records

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The World Wide Web

• Two billion pages of information
• Lacks bibliographic control standards
• No equivalent to the ISBN
• No standard system of cataloguing or
  classification
• Most documents lack even the name of the author
  and the date of publication
• Person working in remote area with no good
  library can access information

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Search Engine

• Huge databases
• Enable quick access to vast amounts of
  information
• Can perform searches on any keyword or subject
  combination
• Access is totally FREE
• But the things you seek may not always be at the
  top of the retrieved page

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Search Engine

• Google (www.google.com)
• Largest database
• Best for ranking results
• Saves web pages
• Google scholar (www.scholar.google.com)
• Provides academic information only
• AllTheWeb (www.alltheweb.com)
• AltaVista (www.altavista.com)

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Specialty databases

• More effective at finding what you need than a
  general search engine
• Dedicated to collecting relevant sites for a
  particular subject

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Medical databases

• MEDLINE
• database of NLM searchable by NLMs pubmed and
  several other search engines
• OMIM
• Online Mendelian Inheritance in Man The most
  comprehensive database on genetic diseases.
• CDC WONDER (http//wonder.cdc.gov/)
• provides a single point of access to a variety of
  CDC reports, guidelines, and numeric public
  health data

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Medical databases

• PDQ- (http//cancernet.nci.nih.gov/pdq.html )
• Physicians Data Query. By National Cancer
  Institute. The best and current database on
  cancer prevention, screening and treatment.
• The Cochrane library
• For evidence based medicine
• National Guideline Clearinhouse
• For guidelines on various diseases.
• Medical Matrix
• OMNI
• UK gateway to quality biomedical and health
  information

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Medline

• MEDLINE (Medical Literature Analysis and
  Retrieval System Online) is the electronic
  version of the Index Medicus
• Over 10 million articles published in 4300
  journals in 40 different languages from 75
  countries
• PubMed is a search interface from the National
  Library of Medicine (NLM) It is free.
• Other search software like Ovid

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Pubmed

• Coverage includes medicine, dentistry, nursing,
  health care literature, veterinary medicine, and
  the pre-clinical sciences
• Covers 4,600 biomedical journals
• Contains over 14 million records dating back to
  1950s
• PubMed includes MEDLINE records, in-process
  records, and out-of scope citations from
  publisher-supplied records

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Basic PubMed Searching

• State what you want to find
• Find information on ocular complications of
  diabetes
• Identify keywords
• Find information on ocular complications of
  diabetes

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Basic PubMed Searching

• Select synonyms and variant word forms
• Ocular, ophthalmic, eye
• Combine keywords, synonyms and variant word forms
• (ocular OR ophthalmic OR eye)
• Check your spelling

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Basic PubMed Searching

• Enter one or more terms in query box (terms are
  automatically combined with AND)
• Hit GO
• PubMed displays results in Summary format

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Learn to use..

• Boolean operators
• MeSH browser
• Limits
• Tags
• Citation matcher
• Related PubMed Articles Link
• Clipboard
• Bookshelf

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Boolean operators

• PubMed Boolean operators AND, OR, NOT (must be
  typed in upper case!)
• Terms are automatically combined with AND dont
  have to type this!
• AND retrieves what 2 or more sets have in common

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Boolean operators

• OR retrieves either term or set (synonyms)
• NOT excludes term or set

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MeSH

• "concept-based" search methodology
• Medical Subject Heading (MeSH)
• Over 19,000 standardised medical terms constitute
  the thesaurus of MeSH
• MeSH is in the form of a tree where subject
  headings are arranged under one another with
  increasing specificity
• 82 subheadings
• Trained indexers scan published articles,
  interpret the findings, identify the thrust or
  themes of these articles, and assign 10-12 MeSH
  terms and subheadings to each article.

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MeSH searching

• When you type a word or phrase in the search box,
  it is automatically matched for a MeSH term and
  also simultaneously searched in all fields as a
  text word
• eg. Typing in olfactory neuroblastoma results
  in search for
• ("esthesioneuroblastoma, olfactory" MeSH Term
  OR olfactory neuroblastoma Text Word).

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MeSH searching
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LIMITS
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Tags

• (AB) Abstract
• (AD) Affiliation
• (AU) Author
• (EDAT) Publication Date
• (MeSH) MeSH Terms
• (TI) Title
• (TA) Journal Title Abbreviation

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RELATED ARTICLES
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CITATION MATCHER
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FULL TEXT ARTICLES
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Free Medical Journals

• NEJM
• BMJ group of journals 27 nos.
• BMJ
• Gut
• Heart
• J of Clin Pathol
• J of Medical Ethics
• Br J of Ophthalmology

• Homeopathy (BHJ)
• Links
• Homeotimes
• Hpathy

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Clipboard

• Place to collect selected citations
• Citations can be saved or printed
• Upto 500 citations can be placed

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BOOK SHELF
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LINKOUT
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Images

• Books
• Bookshelf
• Atlas
• Google images

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SOUND VIDEO
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CRITICAL REVIEW-an overview

• What is critical review?
• What are the important steps?

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CRITICAL REVIEW

• An analytical approach to published work
• Looks at published work in a systematic manner,
  evaluating the pluses and minuses
• Helps in the learning process by giving a proper
  weight to the information contained in a
  published work, as well as informing our own work

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The background and rationale

• What circumstances led to this research?
• What are the socio-economic, biomedical or policy
  questions that underly this question?

Task for group I Discuss the background of the
research question in the paper
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The Research Question
Task for group II Read the article given and
make a three-minute presentation on the research
question

• WHAT is/ are the objectives of the present work?
  What is the research question involved?
• Is it likely to add to the understanding about
  the subject? Is it likely to answer operational
  questions? Is it a locally specific question?
• Is it a me too research?

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Population and sample
Task for group III Comment on this aspect of the
article

• What is the target population in which the study
  was done? Is it an appropriate population?
• What was the sample SIZE? Was it appropriate? Was
  the selection process unbiased?
• Was there an appropriate control group (in
  relevant cases)?

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Methodology
Task for group IV Comment on whether methods
were appropriate

• HOW was the question approached? What was the
  design? Is it appropriate?
• How was information collected? What were the
  opportunities for bias (systematic error) in
  selection or collection of information?
• In case of laboratory methods, were the
  techniques relevant and appropriate?
• In the case of human subjects, was informed
  consent obtained? Was the conduct of the study
  ethical?

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Analysis
Task for group V discuss the analysis of data in
the paper

• Was the analysis appropriate? Were the right
  statistical tests done?
• Is there any approach that could have been used
  in the analysis that was unexplored by the
  authors?
• Are all the subjects in the study accounted for?
  Is the response rate adequate?

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Conclusions
Task for group VI Comment on the conclusions in
the given article

• What are the main conclusions? Are they
  applicable to general population?
• Are the conclusions justifiable from the
  findings? Do the findings allow for alternate
  explanations that have not been considered by the
  authors?
• Have the authors discussed their limitations?

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Thank you
Dr. R. Rejikumar
Ph 98 95 98 15 30