Searching For Qualitative Evidence

1
Searching For Qualitative Evidence

• Helen Buckley Woods

2
Learning Outcomes

• Describe the particular challenges inherent in
  identifying qualitative research
• Apply appropriate tools to focus a qualitative
  question
• Identify key terms to assist retrieval of
  qualitative research
• Demonstrate an awareness of search filters for
  qualitative research

3
Todays Session

• A game of two halves
• Constructing a search strategy and sources of
  evidence
• Filters and other techniques

4
Part One Search strategies and sources

• Whats different about searching for Qualitative
  Research?
• Tools for focussing your question
• Sources of Qualitative Research
• Case study worked search example
• Practical Sifting Abstracts Exercise

5
Qualitative Research

• Qualitative research seeks to understand and
  interpret personal experiences, behaviours,
  interactions, and social contexts to explain the
  phenomena of interest, such as the attitudes,
  beliefs, and perspectives of patients and
  clinicians the interpersonal nature of caregiver
  and patient relationships the illness
  experience or the impact of human suffering.
  (Wong et al, 2004)

6
Qualitative Research

• Research that derives data from observation,
  interviews, or verbal interactions and focuses on
  the meanings and interpretations of the
  participants (From Holloway and Wheeler, "Ethical
  issues in qualitative nursing research," Nursing
  Ethics, 1995 Sep 2(3) 223-232).Year
  introduced 2003
• MeSH

7
What do I need to consider?

• Qualitative research is small part of the
  research literature
• The indexing in databases is inconsistent and
  variable
• Qualitative studies sometimes have creative
  titles or inadequate abstracts
• Medline might not be your preferred resource.
• If searching in limited databases try MEDLINE and
  CINAHL

8
Focussing Qualitative Questions
9
Applying question tools to your search
formulation

• Health services research uses
• PATIENT-INTERVENTION-COMPARISON-OUTCOME (PICO)
  structure
• Within social sciences research SPICE may be more
  appropriate
• SETTING
• PERSPECTIVE
• INTERVENTION / EXPOSURE / INTEREST
• COMPARISON
• EVALUATION

10
An example of SPICE Actual Example

• SETTING Awaiting Surgery
• PERSPECTIVE Patients
• INTERVENTION - Coronary Artery Bypass Graft
  Surgery
• COMPARISON None
• EVALUATION Uncertainty and Anxiety

11
Another example of SPICE

• SETTING Primary Care
• PERSPECTIVE Patients with Diabetes
• INTERVENTION Good Blood Pressure Control
• COMPARISON None
• EVALUATION Attitudes

12
Try and put this question into the SPICE Framework

• What is the impact of childhood cancer on their
  parents in terms of their quality of life in the
  home?
• Setting
• Perspective
• Intervention/Exposure
• Comparison
• Evaluation

13
An alternative - ProPheT!

• Problem First time mothers
• Phenomenon of Interest Attitudes to
  Breastfeeding
• Time Within first six months of birth

14
Exercise Use the SPICE or ProPheT framework to
formulate your own research question
15
Feedback from Exercise One
16
Sources of Qualitative Research
17
(No Transcript)
18
Sources of Qualitative Research - 1

• Journal Articles
• ASSIA
• British Nursing Index
• CINAHL
• ERIC
• MEDLINE
• Social Science Citation Index
• Sociological Abstracts

19
Sources of Qualitative Research - 2

• Dissertations
• Dissertation Abstracts
• Index to Theses
• CINAHL
• Books and Book Chapters
• British Library OPAC
• COPAC
• Specialist Library Collections

20
Case Study

• You are working on an ESRC funded project looking
  at the benefits of a doula (a woman experienced
  in childbirth who provides continuous physical,
  emotional, and informational support to the
  mother before, during and just after childbirth)
  for low-income mothers.

21
Our example of SPICE

• SETTING the Developed World (with comparable
  health systems to the UK)
• PERSPECTIVE Low-income mothers
• INTERVENTION Doula (Lay support)
• COMPARISON Professional support or No Support
  
• EVALUATION Perceived levels of social support,
  birth outcomes, levels of breastfeeding etc.

22
Example of Search Strategy in Cinahl
23
Example of Search Strategy in Cinahl
24
Subject headings
25
Identifying Qualitative Research - Terminology

• Generic terms e.g. qualitative plus
• Exploratory Methods Focus group, Grounded
  theory, Action Research, Content analysis,
  Thematic analysis
• Software Nudist or NVivo
• Citations Glaser Strauss
• Application Ethnology, Psychology
• Phenomenon Perceptions, Attitudes, User Views,
  Standpoint, Viewpoint
• Approaches Ethnographic
• Data Stories, Narratives, Descriptions, Themes,
  Findings
• Experiences Encounters, Experiences

26
Exercise Identifying Qualitative Research from
Abstracts

• Using the handout provided consider the six
  references taken from Cinahl or Medline.
• For each references mark all the words or phrases
  that identify the item as qualitative research.

27
Feedback from Exercise Two
28
Recap on the session so far

• Challenges in searching for qualitative research
• Sources
• Tools to help with your question
• Case Study
• Keywords and subject headings to consider

29
Part Two Search Filters and other search
techniques

• Methodological filters
• Using a key citation to identify research
• Using the web to find research

30
What is a methodological filter?

• A hedge or filter is a standardised search
  strategy that is designed to be used in
  conjunction with a subject search to retrieve
  valid studies from the (primary) medical
  literature.
• Filters work in one of two ways
• by identifying particular publication types or
  study designs most likely to answer a question
• by isolating subject or free-text terms most
  likely to be associated with high-quality studies

31
How do they work?

• Filters come from 3 different sources-
• Subject heading
• Keyword
• Publication type

32
How do I use a methodological filter?

• Step One Carry out a subject search as usual
  using subject headings and/or free text
• Step Two Apply methodological filter appropriate
  to question you are asking
• One-line filter
• Maximum sensitivity filter
• Maximum specificity filter
• Mid-range filter

33
For today, some one-liners ...

• MeSH Heading
• e.g. Qualitative Research Medline 2003-
• Keyword
• Findings
• Publication Type
• Research CINAHL only

34
Methodological filters 1

• MEDLINE
• Nursing-Methodology-Research.DE.
• qualitative ADJ research
• grounded ADJ theory
• ethnograph
• 1 or 2 or 3 or 4

Marks S. Qualitative Studies. In McKibbon A,
editor. PDQ Evidence-Based Principles and
Practice. 1st ed. Hamilton B.C. Decker, Inc.
1999. pp 187-204
35
Methodological filters 2

1. qualitative
2. findings
3. interview
4. interviews.DE.
5. 1 OR 2 OR 3 OR 4

Grant MJ. How does your searching grow? A survey
of search preferences and the use of optimal
search strategies in the identification of
qualitative research. Health Info Libr J. 2004
Mar 21(1)21-32.
36
Methodological filters 3
Sensitivity-maximising filter interview or
px.fs. or health-services-administration.DE.
Specificity-maximising filter qualitative or
themes
Optimised filter interview.TI. or interview.AB.
or interview.DE. or experience.TI. or
experience.AB. or experience.DE. or qualitative
Adapted from Wong SS, Wilczynski NL, Haynes RB.
Developing Optimal Search Strategies for
Detecting Clinically Relevant Qualitative Studies
in MEDLINE. Medinfo. 2004 2004311-6.
37
Definitions

• Sensitivity the ability of a search strategy to
  identify relevant records
• Specificity the ability of a search strategy to
  exclude irrelevant records

Spring M. (2008). Applying the principles of EBM
to public health searching for public health
evidence the experience at the National
Institute for Health and Clinical Excellence
(NICE). Eahil conference, Held on 23-28 June,
Helsinki, Finland.
38
Methodological filters 4 Ovid MEDLINE

• Best Sensitivity
• interview.tw. OR px.fs. OR exp health services
  administration
• Best Sensitivity Small decrease in Sensitivity
  with large increase in Specificity
• interview.mp. OR px.fs. OR qualitative.tw.
• Best Specificity
• qualitative.tw. OR themes.tw.
• Best Specificity Small decrease in Specificity
  with large increase pin Sensitivity
• interviews.mp, t. OR qualitative.mp. OR
  experiences.tw.
• Best Optimization of Sensitivity and Specificity
• interview.mp. OR experience.mp. OR
  qualitative.tw.

39
Methodological filters - 5

• Dont forget MeSH heading Qualitative Research
• Introduced in 2003, so coverage is limited
• But you can combine it with one of the previous
  filters by using the OR operator

40
Methodological filters - 5

• Best sensitivity exp interviews
• Best specificity audiorecording.sh.
• Best optimization of sensitivity and specificity
  exp study design
• Wilczynski NL, Marks S, Haynes RB. Search
  strategies for identifying qualitative studies in
  CINAHL. Qual Health Res. 2007 May17(5)705-10.

41
Methodological Filters 6 EMBASE

• Best Sensitivity (Single term)
• interview.mp.
• Best Sensitivity (Combination)
• interview.mp. OR qualitative.tw. OR exp health
  care organization
• Best Specificity (Single term)
• qualitative.tw.
• Best Specificity (Combination)
• qualitative.tw. Or qualitative study.tw.
• Best Optimization of Sensitivity and Specificity
  (Single)
• exp health care facilities and services
• Best Optimization of Sensitivity and Specificity
  (Combination)
• interview.tw. OR exp health care organization OR
  experiences.tw.

42
So how does this work in practice?

• You are conducting a systematic review to examine
  the lack of support available for the husbands of
  women who have been diagnosed with breast cancer.
• The review commissioners want to answer what
  counselling and support services should be
  offered in response to the husbands needs?
• You start by searching Medline for published
  accounts of the husbands attitudes to their
  wives disease.

Example 1
43
SPICE breakdown

• You break search down into following components
• Setting Primary and Community Care
• Perspective Husbands
• Intervention/
• Exposure Wife with breast cancer
• Comparison Perhaps the needs of the
• wives themselves
• Evaluation Attitudes

Example 1 continued
44
Mapping to Subject Headings

• Match SPICE components to relevant MeSH or other
  headings (if any)
• Setting Primary-Health-Care
• Perspective Spouses
• Exposure Breast-Neoplasms
• Comparison ???
• Evaluation Attitude-To-Health

Example 1 continued
45
Search strategy

1. husband OR Spouses.W..DE.
2. 1 AND Breast-Neoplasms.DE.
3. 2 AND (qualitative OR interview OR findings OR
   Interviews.W..DE. OR Attitude-To-Health.DE.)

Note that in line 3 we have used Grants filter
Example 1 continued
46
Citation Searching
We identify a key methodological or subject text
47
(No Transcript)
48
(No Transcript)
49
(No Transcript)
50
(No Transcript)
51
Using the Web to Identify Qualitative Research
52
Google Scholar (scholar.google.com)
53
Scirus http//www.scirus.com/
54
Scirus
55
Research from Flemming Briggs (2007)

• Findings showed that a simple search strategy
  (broad-based terms - 3 search terms) was as
  effective as a complex one (free text - 48 search
  terms) in locating qualitative research on
  patients experiences of living with a leg ulcer.
• It may be feasible to restrict searches with a
  clear nursing focus to the CINAHL bibliographic
  database.
• Replication of findings with other nursing topics
  is required.

56
Learning Outcomes

• Describe the particular challenges inherent in
  identifying qualitative research
• Apply appropriate tools to focus a qualitative
  question
• Identify key terms to assist retrieval of
  qualitative research
• Demonstrate an awareness of search filters for
  qualitative research

57
References - 1

• Flemming K, Briggs M. Electronic searching to
  locate qualitative research evaluation of three
  strategies. J Adv Nurs. 2007 Jan57(1)95-100.
• Grant MJ. How does your searching grow? A survey
  of search preferences and the use of optimal
  search strategies in the identification of
  qualitative research. Health Info Libr J. 2004
  Mar 21(1)21-32
• Marks S. Qualitative studies. In McKibbon A,
  Eady A and Marks S. PDQ evidence-based principles
  and practice . Hamilton, Canada BC Decker Inc.,
  1999.

58
References - 2

• Spring M. (2008). Applying the principles of EBM
  to public health searching for public health
  evidence the experience at the National
  Institute for Health and Clinical Excellence
  (NICE). Eahil conference, Held on 23-28 June,
  Helsinki, Finland
• Wilczynski NL, Marks S, Haynes RB. Search
  strategies for identifying qualitative studies in
  CINAHL. Qual Health Res. 2007 May17(5)705-10.
• Wong SSL, Wilczynski NL, Haynes RB. Developing
  optimal search strategies for detecting
  clinically relevant qualitative studies in
  Medline. Medinfo 2004311-314.