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PubMed2006

[Rational management of antibiotherapy in ORL infections in children: critical review of the best scientific evidences].

INTRODUCTION: Upper respiratory tract infections are the more prevalent infections in childhood and it is important to know the use and overuse of antibiotics. The objective of this article is to make a systematic and critical review of the best scientific evidence in bibliography in order to use antibiotics rationally in otorhinolaryngology (ORL) infections. MATERIAL AND METHODS: Systematic and structured review of the articles regarding antibiotherapy in ORL infections (pharyngitis, tonsillitis, otitis, sinusitis and laryngitis) in childhood published in secondary (Cochrane Collaboration, clinical practice guidelines, health technology assessment database, etc) and primary (bibliographic databases, biomedical journals, books, etc.) publications and critical appraisal by means of methodology of the Evidence-Based Medicine Working Group. We selected the publications with the main scientific evidence in therapeutical articles (clinical trial, systematic review, meta-analysis and clinical practice guideline). DATA SELECTION: study design, population, intervention, outcomes, main results and applicability in clinical practice. RESULTS: The main secondary information is found in The Cochrane Library and in Clinical practice guideline clearinghouses. The documents in Cochrane Library are, basically, clinical trials, systematic reviews and/or meta-analysis, mainly about otitis (13 documents), sinusitis/rhinosinusitis (6), pharyngitis/tonsillitis (3) and nasopharyngitis (3). We found 17 guidelines, mainly for otitis (8 guidelines), pharyngitis/tonsillitis (5), sinusitis (3) and laryngitis (1). Also, we found some relevant articles in Pubmed database, complementary to secondary publications. CONCLUSIONS: There are a high number of quality scientific studies who support an evidence-based decision making in clinical practice about the rational use of antibiotics in ORL infections in childhood, mainly in otitis, tonsillitis and sinusitis. Every decision in this field will have to be based on a systematic appraisal of the best evidence available in the context of the prevailing values and resources available. Doctor's knowledge (mainly in otorhinolaryngologists and pediatricians) of systematic and critical review of the current literature can help to modify prescribing habits about overuse and misuse of antibiotics in ORL infections.

Anti-Bacterial Agents↗

PubMed2005

[Controversies in the therapeutical management of congenital diaphragmatic hernia: update by means of evidence-based medicine].

INTRODUCTION: Congenital diaphragmatic hernia (CDH) is one of the high-risk diseases in neonatal surgery. The aim of this article is to make an update of the controversies about the therapeutic management (time of surgery and modalities of medical stabilization) of CDH, by means of a systematic and critical review of the best scientific evidence in bibliography. METHODS: Systematic and structured review of the articles about therapeutic management of CDH (surgery, mechanical ventilation, inhaled nitric oxide, extracorporeal membrane oxygenation, surfactant, etc) published in secondary (TRIPdatabase, systematic review in Cochrane Collaboration, clinical practice guidelines, health technology assessment database, etc) and primary (bibliographic databases, biomedical journals, books, etc) publications and critical appraisal by means of methodology of the Evidence-Based Medicine Working Group. We selected the publications with the main scientific evidence in therapeutical articles (clinical trial, systematic review, meta-analysis and clinical practice guideline). RESULTS: The main secondary information is found in The Cochrane Library: 3 systematic review in the Neonatal Group (one specific about the time of surgery, and two related to the use of nitric oxide and extracorporeal membrane oxygenation in neonatal severe respiratory failure). But we found the main relevant articles in Pubmed database, mainly published in Journal Pediatric Surgery and with some clusters of investigation (Congenital Diaphragmatic Hernia Study Group in Texas University and Buffalo Institute of Fetal Therapy in New York University). CONCLUSIONS: From the evidence-based analysis, the results of CDH management between immediate versus delayed surgery were unclear, but delayed surgical (with pre-operative stabilization) has become preferred approach in many centers, and foetal surgery is not better than neonatal one. Opinion regarding the time of surgery has gradually shifted from early repair to a policy of stabilization and delayed repair. Because of associated persistent pulmonary hypertension and/or pulmonary hypoplasia in CDH, medical therapy is focused toward optimizing oxygenation while avoiding barotrauma, using gentle ventilation and permissive hypercarbia. High frequency oscillatory ventilation, inhaled nitric oxide and extracorporeal membrane oxygenation are used in severe cases, but these treatments do not clearly improve the outcome in neonates with CDH. The usefulness of surfactant and partial liquid ventilation are based in animal model experimentation, because the clinical trials in newborns are little and non-conclusive. Challenges for the future in this thematic area include the need for bigger and better trials of therapy in this field, with long-term outcomes among surviving children.

Evidence-Based Medicine↗

PubMed2004

Searching multiple databases for systematic reviews: added value or diminishing returns?

OBJECTIVE: To explore whether searching specialised bibliographic databases identified additional relevant papers to those located by a Medline search for a systematic review of exercise therapy. METHOD: Searches were performed in Medline, two further generalised medical databases (Embase, Cochrane Library) and four specialised databases (CancerLit, Cinahl, PsychInfo, SportDiscus) to identify controlled trials of exercise interventions for cancer patients. RESULTS: A total of 749 different publications were located through the search, of which 18 met inclusion criteria. Fifteen (83%) of these were identified through Medline and three (17%) from three individual specialised databases. A further seven studies meeting inclusion criteria were located through reference lists and contact with experts. CONCLUSION: In this example, searching Medline and additional specialised databases along with checking reference lists and contacting experts was the most effective means of ensuring that all relevant papers were included in the review. Searching Medline alone for systematic reviews of exercise or other unconventional therapies is likely to be inadequate.

Databases, Bibliographic↗

PubMed2002

Reporting of measures of accuracy in systematic reviews of diagnostic literature.

BACKGROUND: There are a variety of ways in which accuracy of clinical tests can be summarised in systematic reviews. Variation in reporting of summary measures has only been assessed in a small survey restricted to meta-analyses of screening studies found in a single database. Therefore, we performed this study to assess the measures of accuracy used for reporting results of primary studies as well as their meta-analysis in systematic reviews of test accuracy studies. METHODS: Relevant reviews on test accuracy were selected from the Database of Abstracts of Reviews of Effectiveness (1994-2000), which electronically searches seven bibliographic databases and manually searches key resources. The structured abstracts of these reviews were screened and information on accuracy measures was extracted from the full texts of 90 relevant reviews, 60 of which used meta-analysis. RESULTS: Sensitivity or specificity was used for reporting the results of primary studies in 65/90 (72%) reviews, predictive values in 26/90 (28%), and likelihood ratios in 20/90 (22%). For meta-analysis, pooled sensitivity or specificity was used in 35/60 (58%) reviews, pooled predictive values in 11/60 (18%), pooled likelihood ratios in 13/60 (22%), and pooled diagnostic odds ratio in 5/60 (8%). Summary ROC was used in 44/60 (73%) of the meta-analyses. There were no significant differences in measures of test accuracy among reviews published earlier (1994-97) and those published later (1998-2000). CONCLUSIONS: There is considerable variation in ways of reporting and summarising results of test accuracy studies in systematic reviews. There is a need for consensus about the best ways of reporting results of test accuracy studies in reviews.

Bias↗

PubMed2003

Measuring use patterns of online journals and databases.

PURPOSE: This research sought to determine use of online biomedical journals and databases and to assess current user characteristics associated with the use of online resources in an academic health sciences center. SETTING: The Library of the Health Sciences-Peoria is a regional site of the University of Illinois at Chicago (UIC) Library with 350 print journals, more than 4,000 online journals, and multiple online databases. METHODOLOGY: A survey was designed to assess online journal use, print journal use, database use, computer literacy levels, and other library user characteristics. A survey was sent through campus mail to all (471) UIC Peoria faculty, residents, and students. RESULTS: Forty-one percent (188) of the surveys were returned. Ninety-eight percent of the students, faculty, and residents reported having convenient access to a computer connected to the Internet. While 53% of the users indicated they searched MEDLINE at least once a week, other databases showed much lower usage. Overall, 71% of respondents indicated a preference for online over print journals when possible. CONCLUSIONS: Users prefer online resources to print, and many choose to access these online resources remotely. Convenience and full-text availability appear to play roles in selecting online resources. The findings of this study suggest that databases without links to full text and online journal collections without links from bibliographic databases will have lower use. These findings have implications for collection development, promotion of library resources, and end-user training.

Computer Literacy↗

PubMed1993

MultiLink--an intermediary system for multi-database access.

The design and implementation is described of MultiLink, a desktop system for direct enduser access to remote bibliographic information. The system is an application of a client-server technique based on a campuswide network, with the objective to assist end-users to accomplish the information--retrieval process by capturing knowledge and expertise for searches in query formulations. MultiLink, via intelligent interfaces, allows users to access several dozens of bibliographic databases. The application integrates regional, national and international resources, and brings library services to the user's desktop level.

Databases, Bibliographic↗

PubMedDate not supplied

Adverse drug reaction monitoring and the Internet: evaluation of the use of the Internet by French Pharmacovigilance Centres and a non-exhaustive survey of websites of interest for collecting information about adverse drug reaction.

The Internet, indisputably the most important source of information obtainable in real time, was long essentially the domain of researchers in the USA, but has now become more accessible to French Pharmacovigilance Centres (CRPV) and pharmaceutical companies. A questionnaire was sent to every CRPV to determine how the Internet was perceived in terms of pharmacovigilance activities and existing Websites of particular value to CRPVs were investigated. Analysis of the questionnaires revealed that 66.7 per cent of CRPVs are connected to the Internet but do not use it fully; 94 per cent of connected CRPVs use it essentially for access to a bibliographic database such as Medline (88 per cent), and none subscribes to discussion lists concerning alert messages on problems related to drugs and therapeutics. Non-connected CRPVs do not intend to use the Internet because of financial considerations, lack of time or the assumption that it is not beneficial in everyday situations. Apparently, many French CRPVs are not sufficiently aware of the importance of the Internet for professional purposes. A non-exhaustive list of sites on the Internet providing information likely to be of use to Pharmacovigilance Centres in their everyday activities is included. The Internet offers far greater possibilities than research for bibliographic references on Medline and could improve the manner in which pharmacovigilance is practised.

Adverse Drug Reaction Reporting Systems↗

PubMed1994

Understanding and using the medical subject headings (MeSH) vocabulary to perform literature searches.

The United States National Library of Medicine's (NLM) MEDLINE database is the largest and most widely used medical bibliographic database. MEDLINE is manually indexed with NLM's Medical Subject Headings (MeSH) vocabulary. Using MeSH, a searcher can potentially create powerful and unambiguous MEDLINE queries. This article reviews the structure and use of MeSH, directed toward the nonexpert, and outlines how MeSH may help resolve a number of common difficulties encountered when searching MEDLINE. The increasing importance of the MEDLINE database as an information resource and the trend toward individuals performing their own bibliographic searches makes it crucial that health care professionals become familiar with MeSH.

Databases, Bibliographic↗

PubMed2003

Electronic searching of the literature for systematic reviews of screening and diagnostic tests for preterm birth.

BACKGROUND: Published systematic reviews on prediction of preterm birth have tended to focus on a limited number of tests and their search strategies have often been relatively simple. Evaluation of all available tests in a systemic review will require a broad search strategy. AIM: To describe a case study of electronic searching for a systematic review of accuracy studies evaluating all tests for predicting preterm birth. METHODS: The search strategy, developed to capture literatures concerning all the tests en-masse consisted of formulation of an appropriate combination of search terms, pilot searches to refine the search term combination, selection of relevant databases, and citation retrieval from the refined searches for selection of potentially relevant papers. Electronic searches were carried out on general bibliographic databases (Biosis, Embase, Medline, Pascal and Scisearch), specialised databases (Database of Abstracts of Reviews of Effectiveness, Medion, National Research Register, Cochrane Controlled Trial Register and Cochrane Database of Systematic Reviews). RESULTS: A total of 30076 citations were identified. Of these 8855 (29%) citations were duplications either within a database or across databases. Of the remaining 21221 citations, 3333 were considered potentially relevant to the review after assessment by two reviewers. These citations covered 19 different tests for predicting preterm birth. CONCLUSIONS: This case study suggests that with use of a concerted effort to organise and manage the electronic searching it is feasible to undertake broad searches for systematic reviews with multiple questions.

Databases, Bibliographic↗

PubMed2004

Cross sectional survey of multicentre clinical databases in the United Kingdom.

OBJECTIVES: To describe the multicentre clinical databases that exist in the United Kingdom, to report on their quality, to explore which organisational and managerial features are associated with high quality, and to make recommendations for improvements. DESIGN: Cross sectional survey, with interviews with database custodians and search of electronic bibliographic database (PubMed). STUDIES REVIEWED: 105 clinical databases across the United Kingdom. RESULTS: Clinical databases existed in all areas of health care, but their distribution was uneven-cancer and surgery were better covered than mental health and obstetrics. They varied greatly in age, size, growth rate, and geographical areas covered. Their scope (and thus their potential uses) and the quality of the data collected also varied. The latter was not associated with any organisational characteristics. Despite impressive achievements, many faced substantial financial uncertainty. Considerable scope existed for improvements: greater use of nationally approved codes; more support from relevant professional organisations; greater involvement by nurses, allied health professionals, managers, and laypeople in database management teams; and more attention to data security and ensuring patient confidentiality. With some notable exceptions, the audit and research potential of most databases had not been realised: half the databases had each produced only four or fewer peer reviewed research articles. CONCLUSIONS: At least one clinical database support unit is needed in the United Kingdom to provide assistance in organisation and management, information technology, epidemiology, and statistics. Without such an initiative, the variable picture of databases reported here is likely to persist and their potential not be realised.

Clinical Medicine↗

PubMed2006

The value of an evidence database for occupational therapists: an international online survey.

BACKGROUND: Online evidence databases can provide access to high quality evidence at the point of care, making evidence-based practice more achievable. A discipline-specific online bibliographic database called OTseeker (www.otseeker.com) was designed for use by occupational therapists. The database is free, and contains citations and abstracts of systematic reviews, and critically appraised randomized controlled trials relevant to occupational therapy. OBJECTIVES: The aim of this study was to investigate search practices of database users, their views on its functionality, and the reported impact, if any, on their practice from using OTseeker. DESIGN: An online survey, placed on the database website for 30 days. SAMPLE: Potential participants were users of OTseeker during a 30-day period. A total of 498 people who had used the database more than once from over 40 countries completed the survey. RESULTS: Three hundred and nine (62%) participants believed that OTseeker had improved their ability to locate research about the effectiveness of occupational therapy interventions, and 92 (19%) agreed that the information in the database had contributed to a change in practice. Those reporting no practice changes agreed that use of OTseeker had improved their knowledge generally (n=189; 38%), confirmed their practice (n=75; 15%), or revealed that there was insufficient research relevant to their search topic (n=92; 19%). Features of the database which helped respondents locate research evidence included: having discipline-specific content, providing critical appraisal ratings for randomized controlled trials, and presenting search results ranked for methodological quality. CONCLUSION: This study confirms the value of a discipline-specific, online database for helping occupational therapists locate high quality research evidence. Information located on databases such as OTseeker can help change or confirm practice, and improve knowledge.

Australia↗

PubMed2006

[Presence of the biomedical periodicals of Hungarian editions in international databases].

Presence of the biomedical periodicals of Hungarian editions in international databases. The majority of Hungarian scientific results in medical and related sciences are published in scientific periodicals of foreign edition with high impact factor (IF) values, and they appear in international scientific literature in foreign languages. In this study the authors dealt with the presence and registered citation in international databases of those periodicals only, which had been published in Hungary and/or in cooperation with foreign publishing companies. The examination went back to year 1980 and covered a 25-year long period. 110 periodicals were selected for more detailed examination. The authors analyzed the situation of the current periodicals in the three most often visited databases (MEDLINE, EMBASE, Web of Science), and discovered, that the biomedical scientific periodicals of Hungarian interests were not represented with reasonable emphasis in the relevant international bibliographic databases. Because of the great number of data the scientific literature of medicine and related sciences could not be represented in its entirety, this publication, however, might give useful information for the inquirers, and call the attention of the competent people.

Bibliometrics↗

PubMed1996

Selecting a database for literature searches in nursing: MEDLINE or CINAHL?

This study compares the usefulness of the MEDLINE and CINAHL databases for students on post-registration nursing courses. We searched for nine topics, using title words only. Identical searches of the two databases retrieved 1162 references, of which 88% were in MEDLINE, 33% in CINAHL and 20% in both sources. The relevance of the references was assessed by student reviewers. The positive predictive value of CINAHL (70%) was higher than that of MEDLINE (54%), but MEDLINE produced more than twice as many relevant references as CINAHL. The sensitivity of MEDLINE was 85% (95% CI 82-88%), and that of CINAHL was 41% (95% CI 37-45%). To assess the ease of obtaining the references, we developed an index of accessibility, based on the holdings of a number of Irish and British libraries. Overall, 47% of relevant references were available in the students' own library, and 64% could be obtained within 48 hours. There was no difference between the two databases overall, but when two topics relating specifically to the organization of nursing were excluded, references found in MEDLINE were significantly more accessible. We recommend that MEDLINE should be regarded as the first choice of bibliographic database for any subject other than one related strictly to the organization of nursing.

Choice Behavior↗

PubMed1999

[The practice of systematic reviews. II. Searching and selection of studies].

Structured searching and selection of studies is an important component of a systematic review. It is recommended to record the various steps in a protocol in advance. The thoroughness of the searching and selection will partially depend on the available resources, like manpower and funds. A search action should be based on an unequivocally formulated research or clinical question, that is operationalized into clear inclusion and exclusion criteria. The actual start of a search strategy is a search in preferably multiple databases like Medline and EMBASE-Excerpta Medica. Additional search actions can be performed in trial registers and printed indexes and by correspondence with experts and hand searching of journals. Storage of the search results in a bibliographic database is recommended. Various methodological problems may play a role in searching and selecting studies for a review: studies may selectively not be published, results are only partially presented in the publication, studies are selectively included in reference lists, and reviewers themselves may make systematic errors in the selection process.

Bias↗

PubMed2002

Examining the evidence in anesthesia literature: a survey and evaluation of obstetrical postdural puncture headache reports.

PURPOSE: To describe a bibliographic database on the literature of postdural puncture headache (PDPH) in the obstetrical population, to describe the research architecture in this field, and to evaluate the quality of case-control studies, cohort studies, and controlled clinical trials on PDPH. METHODS: Computerized bibliographic searches, citation review, and hand searches were conducted to find all relevant citations on incidence, clinical course, prevention, or treatment of PDPH in parturients. The study design and topic(s) covered by each study were evaluated. Case-control studies and cohort studies were evaluated using the Quality Index; clinical trials were evaluated using the Jadad scale. RESULTS: One hundred ninety-six relevant citations were published between 1949 and 1999. Research on PDPH has been increasing rapidly with the majority of studies published in the 1990's. Incidence and prevention were the focus of over half of all citations. Optimal study designs were infrequently utilized. The methodological quality was poor for observational studies (Quality Index 10/29) and clinical trials (Jadad scale 2/5). CONCLUSION: Although the amount of research on PDPH in parturients is increasing, use of optimal study designs and improvement in methodology is needed.

Adult↗

PubMed2005

Searching one or two databases was insufficient for meta-analysis of observational studies.

OBJECTIVE: To address methodologic issues in searching for observational studies by presenting database search methods and results. STUDY DESIGN AND SETTING: Results of two literature searches for publications reporting on observational studies of alcohol consumption and the risk of breast cancer and large bowel cancer were compared, to evaluate the sensitivity of various bibliographic databases and search strategies, including hand-searching reviews and meta-analyses. RESULTS: The target sensitivity of 90% of publications in the breast cancer search was achieved by starting with Medline, then adding Biosis, Embase, and SCI EXPANDED-SSCI, which provided a total of 72 (91%) of the 79 relevant publications. To reach a similar 89% sensitivity for large bowel cancer, at least Biosis, Dissertation Abstracts Online, Embase, ETOH, and Medline had to be searched, with the addition of hand search of reviews and meta-analyses. CONCLUSION: Limiting a search to one or two databases when conducting meta-analyses of observational studies will not provide a thorough summary of the existing literature. The findings support recommendations to implement a comprehensive search of electronic databases and the reference lists of recent review articles and meta-analyses.

Alcohol Drinking↗

PubMed2004

[Scientific information in pediatrics: utility of Indice Médico Español].

The international bibliographic databases (Medline, Embase, Current Contents, etc.) are one of the main sources of information in medicine. Because only some Spanish journals are included in these databases, knowledge and use of the Indice Médico Español (IME) is also important because this database includes almost all Spanish biomedical and scientific journals (basic, experimental and clinical), which provides certain well known advantages for authors and editors in Spain. Of the journals indexed at any given time in the IME (461 journals), those related to pediatrics constitute 5.2 % of the total (24 journals) with a total of 21,006 documents. Only 34 % of all the pediatrics documents in the IME are included in PubMed. The most productive pediatrics journals in the IME are Anales Españoles de Pediatría (8,639, plus 912 registered from 2002 as Anales de Pediatría), Revista Española de Pediatría (2,564), Acta Pediátrica Española (2,189), Archivos de Pediatría (1,365), Pediatrika (1,314), and Cirugía Pediátrica (685). Anales de Pediatría is the third most productive journal in the IME, after Medicina Clínica (13,323) and Revista Clínica Española (9,603). Overall, pediatrics is the second most productive field of research in medicine in Spain after internal medicine. A complementary tool of the IME is the hypothetical study of the national and international impact factor (IF) of Spanish biomedical journals. The hypothetical national IF of Anales de Pediatría (0.334) is noteworthy among Spanish medical journals overall and is much higher than those of Acta Pediátrica Española (0.134), Pediatrika (0.119), Cirugía Pediátrica (0.099) and Revista Española de Pediatría (0.079). The international IF of Anales de Pediatría (0.372) is higher than that of some pediatrics journals included in the Science Citation Index. The IME should be included in bibliographic search strategies for scientific information in pediatrics as a complement to international databases.

Bibliometrics↗

PubMed2026

Published Database Resources for Traditional, Complementary, and Integrative Medicine: Update of a Systematic Review.

BACKGROUND: Traditional, Complementary, and Integrative Medicine (TCIM) has been established in the academic context of universities. In recent years, strategies have been developed worldwide to strengthen the role of TCIM in supporting the health of the population. Online databases are a common way for obtaining evidence-based information. This article is an update of a former systematic review from 2010 on published databases resources for TCIM. METHODS: The databases CINAHL, CAMbase, Web of Science, MEDLINE/PubMed, and Google Scholar search engine were searched for databases related to TCIM published in peer-reviewed journals between 2010 and November 2024. All included databases were visited online, and information on the origin, content, and scope of the database was extracted. RESULTS: A total of 6579 articles were identified through the literature search. After exclusion of irrelevant articles, full-text screening of 127 articles yielded 37 new databases. Together with 16 still available old databases, these mainly contained information on herbal therapies (n = 15) and Traditional Chinese Medicine (n = 11) from 18 different countries. Newly identified medicinal plant databases offer various scientific resources such as crude drugs, indigenous plants, and structures for natural and phytochemical components with molecular biological content. CONCLUSIONS: This literature review illustrates the dynamic development in the database landscape over the last 15 years. While the number of bibliographic databases is shrinking, databases in the field of medical plants/herbal therapy content are on the rise, which might be due to advances in plant genomics and molecular biology.

Humans↗