Finding the Evidence: Tools and Techniques for Literature Searching

Transcription

1 Finding the Evidence: Tools and Techniques for Literature Searching April 24, 2015 Webinar for SHLA CADTH CADTH is an independent, not-for-profit producer and broker of health technology assessments. Federal, provincial, and territorial health care decision-makers rely on our evidence-based information to make informed policy and practice decision about drugs and other health technologies. 1

2 About Us Caitlyn Information Specialist Danielle Rabb Information Specialist Our Team Literature searching for rapid reviews, health technology assessments and CADTH Common Drug Review Agenda and Objectives Systematic Searching The Finding the Evidence Website The use of Filters Value of Peer Review What is Grey Literature and Why Do We Need It? Using Grey Matters and Grey Matters Light Searching Selected Grey Lit Websites 2

3 What is a Systematic Search? Systematic reviews of interventions require a thorough, objective and reproducible search of a range of sources to identify as many relevant studies as possible (within resource limits). This is a major factor in distinguishing systematic reviews from traditional narrative reviews and helps to minimize bias and therefore assist in achieving reliable estimates of effects. Higgins et al. Cochrane handbook for systematic reviews of interventions Section

4 Systematic Search Characteristics Thorough Objective Reproducible Documented Free from bias Peer reviewed The Purpose of Systematic Searches the aspiration of the HTA literature search should not be comprehensiveness but rather the minimization of bias. Booth. Int J Technol Assess Health Care Oct;26(4):

5 Where are they used? Anywhere! Systematic searches are typically performed for the main research questions in an HTAs, Systematic Reviews, Meta Analyses, Rapid Responses, Drug Reviews Examples: All RCTs for X drug treating Y indication All SRs on indication Y All observational studies using drug X All economic evaluations addressing device Z Standards for Systematic Searchers Finding what works in health care: standards for systematic reviews. Washington D.C.: Institute of Medicine of the National Academies; See Chapter 3: Standards for Finding and Assessing Individual Studies. Standard 3.1 Higgins JPT, Green S, eds. Cochrane handbook for systematic reviews of interventions. Version [Updated March 2011]. The Cochrane Collaboration; See Part 2: General methods for Cochrane Reviews. Chapter 6: searching for studies.( Authors: Carol Lefebvre, Eric Manheimer and Julie Glanville on behalf of the Cochrane Information Retrieval Methods Group) 5

6 Finding the Evidence Finding the evidence: literature searching tools in support of systematic reviews 6

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10 Filters Why use filters? Reduce the number of irrelevant results Extract the higher level evidence (i.e. RCTs) Extract a specific concept (ex. QOL, adverse events) Remove off-topic results (ex. animals, editorials) Saves time for IS and researcher Types of Filters Specific methodology RCTs, Systematic reviews Clinical queries Diagnosis, Prognosis, Adverse events Population specific Humans, Pediatrics CADTH Filters InterTASC Search Filter Resource 10

11 Example Filter: RCTs 1. Randomized Controlled Trial.pt. 2. Pragmatic Clinical Trial.pt 3. Randomized Controlled Trials as Topic/ 4. Randomized Controlled Trial/ 5. Randomization/ 6. Double-Blind Method/ 7. Single-Blind Method/ 8. Placebos/ 9. (random* or sham or placebo*).ti,ab,hw. 10. ((singl* or doubl*) adj (blind* or dumm* or mask*)).ti,ab,hw. 11. ((tripl* or trebl*) adj (blind* or dumm* or mask*)).ti,ab,hw. 12. or/1-11 Filters: Warning No filter is infallible Filters are regularly being tested, tweaked and updated but they almost always capture irrelevant records and sometimes exclude relevant ones 11

12 RCT filter would pick up this article And this article Randomized in title and abstract, but not a study! 12

13 But not this one. Study design NOT found anywhere: CADTH Peer Review Checklist for Search Strategies urces/finding- evidence/cadth-peer- review-checklist-search- strategies 13

14 CADTH Peer Review Checklist for Search Strategies Developed from: Sampson M, McGowan J, Lefebvre C, Moher D, Grimshaw J. PRESS: Peer review of electronic search strategies. Ottawa: Canadian Agency for Drugs and Technologies in Health; Peer-Review-Electronic-Search-Strategies_tr_e.pdf Peer Review: Does it Make a Difference? Recent research conducted to determine whether the peer review of literature search strategies has an effect on the number and quality of articles included in CADTH rapid review reports What were the results? 14

15 Phase Two Results: Included Rapid Review Reports EFFECT OF PEER REVIEW ON RETRIEVAL 43% 19% 38% 9/47 (19%) searches: No unique articles retrieved 18/47 (38%) searches: Unique articles retrieved, none included in the final report 20/47 (43%) searches: Unique articles retrieved, one or more articles included in the final report What is Grey Literature? Grey/gray Unpublished Non-commercial material In-house, vertical files Information on the deep web Hard to find Fugitive 15

16 Grey Literature Definition INTERNATIONAL CONFERENCE ON GREY LITERATURE Information produced on all levels of government, academics, business and industry in electronic and print formats not controlled by commercial publishing i.e. where publishing is not the primary activity of the producing body. (Luxembourg, Expanded in New York, 2004) Source: GreyNet: grey literature network service. Amsterdam: GreyNet; Examples of Grey Literature Government Documents Policy Documents Clinical Guidelines Conference Abstracts/Proceedings/Papers Open Access Journals (some un-indexed) Health Technology Assessments Personal Communication Clinical Trials 16

17 Why is Searching Grey Literature Important? Essential component of a comprehensive search Overcomes bias of commercial publications Part of evidence base Most HTAs created for healthcare decision-makers are considered grey literature Comprehensive Coverage Unpublished trials contribute about 20% of the weight in individual meta-analysis. Source: Krishnan RR. Evidence-based practice: how to read what you read. Psychopharmacology Bulletin 2004;37(4):

18 Publication Bias Exclusion of grey literature from meta-analyses can lead to exaggerated estimates of intervention effectiveness McAuley et al. Lancet 2000; 356(Oct 7): Published literature tend to be larger and show larger effects of a health care intervention than those trials found in the grey literature. There was limited evidence to show whether grey trials are of poorer methodological quality than published trials. This means that those carrying out systematic reviews need to search for trials in both the published and grey literature in order to help minimise the effects of publication bias in their review. Hopewell et al. Cochrane Database Syst Rev 2007; 18(2): MR Grey Literature as Evidence Agency for Healthcare Research and Quality (AHRQ): Finding Grey Literature Evidence and Assessing for Outcome and Analysis Reporting Biases When Comparing Medical Interventions: AHRQ and the Effective Health Care Program. Methods Guide for Comparative Effectiveness Reviews. (Prepared by the Oregon Health and Science University and the University of Ottawa Evidence-based Practice Centers under Contract Nos I and I.) AHRQ Publication No. 13(14)-EHC096-EF. Rockville, MD: Agency for Healthcare Research and Quality. November Institute of Medicine (IOM): Institute of Medicine. Finding what works in health care: standards for systematic reviews. Washington D.C.: National Academy of Sciences; March What-Works-in-Health-Care-Standards-for-Systematic-Reviews/ 18

19 Grey Literature as Evidence Health Technology Assessments (HTAs) and/or Meta-analysis Safety advisories or adverse event reports Clinical Practice Guidelines Source: Trip Database Grey Literature: Benefits and Challenges Benefits Challenges Can reduce publication bias Large volume of material Current Time-consuming to find Usually free Not always available online Unique content Quality of evidence varies Information on nonmainstream topics Helps in identifying terms for search strategies Bibliographic information may be missing Inconsistent language, no subject indexing 19

20 Grey Matters: A Practical Deep-Web Search Tool for Evidencebased Medicine nding-evidence-is/grey-matters 20

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26 Health Technology Assessments (HTAs) KEY RESOURCES Databases: Centre for Reviews and Dissemination (CRD) ; The Cochrane Library ($) Trip Database Stand-alone websites: Health Quality Ontario Publications and OHTAC Recommendations L Institut national d excellence en santé et en services sociaux (INESSS) Canadian Agency for Drugs and Technologies in Health (CADTH) 26

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37 Safety/Advisory HEALTH CANADA MedEffect Canada CARN 37

38 Safety/Advisory OTHER KEY RESOURCES U.S. Food and Drug Administration (FDA) MedWatch European Medicines Agency (EMA) Patient Safety cines/landing/pha_listing.jsp&mid=wc0b01ac058001d126 38

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40 Clinical Practice Guidelines A search for clinical practice guidelines may extend to association websites or organizations dedicated to a particular disease or patient group, depending on the requirements of the search Guidelines Protocols Positions statements Patient information sheets and resources Recommendations 40

41 Clinical Practice Guidelines KEY RESOURCES Canadian Medical Association CMA Infobase: Clinical Practice Guidelines (CPGs) National Institute for Health and Clinical Excellence NICE Guidelines National Guideline Clearing House (NGC) 41

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46 Complimentary Medicine and Botanicals HerbMed Memorial-Sloan Kettering Cancer Center 46

47 Browsing by scientific name Searching by scientific or commonly-known name 47

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49 Physiotherapy and Rehabitation Centre for Evidence-Based Physiotherapy: PEDro National Rehabilitation Information Center: REHABDATA 49

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