Optimal search strategies for identifying mental health content in MEDLINE: an analytic survey

OBJECTIVE: General practitioners, mental health practitioners, and researchers wishing to retrieve the best current research evidence in the content area of mental health may have a difficult time when searching large electronic databases such as MEDLINE. When MEDLINE is searched unaided, key articles are often missed while retrieving many articles that are irrelevant to the search. The objectives of this study were to develop optimal search strategies to detect articles with mental health content and to determine the effect of combining mental health content search strategies with methodologic search strategies calibrated to detect the best studies of treatment. METHOD: An analytic survey was conducted, comparing hand searches of 29 journals with retrievals from MEDLINE for 3,395 candidate search terms and 11,317 combinations. The sensitivity, specificity, precision, and accuracy of the search strategies were calculated. RESULTS: 3,277 (26.8%) of the 12,233 articles classified in the 29 journals were considered to be of interest to the discipline area of mental health. Search term combinations reached peak sensitivities of 98.4% with specificity at 50.0%, whereas combinations of search terms to optimize specificity reached peak specificities of 97.1% with sensitivity at 51.7%. Combining content search strategies with methodologic search strategies for treatment led to improved precision: substantive decreases in the number of articles that needed to be sorted through in order to find target articles. CONCLUSION: Empirically derived search strategies can achieve high sensitivity and specificity for retrieving mental health content from MEDLINE. Combining content search strategies with methodologic search strategies led to more precise searches

NGC 4254: An Act of Harassment Uncovered by the Arecibo Legacy Fast ALFA Survey

We present an HI map constructed from the Arecibo Legacy Fast ALFA (ALFALFA) survey of the surroundings of the strongly asymmetric Virgo cluster Sc galaxy NGC 4254. Noted previously for its lopsided appearance, rich interstellar medium, and extradisk HI emission, NGC 4254 is believed to be entering the Virgo environment for the first time and at high speed. The ALFALFA map clearly shows a long HI tail extending ~250 kpc northward from the galaxy. Embedded as one condensation within this HI structure is the object previously identified as a "dark galaxy": Virgo HI21 (Davies et al. 2004). A body of evidence including its location within and velocity with respect to the cluster and the appearance and kinematics of its strong spiral pattern, extra-disk HI and lengthy HI tail is consistent with a picture of "galaxy harassment" as proposed by Moore et al. (1996a,b; 1998). The smoothly varying radial velocity field along the tail as it emerges from NGC 4254 can be used as a timing tool, if interpreted as resulting from the coupling of the rotation of the disk and the collective gravitational forces associated with the harassment mechanism.Comment: accepted for publication in Ap.J.(Lett.). higher resolution figure available at http://egg.astro.cornell.edu/alfalfa/pubs/figs/n4254_f1.ep

A Digital Archive of HI 21 cm Line Spectra of Optically-targeted Galaxies

We present a homogeneous compilation of HI spectral parameters extracted from global 21 cm line spectra for some 9000 galaxies in the local universe (heliocentric velocity -200 < V_Sun < 28,000 km/s) obtained with a variety of large single dish radio telescopes but reanalyzed using a single set of parameter extraction algorithms. Corrections to the observed HI line flux for source extent and pointing offsets and to the HI line widths for instrumental broadening and smoothing are applied according to model estimates to produce a homogenous catalog of derived properties with quantitative error estimates. Where the redshift is available from optical studies, we also provide flux measurements for an additional 156 galaxies classified as marginal HI detections and rms noise limits for 494 galaxies classified as nondetections. Given the diverse nature of the observing programs contributing to it, the characteristics of the combined dataset are heterogeneous, and as such, the compilation is neither integrated HI line flux nor peak flux limited. However, because of the large statistical base and homogenous reprocessing, the spectra and spectral parameters of galaxies in this optically targeted sample can be used to complement data obtained at other wavelengths to characterize the properties of galaxies in the local universe and to explore the large scale structures in which they reside.Comment: 13 pages, 9 figures, 3 external online tables, accepted for publication in ApJ

Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

<p>Abstract</p> <p>Background</p> <p>Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit.</p> <p>Methods</p> <p>The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system.</p> <p>Results</p> <p>Data will be summarized using descriptive summary measures, including proportions for categorical variables and means for continuous variables. Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates. When reporting results from individual studies, we will cite the measures of association and p-values reported in the studies. If appropriate for groups of studies with similar features, we will conduct meta-analyses.</p> <p>Conclusion</p> <p>A decision-maker-researcher partnership provides a model for systematic reviews that may foster knowledge translation and uptake.</p

An overview of the design and methods for retrieving high-quality studies for clinical care

BACKGROUND: With the information explosion, the retrieval of the best clinical evidence from large, general purpose, bibliographic databases such as MEDLINE can be difficult. Both researchers conducting systematic reviews and clinicians faced with a patient care question are confronted with the daunting task of searching for the best medical literature in electronic databases. Many have advocated the use of search filters or "hedges" to assist with the searching process. The purpose of this report is to describe the design and methods of a study that set out to develop optimal search strategies for retrieving sound clinical studies of health disorders in large electronics databases. OBJECTIVE: To describe the design and methods of a study that set out to develop optimal search strategies for retrieving sound clinical studies of health disorders in large electronic databases. DESIGN: An analytic survey comparing hand searches of 170 journals in the year 2000 with retrievals from MEDLINE, EMBASE, CINAHL, and PsycINFO for candidate search terms and combinations. The sensitivity, specificity, precision, and accuracy of unique search terms and combinations of search terms were calculated. CONCLUSION: A study design modeled after a diagnostic testing procedure with a gold standard (the hand search of the literature) and a test (the search terms) is an effective way of developing, testing, and validating search strategies for use in large electronic databases

Rock Bass Learn to Associate Food with a Visual Cue and Remember the Association when Food is Absent

We explored the foraging ability of rock bass (Ambloplites rupestris) by testing three hypotheses consistent with the predictions of optimal foraging theory: 1) fish can learn to associate food with a visual cue; 2) trained fish will go to a visual cue faster than untrained fish; and 3) over time, without the reinforcement of food, trained fish will exhibit a diminished response to a visual cue. Our results supported each hypothesis. During the first 96 h of testing, 88 to 100% of trained fish went to the visual cue first; 50% of the trained fish went to the visual cue first after 312 h. None of the untrained fish went to the visual cue first. Trained fish went to the visual cue significantly faster (11.0 cm sec-1 ) than untrained (1.6 cm sec-1 ) fish. There were no significant differences in velocity to the visual cue among the times tested for control fish (0.8 to 2.6 cm sec-1 ). However, velocities of experimental fish were significantly higher from 0 to 24 h (16.7 cm sec-1 ) than from 48 to 312 h (6.7 cm sec-1 ), suggesting that they began extinguishing their responses as the time since the last food reward associated with the cue increased. If rock bass use these abilities in their natural habitats, they likely improve their foraging efficiency and, thus, their overall fitness. (No actual Publication Date listed on Report

A Modified Evidence-Based Practice- Knowledge, Attitudes, Behaviour and Decisions/Outcomes Questionnaire is Valid Across Multiple Professions Involved in Pain Management

BACKGROUND: A validated and reliable instrument was developed to knowledge, attitudes and behaviours with respect to evidence-based practice (EBB-KABQ) in medical trainees but requires further adaptation and validation to be applied across different health professionals. METHODS: A modified 33-item evidence-based practice scale (EBP-KABQ) was developed to evaluate EBP perceptions and behaviors in clinicians. An international sample of 673 clinicians interested in treatment of pain (mean age = 45 years, 48% occupational therapists/physical therapists, 25% had more than 5 years of clinical training) completed an online English version of the questionnaire and demographics. Scaling properties (internal consistency, floor/ceiling effects) and construct validity (association with EBP activities, comparator constructs) were examined. A confirmatory factor analysis was used to assess the 4-domain structure EBP knowledge, attitudes, behavior, outcomes/decisions). RESULTS: The EBP-KABQ scale demonstrated high internal consistency (Cronbach\u27s alpha = 0.85), no evident floor/ceiling effects, and support for a priori construct validation hypotheses. A 4-factor structure provided the best fit statistics (CFI =0.89, TLI =0.86, and RMSEA = 0.06). CONCLUSIONS: The EBP-KABQ scale demonstrates promising psychometric properties in this sample. Areas for improvement are described

Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

BACKGROUND: Although the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers. METHODS: Electronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints. FINDINGS: Twenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers. CONCLUSIONS: This review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi-faceted interventions. More methodologically rigorous studies that encompass the range of barriers and that include low- and middle-income countries are required in order to inform policies to improve hypertension control

Optimal search strategies for identifying sound clinical prediction studies in EMBASE

BACKGROUND: Clinical prediction guides assist clinicians by pointing to specific elements of the patient's clinical presentation that should be considered when forming a diagnosis, prognosis or judgment regarding treatment outcome. The numbers of validated clinical prediction guides are growing in the medical literature, but their retrieval from large biomedical databases remains problematic and this presents a barrier to their uptake in medical practice. We undertook the systematic development of search strategies ("hedges") for retrieval of empirically tested clinical prediction guides from EMBASE. METHODS: An analytic survey was conducted, testing the retrieval performance of search strategies run in EMBASE against the gold standard of hand searching, using a sample of all 27,769 articles identified in 55 journals for the 2000 publishing year. All articles were categorized as original studies, review articles, general papers, or case reports. The original and review articles were then tagged as 'pass' or 'fail' for methodologic rigor in the areas of clinical prediction guides and other clinical topics. Search terms that depicted clinical prediction guides were selected from a pool of index terms and text words gathered in house and through request to clinicians, librarians and professional searchers. A total of 36,232 search strategies composed of single and multiple term phrases were trialed for retrieval of clinical prediction studies. The sensitivity, specificity, precision, and accuracy of search strategies were calculated to identify which were the best. RESULTS: 163 clinical prediction studies were identified, of which 69 (42.3%) passed criteria for scientific merit. A 3-term strategy optimized sensitivity at 91.3% and specificity at 90.2%. Higher sensitivity (97.1%) was reached with a different 3-term strategy, but with a 16% drop in specificity. The best measure of specificity (98.8%) was found in a 2-term strategy, but with a considerable fall in sensitivity to 60.9%. All single term strategies performed less well than 2- and 3-term strategies. CONCLUSION: The retrieval of sound clinical prediction studies from EMBASE is supported by several search strategies