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Transcript - Medical Research: Finding Studies By Type - May 10 2018

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>> We have a few people now. Before we get started if someone could go to the questions panel and let me know that you can hear me so I know that I am not speaking to no effect. If somebody could just type in there yes, I can hear you. Great. Thank you. Very much. Wonderful. I am just going to go over housekeeping bits before I get started. I will wait until the top of the hour. Sometimes people join at the last minute. The PowerPoint slides are available in the webinar so if you go to the section that says handouts you won't see that if you have the webinar taking up your entire screen so you would need to get out of that and be able to see the panel for the webinar and then you click on handouts and click on PowerPoint and you can download that and save it to your computer forever. We will record the session. I will start the recording when we get going on the content and you are going to automatically get a recording of the webinar in your email. It will come from the goats webinar account so if you don't see it, I will send it in just a few hours after we are done. If you do not see it by the end of the day or tomorrow check your junk or spam mail since it is automated it goes there a lot. And we will answer related questions at the end of the webinar but if you have other library questions that are not related to the content I am covering I ask that you please use our ask a librarian service instead. I want to stay on topic today and get through all the information that I want to share with you so other questions that you have that are not related to what I am talking about please just use our ask a librarian service. And it looks like we are at the top of the hour.

I am going to go ahead and advance my slides and then I will start recording.

>> And share your slides.

>> All right welcome to our webinar today it is about medical research: finding studies by type. I am Erin Guldrandsen. I like to have my WebCam are on just for a little bit so you know I am a real person. And behind the scenes is Julie James the other fantastic health sciences and nursing librarian. She is there and she will be answering questions if you have them behind the scenes.

Let's get into what we are going to cover today I'm going to turn off my WebCam. It can be distracting.

Our objectives are to know where to find the evidence-based practice research guide that we have any library so I am basing some of what I am talking about off of a particular part of that guide so I want you to know where you can find that and learn more about finding evidence-based practice research.

And our focus today in this webinar is learning how to search for unfiltered medical research study types so there are filtered types of articles or filtered types of evidence and the unfiltered types of evidence. Let me briefly explain what that means and we will see again on the evidence based practice research guide when I show you how to get to that.

Unfiltered study types is similar to thinking about primary sources so there is nothing between you, the reader, and the person who did the actual research study. So there is no filtering going on. It is, they went and did some kind of study, and experiment or observational study and they are writing up their article and they get it published. They are telling you what they did and you are reading it. That is opposed to, separate from filtered study types a filtered type of evidence would be something like a systematic review where somebody who is writing that or a team of people writing that systematic review filtering the information for you. They did not actually go through the experiments. They are talking about experiment's others did and they are analyzing and telling you about it as the reader. That is a different topic. The filtered evidence type we are not looking at those today. We are just looking at unfiltered medical research study types. And I'm specifically going to show you how to find randomized control trials, controlled clinical trials, clinical trials and we will talk about what all of these mean and what they are as we go along. Cohort studies and case control studies. I am going to focus my searches in CINAHL and Medline. Yes you can do the other places sometimes that comes up but what about pub med you can do that in pop up, too but for the sake of having a nice succinct webinar I'm just going to show you how to search in CINAHL and Medline. Sometimes people come across these two different study types by chance. They do a keyword search somewhere in a database and they happen to find a randomized controlled trial supported this webinar talks about what each of these study types is, what does it mean in a randomized controlled trial or what is a clinical trial. And then if you did want to find any of these study types on purpose how you can do that purposefully but I think it is also good to know what each of these different study types means so if you come across them in research maybe you don't have to have a randomized controlled trial for an assignment but if you come across one you know what that means and why that is a good level of evidence for whatever it is you are researching.

Let me go ahead and I'm going to start on the library homepage and show you how we get to this evidence-based practice research guide because it is so helpful. The links are there right in the PowerPoint so that is a good reason to save the PowerPoint so that you have the links. But I will show you how to get to it.

This is the library homepage. I hope it looks familiar. I don't like to assume anyone knows anything because maybe you don't use the library very often. You can get to the library homepage through your portal. If you want you can also just bookmark it and you can get right to the library without having to go through your portal so bonus tip there.

To get to that evidence-based research guide I am going to go down here where it says subject resources. I'm going to click select a subject and it is on our nursing guide so let me open that up in a new tab opens it up over here. This is the nursing research home. I'm going to work off of this page anyway but I want to show you down here I scroll down, I see research help and you would click on evidence-based practice research. This is a whole guide that does give you actual help, explaining things. It is not just here's a database. It is the whole idea of evidence-based practice research, what that means and how to go about finding specific types of evidence. I will click there. We have a nice definition here and then we can click right on the guide. I'm going to open it up over here. To get there again I like to show things twice--I started on the library homepage and went to select a subject. I chose nursing. It brought me to the nursing research home and then I scrolled all the way down and went to research help. Under there is evidence-based practice research area. And now I opened up that guide. So I just want to introduce this to you so you know that it exists and what is here. We go through everything related to evidence-based practice research here from how do you form a clinical question usually when you have a clinical question you are then using evidence to answer that question so this is the anatomy of a clinical question using what is normally called a pico- question. You can read about it there if you don't know what that is and I am also going to point out this levels of evidence pyramid. This is the way that most people, most schools and studies will think about evidence. So the quality of evidence on the pyramid gets higher and higher, the higher to the top you go so as we move up the pyramid the quality of the evidence increases. It does not mean that you should not look at the lower quality of evidence. Sometimes that is all there is and I will talk about that a little bit. What that means. In context. But this is where you can see there are these types of studies that are considered filtered information and then there are types of studies that are still good quality of evidence that are considered unfiltered information so there is nothing between you and the researcher again for these. This is what we are going to be focusing on, the unfiltered information in this webinar.

I'm going to close that. You can also see that there are specific help pages for the databases I'm going to be working in today. So if you want to learn about another database called Joanna Briggs you can look at that yourself but we also have here the unfiltered resources where you are going to see everything I'm going to cover basically if you clicked on the unfiltered resources. May be a little bit of different context.

Let me close that. I am back on the nursing research homepage again and I am going to mostly stick in, I am going to stick in CINAHL and Medline so going to open up the nursing databases and open them both up at the same time, both of these databases. I have to log in. I forgot to do that. So I am opening up CINAHL and I am opening up Medline separately. Yes you can search in a combined search but it makes it really difficult to do some of the things I'm going to do today if you do the combined search. You cannot quite get all the same limiters to work exactly the same way. They have different options in the two databases so I want to see everything from CINAHL options I want to work just there and the Medline options I want to work just in Medline so I am opening them up separately.

Let me go back to my slides and we talked about the pyramid so we are looking at unfiltered information today and I showed you how to get to Medline and CINAHL. I'm going to talk about randomized controlled trials now. This is the next level down from the filtered information in that pyramid, the next level down, unfiltered information so it is the highest quality of evidence for unfiltered information on the unfiltered is the randomized controlled trial. It is a type of clinical trial and it is considered the gold standard for clinical trials. Those two words at the start make all the difference. It is randomized, pretty self-explanatory there I hope. We are doing an experiment here with a randomized controlled trial so other study types we will talk about later are not experimental, they are observational where something has happened over going to let something play out and just observe it. This is not observational. This is an actual experiment so we are randomizing our participants either getting the intervention or not. You're getting the placebo or getting the actual medication and it is controlled so we have that control. We have the placebo. We have the groups that are not getting the intervention so we can compare those that are to those that are not and they have been randomized.

It could be blind or could be double-blind so that means that the participants would be unaware of which group they are in. It could also be where the participants and the people actually making the measurements of the effects of the intervention, the researchers themselves might not know who was in which group. So that would be double-blind.

And it is thankfully very easy to find randomized controlled trials. As I said earlier you may have just accidentally found RCTs. Sometimes you will see them abbreviated that way. You may find them on a variety of topics so not just effectiveness of a drug but you may find them for other topics as well.

I'm going to show you know how you would purposely find a randomized controlled trial. Say you are doing some research on a topic and you think I want to make sure I am finding really high-quality of evidence for whatever this is that I am researching. So let me go see if there are randomized controlled trials. I come across a few by accident but I want to see if there are more out there that I am not seeing. This just a little preview I'm going to walk through this but in Medline we need to choose randomized controlled trial as a publication type and CINAHL gives is a handy little checkbox. I'm going to show you each option. I was debating which topic I should do. I feel that is always the hardest part of these. What example am I going to use? Julie mentioned Glucosamine worked really well. Let me see if I can spell that. Glucosamine. We will do that as our topic. Does Glucosamine work? I am in Medline here's a let's say that is my topic I want to see if there are randomized controlled trials were they studied Glucosamine. You have to scroll pretty far to find that publication type. It is at the bottom on the left so write down here. All the with the bottom of all these different options in Medline. I'm going to use the little scrollbar inside the box to get to randomized controlled trial and if you go too fast you will miss it. A tiny little box. Sometimes it is hard to see it. There it is, randomized controlled trial. I am clicking on it. It is highlighted in blue and I can click search now so I will find anything that has been labeled specifically randomized controlled trial that is talking about Glucosamine. I am limited just to 153 randomized controlled trials. So I have 153. And usually they tell you in the title that they did a randomized controlled trial. This one they are giving us a lot of information they are saying it was randomized, placebo-controlled and double-blind so now we know. So they are giving us all that right in the title but you can be absolutely sure that since we used that special option to limit to publication type randomized controlled trial these really are all randomized controlled trials. I don't know that I've even seen a mistake with that ever so that is pretty good. Since people who are entering all these things into this database and sometimes mistakes are made. I don't think I have ever seen that mistake so that is good.

Now I'm going to go over to CINAHL. The frequent question I get is why are you doing the same search both databases? Why are there so many different databases? Why do you have to search different ones? Good question. Each database does search inside different journals so the set I search inside here to get 153, there might be some overlap where he might see some same results in CINAHL but it is search a different set of journals so I should see things that are different. I should see articles that I'm not going to find in Medline. Over here. The same thing holds with any database. They all search inside different sets of journals so you should find different things when you go from one to the other.

I am scrolling down. There is that check marked box for randomized controlled trials over here on the left. It is about, more than halfway down. I scrolled pretty far but it is just a check marked box. I put a check there and I go back up here and click search and let's compare I love doing comparison-shopping. In the databases. I only have 32 so not as many in CINAHL but again everything here is a randomized controlled trial and everything is something to do with Glucosamine. There may be some overlap again but I should be seeing different things. Definitely the first three here I did not see them in the first three results in Medline so I probably have different results here. Some are going to tell you right in the title that they really are randomized controlled trial or more information about the trial. Sometimes it is just right here the information about the article, you can see it where it gives the author names underneath the title and it will give you eternal it is from, the years of the publication, the page numbers and then a little information about the article, it is a journal article, research with tables and charts and it is a randomized controlled trial. If you just want that assurance that it really is a randomized controlled trial you should see it there in the information about the article. You will also see it in the abstract or the summary of the article. They always tell you what they did in the abstract that it is a randomized controlled trial and if you don't want to click the title of the article to go all the way into see the abstract, you can just get a preview of that summary of the article, the abstract by going over here when you are on the results screen there is a little page with a magnifying glass off to the right of the title and if you hover your mouse over it it will give you the detailed record for that article which usually includes the abstract. There it is for this one and it should say. Maybe this one is proving me wrong it is not really saying they did a randomized controlled trial. Interesting. I want to look more into that. Is a hard task for me to read while I talk. So that is a randomized controlled trial and how you can purposely find them. I know you can do this looking just for randomized controlled trials in other databases and other ways. But for the sake of time I'm just showing you CINAHL in Medline. Let me clear everything out and get back to the search screen so I can get ready for our next study type. And hop over to my slides.

We can talk about controlled clinical trials. This is similar. You will notice the absence of the word randomized in the title of this study type. That is what makes it different from a randomized controlled trial. This is just a controlled clinical trial so there is still a control, there is still a placebo or another treatment or no treatment at all. We need to get into one of the groups involved in this experiment so this is an experimental study. We are actually doing an experiment on participants. There should be bias free assignment of the participants so it cannot be like you seem healthier we will put you in this group. Or you seem like you have worse symptoms. We will put you in this group. We cannot be biased over who be assigned to which group the control or the treatments. It is not truly randomized. That means, everyone is just very literal about words which I love. Everything is extremely literal. Randomized really truly has to be completely randomized where you assign people a number, you use a computer system nowadays and just randomly assigns people to one group or the other. If you have, let's say gone with alternation so you signed up and then you and then you and then you, 1, 2, 1, 2, for the list of participants. That is not truly random. So it would be considered quasi-random are let's say you did everybody with an odd-numbered birthday you go in one group and everyone with an even number you go in the next group. It is not truly random when we do that. I know it seems random but this does not fit the scientific definition of randomized. So it is not and so now you are doing just a controlled clinical trial instead of a truly randomized controlled trial. I know it seems like such a small difference but it is not.

How to find in those instead of them being completely randomized maybe they still seem random to you but is not actually randomized. They still used a control and he experiments whatever that is. We find those very similarly to how we found the randomized controlled trials. In Medline is just a different publication type. CINAHL groups all clinical trials together so they cannot actually designate for sure that we want just a controlled clinical trial. We have to click on clinical trial. Most of them will have that control group so we will see what happens. Let's go back to Medline. I'm going to do the same search again with Glucosamine. I will destroy again how to find that publication type box. Same as before and this time I am not going to scroll as far. I want controlled clinical trial. There it is. So I've got controlled clinical trial highlighted. I used the little scrollbar inside the publication type box. I click search to see what comes up that is just a controlled clinical trial. Not as many. Interesting. I only get 11 results so these are the ones that were not actually randomized but we still have a control and they did an experiment. Not as many.

In CINAHL same thing, Glucosamine and then I have to go down now. I forgot what I was doing, to publication type and I choose clinical trial. Let's see what we get with that. Let's take a brief look at the results. And so here you see it is similar to the randomized controlled trial. It is going to tell you, interesting. Is going to tell you that it was a clinical trial the information about the article that appears right underneath the title. This one and the title of the second result is saying that it was randomized but then it got labeled in the database as just a clinical trial, not a randomized controlled trial. That is interesting. That is something I would look at and see did they actually randomized it. Or not. And why did the database not label it as being randomized? Maybe I found a mistake. Usually you can absolutely trust their people like I said making these distinctions and putting the labels. There is it says right there randomized controlled trial so I don't know why come I don't remember if this one came up. I would do an experiment and see if this one comes up when I limit to randomized controlled trial. And if you see this and you are like hey, this does not seem the got labeled right, send it to us because we can, as librarians, we can contact the database and tell them they may want to look at that and see if it is not coming up there in the randomized controlled trial they probably just need to check something on their back end and fix that. I love finding things like that. But we know everything here it is still a controlled trial it is just one step above and it is actually randomized. For whatever reason I don't think it came up when we limited to randomized controlled trial.

This one I got more in CINAHL that I did in Medline but again the limiter I used in CINAHL is more of a catchall. So I might have some things here that did not use a control they just all get lumped together under clinical trial which is probably also why I am getting a randomized controlled trial because they probably lumped a lot of things together under clinical trial.

Next I'm going to talk about just the clinical trials. Clinical trials may not have a control. Clinical trials is what happens with any drug that gets eventually approved by the FDA for being prescribed to people. So clinical trials are registered with the government because it is one step in that process to getting something approved. So you can actually go to and you can see clinical trials that are going on right now which is really interesting to see what is up and coming with different drugs and treatments. And so it is what it sounds like you want to follow a group of subjects who are receiving the treatment or that drug and see what are the effects of it? What symptoms are they having? How prevalent are the systems? It is generating safety dative how safe is this to give to people and in what dose and also is it effective? Is it treating the symptoms it is supposed to treat. Does the treatment efficacy outweigh the risk of these side effects? That is all kind of the information that gets collected in a clinical trial and again there is not necessarily a control there because as we saw in CINAHL yes they do lump all that together were some may be controlled clinical trials but some were just clinical trials. So we saw that in CINAHL but it is different from the RTC or controlled trials because we just want information and data on the specific treatment that we are testing now because again it is experimental. We are getting people something we are going to see what happens. But there is no control.

How do you limit to the clinical trial? We already saw in CINAHL because they are all grouped together unfortunately. I am not going to show you that because we have already seen it. In Medline they give us so many wonderful options. Like I said there are different phases of clinical trials so it passed this phase  --  just a clinical trial right now and now we are moving into phase 2 to see how effective and safe this is and there are different things that happen at these different phases but I love it that Medline actually gives us the ability to limit to later phases if we wanted to see what happened at this phase for this drug.

Let me go into Medline. Again we already saw it in CINAHL. I'm going to go back to the advanced search. You can always get around in the database in the first search screen you saw by clicking under -- I'm going to scroll down now to that publication type. And I'm going to go to clinical trial and here we see the clinical trial in the phase one, two, three, four. Let's actually do that. Let's do phase 4 and see if there's anything there. I don't remember. I have one at phase 4. Interesting. Let me go back to the advanced search and let's just do phase 1 and see what we get with that. I can click search down here as you have seen me do or search at the top next to the search box. It is the same thing. I didn't get anything for phase 2. It does not mean there wasn't anything, it just was not here in Medline so now I'm going to do all the clinical trials for Glucosamine in Medline. Let's do a search and I have 73 total clinical trials. Sometimes they are comparing two different educations. You see this first one is a trademarked or registered brand. They are comparing two different brands or types of glucosamine in this clinical trial which is really cool I think. That was actually an observational study so sometimes it is going to be, they are just giving, these people are taking this. These people are taking that. We are going to observe what happens to them with these two different drugs. What are their side effects? What can we measure as to the effectiveness of it? There was something else I was going to say about clinical trials. I already talked about clinical to see what is up-and-coming. I don't remember. But that is finding them in Medline and again of course you can find them in other places, too. Pub med has clinical trials as well. Pretty much what you see in pub med should be very close to what you see in Medline. You might find some things in pub med that you don't see here in Medline. That is something I know people ask a lot about. Yes you can do it there too but I am just sticking with these two for now. So that was clinical trials.

We have moved down to clinical trials and right. This is what I was going to say. I'm glad I have a slide about it. It--there were problems actually. This is a side note. They were problems with clinical trials because when it did not turn out great, when a drug was not effective, people were not publishing the clinical trial. That is a problem. We need to know what is not working just as much as we need to know what does work so when there were negative outcomes in a clinical trial the researchers were not publishing. And there is actually a study done, let me go to these real fast. There is a study done about how many were not getting published and it was pretty bad. So that actually led to this news article even go to--I'm going to have to leave the slideshow to open the article. Some people did a study and found out all these people are not actually publishing their results and you can get to that study through the link. It led to a change where the United States said we are going to get stricter about this and you need to publish whether it is a positive or a negative outcome. This is the study about compliance to actually report results through clinical and I cannot remember--it was pretty bad. So you can read that.

And this is just a news article but it is really interesting and I just came across this by chance through scientific American one day and I thought I want to talk about this to students I should probably tell them about this. This is a couple years old when that happened and the ruling came out. But the United States has toughened of the rules so that people have to be more transparent and need to disclose all clinical trials whether they are successful or not. And so I just find that fascinating that people did not want to share disappointing results. I mean that is not true science if you are not talking about what did not work. So interesting thing. Is a couple years old now. I hope these rules are still being strictly applied currently. But this is some new rules that were released by the HHS and NIH. Read through that because I just think it is absolutely fascinating. When you have a free moment. [LAUGHING]

I will move on now after my little side note.

It is really good to stay up with current news because you find out about things like that.

I’m going to talk now about cohort studies. This is a lower level, considered a lower quality, lower level of evidence. Why? Because we actually did not do an experiment in a cohort study. We are just observing people. We might take different groups that is why is called cohort. We are taking this group and that group and let's say they all had a common, they share something in common like this group had all ended up diagnosed with a certain type of cancer. And we are going to follow them over time. We might follow them going forward in time from this day forward we are going to follow them and see how different treatments turn out for them or we might look backward in time to see what caused this, what common factors did they share when they all ended up with this type of cancer? What types of exposures did they all have? Something like how much did they smoke or drink or whatever. How much were they exposed to a tocsin. Something like that. Why are these helpful? Let's think about this for a second. Sometimes a cohort study might be the highest level of evidence you can find on something. I have a friend who recently gave birth to a healthy baby boy which I was very happy for her. She was very worried about having any trace amount of caffeine while she was pregnant. Understandable, sometimes things sound scary. And I showed her some cohort studies because I'm a good friend at a library and that is what we do for our friends and I showed her cohort studies because it would not be ethical to give one group of pregnant women overly high amount of caffeine and give this other group of women a really low amount of caffeine and see how your babies turn out. That would violate so many ethics. We are not going to put people's babies at risk like that. We cannot do an experiment to find out what is a safe level of caffeine for a woman having a baby to have, obviously that would not be okay to do. But we can do a cohort study. We can look at certain outcomes in fetal development and ask people questions going back in time, how much coffee did you consume on a daily basis? Did you drink decaf? We can observe what actually happened, what they chose to do. We can ask questions about that to find out what a safe threshold may be of caffeine in pregnancy. But we cannot do an experiment to find out what is the maximum caffeine amount you can have. That would not be safe. Because we are going to find that unsafe threshold at we are doing damage to people.

So sometimes a cohort study that is why sometimes it is the highest level of evidence you can get for a clinical question because it would not be ethical or safe to do an experiment. So that is why we have cohort studies and why they are great things. And again it could be prospective --  let's take these groups of women who just found out they are pregnant and see if we can get them to sign up for this study. We will follow them through their pregnancy and asked them to keep track of how much caffeine they consume they consume no caffeine and we will look at the outcomes when they give birth in there and do it retrospectively. All these people ended up with cancer, a certain type, let's look back and see what shared exposures they may have had, etc. I love cohort studies. I think they are fascinating. There are actually two different ways to find them. This is my nice little picture. Explaining how a prospective cohort study works. We have our group of interest, comparison group. Group of interest drinking coffee when they are pregnant and our comparison group women who never consume caffeine while pregnant and we follow them and hear the outcomes. Two different ways to limit cohort studies. This is the complex way but again is just a little bit more sure that everything you find will actually be a cohort study. Yes my screenshot is from 2016 but just because the number changed everything else is the same. We are going to use what is called a MeSH term which stands for medical subject heading and that is a different type of label that gets put on each article. We put these medical subject heading labels to tell you what is in each article. Somebody the database does. Other people put these labels on articles telling you what is in them or what they are. I don't know why they don't give us a handy little limiter on the search screen but they don't. So we have to use the subject heading instead. I'm going to show you have to search for these. This gets a little involved. So let's do in Medline first I'm going to click here it says MeSH 2017 now but same thing. Click on that. And then I need to search for cohort study so it shows us here I'm going to type in cohort studies in the search box where I am just searching for the medical subject heading for cohort studies. That is those little boxes here that I have. The MeSH search box and I click browse and it comes up right here so we have got that down. And we are going to checkmark it and then have the option to search the database at first for all cohort studies. That is not what we want but this is part of the steps to get there. Be have cohort studies check marked that is the medical subject heading we want to search on and then we are going to search the whole database so yes is going to give me all the cohort studies which is a lot in this database. We have our search screen and all these other search boxes so now I can type in the topic I want to look at so maybe I do want caffeine. Let's try that I have added it end. In the middle box. You can put other search terms and if you need more search boxes you can click the little plus and you can add in different search terms so I might say pregnancy cohort studies. First I had all the cohort studies that I added in caffeine and now I want to look at caffeine intake during pregnancy and these are all cohort studies so I know no one was harmed. None of these are experiments. They are all observational studies, cohort studies, groups of people and I can tell it what I want. If I wanted to see cohort studies let's say what we have on Glucosamine I can just switch out my search term. But I want to leave that top search box alone. I hope you noticed I was not doing anything to the top search box. This is the database telling itself remember she wants cohort studies so it is the medical subject heading for cohort studies. That is why we used the MeSH 2017. We browsed for the term and said give us all the cohort studies and then we put in our topic the other search boxes. It works basically the same way for, this is showing again we had in our keywords. Basically is the same thing in CINAHL but instead of calling the medical subject headings they just called CINAHL headings and it is the same thing I just did. They will have the term prospective studies. You're going to browse still for cohort studies and then you can choose Prospective studies. There is an easier way I'm going to show you. Let's say I still want cohort studies on Glucosamine does not matter which box I have which thing and I have Glucosamine already there and I'm just going to type in cohort study. I put quotes around it because I want it to be that exact phrase, cohort study. I want that phrase to be in every result that I get. Click search. I didn't get anything. I just didn't get anything. Let's go with caffeine then. Cohort study. I think I know what the problem is. I will show you a good oops. Yes I still have clinical trial selected. Because clinical trials are not cohort studies. Those were not ever go together. They are two very different things. Now I have everything cleared out. Click search and everything I get should be a cohort study. Usually again it is going to tell me in the title that is what they did or you can again to the right of the title of the article on the result screen you can use the page with the magnifying glass, hover your mouse over and you can see the abstract and it should say that it is a cohort study. I have got probably all cohort studies. You want to be careful if you use this method of typing in the phrase cohort study. You may get things that talk about some other cohort study but they did not do a cohort study. Like saying this is just a background article or something and we are going to talk about a cohort study but we did not do one. We're going to mention one but we did not do one so you do need to be careful. Make sure that it says that it is a cohort study somewhere. Sometimes you have to go into the full article to see that they say they did a cohort study. Usually you can find it in the title. Or in the abstract. If it has cohort study in the title I know it is a cohort study. Much easier. A little less exact. We may have some things that are not really cohort studies or if you want to save yourself some time and you don't mind double checking that it is a cohort study. Just use the quotes which are very important so you glue it together as an exact phrase. And you can do the same thing in Medline I can just type it in and keep Glucosamine there. You notice I got fewer. Apparently there are some things that Medline had marked as cohort studies and they are not coming up here because I used this different method so you may miss out on some things as well but you have both options.

Next the case control study. We are almost there. I should have a little bit of time for questions at the end. A case control study compares people with a disease and people without a disease over time. Kind of like a cohort study in a way that we have got two different groups of people but we have a diseased group and a non-diseased group. The important thing is that they would have the same risk factors. The problem with a case control study is that there may be a lot of bias. Let me show you how to find case-control studies. Is actually the same exact method as the cohort study. We can use the MeSH 2017 term or we can use the CINAHL heading. Let me show you that in CINAHL. I would go to headings. I have got my browse box for headings and I will type in case-control studies. Click browse. There it is. Case control studies. I checkmark it and tell it give me all of your case-control studies. There we go. And then I can narrow it down to what I want case control study about. I want to see a study where they call a disease not a disease and see what -- let's say I want lymphoma. I am bad at spelling. So I have got 387. I could narrow this down to -- maybe I don't want childhood. Maybe I want the elderly. And I can play with it until I see things that are actually on my topic. So you get the idea first we just find all the case control studies and then we narrow it down from our topic by using other search boxes and again we would leave this alone at the top. So there are other types of studies that I want to briefly talk about how you would learn about them. We are looking at these really specific kinds of studies. It is a randomized controlled trial. They had a control, it is an experiment. We are looking for cohort studies that means this is what they did they observed people and had different groups of people come observed them over time. Sometimes you just want a different methodology altogether. Sometimes you just maybe want to find a qualitative article about some topic. How would you find a qualitative article? We have these wonderful quick answers for different all different kinds of things, every type of research you would want to do. Quick answers are like our frequently asked questions. We have one on how to find qualitative articles. We have one where if you just have some other methodology that you want to see somebody used may be a quantitative methodology where they did a specific statistical analysis. You want to search for that. How would you do it? You can look at this quick answer. Maybe you want to see the difference between a systematic review and integrated review. We have different quick answers on a variety of very specific topics. That is my point. Here is how you would get to quick answers. Go back to the library homepage. Click this button for search everything. It is just the main library search box. First you click on search everything. That is going to search in our quick answers so let's say I wanted something about finding a meta-analysis I would just type in meta-analysis and click search. Search is more than our quick answers but the quick answers appear in the middle of the page when you get results so I see that very first one is probably what I would want. How do I find a meta-analysis research article? And I want to show you quickly these quick answers are actually really in-depth so they are showing me here they are giving me a little bit information, a lot of different databases on meta-analysis and then they are saying here's an example of how you would find one. It is actually walking me through an example search to find it. So if you cannot remember how to find a different study type try quick answer. You have a variety of questions in the library we have so many different quick answers on all kinds of things in the library and you will notice some of these are not from the library also. Other departments are in the quick answer systems you can try this for a lot of different questions that you have about Walden. Please use those quick answers because they are wonderful staff on the back end making those quick answers and trying to get all of this information to you. The last thing I want to mention is our ask a librarian service. If you have questions that are not related to what I covered today. If you are not sure do you have this article in full text? That is a really good question to send to our ask a librarian service. At the top right corner of our webpage it says ask a librarian whether on the homepage or one's other pages is to write up there at the top. I'm going to click that again. You can email us we will get back to you within 24 hours. Usually it is a lot faster than that. Have some chat hours but it is not all day every day, just certain hours. We always tell you what our chat hours are for the day. You can call and leave us a voicemail and we will email you back a response and if you happen to be a doctoral student we also have research appointments. Usually you're going to contact us through email or chat and again things like how do I get this article in full text? I don't see it. How would I find this and do that in pub med instead? I don't know how to do that. Those would be good things to send to our ask a librarian service.


I don't have a lot of time because we covered so much, that was quite a lot but are there any questions I could answer out loud Julie, any questions that have popped up a lot?

>> No I think you pretty much covered it.

>> I know that was a lot; I hope everybody does download the PowerPoint so you have that to refer to but also remember that we covered a lot of this on the evidence-based practice research guide that I showed at the very beginning. It is on the nursing page. It goes over the entire evidence pyramid so if you want to know more about that you can learn about it on this guide and it also does go over finding unfiltered resources you would go to levels of evidence, pyramid and then most of the unfiltered resources that I covered today are talked about here so I would click on unfiltered and it says that you can find these types of things what we covered in CINAHL and Medline. There is even more if you click here for unfiltered guide and that brings us actually someplace else, but that is where it covers going into those databases and then limit to each type what I just showed you today. It goes over that easy method for cohort study and all other different types. And if you have questions, please do contact us through ask a librarian. We are there to help you. And I hope this was informative. I know that was a lot. You will get the recording in your email if you are attending live and if you have questions please contact us. Thank you so much for being here and I will go ahead and stop the recording now.

I'm going to wait and see if anybody does have a question. We will wait it out to take the full hour in case you have a question. All right it looks like we are all good. Again, thank you for attending and have a good day.



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Created June 2018 by Walden University Library