Searching Healthcare
Databases: An Advanced
Guide
Based on a guide created by NLH Search 2.0 Representatives Group
Version 1.0 December 2013
Melissa Griffiths
Contents
What are Healthcare databases?
1
Accessing the Databases
3
Plan Your Search
4
Tips for Searching:
Free Text Searching
6
Thesaurus Mapping
8
Combining Searches
13
Searching Using Different Fields or Tags
15
Applying Limits
16
Removing Duplicates
17
Saving Searches
19
Creating Alerts
20
Retrieving Saved Searches
22
Viewing Results
23
Managing Results
25
Trouble Shooting
28
Additional Help
29
Version 1.0 December 2013
Melissa Griffiths
What are Healthcare Databases?
Healthcare databases can be used to:
•
•
•
•
find specific information on a topic or combination of topics
answer a clinical query
find work by a particular author
search or browse a particular journal
The databases contain references, often with informative summaries or abstracts, of articles
in journals, guidelines, manuscripts, dissertations and book chapters. The databases cover
every aspect of healthcare – from buildings and equipment through public health and social
care to medicine, nursing and everything in between.
Where a full text copy of a document is available a link will be displayed with the reference.
The link will lead to the article where you may read it online or download the article free of
charge.
A search topic will determine how to search and which databases to use. You may find a
basic search across a variety of databases will give you enough results for your needs.
However, a systematic search to support evidence based practice, will require an Advanced
Search. It is advisable that you search more than one database and that you search each
database separately.
There are several healthcare databases available to search:
Version 1.0 December 2013
Melissa Griffiths
Allied and Complementary Medicine (AMED) 1985 Covers occupational therapy, physiotherapy, rehabilitation, plus alternative medicine:
acupuncture, chiropractic, homeopathy, yoga, hypnosis, etc. Indexes over 400 English and
European journals.
British Nursing Index (BNI) 1992 This UK focused database covers A&E, neonatal, cancer, theatres, orthopaedic nursing, etc.
Details of articles from over 250 key English language nursing and midwifery journals
Cumulative Index of Nursing & Allied Health (CINAHL) 1981 A US database covering all aspects of nursing and allied health. Subjects covered include
optometry, radiologic technology, speech and language pathology and nutrition. Contains
materials from over 1,200 journals, theses and pamphlets.
Excerpta Medica Database (EMBASE) 1980 With particular emphasis on European sources, this database covers the whole field of
medicine. Drugs, pharmacology and substance abuse are particularly well covered using
5,000 journals about 1,500 not used in Medline.
Health Management Information Consortium (HMIC) 1979 –
Comprises DH Data and Kings Fund databases both of which cover UK NHS health services
management, policy and standards and social care. DH Data includes planning - financial,
building and equipment; public health; toxicity studies on specific chemicals. Kings Fund’s
focus is on improvements in health and health care, covering health inequalities,
partnership working and workforce development.
General Medical Database (MEDLINE) 1950 This is a large US database of medical information. Other subjects covered include
dentistry, veterinary medicine, medical psychology, genetics and advanced nursing practice.
The database covers over 5,000 journals from 70 countries.
Psychology and Allied Fields (PsycINFO) 1806 Subjects covered relate to clinical, social and biological areas of psychology. These include
addiction, pharmacology, anthropology and law. Published by the American Psychological
Association, material is included from 2,000 international periodicals.
Version 1.0 December 2013
Melissa Griffiths
Accessing the Databases
You will need an NHS Athens username and password to use these databases. To register go
to: https://register.athensams.net/nhs/. If you are on a trust network you will receive your
username and password straight away.
Once you have registered with NHS Athens you can begin searching the databases.
To begin, visit NICE Evidence Search at http://www.evidence.nhs.uk
From the top menu select ‘Journals and Databases’ then select ‘Healthcare Databases
Advanced Search’ and log in with your Athens username and password.
You will then need to select the database you wish to search. In this example, we will be
using Medline. The following screen will then appear and you are ready to being searching:
Version 1.0 December 2013
Melissa Griffiths
Plan Your Search
Before you begin your search it is important to have a clear idea about what you are looking
for and what results you hope to find. Planning your search is therefore crucial to research
success.
Before you begin searching you should:
1. Formulate a focused question
2. Identify the key terms of your search
3. Identify which database(s) to use
Example A
1. Formulate a question that clearly addresses your research topic:
“The effect of exercise therapy on whiplash patients in managing chronic neck pain”
becomes:
Is exercise therapy more effective than non-steroidal anti-inflammatory drugs in
managing chronic pain associated with whiplash?
2. To help define the key terms of your question you can use the PICO model:
Patient
Or
Population
Or
Problem
Whiplash
Intervention
Or
Exposure
Comparison
Exercise
Therapy
Non-steroidal antiinflammatory
drugs
Outcome
(If relevant)
Chronic Pain
Management
You may not need all four elements to construct your search but you should aim to have at
least two.
Version 1.0 December 2013
Melissa Griffiths
Try to identify alternative keywords. Think of alternative or similar words and terminology
to be incorporated into the search. You may also find additional terms whilst searching.
Some alternatives for our first query example:
P - Whiplash
I - Exercise Therapy
C - Anti Inflammatory Drugs
O - Chronic Pain Management
Neck injuries / Neck Pain / Neck distortion
Therapeutic Exercise / Physiotherapy
Pharmacological Interventions
Quality of Life
3. Choose a database
The database you choose should be based on the topic that you are searching for – see the
previous list. You may need to search more than one to be thorough, so think about any
others you will search later.
For this example - Allied and Complementary Medicine (AMED) 1985 -; Cumulative Index of
Nursing & Allied Health (CINAHL) 1981 and General Medical Database (MEDLINE) 1950 –
would be of most use.
Version 1.0 December 2013
Melissa Griffiths
Tips for Searching
Free Text Searching
Free Text Searching is simple and quick – you enter the keywords and click search. However,
it is not as specific as Thesaurus Mapping and your search may be limited. It is therefore
best to combine Free Text Searches with Thesaurus Searches.
It is important to be aware of the limitations of free text searching. e.g. a free text search for
“aids” will retrieve the following article:
Clinical indications for bone anchored hearing aids. Journal of Clinical Otorhinolaryngology,
Head, & Neck Surgery, 2013 Vol. 27(16) p. 861-4
The following tips will help to improve the results of Free Text Searches:
*
*n
“ ”
AND
OR
NOT
ADJn
This asterisk is a wild card and stands for unlimited truncation. Use it
at the end of a word retrieve various endings e.g. nurs* will retrieve
nurse, nurses, nursing, nursed etc.
If you combine the asterisk wild card with a number this will allow for
limited truncation. Use it at the end of a word to retrieve endings
with only a certain number of letters in the variant ending e.g.
physi*3 will retrieve physical but not physiotherapist
Use quotation marks to search for a specific phrase you want to find,
such as “healthcare assistant” or “physical therapy”
Use this to search for words that are both present and appear in any
order e.g. patient AND recovery
Use this to search for any or more of the combined words e.g. nurse
OR doctor
To search for the word or expression preceding the operator but not
the one following it e.g. flu NOT cold
To search for words within the specified number of words (n) of each
other, in any order where n>1. E.g. return ADJ3 work
Sometimes there is no thesaurus term available, so a free text search is the only option.
Using PICO, enter your search terms into the database using the Boolean operators to
optimise your results.
When performing Free Text Searches you should consider the following:
•
•
Synonyms, alternative phrases and commonly used abbreviations or acronyms e.g.
cbt / cognitive behaviour therapy;
Terminology may change over time, e.g. elderly/older;
Version 1.0 December 2013
Melissa Griffiths
•
•
•
Differences in UK and US terminology and spelling e.g. behaviour / behaviour and
physiotherapy / physical therapy;
Interchangeable concepts, e.g. depression / depressive disorder / depressed
patients;
Word order, e.g. depressed patients, patients who are depressed.
If we wanted to research the effect of cognitive behaviour therapy on depression we
could use the following free text search:
By placing “cognitive behaviour
therapy” in quotation marks we
have searched for any articles that
include this exact phrase in the title
or abstract (indicated by the ‘ti,ab’
at the end of the search. This is the
automatic default for HDAS
searching)
By truncating depression with the
wildcard * as depress* our search
will also pick up the words
depressed, depressing, depresses
etc.
We would then combine these results to find articles that include both search terms by
doing the following:
Tick the box next to the line of each search
Scroll to the bottom of the search lines and ensure AND is the chosen option
Click combine selected
The following line will then appear within the search where both terms are in the results:
Version 1.0 December 2013
Melissa Griffiths
Thesaurus Mapping
Thesaurus mapping is recommended for systematic focussed searches. This tool allows you
to match your search term to the indexed vocabulary of a particular database. When new
articles are added to the databases, they are indexed. This indexing is done with its own set
of headings which describe the article. By using thesaurus mapping you increase the
potential to retrieve the type of references you want by picking up articles indexed by the
term you are researching.
Using Thesaurus Mapping
Enter your search term and check the box Map to Thesaurus. Then click search.
Terms which match the concepts of your keyword search will then be displayed. Below is
the thesaurus mapping for depression.
Version 1.0 December 2013
Melissa Griffiths
Sometimes you may not know the correct term to use, but the system will figure this out.
For example:
If you search for any of the following:
lateral epicondylitis
humeral epicondylitides lateral
tennis elbow
Map to Thesaurus
points to
Tennis
Elbow
Some databases may have an American bias and as some organisations, terminology,
spelling and initiatives within the NHS do not exist in the USA they will be placed with the
nearest American equivalent. If you are unsure as to what thesaurus term to use check the
Scope Note which will tell you what the subject term encompasses.
For example:
The NHS does not exist in the US.
So when we search for National
Health Service
Map to Thesaurus
points to
National Health
Programs
Subject terms are organised in a tree structure. More general terms appear on the left hand
side, whilst on the right hand side more specific terms appear as they branch out form the
general terms. Below is an example of the tree structure that appears when you click the +
sign beside a term:
‘Psychiatry and Psychology’ is the
most general term.
‘Behaviour and Behaviour
Mechanisms’ is a subheading of
‘Psychiatry and Psychology’.
In turn, ‘Attitude’ is a subheading
of ‘Behaviour and Behaviour
Mechanisms’
‘Behavioural Symptoms’ is a
subheading of this etc. etc.
Until we reach the specific term
‘Depression’.
Version 1.0 December 2013
Melissa Griffiths
All articles about the same concept are therefore assigned the same subject heading,
regardless of the words the author uses in his article. This makes searching easier and more
successful.
Thesaurus Mapping can also be used to identify different terms you can include in your
search. For examples, if we select Scope next to the subject headings it will provide a list of
terms included under this
thesaurus title.
What is most useful when using Scope are the terms that appear under Used For. This will
provide us with various other spellings and phrases used for particular subjects that we can
use when conducting Free Text searches.
Select
Explode
Put a tick in the Select box if you are only interested in searching a single
term e.g. Depression
This will broaden your search by searching for your thesaurus term plus any
related narrower terms listed (indented) below. For example, if you
selected to explode ‘Behavioural Symptoms’ (as shown previously) you
would also get results for ‘Aggression’, ‘Delusions’ etc.
Major
This is used to retrieve articles where the subject term is the major focus of
the article. This will result in a focussed search and may exclude other
articles of interest.
Subject Headings
These are specific characteristics of a main thesaurus term and enable you
to focus your search even further. To view the Subheadings attached to a
thesaurus term, tick the box in the subheading column and select the
subject headings you are interested in and click ‘Apply’.
You can choose one or more of these different thesaurus types, for example choosing to
search for an exploded, major descriptor with a particular subheading.
Version 1.0 December 2013
Melissa Griffiths
Subject Headings are be used to focus upon a particular
aspect of your topic. To do this, tick the box underneath the
column Subheadings that corresponds to your chosen
search line.
The following screen will then appear where you can select
which aspects of the topic you are most interested in by ticking the corresponding box and
clicking Apply.
Below is a search that shows how using Free Text Searches and the Thesaurus functions of
Select, Explode, Major or Subheadings affects the results achieved through a search.
/ shows that this is a subject
search that has been selected
from Thesaurus Mapping
Free Text Search on
title and abstract
fields
exp shows that the
subject has been
exploded to include any
sub-categories
Version 1.0 December 2013
Melissa Griffiths
* indicates that this
subject has been
selected as major
and is the main focus
of the articles within
the results
px [px=Psychology] is a subheading so has
restricted the search to include only
searches for depression that include this
term
We can see from these results that:
By truncating depression in a free text search (depress*) we achieve the most
results as our search retrieves results that include depression, depressed,
depressing, depressive etc.
By exploding depression, we retrieve results that list depression as a subject heading
including any sub-categories (there are none in this example)
When depression is selected as a major focus, this restricts the search results to
those concerned predominantly with depression
The results are restricted further when we apply a subheading that searches for
results that are concerned primarily with the psychological aspect of depression
Version 1.0 December 2013
Melissa Griffiths
Combining Searches
Combining searches helps to optimise search results, particularly when topics have been
exploded or selected as major focuses.
Here is an example of a search using both free text and thesaurus searches to answer the
following question:
The effect of cognitive behaviour therapy on depression in comparison to antidepressants
As shown before (see ‘Free Text Searching’ p. 7) search terms can be combined to locate the
best results using AND. We can also use the other Boolean operators OR and NOT to
develop these searches further.
AND
Narrows your search
This will retrieve articles that include both search terms
OR
Broadens your search
NOT
Narrows your search
This will retrieve articles that include either search
terms
This will retrieve articles including only the first search
term and excluding any that include the second term
As demonstrated in the previous example (p. 7) – select the terms of your search and
choose the Boolean operator.
By selecting the search terms, *DEPRESSION and depress* ti,ab and combining them with
OR we will retrieve articles that include either of these terms.
Version 1.0 December 2013
Melissa Griffiths
We would then repeat this for each of the terms we have searched for until the following
lines appear in the search:
Then, select each of these combined results and use the Boolean operator AND to combine
the searches and retrieve results that include all of the searched terms.
These searches can also be conducted by typing the numbers and Boolean operators into
the search box. Brackets can also be used to combine results in different ways. To perform
the above search in the search box we would
enter:
Version 1.0 December 2013
Melissa Griffiths
Searching Using Different Fields or Tags
The following shortcuts can be used when
entering terms or selected from the right hand
side of the search box. Enter your search term
with the appropriate tag (field) for your search
(see below).
NB:
If your search term is retrieving
particularly low results, you can often increase the results by selecting an Any Field
search by checking the correct box or following the search terms below.
Where the tag is applied to more than one word enclose them in brackets followed
by the tag ie. (term term).tag or (“phrase”).tag
.ti
Title
.af
Any field
.ab
Abstract
.an
Accession number
.au
Author
.ti,ab
Title & Abstract
.jn
Journal name
.kw
Keywords
.pg
Pagination
.pt
Publication type
Version 1.0 December 2013
Melissa Griffiths
Use this tag to search all record titles for the search
term. E.g. typing diabetes.ti would return all
records with diabetes in the title.
Use this tag to search all record fields for the search
term.
Use this tag to search all record abstracts for the
search term. E.g. using diabetes.ab would return all
records with diabetes in the abstract.
The unique ID number given to a record when
entered into the MEDLINE database.
Use this tag to search all record author fields for the
search term. e.g. using (“Winston R*”).au would
return all records with author surname Winston and
initials or Christian name starting R.
Use this tag to search both the Title and Abstract
fields for the search term. e.g. a search on
(gestational diabetes).ti,ab will search both Title
and Author fields within records. This is the default
for free text searches.
Use this tag to search for a specific journal title.e.g
("british journal of midwifery").jn
You will need brackets and quotes for titles with
more than one term.
Also known as free-text searches, searching using
the Keywords tag searches words or phrases in
multiple record fields.
A search using the Pagination tag searches for
specific page numbers within each record.
The Publication Type tag describes the type of
material the record represents (e.g., Review, Clinical
Trial, Retracted Publication, Letter).
Applying Limits
To Apply Limits click the Apply Limits link on the line of the search you wish to restrict and
select the relevant limits.
You can select the relevant limits from the different tabs and select options from the drop
down menus and boxes under each tab. You can apply more than one limit to each search.
Once options are selected, a * will appear upon that tab. Before beginning another new
search line, make sure all limits are removed by selecting ‘clear all limits’.
Limits Explained
Article, Journal and Publication Type
This limit provides a range of options. For example
different types of clinical trials
Clinical Query
Limits to the following specific study types: Therapy,
Diagnosis, Prognosis, Reviews, Clinical Prediction Guides,
Qualitative studies, Etiology, Costs and Economics. Each
can be sensitive, specific or optimized.
Human or Animal
Restricts your search to records relating to Human or
Animal subjects.
Gender
Use this limit to restrict your search to records relating to
Male or Female subjects.
Age Groups
The Age Groups limit allows you to refine the age
demographic of your results.
Language
Use the extensive Language limit to return records in
particular languages e.g. English, Polish, Hindi.
Other
Select from a range of additional limits, including:
CheckTags (e.g. females, humans, pregnancy) Status (e.g.
In Process, OLDMEDLINE) and Subject Subsets (e.g. AIDS,
History of Medicine, Toxicology).
Version 1.0 December 2013
Melissa Griffiths
Removing Duplicates
`
When performing searches, to retrieve optimum results it is best to search multiple
databases. Once you have finished searching one database you can change this database by
selecting a new one from the drop down box below your search results:
However, when you search multiple databases you can often retrieve similar results. This is
where removing duplicates becomes extremely handy.
As long as the total number of results grouped together is below 500 you will be able to
remove any duplicated results. Select the lines that include your chosen results and then
click Remove Duplicates.
Version 1.0 December 2013
Melissa Griffiths
The following message will appear. Click OK.
A similar line will then appear in your search:
48 results appeared in both searches. To view the results without these duplicates, click on
the link to the Unique Results.
Version 1.0 December 2013
Melissa Griffiths
Saving Searches
To save your search, go to the top of your search history and select either Save All or check
the lines you wish to save and select Save Selected Lines.
If the following message appears, click OK.
The following screen will then appear. Enter a meaningful name for your search and click
Save.
Version 1.0 December 2013
Melissa Griffiths
Creating Alerts
An alert will automatically email you any new information that is relevant to your search
when it is published. This saves you from having to manually repeat the search every
week/month etc.
To create an Alert follow the same steps as described above but, when you save your
search, click Save and Create Alert instead.
The following screen will appear which you can customise to fit your requirements before
clicking Save Alert.
Select a
name for
your Alert
Enter the email address you
want you alert to be sent to
Choose how
often you
want to
receive the
alert:
weekly,
fortnightly
or monthly.
Choose whether you
want your alert to be
sent to you as PDF,
Word, HTML, Plain Text,
XML or Ris format
Version 1.0 December 2013
Melissa Griffiths
Check if you
want your alert
to include your
search history
Select whether you
want the detail to be
small, medium or large.
You can modify or delete your alerts by selecting Alerts from the main menu.
You can also create an Alert from a previously saved search by selecting the search in Saved
Searches and using Create Alert.
Version 1.0 December 2013
Melissa Griffiths
Retrieving Saved Searches
To retrieve a saved search select Saved Searches from the main menu:
A list of your saved searches will then appear.
Select which search results you would like to be displayed and then click Run Search to
perform the search again.
The search will then appear.
Version 1.0 December 2013
Melissa Griffiths
Viewing Results
To view your results, click on the number of results in the View Results column that
correspond to your search. This will display a list of all the articles related to your search.
You can change the way your results are displayed according to your preference:
To see journal
abstracts tick
the Display
Abstracts
button
Results can be
sorted by Author or
Publication Date
Navigate through
the pages of your
search results
Click to choose to
display 5, 10, 20
or 50 results per
page
Once you have retrieved the list of results the options for accessing the article will be listed
underneath the result. Some will have direct links to the full text article (as shown below)
which can be saved or printed. Others will have links to a local library where a print copy will
be available.
Version 1.0 December 2013
Melissa Griffiths
When you click to access the journal and are connected to a different publisher, you may be
required to log in again with your Athens credentials. Look out for a Log in using Athens link
(this may not always be the default log in) to log in with your NHS Athens credentials.
Where there are no links under the full text heading, please consult your local library. They
will be able to give you more information about obtaining copies of these journals. In the
majority of these cases you will be asked to fill out a Document Supply Request Form in
order for the librarians to obtain a copy of the article. This can be found on the Bradford
Health Library’s library page at
http://www.education.bradfordhospitals.nhs.uk/services/library-services/library-services-1
Version 1.0 December 2013
Melissa Griffiths
Managing Results
Manage your search results using the panel provided on each page below the results.
Use these options to select whether you want to
choose specific articles (that you have checked on
the current page next to the item); all of the
articles retrieved by the search (the maximum is
200) or to deselect all of the articles.
Choose what
format you want
your results to be
displayed in
If you want to export
more than 200 records
you can do this in
batches up to 1000.
Choose the details you want to be included in your
results. Short - displays Title, Citation, Author and
Source; Medium - displays Title, Citation, Author,
Language, Abstract, Publication type and Source;
Full - displays Title, Citation, Author, Language, Abstract,
Publication type, Subject headings and Source
PDF and Medium are the recommended formatting options. These results will provide you
with the journal titles and abstracts and links to each article if they are available.
When you have chosen what results you want and the format you wish to view them, you
have several options.
Email Results
If you choose to email your results, the following screen will appear. Enter
your email address and the subject line of the email and click Email results.
This will generate an email that will include a link to your search results.
Version 1.0 December 2013
Melissa Griffiths
Save Results
This will generate a download onto your computer of a document
containing your search strategy and results.
If you have selected PDF the results will appear something like this:
Copy to Clipboard
Tick the boxes of the articles you want to keep and click Copy to Clipboard.
Note: Saving your results to clipboard is temporary. They will only be saved for
the current search session. You can save a maximum of 500 results to
clipboard.
Version 1.0 December 2013
Melissa Griffiths
Continue to select articles from different search results and add them to clipboard. The
system will automatically remove any duplicates.
When you have copied all of the results you are interested into the clipboard, to view them
click View Clipboard
When you are in Clipboard
you can perform similar
actions as before and either
email or save results.
You can also select articles
to Remove from Clipboard
Version 1.0 December 2013
Melissa Griffiths
Troubleshooting
What to do if you don’t find what you are looking for.
Searching for literature can occasionally lead to unsatisfactory results. There are generally
two types of problem that may be encountered:
Too many irrelevant articles in the search result
Too few relevant articles generated by the search.
Too Many Irrelevant Articles
If the search results contain a large amount of irrelevant articles try:
Using the thesaurus (see page 8)
Using the NOT command to exclude a concept which is not wanted. Use only if
results have a strong bias towards a topic that you do not want at all as you may
remove some useful information.
Searching for phrases using “ ”. For example if you search for Mental Health without
quotation marks, the results generated include irrelevant hits where the words
mental and health appear in any order, anywhere in the title or abstract.
Think of more precise keywords that can be used / added to the search.
Using the Limits, such as limit to clinical query type or age group.
Limiting the date of publication range.
Searching by title or title and abstract, rather than all fields.
Using the combine search option to fine tune your search.
Not Enough Useful Articles
If the search results do not contain enough useful articles try:
Alternative spelling – Use the American and European spellings of a word. For
example gynaecology or gynecology
Different synonyms – try using alternative words or phrases to describe your search
topic/concept. For example, try ‘bandage’ as an alternative to ‘dressing’ as a search
term.
Searching an alternative database. I.e. switch from Medline to EMBASE
Widening your search – your search may be restricted by too many different
concepts. Try removing one of the search terms or limits.
Using the OR command, e.g.,’ wound care’ OR ‘wound management’
Truncation – Use the * command to give suffix variations. For example, ‘bandag*’
will find bandage, bandages and bandaging
Searching ‘in any field’ or ‘in title and abstract’ rather than just in title.
Note: If you are searching for results in a new area of research there may be few published
articles.
Version 1.0 December 2013
Melissa Griffiths
Need some support? Or want to know
more?
If you still require further assistance with performing your search or want to
arrange a one-to-one training session with one of the librarians to help to develop
your database searching, please contact your local Library Services Team.
We will be able to assist you with:
Applying search skills to your particular topic
Learning about databases and how to use them to achieve optimum results
Improving your strategy if your search isn’t providing you with the
information you need
Details can be found here at the Bradford Teaching Hospitals Health Library and
Information Service web page:
http://www.education.bradfordhospitals.nhs.uk/services/library-services
Alternatively, you can contact a librarian directly by emailing us at:
[email protected]
Health Library and Information Service
Fieldhouse Education Centre
Bradford Royal Infirmary
Happy Searching!
Version 1.0 December 2013
Melissa Griffiths