UHL Writing Club

Evidence Updates from UHL Clinical Librarian Service

A reminder of the Evidence Updates that we produce, and can be found on our website  or follow us on Twitter to find out when a new one is published @UHLCL

We now design and distribute these via Mailchimp, allowing us to obtain some 'click data'.  It enables us to see how many people are opening the email, and which content they are most interested in.

Regular places that we search when looking for content include NICE, The Cochrane Library, NHS Behind the Headlines and Dynamed Plus.

We produce regular bulletins detailing the latest evidence and literature in the following areas:

Anaesthesia & critical care Breast cancer Cancer Cardiac surgery Cardiology Children's health Clinical genetics Colorectal surgery Corporate nursing Diabetes Emergency medicine Endocrinology Family planning Gastroenterology Haematology Hepatobiliary Infection control

Neonatal Obstetrics & gynaecology Older people's health Ophthalmology Orthopaedics Pain management Palliative care Patient safety & risk Patient and public involvement Renal services Research Respiratory medicine Rheumatology Sexual health Stroke Strategy Urology Vascular surgery

More about search filters

This follows on from an earlier post about the ISSG Search Filter Resource.

In Medline and some other databases, you can limit a search to a particular publication type, for example, an RCT.  But publication types are not always consistently indexed in Medline, with some references that are RCTs not indexed as such, and some which are not RCTs indexed as if they were.  

Very new references will not have any indexing, so will have no publication type.   They will therefore be missed if you rely on the publication type limit.

So, relying on publication type limits may cause you problems if you are conducting a systematic review and need to find all RCTs on your topic.

A search filter is a search strategy that finds a particular publication type.  For example, this, from SIGN, to find RCTs:

1	Randomized Controlled Trials as Topic/
2	randomized controlled trial/
3	Random Allocation/
4	Double Blind Method/
5	Single Blind Method/
6	clinical trial/
7	clinical trial, phase i.pt
8	clinical trial, phase ii.pt
9	clinical trial, phase iii.pt
10	clinical trial, phase iv.pt
11	controlled clinical trial.pt
12	randomized controlled trial.pt
13	multicenter study.pt
14	clinical trial.pt
15	exp Clinical Trials as topic/
16	or/1-15
17	(clinical adj trial$).tw
18	((singl$ or doubl$ or treb$ or tripl$) adj (blind$3 or mask$3)).tw
19	PLACEBOS/
20	placebo$.tw
21	randomly allocated.tw
22	(allocated adj2 random$).tw
23	or/17-22
24	16 or 23
25	case report.tw
26	letter/
27	historical article/
28	or/25-27
29	24 not 28

This uses MeSH headings that might be applied to an RCT, but also title or abstract words that might indicate that a study is an RCT.

The ISSG Search Filter Resource links to search filters for retrieving different study designs, and to information about designing search filters.  

If you are doing a systematic search (including, but not only, searches for evidence for systematic reviews), we recommend looking at the ISSG Search Filter Resource.    For advice on search filters, please do contact your Clinical Librarian.

The East Midlands Congenital Heart Centre

Following the report of a national panel, NHS England have made the decision to stop children’s heart surgery at Glenfield. You can read NHS England’s letter and the Trust’s response.

Services need to reach standards about numbers of surgeons, number of operations they each conduct, and which other services are on the same site.  Leicester does not meet all the requirements (but none of the 14 other services nationally do either), and the report believes that we are unlikely to do so. 

UHL believes that the service offered here is high quality, and that forthcoming NICOR data will show that our outcomes are among the best in the country.   The Understanding Children’s Heart Surgery Outcomes site shows that for children aged 0-16, there is no evidence that chances of survival in the hospital are different from predicted.

Closing children’s heart services here will have an adverse effect on paediatric intensive care services here and elsewhere in the East Midlands, and on the ECMO service here, which is nationally very important.   Locally, patients and their families will have to undertake much longer journeys for treatment and care. 

So, there is a campaign at UHL to keep children’s heart services, and all staff receive weekly updates.   Senior Trust staff have met with local and national government and local MPs.  There has been much local media coverage.

The Clinical Librarian Service will help the campaign by locating, if needed, supporting literature or statistics.  I, the Clinical Librarian for cardiology and cardiac surgery, have added the campaign logo (above) to all my emails!

Read more about UHL’s campaign.  There is also a petition to Parliament asking for a public review, which you might like to consider signing.  

Cochrane Clinical Answers

Did you know that The English, Scottish & Welsh NHS license for the Cochrane Library now includes FREE access to  Cochrane Clinical Answers? 

Cochrane Clinical Answers provides brief evidence based summaries on popular clinical questions and links to the evidence from Cochrane Reviews on those questions. 

Here is a link to the Cochrane Clinical Answers on Diabetes, to give you an idea of what is available: Cochrane Clinical Answers Diabetes