Wednesday, 12 July 2017

Sharing Best Practice at the Midlands and East Summer Conference

I was invited to run two sessions on "Sharing Best Practice" at this year's Summer Conference, held in Peterborough, on 12th July.

I spent some time thinking about what "best practice" actually is, is it different from good practice, from evidence based practice, and is it different from innovation?

In the first session there was a lively discussion on whether librarians actually do evidence based practice, and whether we practise what we preach on using evidence. Does all evidence come through desk based research, or simply learning from others' successes and failures?  There was a lot of talk around whether the evidence base for clinical librarians is now well established to the point that no further work is needed (I'd say not, others disagreed).

We discussed how we use professional judgement and experience alongside evidence gathered through observation and conversation with colleagues in other organisations.

When looking at the best forum in which to share activities we consider as best practice, we talked about conferences and meetings as "down time" and whether it's easier to share in these environments than make time in a busy working day to write a blog post, draft a journal article or enter an award. Many of us are keeping up with the day job and finding that takes all of our energy.

We discussed the value of local networks, talking with trusted colleagues we know well so feel more able to be open. The East of England libraries network run "Can Do Caf├ęs" as forums to share ideas and learn from each other, along with themed "Share Your Stories" sessions, which sound like an excellent way to throw an idea out to colleagues and get feedback and encouragement and/or commiseration.

In the second session we discussed whether it is possible to define what best practice is without giving examples of activities we feel are embodying best practice. Words such as "efficient" and "relevant" were used, but we found it difficult to come up with a single best fit for what best practice is. The group felt that it can be very location and context dependent when deciding what constitutes best practice as it may not work everywhere.

Sharing is not just down to being present at events such as the Summer Conference, the EoE librarians have a well established tradition of reporting and sharing best practice through their LQAF (Library Quality Assurance Framework) returns. This may not work for all, working in the East Midlands, I've never seen another library's LQAF return until I worked as a peer reviewer this year.

Local networks again came up where people feel they can talk openly with trusted colleagues. This did make me wonder how you can break out of your own network and find out about wider practice, and members of the group said that if you want to know, just ask! But this assumes that we're able to find out that something is going on, that we might want to know more about.

Mailing lists, more on the local scale rather than national were thought to be useful where colleagues are not able to meet face to face regularly. There seemed to be a sense of not wanting to put yourself out there for judgement.

We then got onto a rich discussion of whether we ought to be sharing our failures as well as our successes, and if we're reticent to share our success, failure is going to be even harder to come by!

Innovation versus best practice came up again, and the feeling of needing to be doing something unique AND interesting in order to qualify as an innovation before shouting about it appeared to be a widely held concern in the group. However it was agreed that we don't always need to feel we're in direct competition with other health libraries.

Wednesday, 21 June 2017

World Sickle Cell Day

Better late than not at all... 

Monday 19th June was World Sickle Cell Day and our local CLAHRC has been conducting a survey, which found that a greater awareness of sickle cell disease would improve patients' experience, and that staff in emergency settings had a relatively poor knowledge.

They have produced an infographic.

To improve your clinicians' and practitioners' knowledge, here are some resources:

Local

Professor Simon Dyson, De Montfort University,  especially the Resources and Information page, which lists UK organisations and resources for schools.  Professor Dyson has also produced some open educational resources.

Rest of the UK

Clinical Knowledge Summaries for an evidence based summary.

HealthTalk for patient experiences of screening.

NHS Choices for an overview and links to other NHS resources.

NICE material is included in the set relating to blood conditions - a clinical guideline (CG143) and a quality standard (QS58)

Sickle Cell Society - UK based patient support organisation

Rest of the world



emDOCS - The sickle cell patient: ED management of acute complications.   Detailed discussion from this US based emergency medicine blog.  

Life in the Fast Lane (LITFL) - Sickle cell crisis.  Another blog for emergency medicine and critical care, based in Australia and New Zealand.

MedGen for everything genetic.


Wednesday, 14 June 2017

Bicuspid aortic valve - Medline search strategy

The aortic valve should have three "leaflets", so is "tricuspid".    Sometimes it has only two, because two are fused together, and then it is "bicuspid".

Bicuspid aortic valve (BAV) is a congenital condition.  It is linked to aortic aneurysms.

How to find literature about BAV?

There is no MeSH term for bicuspid aortic valve, although there is a "supplementary concept" Bicuspid aortic valve.  This is searchable in PubMed as [Supplementary Concept], but as far as I can work out, is not searched or searchable in HDAS.

In PubMed, the freetext term "bicuspid aortic valve" maps to the supplementary concept.

So is it enough to rely just on the phrase "bicuspid aortic valve(s)"?   I think not, because: 

a) I have seen phrases like "bicuspid and tricuspid aortic valve" and "bicuspid aortopathy".  The latter, I think, relates to the aorta, not the valve, but the aorta as it is affected by the valve.  

b) Perhaps there is literature where BAV is indexed under Heart Defects, Congenital/ and a MeSH term relating to the aortic valve but where phrases describing BAV itself are not used.

I was working on a search about fusion patterns in BAV, that is, which leaflet is joined to which, and that gave me some more terms.

So, taking all that into account, here is my draft of a search strategy for Medline via HDAS:

1. ("bicuspid aort*").ti,ab
2. (BAV).ti,ab
3. "AORTIC VALVE"/
4. "AORTIC VALVE INSUFFICIENCY"/
5. exp "AORTIC VALVE STENOSIS"/         
6. "HEART DEFECTS, CONGENITAL"/
7. "HEART VALVE DISEASES"/
8. (fusion OR fused OR fusing OR morphol* OR morphotyp* OR phenotyp* OR habitus OR raphe).ti,ab
9. ("right noncoronary" OR "left noncoronary" OR "right left" OR "left right").ti,ab
10. ((left OR right) ADJ2 "non coronary").ti,ab
11. (classif* OR pattern* OR commissur*).ti,ab
12. 1 OR 2
13. (3 OR 4 OR 5) AND 6
14. 3 AND 7
15. (8 OR 9 OR 10 OR 11)
16. ("aortic valve*").ti,ab
17. (3 AND 15)
18. (15 AND 16)

19. (12 OR 13 OR 14 OR 17 OR 18)

Lines 3 - 7 are an attempt to capture the way BAV is indexed in the absence of a single MeSH heading.

Lines 8 - 11 describe the fusion patterns and other features of a BAV, although some words are possibly too general ("pattern" for example could be referring to something else, not the valve).

On 14th June 2017, line 1 found 2454, line 19 found 12693.    How many of these extra ones are relevant, but not found in set 1 or 2, is not clear.

Maybe:

12 or 13 or 14 

would be enough (this finds 9939).

All of this, of course needs, testing.  

Perhaps which strategy you use (assuming you think it worth using!) would depend why you are searching, and if there were other aspects to the search, it may matter less.

Tuesday, 23 May 2017

International Clinical Librarian Conference - Programme released

9th International Clinical Librarian Conference, in Leicester UK.
21st to 22nd September 2017


We are pleased to announce the programme for the next ICLC conference, organised by University Hospitals of Leicester NHS Trust.

The conference will be held at Leicester Racecourse, in the vibrant multicultural city of Leicester. Leicester is only 66 minutes away from London via train, and Stratford Upon Avon is only an hour away by car. Leicester is also the home of world famous sports teams, so you could stay on after the conference for some exciting sports viewing!

Accommodation suggestions can be found here and there is free parking at the conference venue.

Monday, 22 May 2017

NEJM Group announces a new website for librarians

Announcement from the New England Journal of Medicine:


You’ll find articles that share the expertise of leading medical librarians, take you behind the scenes of products and events at NEJM Group, and provide resources to help your community take full advantage of our offerings.

Please explore our new site and be sure to register on the home page for an email alert to let you know when new articles are posted.



Friday, 19 May 2017

International Clinical Trials Day

James Lind (1716-1794), by Sir George Chalmers


Friday May 19th is International Clinical Trials Day.

The NIHR is holding events under the heading "I am Research", to increase public awareness of research.

We compiled a set of webpages for the Hope Clinical Trials Facility, based at the Leicester Royal Infirmary, and the pages include links to information about trials registries, participating in trials, and procedures and reporting guidelines.

Have a browse, on this International Clinical Trials Day.

Why this day?   According to the Association of Clinical Research Professionals site, May 20th 1747 is when James Lind began what was probably the first RCT, investigating scurvy.

The James Lind Library contains material illustrating the development of "fair tests of treatments", and can be browsed by topic.   It has information about Lind's trial here.



Portrait of Lind from https://en.wikipedia.org/wiki/James_Lind#/media/File:James_Lind_by_Chalmers.jpg

Wednesday, 10 May 2017

Systematic review filter for ProQuest PsycInfo

Looking for systematic reviews, I needed a systematic review filter for ProQuest PsycInfo.  

I had searched other databases for the same project and used SIGN's filters, but SIGN did not have one for PsycInfo and the other PsycInfo ones I had found were for other interfaces.


The idea behind using a filter, and not relying on database publication type limits, is that not every SR is indexed as one, so the filters look for terminology that is common in SRs to identify items that are SRs.


I adapted the University of Texas School of Public Health filter (found via the ISSG Search Filters Resource) for ProQuest.


This was what I came up with:



1. TI,AB,IF((comprehensive* OR integrative OR systematic*) NEAR/3 (bibliographic* OR review* OR literature))

2. TI,AB,IF((meta-analy* or metaanaly* or "research synthesis" or ((information or data) NEAR/3 synthesis) or (data NEAR/2 extract*)))

3. TI,AB,IF(review NEAR/5 (rationale or evidence)) and ME("Literature Review")

4. AB(cinahl or cinhal or (cochrane NEAR/3 trial*) or embase or medline or psyclit or psychlit or pubmed or scopus or "sociological abstracts" or "web of science")

5. ME("systematic review" or "meta analysis")

6. 1 OR 2 OR 3 OR 4 OR 5

The UTSPH filter is one line, but I got muddled with brackets and found it easier to have several lines...   Line 3 does not include the word PsycInfo because (as I discovered!) every reference in the database has that word in the abstract...  

Monday, 30 January 2017

Registration is now open for ICLC 2017


The International Clinical Librarian Conference (ICLC) runs conferences, targeted at Clinical Librarians and any other health librarian who finds the topics covered of interest.



21st to 22nd September 2017
Leicester Racecourse
Oadby
Leicester LE2 4AL

The International Clinical Librarian Conference is organised by the Clinical Librarian team at University Hospitals of Leicester NHS Trust (UHL) in the United Kingdom.

To find out more information on the UHL team and what they do, please visit their website at www.uhl-library.nhs.uk/cl



Abstract submissions are also currently being accepted:


Tuesday, 10 January 2017

Call for Papers for ICLC 2017 - reminder

Hopefully you will have had time to consider over the Christmas and New Year break what sort of paper you would like to submit for the International Clinical Librarian Conference 2017. If you have, then here is the submission form. http://www.uhl-library.nhs.uk/iclc/abstracts.html


Friday, 6 January 2017

Transfusion Evidence Library

This database of systematic reviews, RCTs and economic studies relevant to transfusion medicine is available to the NHS.  It is compiled by the Systematic Review Initiative, an Oxford based clinical research group.

I must admit this is the first time I have used it.    Search terms used in my exploration are in bold.

Areas covered are listed.   The main audience will be people involved in transfusion medicine, but there is material in it of interest to surgeons, critical care specialists and haematologists. 

The search guide gives search tips, and details of how records are found for inclusion.
  • Total knee replacement finds 164 records
  • Phrase searching is allowed, so “Total knee replacement” 90
  • Boolean is allowed, so total knee (replacement OR arthroplasty) finds 283
  • Like PubMed, strings of words are AND’ed, so total AND knee AND (replacement OR arthroplasty) also finds 283.

Results can be filtered by:
  • Clinical specialty – these include, of course, blood donors, but also haematology and oncology, obstetrics and gynaecology, and surgery.   
  • Subject area - these include Fractionated blood products (under “Alternatives to blood”) and Management of anaemia (under “Clinical Practice”).
  • Study design - SR, RCT or economic.
  • Text availability - TEL links to some publishers and providers like Ovid, but also to things like PubMed Central.

You can apply only one filter from each group at a time.  You can apply filters from different groups together, for example, clinical specialty and study design.  Filters stay applied to searches until you clear them.

Some items (not many in any of the searches I did) have clinical commentaries evaluating quality.

For some searches, you see (at the end of the first page) the expanded query”. This looks like the search that is actually done, but I am not sure.  Sickle cell anaemia does not show an expanded query, where sickle cell anemia does, although both searches give the same number of results. Searching hiv gets the same number as searching hiv OR “human immunodeficiency virus”, and neither shows an expanded query.  For ITP (not the best search in the world!), the expanded query suggests it has searched inosine triphosphate, but the results suggest it has searched immune thrombocytopenia (which is what I was thinking of).   (Using the full name of ITP finds more)

Transfusion Evidence Library looks useful, and I plan to try it out on search requests, where appropriate.  We will be promoting it to our Transfusion team. 


Have you used it?    Please put your thoughts, or anything I have missed or got confused about, in a comment.

Wednesday, 4 January 2017

Run VT

According to HLWIKI encyclopedia, Clinical Librarian (CL) provides specialized library services in teaching hospitals and other health organisations by participating in clinical activities and hospital rounds with health providers. By working closely with assigned teams of clinicians, a clinical librarian can respond to information needs that arise in situ within the clinic. This makes them more 'clinic-driven' than 'library-driven'. Furthermore, Clinical Librarians facilitates access to the medical literature to answer the health professionals most-pressing clinical questions; as such, CLs perform, mediate and coach users through the search process and in locating the best medical evidence from the medical literature. Assistance can also extend to locating the full text of documents in print and electronic formats. 

The health education team in western Sussex has developed a You Tube video 
https://youtu.be/2iZz38HOhAg that further highlights the value of a clinical librarian. 


Web resources about dialysis

It is easy to look for information on the web, but not always easy to find useful things.  The vast number of resources, and their variable quality, mean it is useful sometimes to have a list of selected resources, with notes.

For that reason, the Health Libraries Group Newsletter publishes an "Internet Sites of Interest" column, which (declaration of interest!) I edit.

The hope is that the column is a useful place for health librarians to start with new subject areas.   And also a useful thing to share with library users, whether students or practitioners. 

The latest column is a list of sites about dialysis, one of my clinical areas, so I was able to ask them for suggestions.  There are brief notes about each site, and a quick list of definitions. The column (and previous ones) is listed here.  

Please do use and share the list, with (of course) acknowledgement to the HLG Newsletter.

End of self promotion!