ࡱ> a jbjbdd (ee&p66687dt7LpA?j7R;4;4;4;4; T; `;>>>>>>>,@RB>h;4;4;h;h;>>4;4;>>>>h;4;4;>>$h;>>>>7 6H>d>> ?0A?>C>C>>ppt"dppt"New Features of The Cochrane Library NCDDR Webcast #7 June 27, 2007, 2:00-3:00 PM CST Presenter: Denine Tilery [HYPERLINK "http://www.ncddr.org/webcasts/webcast7.html"Link to NCDDR webcast page to find archived webcast RealPlayer file] Edited Transcript >> JOANN: Good afternoon everyone. Thank you for joining today's webcast on "New Features of The Cochrane Library." My name is Joann Starks. I'm with the  HYPERLINK "http://www.ncddr.org" National Center for the Dissemination of Disability Research, known as the NCDDR, and I'll be moderating today's webcast and voicing your questions to our presenter, Ms. Denine Tilery. Before we start, we want to be sure to thank our partners at ILRU in Houston for helping with the technical side of the webcast. I wanted to let you know you can submit questions at any time during the webcast by clicking the "Submit Question" button at the bottom of your player screen, or you can send e-mail to  HYPERLINK "mailto:webcast@ncddr.org" webcast@ncddr.org. You can also call us toll free at 800-266-1832. Questions will be passed along to Ms. Tilery as they are received. We'd like the session to be as interactive as possible, so please feel free to bring up any questions or concerns that you might have. If anyone has technical difficulties during the webcast, for assistance please call ILRU at (713) 520-0232 and dial 0 for the operator. This number is both voice and TTY capable. I also want to point out that today's webcast has a PowerPoint presentation that will be used during the session. The file is posted on ILRU's website where it can be downloaded. It is also available in a text-only version as a Word document. A copy of the  HYPERLINK "http://www.ilru.org/html/training/webcasts/handouts/2007/06-27-SEDL/CochraneQuickRef.pdf" Cochrane Library Quick Reference can also be found on ILRU's webcast section. The NCDDR is supported by a grant from the U.S. Department of Education to the  HYPERLINK "http://www.sedl.org" Southwest Educational Development Laboratory (SEDL), based in Austin, Texas. The grant is funded through the National Institute on Disability and Rehabilitation Research (NIDRR). The NCDDR is charged with assisting NIDRR-funded researchers to improve the quality of their research design and outcomes so that more NIDRR-funded research makes its way into the larger body of research evidence, as identified through systematic reviews, and to facilitate the use of this evidence. To help achieve this aim, the NCDDR is providing a new service for NIDRR-funded researchers: free-of-charge, online access to The Cochrane Library. If you are affiliated with a NIDRR grant and have not yet registered for this service, go to  HYPERLINK "http://www.ncddr.org" www.ncddr.org and look for the Cochrane Library box on the right-hand side of the page, and go to " HYPERLINK "http://www.ncddr.org/cgi-bin/cochranesignup.cgi" Register." In this webcast, Ms. Denine Tilery will describe The Cochrane Library and some if its newest features, to help subscribers get the most out of using this service. She will discuss the  HYPERLINK "http://www.cochrane.org" Cochrane Collaboration, why systematic reviews are an increasingly important source of research evidence, and she will describe the various Cochrane Library databases and how to browse and search them. Denine Tilery is Account Development Manager for North and Latin America for John Wiley and Sons, Inc./ HYPERLINK "http://www.interscience.com/" Wiley InterScience, publisher of The Cochrane Library and a partner with the Cochrane Collaboration. She has served in this role in publishing for the past six years and is certified through Langevin Learning Services as a Training Manager/Director. Ms. Tilery is responsible for training both Wiley staff and customers on the entire suite of Wiley products, including Evidence-Based Medicine resources such as The Cochrane Library. Now, we'll begin the session by handing it over to Ms. Denine Tilery. Welcome, Denine. >> DENINE: Thank you, Joann, and thank you everyone for joining us today. Right now we're on the first slide, "New Features of the Cochrane Library" June 27, 2007. As Joann mentioned, forward her any questions, comments of any type regarding The Cochrane Library and hopefully I'll be able to respond to your questions today. Slide 2: We're going to go to slide 2 next, which lists my name and information. As well as a little bit about my company, John Wiley and Sons. We're celebrating 200 years of publishing this year, and also I've included a few pictures if you're familiar with the Frommer's Travel Guides or the Dummies series or even some of our encyclopedias or references. John Wiley and Sons published these successfully for over 200 years, including a number of cookbooks, if you're interested. Slide 3: We're going to go to slide 3 now, which talks about our presentation topics. Some of you may have joined Joann and me in January [ HYPERLINK "http://www.ncddr.org/webcasts/webcast2.html" September 2006] for an intro to the Cochrane Library. We will review some of that information, including the information regarding the Cochrane Collaboration. I'm going to go through very briefly our presentation topics. The first topic is an overview, understanding the Cochrane Library. The Cochrane Library contains high quality health care information, including systematic reviews from the Cochrane Collaboration. I'll take a few moments to go in depth about what this information contains. Our first module or few slides, Module 1, is What is the Cochrane Collaboration?, which I think is important in understanding more about the Cochrane Library databases that you're able to search. We also have Module 2, Systematic reviews and protocols. I have a few examples of what is a systematic review and protocol defined by the Cochrane Library. We also have Module 3, the Cochrane Library databases. The Cochrane Library is not just one database of systematic reviews, but also provides additional information on Health Technology Assessments, economic evaluations, as well as clinical trials. Slide 4: I'm going to slide No. 4 to just briefly mention Module 4, Browsing topics and reviews and protocols. During this brief presentation, we'll also show you a few screen shots of how to browse and search a topic of your interest. For expert searchers that are already familiar with The Cochrane Library, in module 5, we'll briefly cover MeSH and Advanced Search tips, and finally we have a list of suggested links that will assist you with using the Cochrane Library. Slide 5: Next, we're going to slide 5. I've mentioned previously during our last Cochrane session that today's medical knowledge thrives on the need to be relevant and valid information; and that this can come from any number of sources and in any number of formats. Some of these you may be already familiar with such as  HYPERLINK "http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed" PubMed,  HYPERLINK "http://www.uptodate.com/" UptoDate, and  HYPERLINK "http://www.nlm.nih.gov/databases/databases_medline.html" MEDLINE, as well as searching practice guidelines and summaries, journal articles, as well as expert opinion. All these formats are used by clinicians, consumers, and statisticians to find out about Evidence-Based Medicine. The Cochrane Library actually challenges you as a consumer, as a statistician to find if a treatment or intervention works using EBM. Slide 6: We're now going to slide 6. Where does this lead us? We're on the slide now "Evidence-Based Medicine." This is an evidence-based medicine definition from the Centre for Evidence-Based Medicine. I highly recommend you take a look at this website because  HYPERLINK "http://www.cebm.net" www.cebm.net provides a comprehensive glossary of terms, online tutorials and numerous other resources to assist you with learning more about EBM. This definition was based on the concepts and theories written by Dr. David Sackett who wrote a number of papers about the importance of EBM. Evidence-Based Medicine is a clinical practice -- evidence-based clinical practice is an approach to decision-making in which the clinician uses the best evidence available in consultation with the patient, to decide upon the option that suits the patient best. So that as this definition explains, it's a conscientious and explicit and judicious use of current EBM when making decisions about the care of your patients. And this is slide 6. Slide 7: Next we're going to slide 7. As you can see, a very colorful chart which shows Cochrane systematic reviews at the top. Cochrane reviews are now considered the gold standard for systematic reviews in key publications such as The Lancet, the New England Journal of Medicine, the British Medical Journal, as well as the Journal of the American Medical Association. You may look on the bottom of the pyramid and can you see there are clinical reference texts, case reports, case studies and so forth, moving up the pyramid. This does not discount that this information is valid or evidence-based, but instead by taking a look at a Cochrane systematic review, we filter through the information that may not be relevant to discover whether a treatment or intervention works. Slide 8: I'm going to slide 8, the Cochrane Collaboration. Wiley InterScience publishes the Cochrane Library for the Cochrane Collaboration. The structure of the Cochrane Collaboration is that it was established as an international organization in 1993 and actaully registered as a charity in the UK. The aim of the Cochrane Collaboration is simple: To help people make well-informed decisions about health care. How, is by preparing and maintaining and promoting access to systematic reviews of the effects of health care interventions. Recently, the latest edition of the Cochrane Library is updated quarterly, the second issue of the Cochrane Library has actually been published. I'm going to at the moment just list a few of the reviews that were highlighted by The Cochrane Library. For example, beta-blockers are less effective than other drugs for first line treatment of high blood pressure. You can read more about this systematic review in the Cochrane Library. Another interesting review, Viagra-like drugs can treat erectile dysfunction in men with diabetes. As the topics are extremely diverse in the Cochrane Library, another topic could be coaching patients over 65 can help them to take an active role in general practice consultations. And these are some of the reviews that are listed in the Cochrane Library. The Cochrane Library, for those of you who are not familiar with this, was named after Dr. Archie Cochrane who was an epidemiologist who did a good deal of work in the importance of EBM. Not only did he find it important that clinicians have relevant information at their fingertips, but consumers, statisticians, or anyone interested in health care could easily access a database. Thus, because of his work in this area, The Cochrane Library was established. Slide 9: We are going to slide 9 where you can see the national site license map. I wanted to just take a few minutes to note that a number of countries have national provisions by which some or all of their residents are able to access The Cochrane Library for free. As you can see, Australia is listed, all residents of Australia with access to the Internet can access the Cochrane Library for free thanks to funding provided by the Australian government and administered by the National Institute for Clinical Studies. Another country is Ireland. All residents within the island of Ireland can access the Cochrane Library for free, thanks to funding by national provision by the Health Research Board in Dublin and the Research and Development Office in Belfast. Recently--which is not listed on this chart--India has now received full access to the Cochrane Library through the government as well. More and more countries and more and more governments are realizing that this information about systematic reviews and whether treatments or interventions work are crucial to the care of their patients globally. Slide 10: We're going to slide 10. So in short, What is the Cochrane [library] Collaboration? The Cochrane Collaboration defines itself as the single most reliable source for evidence on the effects of health care. It is considered the gold standard as a resource for healthcare professionals worldwide. Slide 11: You may ask, for some of you who are new to the Cochrane Collaboration, "Who is involved in the Cochrane Collaboration?," which is listed on slide 11. The members of the Cochrane Collaboration are organized into several groups, known as entities, of which there are actually five different groups. I'm going to very quickly go through the members of each of those groups. When you're searching the Cochrane Collaboration, you will look at reviews written by the  HYPERLINK "http://www.cochrane.org/contact/entities.htm" \l "CRGLIST" Collaborative Review Groups. Worldwide, there are several  HYPERLINK "http://www.cochrane.org/contact/entities.htm" \l "CENTRES" Cochrane Centres, for example, in the United States, the  HYPERLINK "http://www.cochrane.us/" Cochrane Center is at  HYPERLINK "http://apps1.jhsph.edu/cochrane/contact.htm" Johns Hopkins University, where if you're interested in learning more about Cochrane reviews or even training, help with translations or even networking, you can contact any of these Cochrane centers to find more about Cochrane reviews and protocols. The next are the  HYPERLINK "http://www.cochrane.org/contact/entities.htm" \l "MGLIST" Methods Groups, which are made up of people who develop the methodology behind the Cochrane reviews. There is also another group, which is called  HYPERLINK "http://www.cochrane.org/contact/entities.htm" \l "FIELDLIST" Networks, and sometimes these are also called Fields. And these emerge around areas of interest, which extend across a number of health problems. For example, a field coordinator in child health would identify health insures of importance to children and facilitate the reviews across the relevant review. And finally, there is a Cochrane consumer website if you are interested or know anyone who is interested in health care in general, there is a  HYPERLINK "http://www.cochrane.org/consumers/homepage.htm" Cochrane Consumer website that can take you through the basics of what are randomized controlled trails, systematic reviews and protocols, in a plain language summary format. Slide 12: We're now on Page 12 of our PowerPoint and we're looking at the systematic review and protocols process. As I mentioned, we have Cochrane Review Groups. At the moment, there are  HYPERLINK "http://www.cochrane.org/contact/entities.htm" \l "CRGLIST" 51 Cochrane Review Groups where you'll be able to browse and search topics. The members of these groups include trial search coordinators, hand searchers, clinicians, and statisticians. The Cochrane Library is updated quarterly. The review groups must register their title with the  HYPERLINK "http://www.cochrane.org/contact/entities.htm" \l "CCSG" Cochrane Steering Group. Once they receive approval they can actually prepare a protocol and some protocols, which I've even seen myself, have taken over a year to write. A protocol is a review in progress, it's the outline. Finally, once a protocol is complete, when they've actually reviewed the information, you can actually prepare your review. And you may ask why this process takes an exorbitant amount of time, and again the aim of the Cochrane Collaboration is to prepare and maintain and disseminate systematic reviews of the effects of health care. But before you can prepare a systematic review, you have to find the relevant research reports, any case studies, and this usually means reports of randomized clinical trials and this can be surprisingly difficult. So the Cochrane review authors rely on several means of searching for these relevant reports and this includes both electronic and manual methods. So this is why they actually need the trial search coordinators, handsearchers, and even statisticians. Hundreds of journals have been hand-searched by members of the Cochrane Collaboration and some journals by as few as one and others as many as 32 individual searchers. There is an estimate of 1,000 searchers that are contributing to this effort by searching for and cataloging trials for more than 2,000 journals. And as more trials are identified, it will be possible to prepare and maintain and disseminate increasing numbers of systematic reviews. If you're interested in more information on this review process, I certainly encourage you to contact the Johns Hopkins Cochrane Center in Baltimore, Maryland and perhaps they may ask you to join the Cochrane Collaboration, as this is a volunteer organization with over 11,500 members. Slide 13: Next, we're going to page 13. As a refresher, just to mention what is a systematic review. A systematic review identifies an intervention for a specific disease or other problem in health care and determines whether or not this treatment or intervention works. So within the systematic review, you can be assured that trials are assessed and that those that are good enough can be combined to produce both a more statistical and reliable result when determining a treatment or intervention. Nonrandomized controlled trials are not included in Cochrane reviews. However, which we'll note when we take a look at the screen shots, they will note why certain nonrandomized controlled trials are not included in reviews. Some of you may be familiar with searching HYPERLINK "http://www.nlm.nih.gov/databases/databases_medline.html"MEDLINE and HYPERLINK "http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed"PubMed and other sources that I mentioned and showed on the EBM chart. Slide 14: We're on slide 14 now, and what I wanted to show is what to consider when you are reading reviews, whether you're looking at them from the Cochrane Library, or from any other sources. Do the studies address a sensible clinical question? Cochrane reviews always have one objective and tell were you whether the treatment or intervention works. Another point when looking at reviews that you want to note, do the studies possess high quality designs and methods? Again, the Cochrane reviews are very specific, also mentioning whether the trials are standardized, double blinded, reproducible -- again, are these assessments of the highest caliber? As well as are the results from the studies similar or widely different? If we're looking at smoking cessation, for example, we won't want to compare pregnant women versus teenagers in the results of our tests. And also how do the results apply to the care of my patients? Again, with The Cochrane Library, by providing Evidence-Based Medicine and whether a treatment or intervention works, you can easily apply this, or as a consumer understand whether a treatment or intervention really works and the methods behind it. And as always, finally, are all relevant and important outcomes considered? Again, when looking at Cochrane reviews, all this information is considered before putting together a treatment or intervention. Slide 15: Next we're going to briefly cover the Cochrane collection, which is six main databases, which is page 15 of your PowerPoint. We have the Cochrane Database of Systematic Reviews. This is the pay dirt we often say in the office, because Cochrane systematic reviews tell you if a treatment or intervention works. However, if you're doing your research, you may want more information on how a reviewer and a treatment or intervention is put together. So you can look at the additional databases. The second database on slide 15 is "Other Reviews," the Database of Reviews of Effects. This complements the Cochrane reviews by quality assessing and summarizing reviews which have not been carried out by the Cochrane Collaboration. DARE is unique in that it is the only database to contain abstracts of systematic reviews that have been quality assessed. So although there may not be a full systematic review, you can at least take a look at Other Reviews or DARE, to find out if this topic is a work in progress or treatment or intervention that will soon become a systematic review. The next is the Cochrane Central Register of Controlled Trials. This database of trials includes details of published articles taken from bibliographic databases and other published resources. The references include the title of the article, information on where it was published and in many cases the abstract. You will see  HYPERLINK "http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed" PubMed,  HYPERLINK "http://www.nlm.nih.gov/databases/databases_medline.html" MEDLINE, and  HYPERLINK "http://www.embase.com" EMBASE as part of the indexing. The next database--Health Technology Assessment. Health Technology Assessment or HTA as it is referred to, brings together details on ongoing Health Technology Assessments and this includes studies of the medical, social, ethical, and economic implications of health care interventions from around the world. Our next database, the NHS Economic Evaluation Database. As we are all aware, economics plays a part in health care. The economic evaluation database assists decision makers by systematically identifying economic evaluations from around the world as well as appraising their quality and highlighting their relative strengths and weaknesses. You will note when you're searching the Cochrane Library that No. 4 and No. 5, there may be some overlap since both often refer to cost-based analysis. The sixth date a base is the Methodology Register. This is simply the bibliographic reference if you're interested in finding out about the original journal articles included in No. 1, the Cochrane Database of Systematic Reviews. As well as searching the databases, you may also look at more information about No. 7, the Cochrane Collaboration and the Collaborative Review Groups. And also No. 8, which is one of the newest databases when you cross search through Cochrane, you can actually search Cochrane reviews by Cochrane review groups. Slide 16: So next we're going to go to page 16 and we're just going to show a few screen shots of how to browse  HYPERLINK "http://www.thecochranelibrary.com" www.thecochranelibrary.com. Slide 17: We're on slide 17 and what we're going to do right now is take a quick look at the Cochrane Library home page. If you type in the Cochrane Library.com as it was listed on Page 16, it will bring you to this Cochrane home page. As can you see, we've recently updated the Cochrane website due to customer comments about having the ability to easily browse and search through the Cochrane collection. At the far top, which I'll go into detail, you'll see "About Cochrane." If you're interested in learning about the Cochrane Collaboration and organization itself, you would simply click on that link. For "Access to Cochrane," this is for users that may not have access to Cochrane; however, please contact Joann Starks since all of you should have full access to systematic reviews and effects. There is also information if you're interested in becoming an author, or as they say, a "Cochranite." You can find out more information about writing reviews and systematic reviews and protocols. And because this is on a publisher website, can you save this title to your "Favorites" as well as save your searches. If we go a little farther down you can see the Browse menu where you can browse by Topic, New reviews, Updated reviews and so forth. As well as other resources you can actually browse by specific databases. To your far right, you'll see a Quick Search box which allows you to search title, abstract or key words, author names, DOI (Digital Object Identifiers), very simply for the Cochrane Library. As well as for expert searchers, you can see the Advanced Search, MeSH Searching (which stands for Medical Subject Headings), as well as a Search History and again, Saved Searches. To find out more information about the Cochrane Library, go to "Welcome to the Cochrane Library" and click on "What are systematic reviews and protocols?" or review the "Product Descriptions" of each database in depth. Or, if you go to your very far right you'll see "Help, new users start here." As you can also see, we'd like to highlight, based on customer feedback, what's new in Issue 2 for 2007. Here, you can get a quick snapshot of the latest and most popular reviews written by the Cochrane Library. There is also another feature where you can actually see the latest country to receive a national site provision to the Cochrane Library, which I mentioned earlier about India. You can click here in the dark blue box to read all about it. Slide 18: So we're going to go to page 18 and I mentioned on Page 17 if I hit "Help, new users start here," I just wanted to show you that it would actually take you to the Cochrane User Guide page. There is an eight-minute self-paced presentation for you to take a look at, as well as a quicker PowerPoint presentation of ten slides that you can use or customize to train other people on the Cochrane Library, as well as a number of user guides in various languages that will take you step by step of how to access The Cochrane Library. Slide 19: We're going to page 19, and I wanted to just highlight a few notes about "Browse." You don't need to be an expert searcher to take a look at the Cochrane Library. Again, as I mentioned, you can browse Cochrane reviews by topic, new reviews, updated reviews or even the alphabetical listing. Slide 20: We're going to take a moment and we're going to click on the A to Z listing which is on Page 20. You can see I selected AZ. I want to take a look at all -- the entire Cochrane Database of Systematic Reviews to see what's available. Here, you can see every single systematic review and protocol in alphabetical order. If we -- you can also use the links provided to browse the Cochrane systematic reviews by other criteria. You can also see new reviews if you only want to review the Cochrane reviews, updated reviews or by review group. However, I want you to take a look under the alphabetical listing that you can look in HTML or PDF and all reviews have a key to quickly identify their status, whether it's a full review, a protocol, new, updated or even withdrawn. The Cochrane reviews also show if a comment has been added by a reader. A full review is simply that. A complete review with the results and discussion and may include a meta-analysis and odds-ratio diagram. A protocol is the outline of the review in preparation. You may even see a green box that says "Comment" on your screen, and a comment means a full review that also contains a commentary or criticism. Readers or Cochrane searchers such as yourself can submit comments, which are incorporated into the review together with answers and feedback from the review authors. We can't see it here, but there is also a new -- which is a red icon, a new protocol review that has been published in the most recent quarter. Updates, as you can see here in the darker blue, is a review that has been updated in the most recent quarter. You may ask what is a withdrawn review, which you can see here in purple. This is a review or protocol that has been withdrawn, usually due to a lack of activity or update. The reasons for the actual withdrawal are specified in the article. Slide 21: We're going to go to page 21 and I just wanted to show an example of what an HTML systematic review looks like. As you can see, this is an example, if I did a quick search on disability in children, this is one of the reviews that I was able to retrieve in my results. Wiley InterScience and the Cochrane Collaboration actually join together to assure that when you're browsing and searching reviews that you can easily retrieve and read the results. Let's look at the left hand menu bar, you can see that there is a PDF available. This is certainly your option. There is an abstract to the review, and the newest feature is actually the plain language summary. Because Cochrane reviews are also available for consumers, this was added to the Cochrane review, to all Cochrane reviews. You have your background, you have your objectives, and again take a look when you're going through a review, some criteria for considering the studies in the review, the type of search methods that were used, and even the methods in the reviews. There is always a discussion point and the results. And another feature which many reviewers may note is actually the potential conflict of interest. For example if a pharmaceutical -- a rep from a pharmaceutical company was interested in writing a systematic review, because the reviews are to be minimally biased, they would actually note in the review that one of the collaborative review group members works for a pharmaceutical company. And that would be again listed under potential conflict of interest. You can also see on the review page that a Cochrane review title very clearly states the objective of the review and again that objective is noted in the actual review itself. Cochrane reviews also include the search strategy including if they've looked through HYPERLINK "http://www.embase.com"EMBASE, Cochrane controls trials registered, and so forth. So again the information is clearly explained to you whether the treatment or intervention works, as well as what information was provided to put this review together. Slide 22: We're going to the next page, 22. I just wanted you to very quickly see the bottom of the review. This is the same review that we looked at on 21, just to get an idea of the selection of trials, the methods that are done in each review. So again, very clearly indicated about this randomized control trial whether or not the participants in the trial were actually blind -- was it a double blinded study and so forth. Slide 23: If we go to page 23, you can actually see highlighted in the red in the far left "Add or view feedback". As I mentioned previously, you can add or view feedback or comments to systematic reviews by clicking on the "Add or view feedback" link that is another new feature, your feedback will be posted here on a Cochrane systematic review. Slide 24: The other latest new feature that I mentioned, and we are now on Page 24, you can see in purple, "Plain language summary." This is the same as the author's conclusion. Many times a review may be one page, 20 pages, or even 100 pages. So naturally you certainly wouldn't have enough time to read all that if EBM is supposed to be relevant and valid and at a quick pace, so you would simply read the plain language summary or the author's conclusions. Slide 25: Next we're going to page 25 and we're back to our screen shot. I just wanted to highlight another new feature on the Cochrane Library database that you can actually take a look at Cochrane reviews written by each review group. So, again, if you're not an expert searcher, just simply click on "By review group," and just go through the -- select the review group of your choice and take a look at all protocols and reviews written by that review group. And this was another new feature added to assist customers with easily accessing information. Slide 26: Next we're going to slide 26, which shows a protocol. I just wanted to take a moment to let you see a protocol that was actually withdrawn because of various reasons. As you can see, the Cochrane Library shows the reason for the withdrawal on page 26, the sources of support and the cover sheet. And again, the reason for the withdrawal could be any number of reasons. You just have to read each one individually. Slide 27: Because of this, a lot of customers would ask, what about the previous version of the review? So another new feature was added which is called "Current version" or "Other versions" which is listed in red where you can actually not only look at the current review or protocol that was withdrawn, but look at previous reviews and protocols to compare and print out. Slide 28: Next we're going to go to page 28 and the title is searching HYPERLINK "http://www.thecochranelibrary.com"thecochranelibrary.com. Slide 29: If you flip to the next slide, 29, you'll see the Advanced Search screen on the Cochrane Library database. I simply typed in "disability" to just show a general search if I was not familiar with this topic and wanted to know what was available in the Cochrane Library if I did an advanced search. If you look on the left-hand side, you'll see that there is "AND" -- which means that you can also use AND/OR/NOT, the Boolean operators, and you can also see on the far right I can do a search in all text, record title, or author's name. This was recently updated due to customer feedback that they wanted to see the variety of ways they could search the Cochrane Library as soon as they opened the advance search page. You can also restrict your search as you can see in orange by "All of the Cochrane Library." Normally, I will keep this on all of the Cochrane Library and in a moment I will show you why. Slide 30: Let's go to page 30 and you will see that when I hit on the results and search all text for "disability," the Cochrane Library automatically cross-searches each database to let me know how this term was indexed. So as you can see here there are 1,143 Cochrane reviews written. DARE, there are 207 "Other Reviews;" again, these are topics that may be relevant but not yet a systematic review, and so forth. You can also see that to the far right you can save your search as well as edit your search. The records are listed below. Slide 31: If we go to page 31, you can see that I selected one of the second reviews, I actually selected from other reviews just to show you, from DARE. Again, this is a review in progress. The topic is not yet a systematic review but you'll get a clear outline of how they're actually putting together the structured abstract before they write the review. Again if you have questions or you wanted to add feedback about why they were including or not including information, you could certainly do so. Slide 32: Next we're going to go to page 32. Some of you may be familiar with  HYPERLINK "http://www.nlm.nih.gov/databases/databases_medline.html" MEDLINE and  HYPERLINK "http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed" PubMed, which also includes MeSH searching. MeSH stands for HYPERLINK "http://www.nlm.nih.gov/mesh/meshhome.html"Medical Subject Headings. This is basically a thesaurus. If I was interested in learning about a topic and wanted to see if it was indexed through MEDLINE or PubMed, I could simply click on the MeSH Search box. As you can also notice on the screen shot, I actually show that there is a definition key and I can actually see what is the definition used by the Cochrane Library, another nice feature that was added. The "Search" box was actually updated recently to make it more user friendly, so as you can see, you can search the Cochrane Library content by clicking the "Review Results" button; you cal also add qualifier restrictions. For example, if we were interested in drug therapy or anything like that, we could certainly customize the search a little bit more. As you can see, there is a MeSH index tree and a hierarchy that you can explode if needed. And also want you to note at the top of the page you can also search by qualifier alone. This is another feature added to the Cochrane Library. Again, you can always browse topics, and topics by review group or alphabetical listing. But if you do prefer to search you have your options of advanced or MeSH Searching. >> JOANN: Denine, I wanted to interrupt you for just a second here. I saw your search on -- with the term "disabled children" as the MeSH descriptor and we often use the term "children with disabilities." So when I went to see if that search would turn up the same or different items, it turned out that that term was not really used in this MeSH descriptor setup. It gave me "disabled children." I just thought that was kind of interesting that if you put a term in there that's not really a MeSH descriptor, it will give you whatever the term is that they actually use. Then I went and did the same search not using this MeSH category, just going through the regular search box in the advanced search for the Cochrane Library and I did get some different items. I just thought it was interesting to point out that by using the same and different terms but using different areas or different ways to search in the library, you may turn up a few other searches. So I think it's a good idea for people to know that they can do the same search in different ways and they may identify a few other studies. >> DENINE: That's exactly right, Joann.thank you very much for that. I think that's one of the reasons why they added the categories of search "By Review Group," browse "By Review Group." Because there were some people that weren't very aware of that so they at least wanted to just say, hey, at least look under this review group to determine even if your topic is there, as a last resort if you're not an expert searcher. So that's a great point. Thank you very much. We got a lot of feedback on that actually and the Cochrane Collaboration is constantly trying to update searches, so if there is anyone out there who -- you know, you do find something that may not be clear, or like Joann made a good point about searching and you come up with different results, you can certainly contact us as well. >> JOANN: Can you tell me who it is that determines the MeSH descriptor categories? Is it some kind of a committee or something? I know I've heard about it, but I just don't remember the details. I don't know if you have that at the top of your mind either. >> DENINE: It's from the  HYPERLINK "http://www.nlm.nih.gov/" National Library of Medicine, so this is standardized by them and this is just used by a number of medical librarians worldwide, and they actually take training on it and do courses. It's just a standard search method used and Cochrane thought it was important, because medical librarians use it, to include the thesaurus when searching the Cochrane Library. And because the Cochrane Library links to PubMed and other sources, Cochrane reviews are indexed using these terms. >> JOANN: That's very good they made that coordination with something that others have developed. >> DENINE: When we actually acquired Cochrane, we wanted to be sure that this was not just a product by a publisher, this was a volunteer organization that really wants to promote access for everyone, so that you can find relevant information on treatments or interventions. Thank you for bringing that up. That's a good point. Slide 33: I'm going to go to slide 33. The next few slides that we have -- I wanted to quickly show people a few of the other types of reviews or just a few screen shots to get you familiar with what you actually see when you're searching the Cochrane Library. And I'm on Page 33, and I actually wanted to show an economic evaluation outline where you can -- I did another one on "disabled children" and wanted to know what topics or what record information was there on disability in children and economics. Again, because this plays -- the cost benefits play an important part in caring for anyone. So again you can just take a look here at the number of records and I don't know if Joann you retrieved this result as well. You can see there are not a lot of reviews written or indexed through economic evaluations. >> JOANN: Right. >> DENINE: Again, I wanted to just point this out to you when you do this search. This was a MeSH Search that I actually did previously. Slide 34: And I'm going to go to slide 34 and I just wanted to show you what an economic evaluation looks like. Again, the systematic review tells you if the treatment or intervention works. The other five databases provide additional information that show or rather demonstrate how they put the record together. So again if you're looking at a systematic review, you can look at the economic studies that were included or maybe if you just want to take a look at this outline. If it is indexed through  HYPERLINK "http://www.nlm.nih.gov/databases/databases_medline.html" MEDLINE or  HYPERLINK "http://www.embase.com" EMBASE or  HYPERLINK "http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed" PubMed, or any other references, you can click on the index terms on your far left. Slide 35: We're going to go to page 35 and also when Joann and I were searching, I thought it was nice to point out to go to your search history, that you can combine your searches. Some of you may be familiar with this already in MEDLINE, but whether I had one search, two searches, or 20 searches, I could easily combine those searches to restrict my results and perhaps see if I could narrow down my search results if I was searching a broad topic of some sort. >> JOANN: When you do this, does it take out your duplicates or does it just put them altogether? Would they be like next to each other so you would recognize them as duplicates if they come up under different searches? >> DENINE: Unfortunately not, it wouldn't recognize it. That's actually some good feedback we can note to them. >> JOANN: if they would put it in alphabetical order, they would be next to each other and you could delete any that were duplicated. >> DENINE: I think we'll have to hire you as a Cochranite. >> JOANN: We hope some of our listeners out there will get back to us with questions that they may have, things they would like to see in the Library or may not have found that actually do exist in the Library. So we do encourage those grantees who are subscribers and users of the Library to get back with us. If you contact me, I can certainly get in touch with Denine, or you could contact Denine directly, too. Slide 36: >> DENINE: Certainly. And finally, I wanted to show -- we're on Page 36. I just wanted to show that you can save your searches within the Cochrane Library indefinitely. I've done a number of searches for a different organization and again all you have to do, is in the Cochrane Library, set up your own personal profile. You can save your searches, certainly not a problem. And they will be listed here and you can even receive active -- you can receive active alerts if there is new information on a review, this is actually a new feature. You may receive a link saying there's some new information or a review or protocol. So that was another thing we were actually asked by our customers. So within the Cochrane Library, if you look at our screen on Page 36, we can browse by topic, new reviews, updated reviews, alphabetical listing or just by one of the 51 review groups and we can also look at other resources, again, we want to find out what clinical trials have been done, methods studies, technology assessments. We can actually look by database and on the far right we can do a search and we can advance search using Boolean operators or we can do a MeSH Search using index terms through MEDLINE or PubMed. We have our search history, so we can combine or restrict our search to narrow down our results. Then finally we have our saved searches, which are saved indefinitely. >> JOANN: And that's one where you have to actually sign up through Wiley, is that correct? >> DENINE: Yes. >> JOANN: It's not a part of just the Cochrane Library, but it is something that Wiley has set up and I guess it would serve for other databases or library-type features that your publishing company would have. >> DENINE: Yes, you certainly could. It was kind of interesting how they did this, they kind of made the saved searches separate from, normally all of your searches are saved in one box, like journals and books, but because Cochrane is so specific, in the search box you only see your Cochrane saved searches here. >> JOANN: That's good to know. >> DENINE: A lot of people just subscribe to Cochrane and need this information. That was something new as well that they've added. Slide 37: So I'm turning to page 37 and again we're on the final slide of our presentation and just wanted to show again the main page,  HYPERLINK "http://www.thecochranelibrary.com" thecochranelibrary.com. Joann, I don't know if I've missed anything or is there something you'd like to add? >> JOANN: No, I think you've given us a very good overview. We do have a couple of questions that people have sent us, but if there is anything else you would like to say or sum up first, that would be great. >> DENINE: No, I think I'm good. I'd like to hear the questions. Hopefully I'll be able to answer them. >> JOANN: One of the questions we received is, "Does the Cochrane Library offer RSS, or really simple syndication feeds?" These are like news feeds >> DENINE: Not at the moment, but that is something we're working on. We added that to Wiley science in general and I'm sure the Cochrane Library is on the project manager's list to do so. >> JOANN: You said you do have an e-mail alert service that would notify people when specific information is added to a topic area that they've identified? >> DENINE: Yes, as long as you register for the personal profile and when you go under your save searches -- and let me go back to slide 36, you'll see on that page you can see the alert status and you can activate your alerts, daily, weekly or monthly. >> JOANN: Great. >> DENINE: And you'll receive a link and click on that link and access the full text review. Those are great questions. Any more? Those were two I can answer. >> JOANN: I don't know if you'll be able to get this next one here. Do you have any idea how much money the pharmaceutical industry or other medical business entities might contribute to either the Cochrane Collaboration or the Cochrane Library? >> DENINE: That is an excellent question. Whoever did that, Joann, you have to send them a Wiley bag. Actually, the pharmaceutical companies are not allowed to contribute money. This is strictly a volunteer organization. It's paid through the government and again these systematic reviews -- we don't want to encourage you to say use a drug by Purdue Pharma or Bristol-Myers Squibb, one of the pharmaceutical companies over the other. I did have someone from a pharmaceutical company interested in writing reviews. She did that on her own in her free time, but they would note in the systematic review, you know, especially if she played a significant part in writing that review, that there was one person who worked for a pharmaceutical company. >> JOANN: I have noticed in the reviews that I've looked at that there is always some kind of a notation about any kind of conflict of interest. >> DENINE: And that's a very strong point. Again, everyone is a volunteer in this organization and they really don't want -- they really just want to keep -- the point is just getting Evidence-Based Medicine and just getting that strictly clear as possible, minimal bias so you will never see Bristol-Myers Squibb has contributed like $100,000 to the Cochrane Library. They would not accept the money. And I think that's why -- in fact, a number of governments, because this is global information and because it doesn't have that bias, they are willing to actually purchase this for their country. >> JOANN: Well that does lead into another question as to how much it costs to subscribe. We did get a subscription through the NCDDR to allow our NIDRR grantees to register and be able to access the Library. I know you're not really the sales person, but do you have that information or where would someone go to find out if they wanted to get their own subscription? >> DENINE: Pricing actually varies. If it was an individual user, suppose you wanted to use this on your own, we do have pay-per-view article options, which you can certainly do, but I normally don't mention the pricing because it's varied. I only give it to the key contacts for the organization. >> JOANN: So someone should contact you if they happen to be interested in getting their own subscription. >> DENINE: Yes, please, definitely. >> JOANN: Okay. Another question that I have is someone says, "My area of specialty is in employment and vocational rehabilitation. Where would I find information about this in Cochrane?" I don't know if we -- I haven't tried to do a search in that area. >> DENINE: I would try -- and what's interesting about Cochrane, not every single topic is included. I probably would start again by looking by review groups or by looking by topic to see if there was any relevant information or I would do a quick search and I was trying to do one while we were on the phone. There are some topics that are not in the Cochrane Library. But I think you would just go by review group and see what's listed very quickly. And what was that topic again -- employment and -- >> JOANN: Employment, or vocational rehabilitation. >> DENINE: Vocational rehabilitation, I have seen some things on that. Let me try a MeSH Search. It's good to know people weren't asleep. Those are good questions here. >> JOANN: We have had some comments that there were some audio difficulties. I know here at our offices some of the other staff members were having audio difficulties so I'm hoping it was not a system-wide problem. I guess we'll find out later. >> DENINE: We do have another thing, Joann. I'll resend you the recordings of the self-paced tutorials, which are 7-10 minutes, if people want to do their own walk-through of Cochrane. >> JOANN: Great. That would be very helpful. >> DENINE: I just did a MeSH Search on rehabilitation to see what was indexed and I'm getting from dance therapy to early ambulation. >> JOANN: Nothing specifically on employment then? This is probably not the place to find the best information there, which would indicate that maybe they need to do a systematic review in that area so that it could be added to the Cochrane Library. >> DENINE: I did type in employment when I did the MeSH search. Employment, supporteddownsizing.,,,, They may I just pulled up DARE, "An update on supported employment for people with severe mental illness," or "Vocational rehabilitation and schizophrenia-- it doesn't seem like there is a lot. >> JOANN: There are a few things. >> DENINE: You may find a few leads and I don't think actually I showed this on the screen shot, I apologize.At the bottom of the systematic reviews, you'll see the word "Link" in the references and it will link you to other sources such as PubMed and MEDLINE, so if the information is not here in Cochrane, you can go out to other sources and Cochrane encourages that. And with everyone, when you're searching Cochrane is to remember this is a great starting point. Cochrane is not saying just search here and never search anywhere else. What they are saying is we're trying to help do the work for you of looking through published and unpublished journals. We're trying to look through randomized trials; even if there is some non-RCT that should be included. If you were a clinician, on average you would have to search 17,000 articles a day to stay current. Cochrane is saying that we actually have an organization that is trying to do that for you to save you time. Whether you're a clinician, librarian, or consumer. Use this as a starting point. If you don't find the information, it doesn't mean it's not out there, but it does mean when you look at those other sources, maybe you need to consider how valid they are, how much information do they put into those studies, which is a great point with Cochrane. When they are talking about if you see a review by Dr. Denine Tilery, I may not be as thorough as a Cochrane review group. So that's what Cochrane wants you to consider. What are those other people what are their criteria in writing the reviews, systematic reviews, and protocols? Another great question. Sorry we couldn't find the search. I am finding a few things. >> JOANN: Okay, that's good. One other question is, "Who would I contact if I wanted to make copies of some Cochrane reviews and share them with a class of 350 students?" >> DENINE: Please send that to me, actually. We do get that request on occasion. Again, because we are a publisher, we have to be careful with that. We give permission. It depends on specific reasons and I would just say please send that to me so I can confirm that with our Cochrane marketing manager in the UK, that that would be okay. >> JOANN: That sounds good. Those pretty much wrap up the questions that we've received here today. >> DENINE: Great. >> JOANN: I guess if we don't have any more, then we'll go ahead and wrap up a little early today. >> DENINE: Again, thank you all very much for your time and I certainly encourage you to take a look at the Cochrane Library and Joann Starks has heard me do the Cochrane Library many times and I'm sure she's a wonderful asset and can certainly assist you with searching as well. >> JOANN: Also, Lin Harris here in our office works with the Cochrane Library. Any grantees that need any assistance, please feel free to call us at 800-266-1832. And just a reminder, if you have not registered to get access to The Cochrane Library, go to our home page which is  HYPERLINK "http://www.ncddr.org" www.ncddr.org, and look there on the right-hand side for the box that says Cochrane Library. There is a place to " HYPERLINK "http://www.ncddr.org/cochrane/index.html" Register," to "HYPERLINK "http://www.ncddr.org/cochranelibrary/"Log in" if you're already registered, and a link for " HYPERLINK "http://www.ncddr.org/cochrane/cochraneta.html" Technical Support" if you need to write in to get some help. Well, Denine, I want to thank you very much, and thank everyone for participating in the webcast today. >> DENINE: Thank you, Joann. It was a pleasure as always. >> JOANN: The audio file and the transcript of the webcast will be available on the ILRU website archive page in a couple of days. You can find that by visiting HYPERLINK "http://www.ilru.org/html/training/webcasts/archive/2007/06-27-SEDL.html"www.ilru.org. I want to thank the  HYPERLINK "http://www.ed.gov/about/offices/list/osers/nidrr/index.html" National Institute on Disability and Rehabilitation Research (NIDRR) that provided the funding for the webcast and I also want to especially thank the staff at ILRU, because without their efforts, the webcast could not have taken place. And those include Tajauna Arnold, Marj Gordon, Sharon Finney, Dawn Heinsohn, Vinh Nguyen, Maria del Bosque, Rob Dickehuth was taking care of the technology, and Marie Bryant, our realtime captioner. This is Joann Starks with the NCDDR. We hope you'll join us for our next webcast, which will be on August 22nd at 2:00 PM Central time. The topic will be " HYPERLINK "http://www.ncddr.org/webcasts/webcast8.html" Ethnic Diversity in Acceptance of Disability, Community Integration Needs, Barriers, and Supports" and the will be presented by staff members of the HYPERLINK "http://www.tbicommunity.org/"RRTC on Community Integration of Persons with Traumatic Brain Injury. Thank you very much and goodbye. Transcript 06-27-07, P.  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