Conducting Literature Reviews in Health
What's up everybody. Welcome to the first episode of health. Econ weekly where. I show you how to get things done in healthcare. Now you've clicked on this episode because you're super passionate and excited about literature reviews or you couldn't care less but here you are cuz you want to know exactly how to get one done my name is. Abbas I'm Ronnie and I'm gonna be taking you through a step-by-step guide on how to conduct a literature review. Hey I just want to put a disclaimer out there. This is one of many ways to be able to do a literature review. I just want to make a quick shout out to my supervisor friend and colleague Richard Edlund who without him this whole episode would not be possible so without further ado. Let's get right into it. Literature reviews seem so daunting you're off an approach for a project it could be a business case an RFP process or an economic evaluation of such. But where the heck do you start often. You're like okay sweet brilliant. I'm gonna do a lit review at times. It feels a little bit like this when we talk about literature reviews it's important to have the same definition literature reviews are systematic and rigorous ways of seeing. What's been done searching the landscape. For articles and information literature reviews are conducted using a search strategy a search strategy is an organized structure of keywords or themes that are used to search a database one thing. I want to reiterate is that literature reviews are systematic and rigorous before we start. We need to set up a couple of things given that it's a systematic and rigorous literature review. I'm going to assume that you have accessed some of these tools. Hey not to worry. If you don't have access to these tools follow along anyway and there's going to be a tutorial on non systematic literature reviews. The first tool you're going to need is a referencing tool whether you prefer endnote or refworks completely up to you. Whatever you feel comfortable with as long as you have a referencing tool that you're able to use to sift through material the next tool that you'll need is access to a database.
You have a couple of options for databases to use. It doesn't matter what you prefer. I personally use Ovid MEDLINE but you're welcome to use any of the existing databases such as M base PubMed or Scopus. Just be sure to log in via your institution to gain full access as with any research. You're gonna need to formulate a research question now this is an iterative process. And you're gonna want to involve as many stakeholders as possible when writing up your research question. I'd recommend having two or three research questions written up slightly differently this will give you a better understanding of the topic and keywords at hand okay as with everything it's good to look at an example we can use this example as a step-by-step guide on how to conduct a literature review so I'll keep this consistent with health economics one example of a question that I might get asked would be - we're looking at the cost-effectiveness of a mobile intervention for diabetes in relation to improving hba1c as an outcome measure. Once you've got your research question written down alongside multiple variations you're able to pick out some keywords and develop a list we're also told that we're indifferent between type. 1 and type 2 diabetes for the purpose of this exercise. We're only going to write our research question. Once after you've written down your research question you want to highlight some key words after which you want to make a list of key words from your research question this will help you develop your search strategy. Once you've got some basic elements written down. You need to expand your overall understanding of the topic area working as a researcher or working in healthcare. You're often gonna come across a number of areas that you're not familiar with. We need an informal yet systematic way of improving our understanding of the topic.
The whole point is that someone should be able to follow your instructions or your process and be able to generate similar results. A few places that. I like to go to include Wikipedia Google Scholar nice local and national organizations and Institute's such as PHARMAC and district health boards as well as looking at key documents such as health needs assessments and local strategy documents for the purpose of this example. I'm going to be looking at Wikipedia. Nice and health needs assessment from a district health board. I recommend you split. Screen looking at the diabetes page. We're able to draw out some key. Words that we can place in our table be careful of keywords such as hypoglycemia and its spelling as well as hyperglycemia as well as glycemic reading through the title of your articles will help you identify keywords that you will also want to exclude in this example gestational diabetes now that you've got your beast list of keywords and phrases you've got to decide where they're going to appear one assumption. I make is that a relevant article is likely to have the keywords. I'm looking for in the title or the abstract. If it doesn't then it most likely isn't going to be relevant for what. I'm looking for okay. So this is the fun part. Let's start combining most databases are similar and with Ovid MEDLINE. You can use words such as or and and not to combine relevant keywords and phrases scroll down after each search term and see if it's picking up the things that you want it to pick up. Be careful though. Some search terms such as patient can introduce unnecessary noise to your search results. You'll be able to see this because you'll have four hundred and twenty five thousand results and ain't nobody got time to read four hundred twenty five thousand articles. Once you've chosen the database you can begin and turn keywords. One way to combine search terms for diabetic and diabetes is by using the asterisk function. The asterisk truncates the same stem such as diabetes we can now continue inserting other keywords in our search strategy by using the word gleich for hypo and hyper glycemic.
We introduced some noise into our search strategy because gleich will also pick up glycogen something that we don't want. We can begin grouping similar terms together for example related to glycemic control search terms combined using or combine terms using end to find articles that have diabetes an element of glycemic control as well as cost-effectiveness in the title or abstract. You can scroll down and see whether you are picking up the terms that you're not interested in such as gestational related diabetes. Now if you're happy with this then actually. I'm just joking. There's one more thing that you need to add filters depending on what you're looking for filters are an easy way to include and exclude articles three filters are used every single time one year of publication. If it happened in 1965 it might not be relevant today to humans. It's cool if you had diabetic mice but I'm looking for diabetic humans and thirdly English I'm looking for articles that I can read for publication here I typically like to look at the last 20 years of relevant articles again we want to remove keywords not appropriate for our search such as screening some words appear in your initial keywords might introduce unnecessary noise for example patient manager at times we can be interested in a particular ethnic group for example body you can include this directly in your search the hashtag is used because the a and Mahdi can have a macron okay where to from here if you need to run any other search strategies then I'd recommend you just rinse and repeat the process that we just showed in fact I typically run search strategies specific for health economics health-related quality of life or whether I'm looking at incidents and prevalence of a particular disease or condition. I would highly recommend that you save your search strategies.
You're gonna need your economics one. For example again and again you can now save your search strategy by clicking save give your search strategy an identifiable name in an appropriate comment or description if you have you with it then let's get the ball rolling the b-roll that is yep. You guessed it that was exports so we're here to export our results in order to export select all and click export. The window will show up be sure to have included all your articles as well as the format that you need. I'll be exporting in EndNote. Okay so now that you've sussed it you've exported you've downloaded your results bring them into EndNote or any other program that you're using for references now with everything you'll want to back up your results. Anything can happen. The world is a dangerous place. Once you've created a library and given it an appropriate name you can then import the files. You've just downloaded create a folder with the appropriate name. I like to name mine original. I then create a new folder and copy those articles into it to begin working on you can remove duplicates by selecting references find duplicates and choose the record that you want one way to sift through results is to organize articles by title. This will give you the group themes such as cost effectiveness as well as economic evaluations. In the title these can now be cut and paste it into a separate folder named search strategy diabetes in economics a number of guidelines exist to help you systematically and objectively sift through your search results. I typically use cheers guidelines and peacocks to help me identify relevant articles for my list showed you. If you're uncertain about the value of an article you can always create and maybe folder to deal with those specifically hard articles. Well you have it. That's literature reviews in a nutshell. Now if you enjoyed this video please comment place downward kinetic-energy on that like button and don't forget to subscribe and I'll see you in the next episode of healthy Kong be.
You have a couple of options for databases to use. It doesn't matter what you prefer. I personally use Ovid MEDLINE but you're welcome to use any of the existing databases such as M base PubMed or Scopus. Just be sure to log in via your institution to gain full access as with any research. You're gonna need to formulate a research question now this is an iterative process. And you're gonna want to involve as many stakeholders as possible when writing up your research question. I'd recommend having two or three research questions written up slightly differently this will give you a better understanding of the topic and keywords at hand okay as with everything it's good to look at an example we can use this example as a step-by-step guide on how to conduct a literature review so I'll keep this consistent with health economics one example of a question that I might get asked would be - we're looking at the cost-effectiveness of a mobile intervention for diabetes in relation to improving hba1c as an outcome measure. Once you've got your research question written down alongside multiple variations you're able to pick out some keywords and develop a list we're also told that we're indifferent between type. 1 and type 2 diabetes for the purpose of this exercise. We're only going to write our research question. Once after you've written down your research question you want to highlight some key words after which you want to make a list of key words from your research question this will help you develop your search strategy. Once you've got some basic elements written down. You need to expand your overall understanding of the topic area working as a researcher or working in healthcare. You're often gonna come across a number of areas that you're not familiar with. We need an informal yet systematic way of improving our understanding of the topic.
The whole point is that someone should be able to follow your instructions or your process and be able to generate similar results. A few places that. I like to go to include Wikipedia Google Scholar nice local and national organizations and Institute's such as PHARMAC and district health boards as well as looking at key documents such as health needs assessments and local strategy documents for the purpose of this example. I'm going to be looking at Wikipedia. Nice and health needs assessment from a district health board. I recommend you split. Screen looking at the diabetes page. We're able to draw out some key. Words that we can place in our table be careful of keywords such as hypoglycemia and its spelling as well as hyperglycemia as well as glycemic reading through the title of your articles will help you identify keywords that you will also want to exclude in this example gestational diabetes now that you've got your beast list of keywords and phrases you've got to decide where they're going to appear one assumption. I make is that a relevant article is likely to have the keywords. I'm looking for in the title or the abstract. If it doesn't then it most likely isn't going to be relevant for what. I'm looking for okay. So this is the fun part. Let's start combining most databases are similar and with Ovid MEDLINE. You can use words such as or and and not to combine relevant keywords and phrases scroll down after each search term and see if it's picking up the things that you want it to pick up. Be careful though. Some search terms such as patient can introduce unnecessary noise to your search results. You'll be able to see this because you'll have four hundred and twenty five thousand results and ain't nobody got time to read four hundred twenty five thousand articles. Once you've chosen the database you can begin and turn keywords. One way to combine search terms for diabetic and diabetes is by using the asterisk function. The asterisk truncates the same stem such as diabetes we can now continue inserting other keywords in our search strategy by using the word gleich for hypo and hyper glycemic.
We introduced some noise into our search strategy because gleich will also pick up glycogen something that we don't want. We can begin grouping similar terms together for example related to glycemic control search terms combined using or combine terms using end to find articles that have diabetes an element of glycemic control as well as cost-effectiveness in the title or abstract. You can scroll down and see whether you are picking up the terms that you're not interested in such as gestational related diabetes. Now if you're happy with this then actually. I'm just joking. There's one more thing that you need to add filters depending on what you're looking for filters are an easy way to include and exclude articles three filters are used every single time one year of publication. If it happened in 1965 it might not be relevant today to humans. It's cool if you had diabetic mice but I'm looking for diabetic humans and thirdly English I'm looking for articles that I can read for publication here I typically like to look at the last 20 years of relevant articles again we want to remove keywords not appropriate for our search such as screening some words appear in your initial keywords might introduce unnecessary noise for example patient manager at times we can be interested in a particular ethnic group for example body you can include this directly in your search the hashtag is used because the a and Mahdi can have a macron okay where to from here if you need to run any other search strategies then I'd recommend you just rinse and repeat the process that we just showed in fact I typically run search strategies specific for health economics health-related quality of life or whether I'm looking at incidents and prevalence of a particular disease or condition. I would highly recommend that you save your search strategies.
You're gonna need your economics one. For example again and again you can now save your search strategy by clicking save give your search strategy an identifiable name in an appropriate comment or description if you have you with it then let's get the ball rolling the b-roll that is yep. You guessed it that was exports so we're here to export our results in order to export select all and click export. The window will show up be sure to have included all your articles as well as the format that you need. I'll be exporting in EndNote. Okay so now that you've sussed it you've exported you've downloaded your results bring them into EndNote or any other program that you're using for references now with everything you'll want to back up your results. Anything can happen. The world is a dangerous place. Once you've created a library and given it an appropriate name you can then import the files. You've just downloaded create a folder with the appropriate name. I like to name mine original. I then create a new folder and copy those articles into it to begin working on you can remove duplicates by selecting references find duplicates and choose the record that you want one way to sift through results is to organize articles by title. This will give you the group themes such as cost effectiveness as well as economic evaluations. In the title these can now be cut and paste it into a separate folder named search strategy diabetes in economics a number of guidelines exist to help you systematically and objectively sift through your search results. I typically use cheers guidelines and peacocks to help me identify relevant articles for my list showed you. If you're uncertain about the value of an article you can always create and maybe folder to deal with those specifically hard articles. Well you have it. That's literature reviews in a nutshell. Now if you enjoyed this video please comment place downward kinetic-energy on that like button and don't forget to subscribe and I'll see you in the next episode of healthy Kong be.