Biblioteca virtual em saúde homeopatia Brasil Dr. Matheus Marim: o ingresso da homeopatia na literatura científica mundial / Virtual library in health homeopathy Brazil Dr. Matheus Marim: the entrance of homeopathy in scientific literature worldwide

A Biblioteca Virtual em Saúde (BVS) Homeopatia Brasil(1) personifica o ingresso da Homeopatia na literatura médica oficial, sendo o resultado de décadas de um trabalho voluntário de vários homeopatas, tendo uma história de mais 40 anos a qual se mescla de maneira indissociável com a história da Biblioteca Regional de Medicina (BIREME)(2), que adotou posteriormente o nome de Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde(3). É também um testemunho da transformação tecnológica do paradigma das bibliotecas físicas seculares(4), para as atuais bibliotecas digitais online. A BVS é um patrimônio da Homeopatia brasileira, evidenciando a Homeopatia perante as ciências da saúde como sendo uma especialidade médica em nosso país. Ela teve como marco inicial a base de dados HOMEOINDEX, pioneira e exclusiva da literatura homeopática, construída na década de 90, que será abordada mais adiante. Esta biblioteca virtual homeopática faz parte da rede de bibliotecas virtuais em saúde(5), e da rede BVS Brasil(6) operacionalizadas pela BIREME, órgão regional da OPAS(7) (Organização Panamericana de Saúde) e da OMS(8) (Organização Mundial de Saúde). A BIREME tem como missão contribuir para o desenvolvimento da saúde nos países da América Latina e Caribe por meio da democratização do acesso, publicação e uso de informação, conhecimento e evidência científica. A BIREME abriga atualmente mais de 60 BVSs, entre temáticas, nacionais e regionais, que abordam os mais variados aspectos de informações de cada área, com acesso online eficiente, gratuito, universal e eqüitativo à informação Para entendermos a origem da BVS Homeopatia é necessário que seja abordada também a história da BIREME(9). Desde a sua criação no ano de 1967, a BIREME sempre considerou a colaboração das bibliotecas para desenvolver e oferecer seus serviços e produtos de informação. Nos anos iniciais a primeira tarefa foi o serviço colaborativo de comutação bibliográfica (fornecimento de cópias de documentos), já considerando que apenas a coleção de revistas da então Biblioteca Regional de Medicina não seria suficientemente completa para atender a todos os pedidos dos usuários da América Latina e do Caribe. Os primeiros acordos de cooperação da BIREME com as bibliotecas foram estabelecidos no início dos anos 70, com a Faculdade de Odontologia e a Escola de Medicina Veterinária, ambas da Universidade de São Paulo, com o Instituto de Nutrição da América Central e do Panamá (INCAP), com o Centro Latino-Americano de Perinatologia e Desenvolvimento Humano, e com o Centro Pan-Americano de Engenharia Sanitária e Ciências Ambientais (CEPIS).

The Virtual Health Library (VHL) Homeopathy Brazil embodies the inclusion of Homeopathy in the official medical literature, being the result of decades of voluntary work by several homeopaths, having a history of more than 40 years, which is inseparably intertwined with the history of the Regional Library of Medicine (BIREME), which later adopted the name of the Latin American and Caribbean Center on Health Sciences Information. It is also a testament to the technological transformation from the paradigm of centuries-old physical libraries to today's online digital libraries. The VHL is a heritage of Brazilian Homeopathy, highlighting Homeopathy before the health sciences as a medical specialty in our country. Its initial milestone was the HOMEOINDEX database, a pioneer and exclusive database of homeopathic literature, built in the 1990s, which will be discussed later. This virtual homeopathic library is part of the network of virtual health libraries, and the VHL Brazil network operated by BIREME, a regional body of PAHO (Pan American Health Organization) and WHO (World Health Organization). BIREME's mission is to contribute to the health development in Latin American and Caribbean countries through the democratization of access, publication, and use of information, knowledge, and scientific evidence. BIREME currently houses more than 60 VHLs, including thematic, national, and regional, covering the most varied aspects of information in each area, with efficient, free, universal, and equitable online access to information. To understand the origin of the VHL Homeopathy, it is also necessary to address the history of BIREME. Since its creation in 1967, BIREME has always considered the collaboration of libraries to develop and offer its information services and products. In the early years, the first task was the collaborative bibliographic exchange service (provision of document copies), already considering that the journal collection of the then Regional Library of Medicine would not be sufficiently complete to meet all the requests from users in Latin America and the Caribbean. The first cooperation agreements between BIREME and libraries were established in the early 1970s, with the Faculty of Dentistry and the School of Veterinary Medicine, both from the University of São Paulo, with the Institute of Nutrition of Central America and Panama (INCAP), with the Latin American Center for Perinatology and Human Development, and with the Pan-American Center for Sanitary Engineering and Environmental Sciences (CEPIS).

Historical Review of Acute Pancreatitis Research Over the Last 80 Years.

OBJECTIVES: Research on acute pancreatitis (AP) has been ongoing for a long time. It is necessary to summarize and investigate the history of AP research. METHODS: Publications related to AP research were retrieved from PubMed. Medical Subject Headings (MeSH) terms, countries, journals, and publication dates were analyzed. Co-occurrence analysis was conducted to illustrate the holistic trend in AP research. A dynamic bar graph, heat maps, and line charts were created to illustrate change trends of MeSH terms. RESULTS: In total, 28,222 publications with 8558 MeSH terms were retrieved from 1941 to 2020. Among these, 16,575 publications with 7228 MeSH terms were from 2001 to 2020. The top 10 MeSH terms showed a considerable change from 1941 to 1970 but remained stable since the 1970s. Four clusters obtained from the co-occurrence analysis were "experiments on animals," "diagnosis and treatment," "prognosis and expectation," and "protein and enzyme." From 1941 to 2020, 33 MeSH terms with increasing trends (MH-I) and 15 MeSH terms with decreasing trends (MH-D) were selected to create a heat map (every decade). Meanwhile, 16 MH-I and 41 MH-D were selected to create the heat map from 2001 to 2020 (every 2 years). CONCLUSION: Over the past 80 years, the pathogenesis, treatment, risk management, and experimental model were the main research highlights. Optimal supportive management, minimally invasive treatment, and prediction of prognosis are subjects of interest for clinical practitioners; signal transduction to identify a target for precise treatment is the focus of experimental research in AP.

How to bridge the gap? European medical plants used for treating oral mucositis: on the search for evidence.

PURPOSE: Oral mucositis is a common, painful side effect of cancer treatment-be it locoregional (e.g. irradiation) or systemic (e. g. chemotherapy). Phytotherapy is often used by patients to alleviate symptoms. However, knowledge on which medical plants are recommended by literature about Traditional European Medicine (TEM), their effect(s) on symptoms and their efficacy is severely lacking. Therefore, we developed a novel approach to assess traditional knowledge of herbals used in TEM and searched the online databases for studies reporting effects of these plants. METHODS: At first, online research did not yield a satisfying number of studies (MESH terms: "mucositis" OR "stomatitis" AND "herbal" OR "herbal medicine"). Trials were labelled by the country conducting the study. In parallel, we compiled a list of 78 plants recommended for treating oral mucositis by screening 14 books on TEM. Then, a "hit list" of the plants most often mentioned was composed and used further for a second online investigation using the Latin plant designations as MESH term. Studies of both online searches were pooled for analysis. RESULTS: There is a gap between traditional knowledge and trials investigating medical plants used by TEM. Overall, herbal remedies alleviate oral mucositis and especially, gingivitis well. There is good evidence for using Matricaria recutita L., Salvia officinalis L., Calendula officinalis L. and Thymus spp. L. for treating oral mucositis. CONCLUSION: Clinical trials investigating medical plants known in TEM are rare. However, following our research strategy, we could extrapolate four plants with good evidence for alleviating symptoms of oral mucositis and gingivitis.

Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. It is often quite concerning to patients and their partners, and sometimes frustrates couples' attempts to conceive. This article aims to review the pathophysiology of DE and anejaculation (AE), to explore our current understanding of the diagnosis, and to present the treatment options for this condition. Electronic databases were searched from 1966 to October 2017, including PubMed (MEDLINE) and Embase. We combined “delayed ejaculation,” “retarded ejaculation,” “inhibited ejaculation,” or “anejaculation” as Medical Subject Headings (MeSH) terms or keywords with “epidemiology,” “etiology,” “pathophysiology,” “clinical assessment,” “diagnosis,” or “treatment.” Relevant sexual medicine textbooks were searched as well. The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors. Despite the many publications on this condition, the exact pathogenesis is not yet known. There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The history is the key to the diagnosis. Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. An approved form of drug therapy does not exist. A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction.

From a Content Delivery Portal to a Knowledge Management System for Standardized Cancer Documentation.

Heterogeneous tumor documentation and its challenges of interpretation of medical terms lead to problems in analyses of data from clinical and epidemiological cancer registries. The objective of this project was to design, implement and improve a national content delivery portal for oncological terms. Data elements of existing handbooks and documentation sources were analyzed, combined and summarized by medical experts of different comprehensive cancer centers. Informatics experts created a generic data model based on an existing metadata repository. In order to establish a national knowledge management system for standardized cancer documentation, a prototypical tumor wiki was designed and implemented. Requirements engineering techniques were applied to optimize this platform. It is targeted to user groups such as documentation officers, physicians and patients. The linkage to other information sources like PubMed and MeSH was realized.

Knowledge structure and theme trends analysis on general practitioner research: A Co-word perspective.

BACKGROUND: General practitioners (GPs) are the most important providers of primary health care, as proven by related research published several decades ago. However, the knowledge structure and theme trends of such research remain unclear. Accordingly, this study aimed to provide an overview of the development of research on GPs over the period of 1999 to 2014. METHODS: Studies on GPs conducted from 1999 to 2014 were retrieved from PubMed. In this work, co-word, social network analysis, and theme trends analyses were conducted to reveal the knowledge structures and thematic evolution of research on GPs. RESULTS: The number of conducted studies on GPs increased. However, growth speed slowed down during the past 16 years. A total of 27 high-frequency keywords were identified in 1999 to 2003, and more new and specific high-frequency keywords emerged in the subsequent periods. The dynamic of this field was first divergent and then considered convergent. Specifically, network centralization is 19.77%, 19.09%, and 13.04% in 1999 to 2003, 2004 to 2008 and 2009 to 2014, respectively. The major topics of research on GPs completed from 1999 to 2014 were "physician/family,""attitude of health personnel," and "primary health care," and "general practitioner" communities, and so on. CONCLUSION: The research themes on GPs are relatively stable at the beginning of the 21(st) century. However, the thematic evolution and research topics of research on GPs are changing dynamically in recent years. Themes related to the roles and competencies of GPs, and the relations between general practitioner and patients/others have become research foci on GPs. In addition, more substantial research especially on comprehensive approaches and holistic modeling, which have been defined in the European Definition of General Practice/Family Medicine, are expected to be accomplished.

A data mining approach to selecting herbs with similar efficacy: Targeted selection methods based on medical subject headings (MeSH).

ETHNO-PHARMACOLOGICAL RELEVANCE: Natural products have long been the most important source of ingredients in the discovery of new drugs. Moreover, since the Nagoya Protocol, finding alternative herbs with similar efficacy in traditional medicine has become a very important issue. Although random selection is a common method of finding ethno-medicinal herbs of similar efficacy, it proved to be less effective; therefore, this paper proposes a novel targeted selection method using data mining approaches in the MEDLINE database in order to identify and select herbs with a similar degree of efficacy. MATERIALS AND METHODS: From among sixteen categories of medical subject headings (MeSH) descriptors, three categories containing terms related to herbal compounds, efficacy, toxicity, and the metabolic process were selected. In order to select herbs of similar efficacy in a targeted way, we adopted the similarity measurement method based on MeSH. In order to evaluate the proposed algorithm, we built up three different validation datasets which contain lists of original herbs and corresponding medicinal herbs of similar efficacy. RESULTS: The average area under curve (AUC) of the proposed algorithm was found to be about 500% larger than the random selection method. We found that the proposed algorithm puts more hits at the front of the top-10 list than the random selection method, and precisely discerns the efficacy of the herbs. It was also found that the AUC of the experiments either remained the same or increased slightly in all three validation datasets as the search range was increased. CONCLUSION: This study reveals and proves that the proposed algorithm is significantly more accurate and efficient in finding alternative herbs of similar efficacy than the random selection method. As such, it is hoped that this approach will be used in diverse applications in the ethno-pharmacology field.

Reflexiones nerviosas. Los fantasmas / Reflections nerve. The ghosts

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Evaluation of Herbal and Dietary Supplement Resource Term Coverage.

The use of Complementary and Alternative Medicine (CAM) is increasingly popular in places like North America and Europe where western medicine is primarily practiced. People are consuming herbal and dietary supplements along with western medications simultaneously. Sometimes, supplements and drugs react with one another via antagonistic or potentiation actions of the drug or supplement resulting in an adverse event. Unfortunately, it is not easy to study drug-supplement interactions without a standard terminology to describe herbal and dietary supplements. This pilot study investigated coverage of supplement databases to one another as well as coverage by the Unified Medical Language System (UMLS) and RxNorm for supplement terms. We found that none of the supplement databases completely covers supplement terms. UMLS, MeSH, SNOMED CT, RxNorm and NDF-RT cover 54%, 40%, 32%, 22% and 14% of supplement concepts, respectively. NDF-RT provides some value for grouping supplements into drug classes. Enhancing our understanding of the gap between the traditional biomedical terminology systems and supplement terms could lead to the development of a comprehensive terminology resources for supplements, and other secondary uses such as better detection and extraction of drug-supplement interactions.

Using PubMed search strings for efficient retrieval of manual therapy research literature.

OBJECTIVE: The aim of this study was to construct PubMed search strings that could efficiently retrieve studies on manual therapy (MT), especially for time-constrained clinicians. METHODS: Our experts chose 11 Medical Subject Heading terms describing MT along with 84 additional potential terms. For each term that was able to retrieve more than 100 abstracts, we systematically extracted a sample of abstracts from which we estimated the proportion of studies potentially relevant to MT. We then constructed 2 search strings: 1 narrow (threshold of pertinent articles ≥40%) and 1 expanded (including all terms for which a proportion had been calculated). We tested these search strings against articles on 2 conditions relevant to MT (thoracic and temporomandibular pain). We calculated the number of abstracts needed to read (NNR) to identify 1 potentially pertinent article in the context of these conditions. Finally, we evaluated the efficiency of the proposed PubMed search strings to identify relevant articles included in a systematic review on spinal manipulative therapy for chronic low back pain. RESULTS: Fifty-five search terms were able to extract more than 100 citations. The NNR to find 1 potentially pertinent article using the narrow string was 1.2 for thoracic pain and 1.3 for temporomandibular pain, and the NNR for the expanded string was 1.9 and 1.6, respectively. The narrow search strategy retrieved all the randomized controlled trials included in the systematic review selected for comparison. CONCLUSION: The proposed PubMed search strings may help health care professionals locate potentially pertinent articles and review a large number of MT studies efficiently to better implement evidence-based practice.

Leveraging concept-based approaches to identify potential phyto-therapies.

The potential of plant-based remedies has been documented in both traditional and contemporary biomedical literature. Such types of text sources may thus be sources from which one might identify potential plant-based therapies ("phyto-therapies"). Concept-based analytic approaches have been shown to uncover knowledge embedded within biomedical literature. However, to date there has been limited attention towards leveraging such techniques for the identification of potential phyto-therapies. This study presents concept-based analytic approaches for the retrieval and ranking of associations between plants and human diseases. Focusing on identification of phyto-therapies described in MEDLINE, both MeSH descriptors used for indexing and MetaMap inferred UMLS concepts are considered. Furthermore, the identification and ranking consider both direct (i.e., plant concepts directly correlated with disease concepts) and inferred (i.e., plant concepts associated with disease concepts based on shared signs and symptoms) relationships. Based on the two scoring methodologies used in this study, it was found that a Vector Space Model approach outperformed probabilistic reliability based inferences. An evaluation of the approach is provided based on therapeutic interventions catalogued in both ClinicalTrials.gov and NDF-RT. The promising findings from this feasibility study highlight the challenges and applicability of concept-based analytic strategies for distilling phyto-therapeutic knowledge from text based knowledge sources like MEDLINE.

Mining MEDLINE for problems associated with vitamin D.

This paper presents a two-step approach to generating comprehensive abstractive overviews for biomedical topics. It starts with a sensitivity-maximizing search of MEDLINE/PubMed and MeSH-based filtering of the results that are then processed using NLP methods to extract relations between entities of interest. We evaluate this approach in a case study based on the IOM report on the role of vitamin D in human health. The report defines disorders that serve as health indicators for the role of vitamin D. We evaluate the abstractive overviews generated using MeSH indexing and the extracted relations using the disorders listed in the IOM report as reference standard. We conclude that MeSH-based aggregation and filtering of the results is a useful and easy step in the generation of abstractive overviews. Although our relation extraction achieved 83.6% recall and 92.8% precision, only half of the disorders of interest participated in these relations.

Assessment of indexing trends with specific and general terms for herbal medicine.

BACKGROUND: Concepts for medicinal plants are represented by a variety of associated general terms with specific indexing patterns in databases, which may not consistently reflect growth of records. OBJECTIVES: The objectives of this study are to assess the development in databases by identifying general terms that describe herbal medicine with optimal retrieval recall and to identify possible special trends in co-occurrence of specific and general concepts. METHODS: Different search strategies are tested in cab abstracts, medline and web of science. Specific terms (Origanum and Salvia) are employed. Relevant general terms (e.g. 'Plants, Medicinal', Phytotherapy, Herbal drugs) are identified, along with indexing trends and co-occurrences. RESULTS: Growth trends, in specific (narrower) terms, are similar among databases. General terms, however, exhibit dissimilar trends, sometimes almost opposing one another. Co-occurrence of specific and general terms is changing over time. CONCLUSIONS: General terms may not denote definite development of trends as the use of terms differs amongst databases, making it difficult to correctly assess possible numbers of relevant records. Perceived increase can, sometimes, be attributed to an increased occurrence of a more general term alongside the specific one. Thesaurus-controlled databases may yield more hits, because of 'up-posted' (broader) terms. Use of broader terms is helpful as it enhances retrieval of relevant documents.

Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines.

BACKGROUND: The literature suggests a beneficial effect of motor imagery (MI) if combined with physical practice, but detailed descriptions of MI training session (MITS) elements and temporal parameters are lacking. The aim of this review was to identify the characteristics of a successful MITS and compare these for different disciplines, MI session types, task focus, age, gender and MI modification during intervention. METHODS: An extended systematic literature search using 24 databases was performed for five disciplines: Education, Medicine, Music, Psychology and Sports. References that described an MI intervention that focused on motor skills, performance or strength improvement were included. Information describing 17 MITS elements was extracted based on the PETTLEP (physical, environment, timing, task, learning, emotion, perspective) approach. Seven elements describing the MITS temporal parameters were calculated: study duration, intervention duration, MITS duration, total MITS count, MITS per week, MI trials per MITS and total MI training time. RESULTS: Both independent reviewers found 96% congruity, which was tested on a random sample of 20% of all references. After selection, 133 studies reporting 141 MI interventions were included. The locations of the MITS and position of the participants during MI were task-specific. Participants received acoustic detailed MI instructions, which were mostly standardised and live. During MI practice, participants kept their eyes closed. MI training was performed from an internal perspective with a kinaesthetic mode. Changes in MI content, duration and dosage were reported in 31 MI interventions. Familiarisation sessions before the start of the MI intervention were mentioned in 17 reports. MI interventions focused with decreasing relevance on motor-, cognitive- and strength-focused tasks. Average study intervention lasted 34 days, with participants practicing MI on average three times per week for 17 minutes, with 34 MI trials. Average total MI time was 178 minutes including 13 MITS. Reporting rate varied between 25.5% and 95.5%. CONCLUSIONS: MITS elements of successful interventions were individual, supervised and non-directed sessions, added after physical practice. Successful design characteristics were dominant in the Psychology literature, in interventions focusing on motor and strength-related tasks, in interventions with participants aged 20 to 29 years old, and in MI interventions including participants of both genders. Systematic searching of the MI literature was constrained by the lack of a defined MeSH term.

Conceptual-driven classification for coding advise in health insurance reimbursement.

OBJECTIVE: With the non-stop increases in medical treatment fees, the economic survival of a hospital in Taiwan relies on the reimbursements received from the Bureau of National Health Insurance, which in turn depend on the accuracy and completeness of the content of the discharge summaries as well as the correctness of their International Classification of Diseases (ICD) codes. The purpose of this research is to enforce the entire disease classification framework by supporting disease classification specialists in the coding process. METHODOLOGY: This study developed an ICD code advisory system (ICD-AS) that performed knowledge discovery from discharge summaries and suggested ICD codes. Natural language processing and information retrieval techniques based on Zipf's Law were applied to process the content of discharge summaries, and fuzzy formal concept analysis was used to analyze and represent the relationships between the medical terms identified by MeSH. In addition, a certainty factor used as reference during the coding process was calculated to account for uncertainty and strengthen the credibility of the outcome. RESULTS: Two sets of 360 and 2579 textual discharge summaries of patients suffering from cerebrovascular disease was processed to build up ICD-AS and to evaluate the prediction performance. A number of experiments were conducted to investigate the impact of system parameters on accuracy and compare the proposed model to traditional classification techniques including linear-kernel support vector machines. The comparison results showed that the proposed system achieves the better overall performance in terms of several measures. In addition, some useful implication rules were obtained, which improve comprehension of the field of cerebrovascular disease and give insights to the relationships between relevant medical terms. CONCLUSION: Our system contributes valuable guidance to disease classification specialists in the process of coding discharge summaries, which consequently brings benefits in aspects of patient, hospital, and healthcare system.

Hot topics in Chinese herbal drugs research documented in PubMed/MEDLINE by authors inside China and outside of China in the past 10 years: based on co-word cluster analysis.

OBJECTIVE: This study aims to gain an overview of hot topics related to research focused on Chinese herbal drugs by authors inside China and outside of China in the past 10 years. METHODS: PubMed/MEDLINE was utilized in order to investigate and select research that was published on "Chinese herbal drugs" from 1998 to 2007, by authors located both inside and outside of China (MeSH terms were downloaded and ranked). MeSH terms that frequently appeared were identified and co-word analysis was carried out for two groups: (1) authors located in China, and (2) authors based outside of China, respectively. The hot topics concerning research into Chinese herbal drugs were concluded after cluster analysis and related document analysis. RESULTS: For authors in the China group versus those outside the China group, the search results were 4790 versus 2609 citations and approximately 40,000 versus 20,000 MeSH terms, respectively. The threshold value of highly frequent terms was set at 30 versus 20, and the cumulative frequency percentage of these terms was 40.92% versus 36.67%, respectively. Thus, 43 highly frequent MeSH terms were identified and 43 x 43 co-word matrices were acquired for each group. The appearance frequency of MeSH showed that most research focused on pharmacology, therapeutic application, phytotherapy, side-effects of Chinese herbal drugs, and identification of active chemical components in herbs. CONCLUSION: The hot topics are as follows: (1) anti-inflammatory activity, antioxidant activities, anticancer activity of phytogenic antineoplastic agents, and neuroprotective effects of Chinese herbal drugs; (2) common diseases treated with Chinese herbal drugs include hepatocirrhosis, diabetes, angina, chronic hepatitis B in China, and diabetes, asthma, prostate cancer, and hepatocirrhosis outside of China; (3) Chinese herbal nephropathy and acute hepatitis induced by Chinese herbal drugs; (4) PC-SPES (PDQ) for the treatment of prostate cancer, which was a hot topic for researchers located outside of China; (5) research on extraction of active components from medicinal plants; and finally (6) research related to the identification of the Chinese herbal drugs component with state-of-the-art technologies in China.

Consistency and accuracy of the Medical Subject Headings thesaurus for electronic indexing and retrieval of chronobiologic references.

The aim of this study was to investigate the reliability of the National Library of Medicine (NLM)'s Medical Subject Headings (MeSH) thesaurus for electronic indexing and retrieval of published chronobiologic papers. A sample set of 228 recent chronobiologic references was downloaded from the MEDLINE's database together with all MeSH entries associated with them. The following descriptors were analyzed among the headings of obvious chronobiologic relevance: chronobiology, chronobiology disorders, biological clocks, circadian rhythm, chronotherapy, drug administration schedule, periodicity, seasons, sleep disorders/circadian rhythm, and time factors. A comparison was made between the number of references identified by each heading and the number of articles actually pertinent to the same heading (as ascertained after reading each article of the sample set). This made possible an assessment of consistency (retrieved number not less than actual number) and accuracy (retrieved number not greater than actual number) of the usage of each MeSH entry. By reading each article, it was also possible to identify common chronobiologic concepts not yet associated with specific MeSH headings. In the preselected set of chronobiologic references, seasons identified all articles pertinent to seasonal variations and rhythms. However, chronobiology disorders missed 97.6% of its pertinent articles; periodicity, 95.2%; chronobiology, 87.7%; chronotherapy, 70%; time factors, 62.3%; and sleep disorders/circadian rhythm, 47.4%. Drug administration schedule missed 40% of the chronotherapeutic articles and identified 15% of the chronopharmacologic articles; biological clocks missed 24.1% of its pertinent articles and wrongly identified 8.3% of the retrieved articles; and circadian rhythm missed 2.7% of all circadian studies and wrongly identified 8.2% of the articles it retrieved. When used to search chronobiologic articles in the entire MEDLINE database, drug administration schedule, seasons, and time factors appeared to lack sufficient specificity to produce accurate results. Some common chronobiologic concepts were found not to be associated with any specific MeSH heading, namely, chronoepidemiology, chronopharmacology, chronotoxicology, chronotype, entrainment, and masking. For common chronobiologic concepts and definitions, the use of available MeSH headings appears to often yield inconsistent and inaccurate results; moreover, the MeSH thesaurus remains incomplete.

Search strategies for retrieving complementary and alternative medicine clinical trials in oncology.

PURPOSE: Several Medline search strategies exist to retrieve complementary and alternative medicine (CAM) literature related to oncology. The objective of this study was to compare different search methods to ascertain the most optimal strategy. METHODS: All clinical trials with CAM interventions in patients with cancer, published from 1965 to 2004, were abstracted using 4 different approaches. In the CAM filter search, the PubMed complementary medicine filter was used. The Ovid search was performed using a complex search strategy with the Ovid search engine. CAM keyword and not phytogenic searches involved the CAM filter search with the addition of the search terms "AND (complementary OR alternative)" and "NOT (antineoplastic agents, phytogenic), respectively. Articles were evaluated by 3 reviewers to ascertain whether they were clinical trials, the study intervention was related to CAM, and the condition prevented/treated was cancer related (inclusion criteria). RESULTS: The CAM filter search retrieved 10 718 citations, Ovid retrieved 1190, CAM keyword retrieved 2895, and not phytogenic retrieved 1806. Compared to the CAM filter search, all other methods had significantly lower sensitivity (Ovid 48.3% +/- 3.2%, CAM keyword 5.8% +/- 1.5%, and not phytogenic 77.9% +/- 2.7%, P < .001). The specificity of Ovid (38.4% +/- 2.8%) and not phytogenic (40.8% +/- 2.3%) searches was significantly higher (P < .001) compared to CAM filter (8.8% +/- 0.5%) and CAM keyword searches (1.9% +/- 0.5%). CONCLUSION: The search strategy using PubMed's complementary medicine filter, although comprehensive, lacks specificity; other methods, although more specific, lack sensitivity. Future indexing of all CAM clinical trials with a common medical subject heading term complementary medicine would enhance efficient retrieval of relevant citations.

Systematic reviews in midwifery.

This paper highlights the key steps to follow when conducting a systematic review (see Box 2). Healthcare practitioners may be limited by time and resources when conducting literature reviews, however, a systematic and transparent approach should be adopted wherever possible. Further detailed guidance on conducting systematic reviews is available from the NHS Centre for Reviews and Dissemination (NHS CRD, 2001) and the Cochrane Reviewers' Handbook (Alderson et al, 2003).

Developing optimal search strategies for finding information on herbs and other medicinal plants in MEDLINE.

The MEDLINE database is an important resource for locating up-to-date information on herbs and other botanical therapies. However, the evolving nature of complementary and alternative medicine (CAM) and the complexity of herbal terminology can make it difficult to identify useful citations. This paper describes optimal search strategies for finding clinical information on herbs and medicinal plants in MEDLINE using the PubMed retrieval system. Searchers will benefit from an understanding of the structure of Medical Subject Headings (MeSH) and PubMed's advanced search capabilities. Details for using PubMed's MeSH Database, Clinical Queries, Clipboard, and limiting features to retrieve pertinent botanical research are described. Tables containing MeSH terms for medicinal plants and useful print and electronic resources are included.