A systematic approach to searching: an efficient and complete method to develop literature searches.

Creating search strategies for systematic reviews, finding the best balance between sensitivity and specificity, and translating search strategies between databases is challenging. Several methods describe standards for systematic search strategies, but a consistent approach for creating an exhaustive search strategy has not yet been fully described in enough detail to be fully replicable. The authors have established a method that describes step by step the process of developing a systematic search strategy as needed in the systematic review. This method describes how single-line search strategies can be prepared in a text document by typing search syntax (such as field codes, parentheses, and Boolean operators) before copying and pasting search terms (keywords and free-text synonyms) that are found in the thesaurus. To help ensure term completeness, we developed a novel optimization technique that is mainly based on comparing the results retrieved by thesaurus terms with those retrieved by the free-text search words to identify potentially relevant candidate search terms. Macros in Microsoft Word have been developed to convert syntaxes between databases and interfaces almost automatically. This method helps information specialists in developing librarian-mediated searches for systematic reviews as well as medical and health care practitioners who are searching for evidence to answer clinical questions. The described method can be used to create complex and comprehensive search strategies for different databases and interfaces, such as those that are needed when searching for relevant references for systematic reviews, and will assist both information specialists and practitioners when they are searching the biomedical literature.

[Students of medicine are turning medical education on its head; from a closed to an open learning environment]. / Medisch student zet geneeskundeonderwijs op zijn kop.

These days, students are gathering their own source materials using Google and leave the required textbooks on the shelves. This means the future of medical education lies in facilitating and freely sharing modern learning resources. This rapid shift, away from traditional textbooks, is causing unrest in academic education. The faculty is losing control and the overall picture. Existing teaching materials with strict copyrights have made it difficult for teachers and students to learn from each other. The productivity and professional curiosity of a sector that not only desires but also requires life-long learning, is being undermined by meaningless barriers and duplication of work. Free learning resources are making it easier for both students and professionals to learn, share and quickly get access to the right information. In this article, we explain what this means for medical education, what is needed and we provide a few examples.

Evaluation of a new method for librarian-mediated literature searches for systematic reviews.

To evaluate and validate the time of completion and results of a new method of searching for systematic reviews, the exhaustive search method (ESM), using a pragmatic comparison. METHODS: Single-line search strategies were prepared in a text document. Term completeness was ensured with a novel optimization technique. Macros in MS Word converted the syntaxes between databases and interfaces almost automatically. We compared search characteristics, such as number of search terms and databases, and outcomes, such as number of included and retrieved references and precision, from ESM searches and other Dutch academic hospitals identified by searching PubMed for systematic reviews published between 2014 and 2016. We compared time to perform the ESM with a secondary comparator of recorded search times from published literature and contact with authors to acquire unpublished data. RESULTS: We identified 73 published Erasmus MC systematic reviews and 258 published by other Dutch academic hospitals meeting our criteria. We pooled search time data from 204 other systematic reviews. The ESM searches differed by using 2 times more databases, retrieving 44% more references, including 20% more studies in the final systematic review, but the time needed for the search was 8% of that of the control group. Similarities between methods include precision and the number of search terms. CONCLUSIONS: The evaluated similarities and differences suggest that the ESM is a highly efficient way to locate more references meeting the specified selection criteria in systematic reviews than traditional search methods. Further prospective research is required.

Importance of right and left atrial dilation and linear ablation for perpetuation of sustained atrial fibrillation.

INTRODUCTION: Atrial dilation associated with increasing atrial pressure plays an apparent role in the development of atrial fibrillation (AF). We characterized a new model of separate and biatrial dilation in the Langendorff-perfused rabbit heart. The aim of this study was to examine if sustained AF in this model (1) would be inducible by separate right atrial (RA) and left atrial (LA) dilation; (2) would be reproducibly inducible at the same pressure level; and (3) could be suppressed by RA, LA, or biatrial ablation. METHODS AND RESULTS: Intra-atrial pressure was increased stepwise in the RA (n = 13), LA (n = 12), or both atria (n = 25) until sustained AF could be induced or a pressure of 20 cm H2O was reached. The stimulation protocol was repeated once in RA and LA dilation (n = 9) and three times in biatrial dilation (n = 7). Then, RA orifices (superior and inferior caval veins, tricuspid valve annulus, and foramen ovale) or LA orifices (pulmonary veins, mitral valve annulus, and foramen ovale) were connected by radiofrequency (RF) lesions. Sustained AF was rendered inducible in 100% of hearts with biatrial dilation, but in only 92% of hearts with RA dilation and 67% with LA dilation. Inducibility of sustained AF was reproducible. Under biatrial dilation, not RA ablation (0/10 hearts; P = NS) but LA ablation (4/11 hearts; P < 0.05) and biatrial ablation (16/21; P < 0.01) reduced the inducibility of sustained AF. CONCLUSION: The inducibility of sustained AF due to increased intra-atrial pressure differs between the RA and LA. LA and biatrial lesions, not RA RF lesions, reduce the ability to perpetuate sustained AF.