.Information Literacy in the Health Sciences

Traditional library databases usually include records of journal articles, books, and other publications. Health science databases can include features that are of special interest to the professionals and researchers in the health sciences. 

[About coding in the clinical setting.]

The special features may be intimidating when first encountered. Don't be discouraged. Like many things, practice and familiarity make their use simpler and more efficient. As you learn concepts within the discipline, you learn how to use many of the specialized features of the databases.

Some specialized databases do not contain full-text; however, they may link to the full-text of a source. Health science databases may be very expensive and may not be available to the general public outside of a university or corporate setting.

A database is a structured collection of records or data. A file cabinet of files and folders is a database. Technically, a spreadsheet of data is a database. A software program of searchable bibliographic library records is also a database and is more commonly thought of when the term "database" is used.

The ISU Library provides access to many electronic databases that are useful for research, study, and knowledge acquisition. Some are available for free to anyone but some are provided through a subscription paid by the Indiana State University Library.

Databases can be an efficient and effective way to search for information. Electronic databases use a search engine to simultaneously search, access, and retrieve relevant records from multiple journals and other sources. Patrons enter into the search engine terms relevant to what they wants to know and the search engine retrieves records with those terms according to whatever rules were programmed into that search engine.

Different search engines work differently. They follow different rules for searching and ordering results. And different databases contain different records within them so it is useful to search more than one database if you are researching a topic thoroughly.

For a typical health topic, the librarian typically chooses to start her search in CINAHL, MEDLINE via EBSCOhost, or PubMed. 

• Health databases, such as CINAHL, MEDLINE via EBSCOhost, PubMed, PsycINFO, Cochrane Library 

CINAHL is a nursing and allied health database with millions of publication records in it. It is a good start for nursing and allied health topics, such as holistic medicine, wellness, patient education, outreach, dietetics, occupational therapy, genetic counseling, etc.

MEDLINE via EBSCOhost is a medical database with millions of publication records in it. It is a good start for medical topics that physicians deal with, such as diseases, diagnosis, treatments, drugs, epidemiology, etc. 

But there is overlap between CINAHL and MEDLINE. They have many of the same journals. (They both include the Journal of Genetic Counseling.) But they also have unique journals. And many topics can be searched in either or both databases.

To search for a topic in the databases, the librarian typically maps the topic to the specialized subjects in order to determine in which databases to search. 

While the ISU Library has many databases, below are some of the librarian's favored starting databases in certain subjects.

• Health databases, such as CINAHL, MEDLINE via EBSCOhost, PubMed, PsycINFO, Cochrane Library 
• Sport databases, such as SPORTDiscus
• Psychology databases, such as PsycINFO
• Education databases, such as Education Source, ERIC via EBSCOhost
• Science databases, such as Biological Abstracts, Zoological Record, Web of Science

Preferentially search MEDLINE, CINAHL, and PubMed using the Subjects. 

CLINICAL SETTING & EHR SYSTEMS

When a patient visits their healthcare providers, their information is entered into the electronic health record (EHR) system. If the patient has the flu, the healthcare providers enter the code for Influenza into the patient's EHR. if any treatments are prescribed, those codes are entered, too. 

When it comes time to send a bill, the clinic runs a search on the EHR system asking for all items in the patient record that are unpaid. They can then generate a bill and send it to the patient. To do this, they have run a search using the medical codes. The medical codes make it easier to pull that information out of the system later.

In addition, periodically the clinic is required to send information to the Center for Disease Control and Prevention (CDC). So the clinic runs a search for all records coded for Influenza in the past month (week?). Then they can collect the appropriate statistics and information for the CDC and send it off. Again, the clinic used the medical codes to pull information out of the EHR system.

LIBRARY DATABASES

Library databases operate in a similar manner. 

MeSH Terms are Medical Subject Headings. A MeSH Term for a topic is assigned to the record of a publication when the publication is ABOUT that topic. And the MeSH Term "Influenza, Human" is attached to the record of publications that are about human influenza, even if the term "influenza" never appeared in the article but the term "flu" was used instead. And publications about bird flu are not retrieved by a search for the MeSH Term "Influenza, Human." The MeSH Term can make the desired topic more findable. 

Observe the MeSH Terms that have an asterisk (*) next to them. These are "Major Subject Headings." These are the major topics of the publication; the primary focus of the article in the opinion of the database employee who assigned the MeSH Terms. 

Notice the other MeSH Terms. These are minor Subject Headings. OR they are descriptive Subject Headings *about* the publication. So "Humans" tells us that the publication project involved human patients or research subjects. "Animals" would tell us that the project involved patients or research subjects. 

Observe that some words in MeSH follow after a slash (/). These are Subheadings, which modify the MeSH Term. Therefore, "Influenza, Human*/therapy" refers to the "therapy for Human Influenza" and is a Major Subject of the publication.

Therefore, MeSH Terms can be used to help you search. 

LIBRARY PRACTICE EXERCISE

1. Open this database record. 
2. Observe the "Limiters" within the record. What Limiters do you see for this record? (Language, Publication Type, Source, MeSH Terms, etc.)
3. Look at the MeSH Terms. Look at the first MeSH Term with an asterisk (*). Does it have a Subheading? What does the asterisk (*) mean?
4. Click on the first MeSH Term. A search is performed. What is entered into the first search box? What are the first two letters?
5. To the right, click Select a Field (optional). What do those two letters mean?
6. Is full-text of the publication available? Or do you see the link Check Availability?
7. At the top of the window, click MeSH 2023. A new window opens.
8. In the new search box, enter Disease Outbreaks. Skim down the results.
9. Click the link Disease Outbreaks.
10. Scroll down and check the box to the left of Disease Outbreaks.
11. Also check the box to the right of Disease Outbreaks. This will automatically prepare a search for Disease Outbreaks, Epidemics, Opioid Epidemic, Pandemics, Space-Time Clustering, and Disease Hotspots.
12. In the blue box on the right, look at the Subheadings. By default, the database will search all Subheadings unless you check only the boxes of the Subheadings you want to search.
13. Look down in the Blue box. Is there a Related Heading listed?
14. Now, let's search. On the right, click Search Database.
15. The results display. 
16. To the right of the first search box, click Select a Field (optional). What does MH mean?
17. The plus sign (+) means that we exploded the search to find all of the items coded for the MeSH Terms of Disease Outbreaks, Epidemics, Opioid Epidemic, Pandemics, Space-Time Clustering, and Disease Hotspots.
18. Now, do you think you could try this in your own searches? Contact the librarians if you have questions.

Internet browsers like Google, Bing, and Edge, do not have Limiters like the databases. They do allow some Advanced Searching using some of the computer code used to make a webpage, but it is not quite as sophisticated as database codes or Limiters. This is why librarians recommend that you use the specialized databases to find publications in a major or discipline.

Recommended databases are chosen because they may be standards in their field, may be larger, or may contain better quality information on average than the other database choices. This does not guarantee that they are the best choice for YOUR research topic.