.Information Literacy in the Health Sciences

So, think about medical coding for a minute... 

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 (1) in this patient's health record and (2) that are unpaid. They can then generate a bill and send it to the patient. To do this, they have run a search in the system 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 of all patients 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 do a search and pull information out of the EHR system.

So what does this have to do with searching library databases?

Remember using medical coding to search healthcare computer systems to find patient information? Library databases operate in a similar manner. 

LIBRARY DATABASES

When a journal issue is published, the employees of a library database obtain the issue and add the articles into the database. They enter basic information about the articles, such as the citation information (author, year, article title, journal title, volume number, issue number, pages). And they also enter additional useful information that someone in the profession may think interesting, such as language, age, gender, type of publication, etc. Just like medical coding, these code-like things called Limiters can be used to search and pull out specific results later. 

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

One very useful category of Limiters is called Subjects or Subject Headings. These are very useful in the health sciences.

MEDLINE (PubMed) uses MeSH.

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" because they are topics included in the publication but not very much. OR else they are descriptive Subject Headings *about* the publication. For example, "Humans" tells us that the publication project involved human patients or research subjects. "Animals" would tell us that the project involved animal patients or research subjects. "Female" would tell us the gender of the patients or research subjects. "Descriptive Statistics" would tell us what type of statistical analysis was used in the publication; it would not mean that the article was about descriptive statistics.

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 the asterisk (*) tells us it 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.