A 1.5 hour workshop on Medline meant for researchers who already have some experience with Medline. Built to be as interface neutral as possible and therefore usable for teaching Pubmed or OvidSP. Focus is on active learning and includes a worksheet where participants can record things they notice about MeSH headings and search results as they work through the activities. Feedback very welcome. Edited to remove section on filters and add an activity around limits.

1. Advanced Medline
Franklin Sayre
franklin.sayre@ubc.ca

2. Objectives
By the end of this session you should be able to:
1. Use MeSH scope notes to better focus your searching
2. Determine when to use explode, focus, and subheadings
3. Determine when to use keywords
4. Use some advanced keyword search operators

3. Medline: Content & Scope
• Produced by the U.S. National Library of Medicine (NLM)
• 1946 to present
• ~20 million records
• US Based, 95% english
• Citations from approximately 5,600 worldwide journals in 39
languages (careful review of journals for selection)
• 2,000-4,000 records added per day

4. Medline: Pubmed vs. Medline
Pubmed
MEDLINE (searchable
in Pubmed, OvidSP,
EBSCO, etc.)
• Some in-
process
citations
• Some
older
material
• Some
eBooks
• Medline is a
database
• Pubmed is an
interface to Medline
that includes some
other material
• Medline can be
searched using
different interfaces
(OvidSP, EBSCO)
*98% of what pubmed
searches is
searchable from other
Medline is a database searchable through different interfaces

5. Review: Medline - Organization
Medline contains bibliographic records not the full text of articles:
• A bibliographic record contains:
• Title
• Authors
• Abstract
• MeSH Headings
• Other descriptive information
• Example Record: Mortality in relation to smoking: 50 years'
observations on male British doctors:
http://www.ncbi.nlm.nih.gov/pubmed/15213107

6. Medical Subject Headings (MeSH)
MeSH are a system of Subject Headings (also called a “Controlled
Vocabulary”):
• Subject Headings are a system that designates a single
authorized term or phrase for each unique concept
• Helps control for variations in human language such as
synonyms, spelling, and alternative phrasings
• Similar to ICD9/10 Codes and other classification systems
• Assigned to articles by indexers who apply the most
appropriate headings to describe the content of the article

7. Medical Subject Headings(MeSH): Examples
Two example MeSH:
•Pregnancy: http://www.ncbi.nlm.nih.gov/mesh/68011247
•Pregnant Women: http://www.ncbi.nlm.nih.gov/mesh/68037841
Example Record with MeSH:
•Mortality in relation to smoking: 50 years' observations on male
British doctors: http://www.ncbi.nlm.nih.gov/pubmed/15213107
•See the MeSH headings applied to this article and how they
describe various characteristics of the article

8. Medical Subject Headings (MeSH): Scope Notes
Parts of a Scope Note:
PREFERED TERM: The official term for that disease, process,
etc. as assigned by NLM
DEFINITION: The scope of the definition; what this MeSH
covers.
YEAR INTRODUCED: Important because articles indexed before
this year will not be searchable using this MeSH.
PREVIOUS INDEXING: The MeSH used to index this concept
before the term was created.
AVAILABLE SUBHEADINGS: Subheadings that can be applied
ENTRY TERMS: Other terms for this concept (useful for building
lists of keywords)
SEE ALSO: Related MeSH terms
MeSH TREE: Location within MeSH Tree

9. Activity: Understanding MeSH Scope Notes (5
minutes)
• Search for a few different kinds of concepts, e.g.
• A disease or condition
• Something that causes a disease or condition
• A therapy/test/intervention
• An outcome
• A social/cultural concept, group, geographic area
• Record the name of the MeSH and anything interesting about
the definition, year introduced, related terms, and available
subheadings (don’t worry about writing everything down)

10. Activity: Understand MeSH Scope Notes
(Wrap-up & Discussion)
Did you notice anything interesting?
•Definition: Notice how specific the definition is?
•Year Introduced: Why then? How would this effect searching?
•Previous Indexing: What would you need to do to find older
material?
•Way that MeSH split concepts up: E.G. Definition? Related
Terms? Previous Indexing?
•Available Subheadings: How do they compare with the
subheadings available for other kinds of concepts?

11. Searching with MeSH: Three Questions
Explode, focus, subheadings
1. Should I explode?
2. Should I focus?
3. Should I use subheadings?

12. Searching with MeSH: Do I want to explode?
Explode includes all narrower headings in the MeSH tree
• MeSH headings are organized in a hierarchy from broad to
narrow concepts
• Articles are indexed to the narrowest (most specific) level
possible
• Example: Canada (http://www.ncbi.nlm.nih.gov/mesh/68002170)
• If an article is about Canada generally it will be indexed with
“Canada”
• If it is specifically about British Columbia it will be indexed
with “British Columbia” but NOT with “Canada”
• Explode includes all narrower concepts bellow that heading in
the MeSH tree in your search

13. Medical Subject Headings (MeSH): Tree
A. Anatomic terms
B. Organisms
C. Diseases
D. Drugs and chemicals
E. Analytical,Diagnostic
&Therapeutic Techniques &
equipment
F. Psychiatry and Psychology
G. Phenomena & Processes
H. Disciplines & Occupations
I. Anthropology,Education,
Sociology and Social Phenomena
G. Technology,Industry,Agriculture
K. Humanities
L. Information Science
Named Groups
N. Health Care
M.Publication Characteristics
P. Geographicals

14. Activity: Exploding vs. Not Exploding (5 minutes)
Take one or more of the MeSH headings you found earlier:
1.Find where it is located in the MeSH tree
2.See if it has any narrower headings under it, if it doesn’t use
another heading that does
3.Run a search with just the heading (not exploded)
4.Run a second search where you explode the heading
5.Notice the difference in search results
NOTE: For now ignore both focus and subheadings

15. Searching with MeSH: Do I Want to Focus?
Focus designates the MeSH that are the main intellectual “focus” of
the article
• Focus is given to 2-4 MeSH that reflect the main “focus” of an article, i.e.
the concepts that the article is primarily about
• Example: Mortality in relation to smoking: 50 years' observations on
male British doctors (http://www.ncbi.nlm.nih.gov/pubmed/15213107)
Focus was given to:
• Neoplasms/mortality*
• Physicians/statistics & numerical data*
• Smoking/mortality*
• Smoking Cessation/statistics & numerical data*
• When you use “focus” you’re saying you only want to see articles where
the concept that MeSH designates is a main focus of the article.
• Should not be used with systematic reviews or if you need to be
comprehensive.

16. Activity: Using Focus (5 minutes)
Take one or more of the MeSH Headings you searched for
earlier:
1.Search for it again and this time select the focus option
2.Run the search and compare how many results you received
with the number you returned when you didn’t use focus
3.Scan through a few of the results and note how their content
more closely centres around that concept.
NOTE: For now ignore subheadings

17. Searching with MeSH: Do I want to use Subheadings?
Subheadings limit your search to particular aspects of a concept
• Subheadings get at particular aspects of a MeSH heading
• Also called qualifiers
• Example Record: Mortality in relation to smoking:
• Neoplasms/mortality
• Smoking Cessation/statistics & numerical data
• 88 in total, including: Diagnosis, Drug Therapy, Drug Effects,
Economics, Psychology, Rehabilitation, Trends, etc.
• Specific subheadings are only available if relevant to that
MeSH heading (not every subheading is applicable for
every MeSH heading)

18. Activity: Using Subheadings (5 minutes)
Take a MeSH you searched for earlier:
1.Search for it again, this time when you get to the subheadings
screen select one of the subheadings
2.Look at the results and see how they differ from the results
you found earlier in number and content
3.Search for a different kind of heading (e.g. if you already
searched for a diseases try searching for a drug or social
group) and note the different subheadings that are available
NOTE: For now ignore subheadings

19. Keywords
• Keywords are words used in the title and abstract of the
article (and a number of other fields)
• Based on simple character matching
• Things to think about:
• Language used by authors in your field
• Synonyms
• Alternative spellings (including British spellings)
• Plural and other word root endings
• Alternative phrasing
• Abbreviations
• etc.

20. MeSH vs. Keywords
MeSH Keywords
• Established concepts
(Diabetes, Heart Disease)
• Core biomedical concepts
(diseases, drugs & chemicals,
anatomy)
• Traditional parts of medicine
(Surgery, Immunology)
• Newer concepts (eHealth)
• Boundary-crossing topics
(psychosocial and humanities
concepts)
• New parts of medicine
(Rehabilitative Sciences,
Population and Public Health,
etc.)
• New Articles (not yet indexed)
• Errors in indexing
Often you need to use a combination of MeSH and keywords

21. Indexing Status and MeSH vs. Keywords
The delay in indexing articles means newer material can only be
found using keywords
Status What it Means Search using
MeSH?
PubMed -
as
supplied
by
publisher
Citations recently added to PubMed via
electronic submission from a publisher, and are
soon to proceed to the next stage, PubMed - in
process
No
PubMed -
in
process
Citations bibliographic data will be reviewed and
indexed, i.e., MeSH terms will be assigned (if
the subject of the article is within the scope of
MEDLINE).
No
PubMed -
indexed
for
MEDLINE
Citations that have been indexed with MeSH
terms, Publication Types, Substance Names,
etc., and bibliographic data have been
reviewed.
Yes

22. Tools for Keywords
Phrases: Find a specific phrase (more specific)
•“cultural deprivation”
Proximity: Find words within a X words of each other (more
flexible, increases the number of results)
•needle ADJ2 exchange
•Proximity searching is not available in every interface, see help
Truncation: Find alternative word endings (increases results)
$ OR * in OvidSP databases will search for multiple word endings
•needle* – will search for needle or needles etc
Wildcards: Find alternative spellings (more flexible, inceases
results)
•Colo*r

23. Activity: Search using keywords (10 minutes)
1. Try searching using:
1. An individual word (e.g. education)
2. A phrase (e.g. “medical education”)
3. Truncation (educat*)
4. Proximity searching (e.g. medical ADJ3 education)

24. Limits
Aspects of Study Design and Publication Type
• Always apply limits last
• Limits are not necessarily perfectly applied and their
application may not always be consistent. When doing
systematic reviews speak to a librarian about using filters
instead

25. Activity: Applying Limits (5 minutes)
1. Try the following limits:
1. Publication Year
2. Age Groups (age of study population)
3. Publication Types
1. Randomized Controlled Trial
2. Review
3. Systematic Review
4. Comparative Study

26. Activity: Survey (3 minutes)
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