While the proposed prediction model provides a useful tool to estimate bias in disease prevalence due to incomplete claims data, it is equally important to con- sider how other databases can be used to address gaps in these data. Electronic medical records are increas- ingly being adopted in population-based chronic disease research and surveillance studies, 30 and could represent an important additional source of data for case ascer- tainment. Pharmacy databases have also been used for case ascertainment 31 when the medications used for disease treatment have high speci ﬁ city for case capture.
Abstract The electronic healthcare databases are start- ing to become more readily available and are thought to have excellent potential for generating adverse drug re- action signals. The Health Improvement Network (THIN) database is an electronic healthcare database contain- ing medical information on over 11 million patients that has excellent potential for detecting ADRs. In this pa- per we apply four existing electronic healthcare data- base signal detecting algorithms (MUTARA, HUNT, Temporal Pattern Discovery and modified ROR) on the THIN database for a selection of drugs from six chosen drug families. This is the first comparison of ADR sig- nalling algorithms that includes MUTARA and HUNT and enabled us to set a benchmark for the adverse drug reaction signalling ability of the THIN database. The drugs were selectively chosen to enable a comparison with previous work and for variety. It was found that no algorithm was generally superior and the algorithms’ natural thresholds act at variable stringencies. Further- more, none of the algorithms perform well at detecting rare ADRs.
As in other epidemiological studies, the incidence of HZ is strongly sex- and age-related, with higher incidences in women over 50 years. Our incidence was slightly higher than in other European studies using electronicdatabases. In France, the yearly HZ incidence rate for all ages aver- aged 3.82/1000 PY in the study period 2005-2008 , while in Italy a retrospective study showed an incidence of 4.31/1000 PY for population aged 15 years or older during the three-year study period (2003-2005) . Another study conducted in the Netherlands during 1994-1999, calculated an HZ incidence of 3.4/1000 PY . A similar German study performed in an older population (≥ 50 years) reported higher figures (9.60/1000 PY during 2007- 2008) . We found similar rates in the United States: 4.4/1000 PY for all ages during 2006 . Apart from the fact that the results of different descriptive epidemiological Table 2 Hospitalizations due to Herpes Zoster by age-groups in the Valencian Community (Spain), 2007-2010
It may also be hypothesised that conducting a more extensive ELS and manual search could have led to a greater number of, and possibly more overlap between, studies identified by each component of our search strategy. Ways to achieve a more extensive search could have included using more electronicdatabases and other relevant data sources, identifying a wider number of synonyms for both the health outcomes and other concepts included in the review, using both subject headings and words in the title and abstract to search for every concept in the search strategy and minimising reliance on the accuracy of database indexers. There is also some existing evidence that the effectiveness of different search strategies may vary depending on the subject of the review. 5 Therefore, it is worth testing our findings in the context of other reviews and different types of literature search, including more sensitive searches. Missing out health outcomes altogether is an alternative means of increasing search sensitivity but we note that our initial search identified well in excess of 10 000 hits. Given the broad review question, attempts to vastly expand the search risked increasing the number of hits to unmanageable levels.
Regarding the quality of reporting, we found 9 studies examining sustained exposures (e.g., antihypertensive treatments or low-dose aspirin for secondary prevention of cardiovascular events), which indicates the reporting of the design being appropriate to study abrupt-onset outcome and transient drug exposure. This high number underlines that authors and reviewers should be aware of the design’s validity assumptions, recommendations for use and the need to report validity assumptions fulfilled (or not). Indeed, the minor assumptions were rarely reported in the papers we reviewed. In addition, the sample size or power calculation was rarely reported, with no improvement compared to a previous review . However, studies involving electronic healthcare databases usually have very large sample sizes and perhaps the sample size calculation is not needed in this context, because the sample size cannot be chosen. However post-hoc power calculation in the database study sample is important to decide which healthcare database should be used and to interpret the absence of a statistical association, especially in the context of a very rare event. Post-hoc power calculation indicates how easily an effect that is fixed a priori can be shown (accounting for the observed number of patients/cases and the observed variability). Even if confidence intervals (which represent how accurate the results are estimated) are reported, the power calculation is more related to the number of observed events, and is information that is easier for the reader to understand: in case of non- significant associations, power can be quite difficult to interpret on the basis of the sole confidence interval. Table 3 Quality of reporting
Apart from this application, collection of clinical genetic information on patients with particular genetic diseases, the investigation of a family’s clini- cal history and genotype – phenotype correlations are also important. 14 Such data could be deposited in a central data warehouse derived from the various databases that exist in different healthcare institutions, namely hospitals, clinics and so on. The construction of depositories with genotype and phenotype information keyed to many individ- uals could be considered the ultimate database, hereafter termed ‘clinical genetics databases (CGDBs)’. At present, such databases are necessary components of large population-wide epidemiolo- gical projects that have been initiated in various countries, such as Iceland, Estonia, India and the UK. Certainly, when whole-genome sequencing becomes routine, and personalised medicine is common, then we may well take these CGDBs for granted. In the meantime, the first efforts in that direction have begun to appear. In particular, a pro- totype software, allowing an individual’s genetic profile to be stored in such a way that the infor- mation can only be retrieved by the patient and his/her physician, has been developed (Gkantouna, Tzimas and Patrinos, unpublished) (Figure 4). A convenient graphical interface is provided for the end user, who can enter data and retrieve results
There are a variety of Internet-based resources, such as Web portals, online databases, electronic journals, and electronic books [6-8]. Web Portals have been a good starting point to search medical information. A growing trend of using Web portals has been noticed around the world . However, challenges exist regarding how to easily find quality information from an overwhelmingly large number of Web-search results. In addition, the pub- lication policy of traditional journals and textbooks has been changed with the advent of Internet . The number of medical journals and textbooks that offer electronic versions of their publications has grown tremendously . There is an increase of free available electronic journals and books. Furthermore, online databases offer
Description of the iBM Truven Marketscan database The IBM Truven MarketScan databases are comprised of two main components: the MarketScan Commercial Claims and Encounters (CCAE) database and the Medicare Supplemental and Coordination of Benefits (MDCR) database. Patients rep- resented in the databases are active employees, dependants, Consolidated Omnibus Budget Reconciliation Act (COBRA) recipients, or Medicare-eligible retirees with Medicare- supplemental plans, and the data are drawn from employers, health plans, and public organizations in the USA. In the current study, approximately 149.7 million patients were available for analysis, with records spanning from January 1, 2008, to March 31, 2016. Records were primarily drawn from CCAE and MDCR Enrollment Detail, Inpatient Admissions, Inpatient Services, and Outpatient Services tables. Patients were defined as observable between the periods of enrollment start and end dates available in the database.
selected should be expressed in English, Spanish, or Portuguese. Therefore, in these three electronic data- bases, the following keywords related to our research topic were added: Epstein-Barr virus OR EBV OR virus AND cancer OR tumor OR neoplasia OR nasopharyngeal carcinoma AND LMP1 30-bp deletion OR LMP1 variant OR BNLF1 AND XhoI polymorphism OR XhoI variants. We also adopted another strategy to search the data to re- duce possible selection bias, which was the recovery of all references of ‘pre-selected’ studies to retrieve articles of interest available only in other electronicdatabases. Finally, the selection criteria were as follows: 1) cohort or case– control studies that analyzed the 30-bp deletion and/or XhoI-loss present in the EBV LMP1 gene of patients with NPC; and 2) studies that showed the variables of interest as previously stated were selected regardless of the place of origin of the search, age, and sex as well as the histological type of NPC presented by these individuals. The exclusion criteria included the following: 1) review studies; 2) analysis only of other cancers ‘non-NPC’; 3) duplicated previous publications; and 4) studies that did not disclose the vari- ables of interest as the frequency of the 30-bp deletion or the XhoI polymorphism in the EBV LMP1 gene separately for patients with NPC.
This study aimed to identify all RCTs to assess the efficacy of PIC in the treatment of patients with respiratory failure due to COPD exacerbation. The electronic search strategy applied standard filters for the identification of RCTs. The following databases were searched: MEDLINE, EMBASE, Cochrane databases, Chinese electronicdatabases (eg, Wan Fang Data- base), CNKI (China National Knowledge Infrastructure) Data- base, and Current Controlled Trials from its inception to February 2016. The search included the following: pulmonary infection control window; continuous positive airway pressure; bilevel positive airway; non-invasive ventilation; COPD; lung disease; pulmonary disease; airway obstruction; obstructive pulmonary disease; emphysema; acute exacerbation; respi- ratory failure linked with RCT OR controlled clinical trial, in various combinations. There were no limits regarding the language of publication. Cross-references from original articles and reviews were checked, and sometimes authors were contacted to obtain additional unpublished data. Similarly a search of relevant trials from the clinical trial registry was performed to identify the existence of unpublished data. Trials published solely in abstract form were excluded.
This search restriction is used because since 1998, we have seen the emergence of advance developments of rapid HIV diagnostic tests (RDTs) including self-testing . The review will search for related studies in PubMed, the Cochrane Central Register of Controlled Trails (CENTRAL), the Cochrane Database of System- atic Reviews (CDSR), Databases of Abstracts of Reviews of Effectiveness (DARE), Social Sciences Citation Index, Web of Science, and African Index Medicus. In addition, we will search websites and databases for gray materials such as World Health Organization Li- brary Information System (WHOLIS), WHO Global Index Medicus, the Joint United Nations Programme on HIV/ AIDS (UNAIDS resource library), Alliance of Health Pol- icy and Systems Research, and The World Bank. The search strategies for electronicdatabases will incorporate Medical Subject Headings (MeSH), free-text terms, and comprehensive African search filter that will be adapted to suit each individual database using applicable con- trolled vocabulary [27, 28]. We will also check reference lists of included studies for other eligible reports.
Abstract: More than half of all pregnant women take prescription medications, raising con- cerns about fetal safety. Medical databases routinely collecting data from large populations are potentially valuable resources for cohort studies addressing teratogenicity of drugs. These include electronic medical records, administrative databases, population health registries, and teratogenicity information services. Medical databases allow estimation of prevalences of birth defects with enhanced precision, but systematic error remains a potentially serious problem. In this review, we first provide a brief description of types of North American and European medical databases suitable for studying teratogenicity of drugs and then discuss manifestation of system- atic errors in teratogenicity studies based on such databases. Selection bias stems primarily from the inability to ascertain all reproductive outcomes. Information bias (misclassification) may be caused by paucity of recorded clinical details or incomplete documentation of medication use. Confounding, particularly confounding by indication, can rarely be ruled out. Bias that either masks teratogenicity or creates false appearance thereof, may have adverse consequences for the health of the child and the mother. Biases should be quantified and their potential impact on the study results should be assessed. Both theory and software are available for such estimation. Provided that methodological problems are understood and effectively handled, computerized medical databases are a valuable source of data for studies of teratogenicity of drugs.
The most important part of the searching process is choosing your keywords. Electronic tools such as databases and search engines will only search for the exact words that you provide so it is important that you are equipped with a range of defining and descriptive keywords to make sure that you cover all the elements of the research topic and that you don’t miss out on important information due to alternative ways of expressing your search terms. Remember that you are in control of your searching, not the computer! A very effective way to begin to gather your keywords is to use techniques such as mind-mapping. Mind-maps can help you to:
Abstract: Alterations in the levels of intestinal microbiota, endo- toxemia, and inﬂammation are novel areas of interest in the pathogenesis of hepatic encephalopathy (HE). Probiotics and symbiotics are a promising treatment option for HE due to possible beneﬁcial eﬀects in modulating gut microﬂora and might be better tolerated and more cost-eﬀective than the traditional treatment with lactulose, rifaximin or L -ornithine- L -aspartate. A systematic search of the electronicdatabases PubMed, ISI Web of Science, EMBASE, and Cochrane Library was conducted for randomized controlled clinical trials in adult patients with cirrhosis, evaluating the eﬀect of probiotics and symbiotics in changes on intestinal microﬂora, reduction of endotoxemia, inﬂammation, and ammo- nia, reversal of minimal hepatic encephalopathy (MHE), pre- vention of overt hepatic encephalopathy (OHE), and improvement of quality of life. Nineteen trials met the inclusion criteria. Pro- biotics and symbiotics increased beneﬁcial microﬂora and decreased pathogenic bacteria and endotoxemia compared with placebo/no treatment, but no eﬀect was observed on inﬂammation. Probiotics signiﬁcantly reversed MHE [risk ratio, 1.53; 95% con- ﬁdence interval (CI): 1.14, 2.05; P = 0.005] and reduced OHE development (risk ratio, 0.62; 95% CI: 0.48, 0.80; P = 0.0002) compared with placebo/no treatment. Symbiotics signiﬁcantly decreased ammonia levels compared with placebo (15.24; 95% CI: 26.01, 4.47; P = 0.006). Probiotics did not show any additional beneﬁt on reversal of MHE and prevention of OHE development when compared with lactulose, rifaximin, and L -ornithine- L -
Methods: Electronic searches of nine databases, supplemented with reference list searches and forward citation tracking, were used to identify randomised, experimental studies assessing immediate effects of exposure to alcohol marketing communications on objective alcohol consumption (primary outcome), explicit or implicit alcohol-related cognitions, or selection without purchasing (secondary outcomes). Study limitations were assessed using the Cochrane Risk of Bias tool. Random and fixed effects meta-analyses were conducted to estimate effect sizes. Results: Twenty four studies met the eligibility criteria. A meta-analysis integrating seven studies (758 participants, all students) found that viewing alcohol advertisements increased immediate alcohol consumption relative to viewing non-alcohol advertisements (SMD = 0.20, 95 % CI = 0.05, 0.34). A meta-analysis integrating six studies (631 participants, all students) did not find that viewing alcohol portrayals in television programmes or films increased consumption (SMD = 0.16, 95 % CI = − 0.05, 0.37). Meta-analyses of secondary outcome data found that exposure to alcohol portrayals increased explicit alcohol-related cognitions, but did not find that exposure to alcohol advertisements influenced explicit or implicit alcohol-related cognitions. Confidence in results is diminished by underpowered analyses and unclear risk of bias.
On the topic of information technology (IT) business value, there has been great interest among IT researchers, IT vendors, and business managers in demonstrating what organisations can achieve with IT, thus providing reasons to justify investments in IT. To understand how organisations leverage IT to their advantage, this paper searched in three major electronicdatabases for journal articles that studied information technology or information systems success, performance, value, benefit, evaluation, payoff, productivity, effectiveness, and efficiency. Having summarized a vast number of past findings reported in the journal articles, this paper concludes that there is still much work to do on the topic of IT business value and recommends several future research directions. This paper is a timely effort to complement past literature reviews on IT business value, updating what has been reported since the early 2000s.
Many database producers and vendors allow users download a portion of the database on to a ‘temporary file’ for research purposes under fair use principle. However, there are no clear-cut guidelines as to how much data can be downloaded at a time. In the case of printed documents, depending upon the size of the original, up to 5-10 per cent of the original document or a chapter can be photocopied under fair use. The same fair use principle cannot be applied in the case of databases, as even 5 per cent material would be voluminous when cumulative and large databases are used. And, when such downloading is made regularly over a period, say 2-3 years, then the resulting database would be considerably large. Such issues would become more frequent since users would like to keep the useful downloaded data in their personal library, much the same way they retain and maintain photocopies of articles in areas of their interest for re-use. Most of the CD- ROM databases are used in providing SDI services to the institution’s research community. Some- times, downloaded data against an SDI profile is sent by e-mail to save time. This is illegal as transmission of electronic information over communication networks is an infringement of copyright and is prohibited by all database owners.
The nature of this systematic review with its focus on set- tings where burden of disease is highest necessitates exten- sive searching of developing country sources. However, literature from developing countries is difficult to access and it is not well represented in MEDLINE or other well- known electronicdatabases [13,14]. An editorial by Zielinksi in 1995 stated that only 2% of the journals indexed in MEDLINE or the Science Citation Index were from developing countries . In 2004, the situation was similar. We calculated the number of journals pub- lished in developing countries and also indexed in MEDLINE to be about 6%. In 1996, the whole Latin American continent accounted for 0.39% of the total number of articles included in MEDLINE, down from a high of 2.03% in 1966 . One of the reasons for this is the indexing of journals on a priority system where the impact factor of a journal influences its chances of being indexed. This results in country bias since western jour- nals have in general higher impact factors, and they are therefore more likely to be indexed than those from devel- oping countries.
Jacquesson (1995) discussed the history and various aspects of the development of automation in libraries in Western Europe, the United States and Canada, considering issues such as functions of automated systems, OPAC catalogues and library networks. Dech (2012) provided a brief history of the use of technologies in libraries, focusing on library automation efforts of the IFLA’s Mechanization Committee. He also discussed OPAC catalogues, the use of the internet in libraries and innovations such as smartphones, and electronic books readers. Moghaddam (2009) focused on the development of databases from paper-based to web-based, including their functionality and search features. Other concerns included organising national consortia for licensing databases (Tollefsen and Gulliksen, 1999), managing electronic journals and user training (Kidd, 1997), licensed electronic resources management (Webb, 1998), cataloging and management policies (West and Miller, 2011), and user behaviour (Nicholas, 2010).
Dermatoglyphics is focused on studying the fine patterned dermal ridges on volar surfaces of soles, palms, and ridges. The volar pads are mound-shaped elevations on each finger above the proximal end of the distal metacarpal bone. Most dermatoglyphics which are correlated with genetic abnormalities, are used in biomedical studies. This study aims to systematically review and to assess the correlation between dermatoglyphics and orofacial disease in human population. An electronic search was initiated in the PubMed, Embase, and Google Scholar databases about the articles discussing the relationship between dermatoglyphics and orofacial diseases using specific keyword search terms. A PIO analysis was done to identify the articles. The search methodology yielded and was excluded and included. 32 articles were generated among which 9 articles were excluded and 23 articles were included finally to discuss the relationship between orofacial disorders and dermatoglyphics. Out of the 23 articles, 5 were research articles and 18 review articles. Extraction of data revealed a positive correlation between dermatoglyphics and orofacial disorders. Dermatoglyphics can be used as a predictive model to diagnose orofacial disease conditions.