Cochrane Library 활용과 이해

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Systematic Review 중심의 EBM DB Cochrane Library 활용 1

Systematic Review Identify the issue and determine the question Write a plan for the review (Protocol) 사전에엄밀하게정의된방법에따라논문을선별및통합하여, 결과를도출 과학적근거를기반으로의료기술에대한안전성및유효성평가 근거중심의학 (EBM) 의 Gold Standard 는 Cochrane Library Sift and select studies Extract data from the studies Assess the quality of the studies Combine the data (Synthesis or meta-analysis) Discuss and conclude overall findings Search for studies Systematic Review Dissemination 2

Cochrane Library? Cochrane exists so that healthcare decisions get better 과학적근거에기반한의사결정과개선된환자치료를지원 국제적비영리조직인 Cochrane Collaboration 에의해아티클생산 총 6 개의데이터베이스로구성 1) Cochrane Database of Systematic Reviews (Cochrane Reviews) 2) Database of Abstracts of Reviews of Effects (Other Reviews) 3) Cochrane Central Register of Controlled Trials (Clinical Trials) 4) The Cochrane Methodology Register (Method Studies) 5) Health Technology Assessment Database (Technology Assessments) 6) The NHS Economic Evaluation Database (Economic Evaluations) 3

What can you do with Cochrane Library? Cochrane exists so that healthcare decisions get better 임상 : 보다개선된환자치료를위해임상에서활용 연구 : 신뢰도높은정보로연구에활용 (6.032 Impact Factor / 2014 JCR) 번역 : Systematic Review 아티클 abstract 번역에참여 피드백제공 : review article 관련정보 or 의견제공 아티클개제 : Review article 개제 4

Impact factor of Cochrane Library 2014 Impact factor: 6.032 13 th in the Medicine, General & Internal category ( 총 153 종 ) 5 *Source: www.cochranelibrary.com (2015)

Cochrane research trend WHO Top 10 causes of death in the world 6 *Source: http://www.who.int/mediacentre/factsheets/fs310/en/ (2014.05)

53 개 Review Group Acute Respiratory Infections Group Effective Practice and Organisation of Care Group Injuries Group Public Health Group Airways Group ENT Group Lung Cancer Group Renal Group Anaesthesia, Critical and Emergency Care Group Epilepsy Group Menstrual Disorders and Subfertility Group Schizophrenia Group Back Group Eyes and Vision Group Metabolic and Endocrine Disorders Sexually Transmitted Infections Group Group' Bone, Joint and Muscle Trauma Fertility Regulation Group Methodology Review Group Skin Group Group Breast Cancer Group Gynaecological, Neuro-oncology, Movement Disorders Group Stroke Group Orphan Cancers Group Childhood Cancer Group Haematological Malignancies Multiple Sclerosis and Rare Tobacco Addiction Group Group Diseases of the Central Nervous System Group Colorectal Cancer Group Heart Group Musculoskeletal Group Upper GI and Pancreatic Diseases Group Consumers and Communication Hepato-Biliary Group Neonatal Group Urology Group Group Cystic Fibrosis and Genetic HIV/AIDS Group Neuromuscular Disease Group Work Group Disorders Group Dementia and Cognitive Hypertension Group Oral Health Group Wounds Group Improvement Group Depression, Anxiety and Neurosis Group Incontinence Group Pain, Palliative and Supportive Care Group Developmental, Psychosocial and Infectious Diseases Group Peripheral Vascular Diseases Group Learning Problems Group Drugs and Alcohol Group Inflammatory Bowel Disease and Functional Bowel Disorders Group Pregnancy and Childbirth Group 7 *Source: http://www.cochrane.org/contact/review-groups

Cochrane Reviews Groups Presentation by Health Topics 8

New platform of Cochrane Library Improved navigation: 인터페이스가심플하게개선되어더욱쉽게브라우징할수있습니다. Mobile optimization: 타블렛이나스마트폰으로도손쉽게 Cochrane Library 를검색하고열람할수있습니다. Better browsing: Cochrane Reviews 를토픽별혹은리뷰그룹별로브라우징할수있습니다. Anywhere Systematic Reviews: HTML 로제공되는 "Anywhere Systematic Review" 는가독성과휴대성을향상시켜, 언제어디서나어떤기기에서도쉽고편리하게이용할수있습니다. 9

10

- CDSR 소개 - CDSR browsing (by Topic, CRGs) - TOC (by Year) - Supplements (Colloquium Proceeding) - CENTRAL 제한검색 - CENTRAL 소개 - DARE, CMR, HTA, EED 제한검색 - COCHRANE COLLABORATION - JOURNAL CLUB, CCA 등링크 - COCHRANE LIBRARY 편집위원, COCHRANE DB, COCHRANE REVIEW, CRGs 소개 11 - COCHRANE LIBRARY 이용방법 - COCHRANE REVIEW 작성 - 웹사이트업데이트

New Design 1 2 3 1. Search 기존의 basic search 에해당되는 single line 의간단한검색시이용 2. Search Manager 기존의 advanced search 와유사한보다심화된검색전략수립시이용 3. Medical Terms MeSH Term 을이용한검색전략수립시이용

1. Search: Search help 일반적인간단한검색시 Search Tab 이용

1. Search: Field limits 필드제한을통해검색결과를제한할수있음.

1. Search: Autocomplete feature 일반적인검색어입력시자동제안기능제공.

1. Search: Limits

Search limit 버튼을이용하여 데이터베이스종류 아티클상태 리뷰그룹 출판일자 단어변형등을제한 1. Search: Limits

1. Search: Add Lines 플러스버튼을이용하여검색어를추가. 검색어라인은최대 5 개까지확장가능.

1. Search: Limits Add to Search Manager 버튼을통해 Search Manager Tab 으로이동. 좀더복잡한검색식을조합할수있음.

1. Search: Result View 검색어입력후 Go 버튼을클릭하거나혹은 Enter 키를누르면검색결과를확인.

1 검색결과페이지상에서다시한번데이터베이스종류를선택하여검색결과제한가능. 1. Search: Limit by Database 2 검색결과를유사도, 알파벳순서별혹은출판일자별로정렬가능.

1. Search: Status Labeling 아티클마다현재상태를나타내는레이블제공. 각각의레이블주위에커서를가져가면아티클상태에대한자세한설명을확인할수있음.

1. Search: Status Labeling Methodological study에대한 Systematic Review (Full-Text) Diagnostic test의정확성평가에대한 Systematic Review (Full-Text) 다양한 Cochrane Intervention Review의개요. 발표된리뷰의 conclusion에중요한변화가발생한경우. 가장최근에발표된리뷰에대한새로운내용이추가되었을경우. 최근에수록된프로토콜이수정된경우. About Cochrane Collaboration 에새로운내용이추가되었을경우리뷰혹은프로토콜이연구철회된경우 ( 연구철회의이유에대해명시 ) Comment (Reader의 feedback과저자의답변등 ) 가달린리뷰자료

1. Search: Improved Results 특정아티클을 Click 시새로운창이열림 검색결과전체 export 기능이새롭게추가. : txt 로 citation 가능 (Abstract 까지반출가능 )

1. Search: There are no result 오타등의이유로검색결과가없을경우적색으로유사키워드제공.

2. Medical Terms (MeSH Search) NLM(The National Library of Medicine) 의통제어휘시소러스를기준으로하는 의학주제표목 Mesh (Medical Subject Heading) 으로 Cochrane 의 데이터베이스는아래와같이 MeSH index 지원. Database Cochrane Reviews Cochrane Protocols Clinical Trials Other Reviews Technology Assessments Economic Evaluations MeSH indexing Fully indexed except for Reviews first published in recent issues No MeSH indexing Only reviews taken from Medline Fully indexed Fully indexed Fully indexed

Previous MeSH Search 기존의복잡한 MeSH 검색화면

2. Medical Terms (MeSH) 검색어입력 Subheading / Qualifier 선택 : 기형약물 / 투여량부작용해부학 / 조직학등 : Lookup 버튼혹은 enter 키를통해결과검색

2. Medical Terms: MeSH Autocomplete New: Auto-Suggest Feature 입력검색어에대한자동제안및 MeSH term 상의동의어로변환 Cancer, Tumor > Neoplasms

MeSH 검색의모든정보가한페이지상에서디스플레이. 2. Medical Terms: MeSH View 1. Definition: MeSH term 에대한정의 2. Thesaurus Matches : 매칭되는단어나열 : 복수의 term 으로검색시 Phrase (MeSH Heading 이나동의어 ) 나열 1 2 3 4 3. MeSH Tree 디스플레이 4. Result Box: MeSH term 검색결과현황. view results 클릭 : 전체검색결과 ( 아티클레벨 ) 디스플레이

MeSH Tree 상에서관련있는다른 MeSH term 을브라우징하여선택하거나혹은전체를선택하여, MeSH 검색결과를확장하거나제한. 원하는 MeSH term 을선택후반드시 select 버튼클릭. 2. Medical Terms: MeSH View

2. Medical Terms: MeSH View 검색결과 Box 에서 1. MeSH 검색만을별도로저장하거나, 2. Search Manager 에추가하거나, 1 2 3. 바로검색결과로이동가능. 3

Search and MeSH: Saved Searches 싱글라인검색은 Search 혹은 MeSH 검색양쪽탭에서모두저장가능. 저장된 search strategy는박스에체크를함으로써 alert 설정할수있음.

3. Search Manager 동일한페이지내에서검색전략을추가, 편집및검색식이름저장기능등제공.

3. Search Manager: Creating a Search Search Manager 를이용하여좀더복잡한검색전략 (search strategies) 을세울수있습니다. 검색라인삭제검색라인추가 MeSH Term 이동검색제한검색값추출 M 버튼을이용하여 MeSH 검색탭으로이동. MeSH term 을선택하여검색후 Update search manager 버튼을클릭하여 search manager 로이동가능.

3. Search Manager: Syntax 불리안연산자 근접연산자 NESTING 제공 : 구검색시 사용 : Nesting 부울연산자혹은근접연산자를통한그룹검색시기본우선순위를변경하기위해괄호 ( ) 를사용 필드레벨조합기능제공 각각의검색식에대한검색결과확인.

3. Search Manager: Insert a Search Line 검색식어느라인에서나검색라인을추가가능. : 마지막라인의필드조합번호자동변경

3. Search Manager: Find Orphan lines Use Highlight Orphan line 하이라이트기능 : 검색필드 1, 2, 4 를조합하여최종검색식을완료하였을경우 Highlight Orphan Line 을체크하면최종검색결과에사용되지않은검색라인 (#3) 확인

3. Search Manager: Limits 버튼을이용하여프로덕타입, 아티클상태, 그리고출판년도등으로검색을제한가능.

3. Search Manager: Saving Strategies Search Strategy 의이름을지정하여저장가능. 단 Search Strategy 저장을위해서는 TCL 상의본인개정을만들고로그인해야만함.

3. Search Manager: Strategy Library 저장된검색전략은 Search Manager 탭상의 Strategy Library 를이용하여관리할수있음. 저장된검색전략을실행저장된검색전략을현재검색전략에추가저장된검색전략을공유 저장된검색전략을반출 Sort by: Last saved date Name of search

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