Setting up Nomad
LibKey Nomad is a browser extension that facilitates access to the Libraries' full text resources as you find research on the web. LibKey Nomad provides one-click access to full text from websites like PubMed, Web of Science, Scopus and publisher pages.
Currently, LibKey Nomad is available for the following browsers: Google Chrome, Firefox, Edge, Brace & Vivaldi
How to set up LibKey Nomad
- Go to the Download LibKey Nomad website
- Click on the icon for your browser of choice and follow the prompts to add the extension
- Choose University of Rochester as your institution
SEARCHING RESOURCES
List of Secondary Sources
- ACP Clinical InformationSearch engine that accesses ACP Clinical Guidelines, ACP Journal Club, and 3 ACP-based journals (Annals of Internal Medicine, ACP Hospitalist, ACP Internist). May locate some primary literature along with summary/secondary sources due to the journals above.
- AFPAmerican Family Physician. Journal of review articles written by real-life family docs currently in practice. Extremely high relevance, even if the comprehensiveness of each review is not quite at Cochrane level. Usually focuses on updates in practice. Free through URMC and through your AAFP membership.
- BandolierAn independent British online publication started by 2 Oxford scientists in 1994 and expanded since then. Funded by subscription (not required for most content), donations, and sponsorships ("no-strings" only, meaning sponsors have no control over content). Use the search field in top left corner, or "knowledge library" (just under the "donate" button on L side).
- CochraneTHE authority/gold standard for systematic reviews. Updated regularly. "The Cochrane Method" is a standardized way of doing systematic reviews to ensure that the reference search is absolutely comprehensive for each review. Use the search field in the upper Left corner. Full text available through URMC.
- DynamedSubscription-only service for evidence-based topic summaries in bulleted format. It is updated more frequently than is UpToDate, but is less comprehensive (fewer obscure topics). Less variation from topic to topic than UpToDate--quality of each topic is more reliable. More evidence-based than is UpToDate (ie, less "at our center, we recommend..."). Less pathophys info than UpToDate, so less good if you are trying to understand a disease process. Great for finding the best diagnostic & treatment tools. Consider subscribing during residency for half-price.
- ECRI Guidelines TrustECRI is the new home of the database of evidence-based clinical practice guidelines, maintained by the Agency for Healthcare Research and Quality (AHRQ), under the U.S. Department of Health and Human Services.
As of 10/5/23: Users no longer have to create an account. - EPC ReportsEvidence-based Practice Center Reports. Sponsored by the Agency for Healthcare Research and Quality (AHRQ), these 5 centers compile evidence-based reports and publish on this website. These reports are similar to other clinical guidelines/systematic reviews, etc. except that they are federally funded by AHRQ. Use filters on the left to narrow your search.
- Essential Evidence PlusOne of the original "point of care/evidence-based" online resources. Originator of "POEM's:" patient-oriented-evidence-that-matters. Searches multiple databases at once, including POEMs, Cochrane, Calculators. Easy to pull up only 1 type of result (ie, I only want to see POEMs) using filters. Subscription through URMC.
As of 9/11/23, EEP requires users to create an account for access. - NEJM Journal WatchWeekly newsletter divided by specialty/topic (cards, psychiatry, etc.). Each week's publication covers a "practice-changing" or clinically important article, and summarizes it in a "POEM"-like format. You can sign up for weekly email alerts (foraging tool! see below), but simply searching the website for your clinical question is a better strategy.
- PubMed Clinical QueriesClinical Queries is a feature that searches PubMed for your specified search terms and then applies specialized search "filters." This is not a comprehensive search of PubMed, but it is a method for quickly identifying evidence-based clinical literature, including systematic reviews.
- TRIP DatabaseTurning Research into Practice. A search engine that probes multiple "secondary" sources such as review articles. UR has a "Pro" account but you have to create your own user name/password. Go to the small box on the R lower side that says "Your PRO account." From the next screen, find the "sign up" link on the R upper side and set up your account and password. You'll need to be logged in remotely to UR's network or on-site to do this.
- USPSTF WebsiteUnited States Preventive Services Task Force website. More comprehensive than the smartphone App (EPSS, which I also recommend). Use the search field at top right screen. Once you select a recommendation from the search results, look at the right mid/lower screen for the box titled "Clinical Summary." Click the tiny link underneath for a succinct yet thorough rationale for the guideline.
Searching Tips and Tricks
Combining Searches Using Boolean Operators
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A comprehensive and systematic search of PubMed includes both controlled vocabulary and keyword terms (i.e. free text, natural language, and synonyms).
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Boolean operators are used to combine search terms. In PubMed, you can use the operators AND, OR, and NOT.
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Boolean operators MUST be used as upper case (AND, OR, NOT).
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OR--use OR between similar keywords, like synonyms, acronyms, and variations in spelling within the same idea or concept
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Nutrition OR Diet
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AND—use AND to link ideas and concepts where you want to see both ideas or concepts in your search results
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Poverty AND Built Environment
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NOT—used to exclude specific keywords from the search, however, you will want to use NOT with caution because you may end up missing something important.
- Attention Deficit Hyperactivity Disorder NOT Ritalin
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Parenthesis/Nesting
(poverty OR low-income) AND (obesity OR overweight)
Foraging Resources
What is a foraging tool? It is a tool or program that searches for important updates in the literature, and sends you automatic alerts (usually in email form). Some people love them, some people don't. While they add to email burden and are easily deleted, they are one way of staying abreast of some (not all) new developments in family medicine if used appropriately (systematic method of making sure you read them). One example of a foraging tool is the Daily POEM, put out by EE+. Other organizations have similar daily/weekly/monthly emails. How do you know a good tool from a less useful one? See Link below for one way to distinguish the two.