Searching For Qualitative
Evidence
Helen Buckley Woods
Learning Outcomes
• Describe the particular challenges inherent in
identifying qualitative research
• Apply appropriate tools to focus a qualitative
question
• Identify key terms to assist retrieval of
qualitative research
• Demonstrate an awareness of search filters for
qualitative research
Today’s Session
• A game of two halves:
– Constructing a search strategy and
sources of evidence
– Filters and other techniques
Part One: Search strategies and sources
• What’s different about searching for
Qualitative Research?
• Tools for focussing your question
• Sources of Qualitative Research
• Case study: worked search example
• Practical: Sifting Abstracts Exercise
Qualitative Research
• Qualitative research seeks to
understand and interpret personal
experiences, behaviours, interactions,
and social contexts to explain the
phenomena of interest, such as the
attitudes, beliefs, and perspectives of
patients and clinicians; the interpersonal
nature of caregiver and patient
relationships; the illness experience; or
the impact of human suffering. (Wong et
al, 2004)
Qualitative Research
• “Research that derives data from
observation, interviews, or verbal
interactions and focuses on the
meanings and interpretations of the
participants (From Holloway and
Wheeler, "Ethical issues in qualitative
nursing research," Nursing Ethics, 1995
Sep; 2(3): 223-232).
Year introduced: 2003”
[MeSH]
What do I need to consider?
• Qualitative research is small part of the
research literature
• The indexing in databases is
inconsistent and variable
• Qualitative studies sometimes have
creative titles or inadequate abstracts
• Medline might not be your preferred
resource.
• If searching in limited databases try
MEDLINE and CINAHL
Focussing Qualitative
Questions
Applying question tools to your
search formulation
Health services research uses
PATIENT-INTERVENTION-COMPARISON-OUTCOME
(PICO) structure
Within social sciences research SPICE may be
more appropriate:
SETTING
PERSPECTIVE
INTERVENTION / EXPOSURE / INTEREST
COMPARISON
EVALUATION
An example of SPICE [Actual Example]
• SETTING – Awaiting Surgery
• PERSPECTIVE – Patients
• INTERVENTION - Coronary Artery
Bypass Graft Surgery
• COMPARISON – None
• EVALUATION – Uncertainty and
Anxiety
Another example of SPICE
• SETTING – Primary Care
• PERSPECTIVE – Patients with
Diabetes
• INTERVENTION – Good Blood
Pressure Control
• COMPARISON – None
• EVALUATION – Attitudes
Try and put this question into the SPICE
Framework
• What is the impact of childhood cancer
on their parents in terms of their quality
of life in the home?
• Setting
• Perspective
• Intervention/Exposure
• Comparison
• Evaluation
An alternative - ProPheT!
• Problem – First time
mothers
• Phenomenon of
Interest – Attitudes to
Breastfeeding
• Time – Within first
six months of birth
Exercise: Use the SPICE or ProPheT
framework to formulate your own
research question
Feedback from Exercise One
Sources of Qualitative Research
Citation
indexes
Registers
General
e.g.
ASSIA
Subject
specific
e.g. MEDLINE
Evidencebased
Research
Councils
Research
Reference
lists
Databases
Contact with
researchers/
practitioners
SOURCES
Handsearching
Grey
literature
Conference
proceedings
Published
copies
Indexes
Pharmaceutical
industry
OPACs
Databases
Direct
contact
Internet
Sources of Qualitative Research - 1
Journal Articles
• ASSIA
• British Nursing Index
• CINAHL
• ERIC
• MEDLINE
• Social Science Citation Index
• Sociological Abstracts
Sources of Qualitative Research - 2
Dissertations
• Dissertation Abstracts
• Index to Theses
• CINAHL
Books and Book Chapters
• British Library OPAC
• COPAC
• Specialist Library Collections
Case Study
• You are working on an ESRC funded
project looking at the benefits of a doula
(a woman experienced in childbirth who
provides continuous physical,
emotional, and informational support to
the mother before, during and just after
childbirth) for low-income mothers.
Our example of SPICE
• SETTING – the Developed World (with
comparable health systems to the UK)
• PERSPECTIVE – Low-income mothers
• INTERVENTION – Doula (Lay support)
• COMPARISON – Professional support
[or No Support]
• EVALUATION – Perceived levels of
social support, birth outcomes, levels of
breastfeeding etc.
Example of Search Strategy in Cinahl
Example of Search Strategy in Cinahl
Subject headings
Identifying Qualitative Research - Terminology
• Generic terms: e.g. “qualitative” plus
• Exploratory Methods: Focus group, Grounded theory,
Action Research, Content analysis, Thematic
analysis
• Software: Nudist or NVivo
• Citations: Glaser & Strauss
• Application: Ethnology, Psychology
• Phenomenon: Perceptions, Attitudes, User Views,
Standpoint, Viewpoint
• Approaches: Ethnographic
• Data: Stories, Narratives, Descriptions, Themes,
Findings
• Experiences: Encounters, Experiences
Exercise
Identifying Qualitative Research from Abstracts
• Using the handout provided consider
the six references taken from Cinahl or
Medline.
• For each references mark all the words
or phrases that identify the item as
qualitative research.
Feedback from Exercise Two
Recap on the session so far
• Challenges in searching for qualitative
research
• Sources
• Tools to help with your question
• Case Study
• Keywords and subject headings to
consider
Part Two: Search Filters and
other search techniques
• Methodological filters
• Using a key citation to identify research
• Using the web to find research
What is a methodological filter?
• “A hedge or filter is a standardised search strategy
that is designed to be used in conjunction with a
subject search to retrieve valid studies from the
(primary) medical literature”.
• Filters work in one of two ways:
– by identifying particular publication types or
study designs most likely to answer a question
– by isolating subject or free-text terms most likely
to be associated with high-quality studies
How do they work?
• Filters come from 3 different sources:– Subject heading
– Keyword
– Publication type
How do I use a methodological filter?
Step One: Carry out a subject search as
usual using subject headings and/or
free text
Step Two: Apply methodological filter
appropriate to question you are asking
• One-line filter
• Maximum sensitivity filter
• Maximum specificity filter
• Mid-range filter
For today, some one-liners ...
• MeSH Heading
– e.g. Qualitative Research [Medline 2003-]
• Keyword
– “Findings”
• Publication Type
– Research [CINAHL only]
Methodological filters 1
MEDLINE
1.
2.
3.
4.
5.
Nursing-Methodology-Research.DE.
qualitative ADJ research
grounded ADJ theory
ethnograph$
1 or 2 or 3 or 4
Marks S. “Qualitative Studies”. In McKibbon A, editor. PDQ EvidenceBased Principles and Practice. 1st ed. Hamilton: B.C. Decker, Inc.; 1999.
pp 187-204
Methodological filters 2
1.
2.
3.
4.
5.
qualitative$
findings
interview$
interviews.DE.
1 OR 2 OR 3 OR 4
Grant MJ. “How does your searching grow? A survey of search
preferences and the use of optimal search strategies in the identification of
qualitative research.” Health Info Libr J. 2004 Mar; 21(1):21-32.
Methodological filters 3
Sensitivity-maximising filter
interview$ or px.fs. or health-services-administration.DE.
Specificity-maximising filter
qualitative or themes
Optimised filter
interview$.TI. or interview$.AB. or interview$.DE. or
experience$.TI. or experience$.AB. or experience$.DE. or
qualitative
Adapted from Wong SS, Wilczynski NL, Haynes RB. “Developing
Optimal Search Strategies for Detecting Clinically Relevant Qualitative
Studies in MEDLINE”. Medinfo. 2004; 2004:311-6.
Definitions
• Sensitivity: the ability of a search
strategy to identify relevant records
• Specificity: the ability of a search
strategy to exclude irrelevant records
Spring M. (2008). Applying the principles of EBM to public
health – searching for public health evidence – the
experience at the National Institute for Health and Clinical
Excellence (NICE). Eahil conference, Held on 23-28 June,
Helsinki, Finland.
Methodological filters 4 – Ovid MEDLINE
Best Sensitivity
• interview:.tw. OR px.fs. OR exp health services
administration
Best Sensitivity – Small decrease in Sensitivity with
large increase in Specificity
• interview:.mp. OR px.fs. OR qualitative.tw.
Best Specificity
• qualitative.tw. OR themes.tw.
Best Specificity – Small decrease in Specificity with
large increase pin Sensitivity
• interviews.mp, t. OR qualitative.mp. OR
experiences.tw.
Best Optimization of Sensitivity and Specificity
• interview:.mp. OR experience:.mp. OR qualitative.tw.
Methodological filters - 5
• Don’t forget MeSH heading Qualitative
Research
– Introduced in 2003, so coverage is limited
– But you can combine it with one of the
previous filters by using the “OR” operator
Methodological filters - 5
• Best sensitivity: exp interviews
• Best specificity: audiorecording.sh.
• Best optimization of sensitivity and specificity:
exp study design
• Wilczynski NL, Marks S, Haynes RB. Search
strategies for identifying qualitative studies in
CINAHL. Qual Health Res. 2007 May;17(5):705-10.
Methodological Filters – 6
EMBASE
Best Sensitivity (Single term)
• interview:.mp.
Best Sensitivity (Combination)
• interview:.mp. OR qualitative.tw. OR exp health care
organization
Best Specificity (Single term)
• qualitative.tw.
Best Specificity (Combination)
• qualitative.tw. Or qualitative study.tw.
Best Optimization of Sensitivity and Specificity
(Single)
• exp health care facilities and services
Best Optimization of Sensitivity and Specificity
(Combination)
• interview.tw. OR exp health care organization OR
experiences.tw.
So how does this work in practice?
You are conducting a systematic review to examine
the lack of support available for the husbands of
women who have been diagnosed with breast
cancer.
The review commissioners want to answer “what
counselling and support services should be offered in
response to the husbands’ needs?”
You start by searching Medline for published
accounts of the husbands’ attitudes to their wives’
disease.
Example 1
SPICE breakdown
• You break search down into following components:
Setting:
Perspective:
Intervention/
Exposure:
Comparison:
Evaluation:
Primary and Community Care
Husbands
Wife with breast cancer
[Perhaps] the needs of the
wives themselves
Attitudes
Example 1 continued
Mapping to Subject Headings
• Match SPICE components to relevant MeSH
or other headings (if any):
Setting:
Perspective:
Exposure:
Comparison:
Evaluation:
[Primary-Health-Care]
Spouses
Breast-Neoplasms
???
Attitude-To-Health
Example 1 continued
Search strategy
1. husband$ OR Spouses.W..DE.
2. 1 AND Breast-Neoplasms#.DE.
3. 2 AND (qualitative OR interview$ OR
findings OR Interviews.W..DE. OR
Attitude-To-Health#.DE.)
Note that in line 3 we have used Grant’s filter
Example 1 continued
Citation Searching
We identify a key
methodological or
subject text
Using the Web to Identify
Qualitative Research
Google Scholar
(scholar.google.com)
Scirus
http://www.scirus.com/
Scirus
Research from Flemming & Briggs
(2007)
• Findings showed that a simple search
strategy (broad-based terms - 3 search
terms) was as effective as a complex one
(free text - 48 search terms) in locating
qualitative research on patients’ experiences
of living with a leg ulcer.
• It may be feasible to restrict searches with a
clear nursing focus to the CINAHL
bibliographic database.
• Replication of findings with other nursing
topics is required.
Learning Outcomes
• Describe the particular challenges inherent in
identifying qualitative research
• Apply appropriate tools to focus a qualitative
question
• Identify key terms to assist retrieval of
qualitative research
• Demonstrate an awareness of search filters
for qualitative research
References - 1
• Flemming K, Briggs M. Electronic searching to locate
qualitative research: evaluation of three strategies. J
Adv Nurs. 2007 Jan;57(1):95-100.
• Grant MJ. How does your searching grow? A survey of
search preferences and the use of optimal search
strategies in the identification of qualitative research.
Health Info Libr J. 2004 Mar; 21(1):21-32
• Marks S. Qualitative studies. In: McKibbon A, Eady A
and Marks S. PDQ evidence-based principles and
practice . Hamilton, Canada: BC Decker Inc., 1999.
References - 2
• Spring M. (2008). Applying the principles of EBM to
public health – searching for public health evidence –
the experience at the National Institute for Health and
Clinical Excellence (NICE). Eahil conference, Held on
23-28 June, Helsinki, Finland
• Wilczynski NL, Marks S, Haynes RB. Search
strategies for identifying qualitative studies in
CINAHL. Qual Health Res. 2007 May;17(5):705-10.
• Wong SSL, Wilczynski NL, Haynes RB. Developing
optimal search strategies for detecting clinically
relevant qualitative studies in Medline. Medinfo
2004;311-314.