Outpatients vs Inpatients

Medline:

Outpatients:

"Outpatients"[Mesh] OR "Outpatient Clinics, Hospital"[Mesh] OR "Ambulatory Care"[Mesh] OR "Ambulatory Care Facilities"[Mesh] OR "Community Health Services"[Mesh] OR "Community Health Centers"[Mesh] OR "Community Health Planning"[Mesh] OR "Community Medicine"[Mesh] OR "Primary Health Care"[Mesh:NoExp] OR "General Practice"[Mesh] OR "House Calls"[Mesh] OR "Day Care, Medical"[Mesh]

Now, some of these terms are narrower terms of Ambulatory Care Facilities. So you may be thinking, why not clean this up a bit? However, sometimes if you go too broad, you lose some of the narrowest terms (see my post about this) so I kept them in just to be sure to get everything.

Keywords: outpatient*[tiab] OR out-patient*[tiab] OR ambulatory[tiab] OR communit*[tiab] OR family practi*[tiab] OR "general practice"[tiab] OR general practitioner*[tiab] OR "primary care"[tiab] OR "primary health care"[tiab] OR "primary healthcare"[tiab] OR "family medicine"[tiab] OR "family health"[tiab] OR "office based"[tiab] OR officebased[tiab]

Additional MesH which may or may not be relevant to your question:
"Ambulatory Surgical Procedures"[Mesh] OR "Community Psychiatry"[Mesh] OR "Community Dentistry"[Mesh] OR "Community Health Workers"[Mesh] OR "Nurses, Community Health"[Mesh] OR "Primary Care Nursing"[Mesh] OR "Physicians, Primary Care"[Mesh] OR "Physicians, Family"[Mesh] OR "General Practitioners"[Mesh]

Nursing Homes and Group Homes are usually considered Outpatient rather than Inpatient, but make the best decision for your question:
"Residential Facilities"[Mesh]

These are sometimes inpatient and sometimes outpatient:
"Residential Treatment"[Mesh] OR "Long-Term Care"[Mesh]

Inpatients:

"Inpatients"[Mesh] OR "Hospitalization"[Mesh] OR "Hospital Units"[Mesh] OR Hospitals[Mesh] OR "Hospital Departments"[Mesh:NoExp] OR "Institutionalization"[Mesh] OR "Child, Hospitalized"[Mesh] OR "Child, Institutionalized"[Mesh] OR "Adolescent, Hospitalized"[Mesh] OR "Adolescent, Institutionalized"[Mesh]

Keywords: inpatient*[tiab] OR in-patient*[tiab] OR hospitaliz*[tiab] OR hospitalis*[tiab] OR residential*[tiab] OR institutionaliz*[tiab] OR institutionalis*[tiab] OR admitted[tiab] OR admission[tiab] OR readmission[tiab]

Additional MeSH which may or may not be relevant to your question:
"Health Facility Environment"[Mesh] OR "Anesthesia Department, Hospital"[Mesh] OR "Cardiology Service, Hospital"[Mesh] OR "Emergency Service, Hospital"[Mesh] OR "Nuclear Medicine Department, Hospital"[Mesh] OR "Obstetrics and Gynecology Department, Hospital"[Mesh] OR "Oncology Service, Hospital"[Mesh] OR "Psychiatric Department, Hospital"[Mesh] OR "Radiology Department, Hospital"[Mesh] OR "Surgery Department, Hospital"[Mesh] OR "Urology Department, Hospital"[Mesh]

This list does not include all of the departments listed under the MeSH term Hospital Departments – it focusses on the clinical ones. You may wish to check the list to make sure that nothing relevant has been missed.
https://www.ncbi.nlm.nih.gov/mesh/?term=hospital+departments

CINAHL:

Outpatients:

MH "Outpatients" OR MH "Outpatient Service" OR MH "Ambulatory Care Facilities+" OR MH "Ambulatory Care" OR MH "Community Health Services+" OR MH "Community Health Centers+" OR MH "Community Medicine" OR MH "Community Living" OR MH "Rehabilitation, Community-Based" OR MH "Primary Health Care" OR MH "Family Practice" OR MH "Home Health Care+" OR MH "Day Care" OR MH "Respite Care"


MH "Ambulatory Surgery" OR MH "Ambulatory Care Nursing" OR MH "Community Health Nursing+" OR MH "Community Health Workers"  OR MH "Physicians, Family" OR MH "Home Nursing"

MH "Residential Facilities+" OR MH "Residential Care" OR MH "Long-Term Care"

Inpatients:

MH "Inpatients" OR MH "Institutionalization+" OR MH "Hospital Units+" OR MH "Hospitals+" OR MH "Health Facility Departments"

MH "Health Facility Environment" OR MH "Anesthesiology Service" OR MH "Emergency Service+" OR MH "Obstetric Service" OR MH "Psychiatric Service" OR  MH "Radiology Service"

Again, I selected the most clinical-sounding Health Facility Departments.

EMBASE:

Outpatients:

exp community care/ OR exp community medicine/ OR exp community living/

exp outpatient/ or exp outpatient department/ or exp community care/ or exp community mental health center/ or exp community medicine/ or exp primary health care/ or exp general practice/ or exp home care/ or exp day care/

exp ambulatory surgery/ or exp social psychiatry/ or exp health auxiliary/ or exp general practitioner/

exp residential home/ or exp residential care/ or long term care/ or exp institutional care/

Inpatients:

exp hospital patient/ or exp hospitalization/ or exp hospital admission/ or exp hospital readmission/ or exp child hospitalization/ or "hospital subdivisions and components"/ or exp hospital/

exp delivery room/ or exp heart center/ or exp hospital department/ or exp operating room/ or exp radiology department/ or exp recovery room/ or exp ward/

Articles by occupational group including unspecified

Sometimes you get a question about a particular healthcare occupation.

Sometimes you can take the associated MeSH term and just add it to your search: AND "Physicians"[Mesh]

However, sometimes, especially for ethical questions, there are lots of good articles which don't specify the occupational group, and you want to include those. Here's where the famous double NOT comes in handy.

Example: Physicians and unspecified:
NOT ("Health Personnel"[Mesh] NOT ("Faculty, Medical"[Mesh] OR "Medical Staff"[Mesh] OR "Physicians"[Mesh]))

For the search I'm doing today, the double NOT search returned 775 articles, whereas "Physicians[Mesh] returned 88 results.

Return to Work

MeSH: "Return to Work" added 2013.

For older articles, Use (return* adj3 work*).ti,ab,kw. and (resum* adj3 work*).ti,ab,kw. in Ovid, as well as (work resumption or job re-entry or job reentry or reemployment or re-employment).ti,ab,kw.

(return* adj3 active duty).ti,ab,kw may also be useful if soldiers are involved.

EMBASE: exp return to work/ or exp work resumption/
(see above for keywords)

CINAHL has MH "Job Re-entry"

PsycInfo has DE "Reemployment"

plus of course: TI return* N3 work* OR AB return* N3 work*

In the Operating Room

Yes, it's that time again! Time for a Settings question!

"Operating Rooms"[Mesh] OR "Surgery Department, Hospital"[Mesh] OR "Intraoperative Complications"[Mesh] OR "Surgical Procedures, Operative"[Mesh]

keywords: "operating room"[tiab] OR "operating rooms"[tiab] OR "operating theatre"[tiab] OR "operating theatres"[tiab] OR "operating theater"[tiab] OR "operating theaters"[tiab] OR "surgical theatre"[tiab] OR "surgical theatres"[tiab] OR "surgical theater"[tiab] OR "surgical theaters"[tiab] OR "surgical room"[tiab] OR "surgical rooms"[tiab] OR "surgical department"[tiab] OR "surgical departments"[tiab] OR "surgical ward"[tiab] OR "surgical wards"[tiab] OR "surgery ward"[tiab] OR "surgery wards"[tiab]


CINAHL:
MH "Operating Rooms" OR MH "Operating Room Personnel+" OR MH "Surgery, Operative+" OR MH "Intraoperative Complications+"

MH "Operating Room Information Systems" - maybe? Depends on your question.

Keywords: operating room* OR operating theat* OR surgical theat* OR surgical room* OR surg* department* or surg* ward*


EMBASE:
exp operating room/ or exp surgical ward/ or exp surgery/ or exp peroperative complication/ or exp operating room personnel/ or exp surgeon/

keywords: 
(operating room* or operating theat* or surgical theat* or surgical room* or surg* department* or surg* ward*).ti,ab.

When Ovid won't map to a known MeSH term

OK, here is a weird thing. If you search "documentaries and factual films" in Ovid (note the quotes to deal with the "and"), you will receive the notice: Ovid was unable to map your term 'documentaries and factual films' to a subject heading.

However, this term is definitely a MeSH term. You can find it in the MeSH database (it is a Publication Type), and it has been called this since 2008 (it was called something else 1997-2008).

Weird! Since it is a publication type, we tried searching "documentaries and factual films".pt. in Ovid, and got zero results. Which was a clue, but we didn't know it at the time.

We then thought, OK, we'll search it in PubMed, and find an article, and then look at the Complete Reference for that article.

However, when we searched it in PubMed, it turned out that there were zero results. Not a single document has been labelled with this publication type since 1997!

(Which kind of made us wonder why it is a publication type at all. I mean, why is this a publication type and systematic review is not a publication type?!? But I digress...)

And this explains Ovid's behaviour too. Although the exact algorithm that Ovid uses is proprietary, it's generally known that Ovid takes the term you enter, looks for it in an unknown set of fields in the articles in its database, and then returns the most prevalent MeSH terms in the articles containing that term. Since this is a MeSH term that has never been used, and the phrase is stilted enough that apparently it doesn't appear in any titles and abstracts either, no results were found.

Now, I presumed from some of Ovid's other behaviour, that it searched the MeSH database directly as well as looking for the phrase in the titles, abstracts, and indexing of individual articles. I thought that's why a search for public health returned public health but not public health surveillance and other terms containing the words "public health". I presumed that the algorithm found an exact match in the MeSH database and therefore stopped looking. However, if that were true, then this search would have returned exp "Documentaries and Factual Films"/ with zero results.

No, I think this means that a direct search in the MeSH database is not part of Ovid's mapping algorithm. Instead, I guess it does search of articles every single time, even if the entry is exactly the same as a MeSH term. Then, it must generate a list of potential MeSH, and then (get this!) it must delete all of the other found MeSH if there is an exact match. (Whaaat?!?)

Well, I'm sure that it makes sense to someone, somewhere.

Anyway, if you search a known MeSH in the Ovid interface and get an error message, try confirming in PubMed to see if there are zero results. BTW, typing exp "Documentaries and Factual Films"/ did not produce an error message. There were, of course, zero results.

Thanks to my colleague Robert for bringing this to my attention.

If you can't find any reviews...

My colleague Angela totally saved me today. I was doing this search on spinal/epidural anesthetics for C-sections, and all I could find was studies. Seriously, where were the reviews? It didn't seem possible that there were no reviews, and yet, I couldn't find any (in Medline).

My MeSH terms were: "Anesthesia, Spinal"[Mesh] OR "Anesthesia, Epidural"[Mesh]

Which seemed reasonable at the time, but there were no reviews.

Angela did the peer review on my search and was also surprised that there were no reviews. A few minutes later she came back with a Cochrane review exactly on topic. Whaaat?

So, it turns out that the Cochrane review was indexed with the broader term of the two MeSH that I used, which is "Anesthesia, Conduction"[Mesh]. I'd come across two other terms for this (regional and neuraxial) but not conduction, so I had assumed it was too broad.

I think this might be a bit like the rule of three situation that sometimes occurs. Anyway, I'm thinking that when there aren't many reviews for a topic which would seem to be a good one for reviews, a good strategy would be to check out some broader terms, since reviews tend to be broader in scope than studies.

I'll try it out a few times and report back whether it's a broadly applicable strategy or just applies in this instance.

Children

Apparently I don't have a blog posting for searching for info about children

This is useful when the limits ("Adolescent"[Mesh] OR "Child"[Mesh] OR "Infant"[Mesh])
 just aren't doing it for you. Which is kind of often, because of the whole "is 18 years an adolescent or an adult" thing, plus the whole reviews-don't-require-checktags thing.

If you're looking for everything you can find:

child[all fields] OR children[all fields] OR childhood[all fields] OR pediatr*[all fields] OR paediatr*[all fields] OR juvenile*[all fields] OR adolesc*[all fields] OR teen*[all fields] OR youth[all fields] OR boy[all fields] OR boys[all fields] OR girl[all fields] OR girls[all fields] OR infan*[all fields] OR newborn*[all fields] OR neonat*[all fields] OR toddler*[all fields] OR preschool*[all fields] OR pre-school*[all fields] OR school age*[all fields] OR elementary[all fields] OR high school*[all fields] OR secondary school*[all fields] OR grade school*[all fields] OR preteen*[all fields] OR pre-teen*[all fields] OR prepubescen*[all fields] OR pre-pubescen*[all fields] OR middle school*[all fields] OR schoolchild*[all fields]

If you're trying to narrow to just the pediatric-specific stuff:

child*[tiab] OR pediatr*[tiab] OR paediatr*[tiab] OR juvenile*[tiab] OR adolesc*[tiab] OR teen*[tiab] OR youth[tiab] OR boy[tiab] OR boys[tiab] OR girl*[tiab] OR infan*[tiab] OR newborn*[tiab] OR neonat*[tiab] OR toddler*[tiab] OR preschool*[tiab] OR pre-school*[tiab] OR school age*[tiab] OR elementary[tiab] OR high school*[tiab] OR secondary school*[tiab] OR grade school*[tiab] OR preteen*[tiab] OR pre-teen*[tiab] OR prepubescen*[tiab] OR pre-pubescen*[tiab] OR middle school*[tiab] OR schoolchild*[tiab]

For Ovid Medline:

(child* OR pediatr* OR paediatr* OR juvenile* OR adolesc* OR teen* OR youth OR boy OR boys OR girl* or infan* or newborn* or neonat* or toddler* or preschool*or pre-school* OR school age* OR elementary OR high school* OR secondary school* OR grade school* OR preteen* OR pre-teen* OR prepubescen* OR pre-pubescen* or middle school* or schoolchild*).ti,ab.