Michael G. Kendrach

Google Scholar Versus PubMed in Locating Primary Literature to Answer Drug-Related Questions

Background: Google Scholar linked more visitors to biomedical journal Web sites than did PubMed after the databases initial release; however, its usefulness in locating primary literature articles is unknown. Objective: To assess in both databases the availability of primary literature target articles; total number of citations; availability of free, full-text journal articles; and number of primary literature target articles retrieved by year within the first 100 citations of the search results. Methods: Drug information question reviews published in The Annals of Pharmacotherapy Drug Information Rounds column served as targets to determine the retrieval ability of Google Scholar and PubMed searches. Reviews printed in this column from January 2006 to June 2007 were eligible for study inclusion. Articles were chosen if at least 2 key words of the printed article were included in the PubMed Medical Subject Heading (MeSH) database, and these terms were searched in both databases. Results: Twenty-two of 33 (67%) eligible Drug Information Rounds articles met the inclusion criteria. The median number of primary literature articles used in each of these articles was 6.5 (IQR 4.8, 8.3; mean ± SD 8 ± 5.4). No significant differences were found for the mean number of target primary literature articles located within the first 100 citations in Google Scholar and PubMed searches (5.1 ± 3.9 vs 5.3 ± 3.3; p = 0.868). Google Scholar searches located more total results than PubMed (2211.6 ± 3999.5 vs 44.2 ± 47.4; p = 0.019). The availability of free, full-text journal articles per Drug Information Rounds article was similar between the databases (1.8 ± 1.7 vs 2.3 ± 1.7; p = 0.325). More primary literature articles published prior to 2000 were located with Google Scholar searches compared with PubMed (62.8% vs 34.9%; p = 0.017); however, no statistically significant differences between the databases were observed for articles published after 2000 (66.4 vs 77.1; p = 0.074). Conclusions: No significant differences were identified in the number of target primary literature articles located between databases. PubMed searches yielded fewer total citations than Google Scholar results; however, PubMed appears to be more specific than Google Scholar for locating relevant primary literature articles.

Accuracy of Abstracts for Original Research Articles in Pharmacy Journals

BACKGROUND: Accuracy of abstracts representing original research articles is imperative since these are readily available and biomedical literature readers may not have access to the full-text article. Furthermore, previous reports document discrepancies in published original research abstracts compared with the full-text article. OBJECTIVE: To determine the accuracy of abstracts for original research articles published in nationally represented, widely circulated pharmacy-specific journals (American Journal of Health-System Pharmacy, The Annals of Pharmacotherapy, The Consultant Pharmacist, Hospital Pharmacy, Journal of the American Pharmacists Association, Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy) from June 2001 through May 2002. METHODS: Outcome measures included an omission, defined as data in the abstract not located in the article. In addition, abstracts were considered deficient if these included an omission, inaccurate factual (ie, qualitative and quantitative) information presented in the abstract that differed from information contained within the text, an inconsistency in following the “Instructions for Authors” for the respective journal, or a discrepancy between the placement of text in the manuscript and a structured abstract. RESULTS: A total of 243 abstracts for original research articles were published in selected journal issues. Evaluation of these abstracts identified 60 (24.7%) abstracts containing omissions; 81 (33.3%) abstracts contained either an omission or inaccuracy. A total of 147 (60.5%) abstracts were classified as deficient. CONCLUSIONS: Results of this analysis demonstrate that improvements are needed within abstracts for original research articles published in pharmacy-specific journals. Authors and peer reviewers should analyze the abstract contents closely to ensure that the abstract accurately represents the full-text article.

Blood Pressure Monitoring with Home Monitors versus Mercury Sphygmomanometer

OBJECTIVE: To determine the accuracy of three automatic monitors (arm, wrist, finger) for blood pressure measurement manufactured by Omron compared with a standard mercury sphygmomanometer. PRIMARY END POINT: Difference in the mean blood pressure readings from each monitor; the secondary end point was difference in pulse readings. DESIGN: A single-visit, crossover trial tested each device twice on the left arm of each participant; the average of the two readings was recorded. The pulse readings from each monitor were also recorded. ANOVA was used to compare mean blood pressure readings and pulse readings from each device. RESULTS: A total of 55 persons (mean age 53 y; 36 women) met inclusion criteria and completed the study. The mean systolic and diastolic readings obtained from the electronic arm unit were comparable to the mercury readings (124.4/78.02 vs. 129.45/77.87 mm Hg, respectively; p > 0.05 for both readings). The mean results obtained from the wrist and finger monitors differed significantly from those of the mercury readings (145.44/89.58 and 113.94/69.07 mm Hg, respectively; p < 0.05 for both monitors compared with control). No difference was measured in the mean pulse readings between the comparisons (p = 0.72). The absolute difference in systolic and diastolic blood pressure readings from control varied the least with the arm monitor. CONCLUSIONS: Compared with the mercury sphygmomanometer, the arm monitor was the most accurate in measuring blood pressure. The wrist and finger monitors resulted in statistically significant mean systolic and diastolic differences compared with the mercury sphygmomanometer.

A Survey of Drug Information Resources in Alabama Pharmacy Facilities

The primary purpose of this study was to evaluate the availability and usage of drug information (DI) resources in Alabama pharmacy facilities licensed by the Alabama State Board of Pharmacy. A survey consisting of questions regarding accessible DI resources and their usage was mailed to 1,430 pharmacy facilities, of which 604 (42%) were returned. The survey also consisted of other questions concerning personal data/digital assistant (PDA) usage, computer resources, types of DI questions answered, and other DI-related questions. Drug Facts and Comparisons was the most available and used resource for all pharmacy types; the PDR (Physicians Desk Reference) and OTC (over-the-counter) references were second and third, respectively. PDA usage was relatively low (19.5%) among all pharmacies, but hospital/mental health pharmacies had the highest usage (32.4%). The primary drug questions answered by pharmacists for all pharmacy types concerned drug interaction, adverse reactions, and OTC questions.

Understanding Statistical and Clinical Significance: Hypothesis Testing

This primer reviews a number of statistical concepts integral to the hypothesis testing process and its role in decision making. Concepts of variables, scales of measure, and measures of central tendency and dispersion are discussed, and a 5-step process of hypothesis testing is presented. Finally, a discussion of the statistical and clinical significance of research results is presented, along with the concept of confidence intervals as a method of conveying information about the effect size as well as the statistical significance of a difference between groups.

A Review of the Three Types of Biomedical Literature and the Systematic Approach to Answer a Drug Information Request

The pharmacist is relied upon to provide drug information on a daily basis for patients and health care professionals. Performing drug information tasks requires the ability to efficiently search, critically analyze, and objectively evaluate the biomedical literature. Pharmacists and pharmacy students need to understand the biomedical literature and an organized method to answer drug information questions. Therefore, the tertiary, secondary, and primary literature resources are defined and examples are presented. In addition, the modified systematic approach to answer a drug information request is reviewed. Understanding the different types of literature and applying the systematic approach assists practitioners in efficiently supplying drug information. The purpose of this article is to assist the pharmacist and pharmacy student in determining the strengths and limitations of the various types of literature and applying the systematic approach to a drug information inquiry.

Assessment of Electronic Drug Information Resource Availability in Alabama Pharmacies

The two primary objectives of this study were to identify available electronic drug information (DI) resources in licensed Alabama pharmacies and to identify common electronic resources to teach in the doctor of pharmacy curriculum at the McWhorter School of Pharmacy. A survey consisting of 10 questions was mailed to all licensed medication-dispensing pharmacy practices in Alabama (N = 1,562), of which 699 (44%) were returned for analysis, primarily by community and hospital practices (78.8% and 10.7%, respectively). The survey identified type of pharmacy, demographics, and availability and usage of electronic DI resources. Drug Facts and Comparisons, Internet search engine, the Pharmacists Letter, and Clinical Pharmacology were the most available electronic DI resources (59.5%, 48.6%, 42.3%, and 31%, respectively) among responding pharmacies. Drug Facts and Comparisons was the most common print-based resource; Lexi-Comp and Epocrates were the most utilized handheld DI resources.

Herbal Medicinals: A Clinician's Guide, 1st Edition: Heather Oakley, PharmD Candidate and Michael Kendrach, PharmD Miller LG and Murray WL, editors, 1998 Pharmaceutical Products Press New York, NY Number of Pages: 823

Miller LG and Murray WL, editors, 1998 Pharmaceutical Products Press New York, NY Number of Pages: 823 Since the use of herbal products is becoming an increasing trend in today’s society, pharmacists should be aware of different issues involving the efficacy and safety of these agents. In order to provide appropriate care to the patient, the pharmacist must be knowledgeable of the scientific evidence of efficacy plus potential interactions and side effects that can occur with each of these products. It is important for the pharmacist to counsel patients on the proper use of these products to prevent any harmful events that could occur while taking other medications. Herbal hfedicinals: A Clinician’s Guide serves as a resource to advise primarily health care professionals regarding the safe use of herbal products as well as how these products affect selected disease states. Since the two editors of this text (Lucinda Miller PharmD, BCPS and Wallace Murray PhD) are pharmacy educators, the content and presentation style can be easily integrated into cornprehensive patient care techniques. Furthermore, the 15 contributing authors (predominately pharmacists and physicians) discuss herb use in commonly encountered practice-related situations. The organization of the text begins with the table of contents followed by 17 chapters addressing different issues of herbal remedies. The first chapter provides a general overview of herbal remedies in terms of defining various terms (e.g., herbal medicinals, phytopharmaceuticals, nutraceuticals); differentiating between homeopathy and herbal remedies; discussing consequences of mislabeling herbals; and identifying the multiple uses of individual herbal medicinals. The remaining 16 chapters, with the exception of the last two chapters, focus on the use of herbal products in various medical conditions. For instance, Chapter 2 is titled “Renal Implications of Herbal Remedies”; other disease states include gastrointestinal disorders, rheumatoid/ osteoarthritis, diabetes, asthma, derrnatologic issues, and gynecological and obstetric concerns. The content arrangement is unique because each chapter begins with an introduction describing the particular medical condition accompanied by single paragraph case studies, which incorporate the use of various herbs. Following each case, study summaries (some brief, others extensive) reporting the use of the various herbs in this specific disorder are provided. Each chapter contains citations of the references with the complete listing of references in the bibliography at the end of the chapter. Helpful charts and tables are present in most chapters that present various information. Thelast twochaptersdonotpresent the herbal topics according to the disease-state chapter format. Chapter 16, titled “Specific Toxicologic Considerations of Selection Herbal Products,” discusses I 1 herbals that include shankhapushpi, gossypol, hawthorn, and gingko biloba.The arrangement is similar to the previous chapters beginning with the introduction, followed by case studies and discussions. The final chapter provides a historical perspective of herb use in the United States plus legal and regulatory perspectives. Topics reviewed include discussions of herbs as drugs in the USP. lists of unsafe herbs, Dietary Supplement Health and Education Act of 1994, and Commission on Dietary Supplement Labels. The last section of the text includes an extensive index that lists fopic subheadings with most terms cross-referenced by both scientific and common herbal names. This text is extremely unique since the case studies describe the beneficial and harmful effects of herbal medicinals in particular patient scenarios. Most case studies provide detailed descriptions of each herb followed by explanations for whether or not each product should be recommended given significant circumstances. The resource contains numerous tables and charts which organize the information in a manner that categorizes pertinent data relating to topics such as toxicity, dosing, adverse events, and interactions. Although Herbal Remedies: A Clinician ’5 Guide is an informative reference guide to obtain herbal medicinal information, a few limitations should be noted. The book does not completely discuss all of the herbal products that are available for therapeutic interventions. Also not all of the chapters are arranged in the same manner. For example, some chapters have an extensive overview of the disease state, whereas others just provide a brief review. In addition, tables are not within each chapter. Although, and understandably, the text is organized in a fashion that limits the ability to locate comprehensive herbal information (i.e., not an herbal monograph resource). Overall, Herbal Remedies: A Clinician’s Guide is an informative reference for pharmacists and other health care practitioners that provides pertinent information to make informative decisions. The text addresses important topics that tend to be overlooked in practice or not addressed in other herbal resources. Information (i.e., “evidence”) is provided that can guide pharmacists to effectively counsel patients regarding the appropriate use, potential adverse reactions and drug interactions that may occur while taking herbal products.

Effect of an Individualized Post-Examination Instructor Remediation on Pharmacy Student Performance in a Biochemistry Course

Objective. To assess the effectiveness of a post-examination, one-on-one instructor remediation process on student performance in a pharmacy biochemistry course by measuring the degree of score improvement on a subsequent examination. Methods. Students who scored below 70% on any examination were encouraged to meet with the course coordinator. A typical remediation session lasts about 30 minutes, and covers academic preparation, study habits, concept understanding, application, critical thinking, time management, and stress control. Scores in two consecutive examinations were compared between students who underwent remediation and those who did not. All scores were adjusted for level of difficulty. Results. At-risk students with relatively lower scores are more likely to seek remediation. After receiving a score below 70%, students perform better on the next examination regardless of remediation. However, the remediation process results in a statistically significant 43% increase in the degree of improvement in student performance on the next examination. Conclusion. A post-examination, one-on-one remediation is effective in enhancing student performance in the biochemistry course. As this course is one of the two with the highest failure rates in the PharmD program, current intervention might improve student retention.