MEDLINE
Search Strategies: Physical Inactivity
This
is where we will figure out search strategies for evidence to support
of estimates of population attributable fractions, search strategies
to substantiate causal web links, and search strategies for prevention.Papers
concerning physical inactivity are indexed under the Medical Subject
Heading (MeSH) exercise.
For example, you search under "exercise[mesh] AND n engl j med"
(without quotation marks), you will find recent evidence (preconstructed
search) about the importance of physical activity as published
in the New England Journal of Medicine. [Note that these
preconstructed searches on this page are links to the search strategy,
not the static results, so the results will always be current.]
Downstream
Effects of Physical Inactivity
We can use the Surgeon
General's Report on Physical Inactivity and Health
(though this was published in 1996) to get an idea of where to look
for the main outcomes. These can then be expanded, based on more recent
data. Here are some important outcomes, by common name(s) and MeSH:
| Outcome |
exercise
is MeSH. For the outcomes below, use the
National Library of Medicine's MeSH
Browser to find the most useful terms (MeSH terms)
|
| death,
mortality, years of life lost |
mortality |
| coronary
heart disease |
myocardial
ischemia (encompasses narrower MeSH, such as coronary disease
or myocardial infarction or angina pectoris) |
| diabetes |
diabetes
mellitus, non-insulin-dependent (note that there are different
MeSH for diabetic-related health problems, such as diabetic
retinopathy, diabetic nephropathies, diabetic foot, etc...see
the broad MeSH diabetes mellitus for links to these) |
| high
blood pressure, hypertension |
hypertension |
| high
cholesterol |
hypercholesterolemia
(note that hyperlipidemia is broader) |
| overweight,
excess body weight |
body
mass index is often useful |
| obesity
(a pathologic condition) |
obesity |
| breast
cancer |
breast
neoplasms |
| colon
cancer |
colonic
neoplasms |
| etc |
|
Note also, many
of the above outcomes are major indications for drug therapy, which
accounts for 15-20% of health care costs. Specific pathways could
be mapped.
Contribution
to Overall Burden (Attributable Burden)
To make this calculation,
we need to determine both relative risk and prevalence:
| Concept |
MeSH
(search with exercise) |
| relative
risk |
risk
captures this concept ("risk assessment" is narrower
but this may miss key studies) |
| prevalence |
prevalence |
| population
attributable risk |
no
close match...search as word string with quotes ("population
attributable risk") |
Upstream
Causes of Physical Inactivity
The Medical Subject
Heading (MeSH) socioeconomic factors (which encompasses narrower concepts
such as career mobility, educational status, employment, family characteristics,
income, medical indigency, occupations, poverty, social change, social
class, and social conditions -- several of which encompass still more
specific MeSH) can be searched in MEDLINE for papers that are also
indexed under the MeSH exercise. However, if we conduct the search
exercise[MeSH]
AND "socioeconomic factors"[MeSH], we find many hundreds
of papers...too many to be useful and many of which touch only parenthetically
on either exercise or socioeconomic factors.
There are several
alternative approaches. For example, the above search strategy (which
is very broad) could be limited to papers that were published in the
Am J Public Health.
This produces an interesting
list of papers that most public health workers can read without a
special trip to the library.
Or,
we could search under a MeSH that is more specific than socioeconomic
factors (follow the link to see the possibilities).
Or, we could use
another MeSH that is separate (in MeSH taxonomy) from socioeconomic
factors, such as social environment. A search for exercise[MeSH]
AND "social environment"[MeSH] finds another body of
literature (though there is some overlap). To make this search more
specific, these
MeSH could be designated as the major topics of the papers.
What other social
MeSH should be employed in researching the social determinants of
physical inactivity?
|
Physical
Inactivity
Overview
Contribution
to overall disease burden in SF
Downstream
(Health Consequences)
Upstream
Causes
What
can be done?
Web
resources
MEDLINE strategies |
