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Clinical Essentials: Find health information: Literature Search

Find health information strategically

 

Do a literature search: step-by-step

 

Process

     Define the question

     Concentrate on the key concepts

     Gather search terms

     Write the search statement

     Search a database

     Make search refinements

 

Step 1: Define the question

Use the PICO mnemonic to frame your clinical question.

This framework will help you generate search terms.

 

►  Determine the PICO components of your question

 

P Problem, Patient, and/or Population – Who is the patient or population?
– What is the problem, condition, or issue?
I Intervention or Exposure – What is the proposed treatment?
– What is the proposed test or procedure?
– What is the factor of interest?
C Comparison – Am I comparing with another intervention or exposure?
O Outcome – What do I hope to improve, measure, or accomplish?

 

Example PICO
Problem: heart attack
Intervention: aspirin
Comparison: other antiplatelet aggregators
Outcome: heart attack prevention

 

►  Frame the PICO question

 

Example PICO question

For patients with a history of heart attacks (P), is aspirin (I) more effective than other antiplatelet aggregators (C) in preventing further heart attacks (O)?

 

Use a template to frame your PICO question →

 

Step 2: Concentrate on the key concepts

Less is more.

If you search on just a few ideas, you will impose fewer restrictions and retrieve more extensive search results.

 

►  Focus on 2 or 3 ideas from your question

 

Recommendation

Search these concepts first:

  Problem

  Intervention

 

Why these two concepts?

In general, the problem and intervention are defined more clearly in publication titles and abstracts.

 

Step 3: Gather search terms

Researchers use different terms to describe the same idea.

Therefore, search using a range of synonymous terms to find literature comprehensively.

 

►  Collect similar terminology for each concept

Consider the following types of similar terms:

 

Types of similar terms Examples
Synonyms hypertension, high blood pressure
Acronyms AIDS, ALS, MRI, SIDS
Abbreviations CO2, bp, ddx
Plurals viscus – viscera, femur – femora
Professional or research terms cerebrovascular accident for stroke
Slang or vernacular terms bounceback for readmission
Different spellings pediatrics – paediatrics (US & UK)
Related concepts cancer, malignancy, tumor

 

Try additional ways of gathering search terms:

►  Consider other types of similar terms → 

►  Review background sources (like UpToDate or Wikipedia) to find more expressions.

►  Run a preliminary database search and examine the results for helpful language.

 

Example search terms
Problem:

heart attack
myocardial infarction
heart infarction
AMI
MI

Intervention: aspirin
acetylsalicylic acid
ASA

 

Step 4: Write the search statement

The search statement is the text entered into the search box.

 

►  Arrange your search terms in this pattern

 

Search statement template


(  __  OR  __  OR   __  )  AND  (  __  OR  __  OR   __  )

 


Fill in the blanks with
Concept #1 terms

Fill in the blanks with
Concept #2 terms

 

Add more search terms or concepts using the proper operator: OR, AND, or ( ).

 

Example search statement

(heart attack OR myocardial infarction OR heart infarction OR AMI OR MI) AND (aspirin OR acetylsalicylic acid OR ASA)

 

The search operators define the logical relationships between search terms. Here are the ways:

►  OR joins similar terms – such as synonyms and related concepts.

►  AND combines different concepts.

►  Parentheses ( ) group together similar terms into a conceptual unit.

Learn how search operators work →

 

Step 5: Search a database

Databases are searchable collections of information.

You have several database options for health literature searching.

 

►  Choose a database specializing in your topic

We recommend the following databases as starting points for your research.

 

  Databases for extensive searching

Use the following databases for a comprehensive literature search.

They are suitable for research projects.

 

Topic Area Databases
All health specialties PubMed All health topics. A popular database.
Embase All health topics. Specialized in pharmacology.
Psychiatry and psychology PsycInfo Behavioral and social sciences focus
Nursing and allied health CINAHL Nursing and allied health (OT, PT, RD, SLP) literature
Life sciences BIOSIS Biology, genetics, and basic health sciences focus
Multidisciplinary Web of Science

Google Scholar
Diverse research fields. Beneficial for multidisciplinary topics.

Find databases in other subject areas →

 

  Databases for summaries of research

Use the following databases to find reviews of research literature.

Reviews are helpful when you're short on time.

 

Types of Reviews Databases
Literature reviews and
Systematic reviews
PubMed

Embase
Filter your search results for reviews or systematic reviews
Summaries UpToDate Find clinical recommendations and research summaries

 

  Databases for clinical support

Use the following databases to find research on clinical practice and care.

Caution: Search results in these databases may exclude non-clinical literature.

 

Type Databases
Clinical search engines PubMed Clinical Queries Filter results for therapy, diagnosis, etiology, prognosis, and clinical prediction guides
TRIP Search evidence-based information for clinical practice and care

 

►  Run the search

Enter your search statement into the database search box.

 

Example search
(heart attack OR myocardial infarction OR heart infarction OR AMI OR MI) AND (aspirin OR acetylsalicylic acid OR ASA)

View this search in a database:

PubMed
Google Scholar
Trip

 

To get a comprehensive search, use multiple databases.

 

Step 6: Make search refinements

 

►  Evaluate the search results for gaps

 

Search gaps
Relevance Do the publications address your research question?
Coverage Do the results cover your research topics? Are there missing topics?
Level Are the publications too specialized? or too general?
Size Is the quantity of results lower than expected? or higher?
Error Are there notifications of database errors?

 

►  Change the scope of the search

 

When this happens: Try to:
I have many results that do not relate to my topic Focus the search
I have too few results Expand the search
  Ways to focus the search

 

Use a more specific topic Instead of: mental illness
Search for: depression

Instead of: back pain
Search for: low back pain

 

Place “double quotes” around phrases Instead of: quality of life
Search for: “quality of life”


Double quotes let you define precisely how the words will appear.


Without them, results may have the terms in a different order.

 

Apply filters Use the sidebar filters to sift through results by features, including publication date, article type, study design, and more.

PubMed filters in the sidebar

PubMed filters in the sidebar

 

Use controlled vocabulary to enhance the search

Controlled vocabulary is the standardized terms that describe and categorize medical topics in a database. 

Databases mark publications with controlled vocabulary to summarize the subject matter.

 

How to use controlled vocabulary in a PubMed search:

PubMed's controlled vocabulary is MeSH, short for Medical Subject Headings.


– When you find a relevant publication, go to the "MeSH terms" section in the PubMed record.

– Make a note of the MeSH terms of interest, and then add them to your search statement.


More information: Controlled vocabulary searches in PubMed →

 

Add an extra topic Instead of: mental health AND exercise
Search for: mental health AND exercise AND mood

 

Try more ways to focus the search → 

  Ways to expand the search

 

Add similar terms Instead of: hypertension
Search for: hypertension OR high blood pressure

Instead of: quality of life
Search for: quality of life OR patient satisfaction OR resilience

 

Use a broader topic Instead of: aortopulmonary septal defect
Search for: congenital heart defects

 

Examine similar articles Databases can suggest comparable publications for an article.

In PubMed, turn to the "Similar articles" section beneath the item's abstract.

 

Eliminate a topic Instead of: heart attack AND aspirin AND high blood pressure
Search for: heart attack AND aspirin

 

Try more ways to expand the search → 

 

Repeat

A literature search is an iterative process. You will:

–  Run a preliminary search
–  Evaluate the search results
–  Address any gaps by revising the search strategy
–  And repeat the process