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Clinical Essentials: Search

Find health research literature strategically

1. Frame the question

Your question is a critical guide to the search process.

 

Template

For PATIENTS with PROBLEM, can INTERVENTION compared to COMPARISON lead to OUTCOME?

                      

Patient, Problem  Characteristics of the patient, condition, or issue
Intervention / Indicator Specific drug, procedure, exposure, or characteristic
Comparison  Alternative being considered
Outcome   Goal or improvement

Example

For elderly females with type 2 diabetes, can eating cinnamon with prescribed medications compared to medication alone improve fasting blood glucose levels?


 

   

2. Choose search terms

Extract the PATIENT, PROBLEM, and INTERVENTION concepts from your question.

And then identify the SYNONYMS of these terms.

 

Example

Concepts Synonyms
type 2 diabetes noninsulin dependent diabetes maturity onset diabetes mellitus
cinnamon cinnamomum

 

 

Note
We excluded the patient demographic terms (elderly, female) to start with a broad and simple search. We can filter for demographic groups later.
 


 

3. Write the search statement

 

Template

 

Concepts   Synonyms
_______  OR  _______  OR  _______  )  AND
(  _______  OR  _______  OR  _______  )  AND
(  _______  OR  _______  OR  _______  )

 

Example

(  type 2 diabetes  OR   noninsulin dependent diabetes   OR   maturity onset diabetes mellitus   )  AND
( cinnamon   OR   cinnamomum  )

In a search engine, enter as a continuous line.

(type 2 diabetes OR noninsulin dependent diabetes OR maturity onset diabetes mellitus) AND (cinnamon OR cinnamomum)

See this search in PubMed


 

 

4. Search secondary sources

They summarize research studies and make clinical recommendations.

 

  Start with sources at the TOP OF THE TABLE and work your way down until you find a sufficient answer.

Type Recommended Sources

Summary Resources

UpToDate

DynaMed Plus

Clinical Guidelines

ECRI Guidelines Trust

Synopses of Systematic Reviews

Cochrane Library

Systematic Reviews
Comprehensive appraisals of studies on a focused question

PubMed Clinical Queries

Cochrane Library

Synopses of Studies

ACP Journal Club


 

 

5. Search primary sources

These are individual research studies. Use primary sources when secondary sources are not current, not in scope, or poor quality.

 

 

Type Recommended Sources

Studies filtered for clinical relevance

PubMed Clinical Queries

Unfiltered studies

PubMed

Embase


 

6. Refine the search

 

Filter for relevant parameters

In search results, activate filters for:

  • age group
  • date
  • sex
  • study design
  • and other parameters

 

 

Focus on the best evidence

Question Type

Best Research Design for Answer

Therapy

Randomized Controlled Trials (RCTs) are preferred

Etiology / Harm

1. Randomized Controlled Trials (RCTs) → best choice

2. Cohort Study

3. Case Control

4. Case Series

Diagnosis

Prospective, blind comparison to gold standard

Prognosis

1. Cohort Study → best choice

2. Case Control

3. Case Series

 

 

Exclude non-relevant results

Focus the Search Example
Add more concepts

POOR:    cancer

BETTER: cancer AND liver AND children

Add the COMPARISON and OUTCOME terms from your research question in Step 1.

Use more specific concepts Replace diabetes with type 2 diabetes
Exclude words with the NOT operator cancer NOT lung
Filter search results for conditions Filter by age group, study design, sex, publication date, etc.
Search a different database

PubMed

Embase

Google Scholar

Web of Science

 Find more databases

 

Get more results

Expand the Search Example
Add more synonyms and related terms (cancer OR neoplasms OR tumors)
Use broader concepts Replace type 2 diabetes with diabetes
Search for word variants

Use the asterisk operator for a truncation search

prevent* will retrieve

prevent

prevention

preventative

and more variants beginning with prevent

Remove concepts hepatitis AND treatment AND clinic locations
Use the related articles link in a result

Similar articles 

Mine the bibliography of a relevant article
Search a different database

PubMed

Embase

Google Scholar

Web of Science

→ Find more databases