Edwin Chan 1 Developing a search strategy / Slide 2 Edwin Chan
Evidence-Based Medicine (EBM) Resources 2 Slide 3 Edwin Chan
Systematic Reviews and Meta- Analyses The Cochrane Database of
Systematic Reviews The Database of Abstracts of Reviews of Effects
(DARE) 3 Slide 4 Edwin Chan Critically-Appraised Topics (Evidence
Syntheses) Clinical Evidence DynaMed National Guideline
Clearinghouse 4 Slide 5 Edwin Chan Critically-Appraised Individual
Articles (Article Synopses) The ACP Journal Club Evidence Updates
Dartmouth EBM Database 5 Slide 6 Edwin Chan Unfiltered Resources
[Finding an original study] Pubmed Medline 6 Slide 7 Edwin Chan
Background Information/Expert Opinion UpToDate eMedicine National
Guideline Clearinghouse 7 Slide 8 Edwin Chan 8 Outline Strategic
approach to locating studies Designing a search strategy Tips to
search PubMed Documenting a search Slide 9 Edwin Chan 9 Contexts
Clinical care Clinical education Clinical research Slide 10 Edwin
Chan 10 Finding as much as possible and being strategic Use
multiple sources and start with the highest yield Electronic
databases -Cochrane Review Group register -Cochrane Central
Register of Controlled Trials(CENTRAL) -MEDLINE -EMBASE -Other
databases-depending on your topic Reference lists of trials and
reviews Handsearching journals and conference proceedings Personal
communication Slide 11 Edwin Chan 11 Designing a search strategy
Formulate a focused question(PICO) Identify search terms from the
elements of the focused question Combine the search terms Search
the database Slide 12 Edwin Chan 12 Focused question Translate the
clinical problem into a focused question Dose preoperative
education improve outcomes in patients undergoing lower limb joint
replacement? Slide 13 Edwin Chan 13 Extract the PICO terms from the
focused question Does preoperative education improve outcomes in
patients undergoing lower limb joint replacement? Patients or
problemHip or knee replacement Intervention(s)Preoperative
education,information,instruction ControlRoutine or standard care
OutcomePain,QOL,mobility,LOS designRCT,systematic reviews Slide 14
Edwin Chan 14 Note Not all PICOD terms are equally useful for
searching Typically start with P & I C is useful if a specific
comparator is named e.g. placebo or active treatment D is useful
for limiting search to gold-standard designs Do not have to use all
PICOD elements,sometimes just 2 will suffice Searching is an
iterative process (trial and error ) Don t expect to get it right
the first time Slide 15 Edwin Chan 15 Searching the database
-2methods Using Free-text terms directly search PubMed
bibliographic database using the searchable PICO terms just
identified Using MeSH terms MeSH thesaurus is a standardized
dictionary of terms first search the MeSH thesaurus for MeSH terms
then search the bibliographic database using the selected MeSH
terms Slide 16 Edwin Chan 16 http://www.ncbi.nlm.nih.gov/pubmed
Slide 17 Edwin Chan 17 Outline your Strategy Which of the PICOS
elements will I initially use? Shall I do both MeSH &/or
free-text searches? Shall limit the search Slide 18 Edwin Chan 18
lnitial search strategy Start with a MeSH search of the P term
Followed by a free text search of the I term Combine the 2 searches
and check the yield Patients or problemHip or knee
replacement[MesH] Intervention(s)Preoperative
educationm,information,instruction[Fr ee-text] ControlRoutine or
standard care OutcomePain,QOL,mobility,LOS designRCT,systematic
reviews Slide 19 Edwin Chan Searching with MeSH terms 19 Slide 20
Edwin Chan 20 Search for the MeSH term/s corresponding to the P
term/s Slide 21 Edwin Chan 21 Result of MeSH thesaurus search Slide
22 Edwin Chan 22 Combine MeSH term/s with OR Slide 23 Edwin Chan 23
Search PubMed using combined MeSH terms Slide 24 Edwin Chan 24
Search PubMed using MeSH terms as Major Topics only Slide 25 Edwin
Chan 25 MeSH Search Results Scroll down to See syntax Slide 26
Edwin Chan 26 Search syntax in Search details box Slide 27 Edwin
Chan Searching with free-text terms 27 Slide 28 Edwin Chan 28
Free-text searching for the I term "preoperative education" OR
"preoperative instruction" OR "preoperative information" Slide 29
Edwin Chan 29 Free-text Search Results Slide 30 Edwin Chan 30 Check
search history by going to Advanced search view Slide 31 Edwin Chan
31 Combine P and I searches using AND(Advanced search) Slide 32
Edwin Chan 32 Preview of search results (#of hits) Slide 33 Edwin
Chan 33 Select additional search limits if necessary Slide 34 Edwin
Chan 34 Search with limits Slide 35 Edwin Chan 35 Result of limit
search, click on Display Settings arrow Slide 36 Edwin Chan 36
Tips:In order to minimise bias don t limit search on Language
Source(which journal, database etc) Publication status (full
article, conference abstract, unpublished etc) Publication date
Slide 37 Edwin Chan 37 Searching with Clinical Queries Slide 38
Edwin Chan 38 Search for specific study aims Slide 39 Edwin Chan 39
Select Abstract format from Display Settings To save references in
format exportable to RevMan, choose the MEDLINE display Slide 40
Edwin Chan 40 Save or e-mail search results using the Send to menu
Slide 41 Edwin Chan 41 Print from the web browser Slide 42 Edwin
Chan 42 Documenting your search important for you, so you coa
remember what you ve done important for users of you review
document What you searched (databases etc) When you search ed
(year) How you searched (syntax) Slide 43 Edwin Chan 43 Managing
you search history Slide 44 Edwin Chan 44 Saving the search syntax
in Slide 45 Edwin Chan 45 You re My NCBI account Slide 46 Edwin
Chan 46 Click on search syntax name to rerun search Slide 47 Edwin
Chan 47 Saving the search syntax in you re my NCBI account(alt)
Slide 48 Edwin Chan 48 Name the search syntax & save Slide 49
Edwin Chan 49 Specify any e-mail update options in the Settings
dialog box Slide 50 Edwin Chan 50 Return to the list of your Saved
Searches Slide 51 Edwin Chan 51 Manage searches from Saved Search
list-search, delete,edit Slide 52 Edwin Chan 52 Search strategy
summary 3.Publication types e.g.RCTs 1.Patient/Problem (MeSH
headings OR text words) 2.Intervention (MeSH headings OR text
words) AND Slide 53 Edwin Chan 53 What if Too many references is
your topic too broad? is your question focused enough ? have you
used enough PICO elements? have you mistakenly used OR instead of
AND to combine across PICO elements try using limits try using NOT
to exclude specific articles Slide 54 Edwin Chan 54 What if Too few
references is your topic too focused? try using MeSH searches too
capture all synonyms have you used too many PICO elements? have you
mistakenly used AND instead of OR to combine within PICO elements
don t use NOT have you left the limits function on by mistake? try
checking known references for relevant key words are you searching
the right database? is the terminology just too unstandardized
& inconsistently used in this field? Slide 55 Edwin Chan 55
Additional points No right time to stop searching;be guided by
returns and resources Ideas for search terms from citatins you know
of;try them and check returns Use a referencing database to manage
citations Can import references into RevMan 5- display searches in
MEDLINE format & save
