Techniques for Searching the Scientific Literature

For evidence-based practice it’s
important to learn new skills for searching article databases to find
answers to clinical questions. In this video, I’ll talk about the techniques
that will make your searching more efficient. While you’re used to using search
engines (such as Bing, Yahoo or Google) for finding many things, they’re not a good
way to find evidence-based answers to clinical questions. Article databases such as PubMed, Embase, CINAHL, and others provide a more
structured environment for searching. They contain both the primary literature,
such as reports of clinical trials, and the secondary literature, such as
systematic reviews. Databases are also often indexed, using terms with specific
definitions. Knowing how to work with these index terms will help you to create more
precise and efficient queries. Let’s begin with a clinical scenario. A
60-year-old patient has been taking oral bisphosphonates for osteoporosis
for several years. She now needs to have a dental implant. You know that there can
be serious problems for patients who take bisphosphonates and have dental
procedures. What advice should you give the patient
to decrease her risk of osteonecrosis? Because this is a clinical question, I’ll
use the PICO framework. It helps you to distill the main issues
in complex patient presentations into a question, or series of questions, that can
be answered in the journal literature. P is for patient, population, problem; I
is for intervention; C is for comparison, if any; O is for outcome. Here are the major concepts in this
clinical scenario: P, 60-year-old female patient, osteoporosis, bisphosphonates; I, dental procedure; C current care; O, decreased risk of
osteonecrosis. Not every fact may be included in the
research question or used as a search term. For example, age or sex may not be needed
in this search. Sometimes you’ll need to use a broader term in the search, for example, dental procedures instead of dental implants. The concepts from this scenario can be
phrased as a question: “How can the risk of osteonecrosis be managed in a 60-year-old female patient taking bisphosphonates who needs to have a dental procedure?” Next, I’ll think of synonyms for the
major concepts. Synonyms are an important part of a well-constructed search,
because they can help appropriately broaden a search concept. Here, I’ve listed synonyms or related terms for the concepts that I’m using in
my search: bone density for osteoporosis; bone cancer and jaw diseases for
osteonecrosis; dentistry for dental procedure. If you can’t think of a synonym for each concept, that’s okay, but you should use synonyms
for most of your search concepts. Next, I’ll build the search logically.
Boolean operators, such as AND and OR, are used to define the relationship
between search terms. OR is used to connect synonyms or
related terms; it helps to appropriately broaden a search. For example, if I search
for osteonecrosis or bone cancer, I’ll find citations for all terms together
and each term individually. AND is used to connect concepts and
gives you a smaller set of results. For example, if I search for osteoporosis and
osteonecrosis, I’ll retrieve only those articles that contain both terms. Here’s the search that I’ve created, connecting the synonyms using OR and the
concepts using AND. This search will work in any database, or even Google Scholar.
I’ve placed the synonyms within parentheses, which tells the database
that certain terms should be searched in a certain way. If you forget to use
parentheses, your results won’t be as useful. Note that I’ve decided to try my
search first with three concepts; if my search results are too large, I’ll add
the fourth concept, dental procedure. To find PubMed and other
resources, use the links on the left side of the Taubman Health Sciences Library
website or use a departmental or course research guide. Accessing databases from
a library website, at home or on campus, will connect you to all of the journal
subscriptions paid for by the library. If you have any questions, please contact
your informationist or the Taubman Health Sciences Library.

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