Planning a Search Strategy PICO, Concept Boxes and Boolean Operators

Online Searching at a Glance Useful terminology: o Pearl Searching : find a good article aka pearl and look at the references o Boolean operators : most databases allow boolean operators to narrow or broaden a search (AND, OR, NOT) o Truncation : most databases use symbols such as * for truncation, e.g., dent* will retrieve dental, dentistry, dentist, etc.

BOOLEAN SEARCHING Using AND, OR, and NOT

AND bisphosphonates AND osteonecrosis

OR osteonecrosis OR death of bone OR bone death OR bone necrosis

osteonecrosis NOT femur head necrosis NOT

Truncation Using * (asterisk) and ? (question mark)

Using * to truncate retrieves any ending after the truncated part of the word. Manag* will retrieve manage, management, manager, etc.

But, be careful Truncating too soon can be problematic

cat* cat cats catapult cattle

? will find different spellings within a word wom?n will retrieve woman and women

? can also be used to find British/Canadian and American spelling

gr?y cat

grey cat gray cat

British and North American spellings vary. When entering textwords in search engines for international databases such as Cochrane or Medline, it is necessary to allow for the different spellings, or else some citations may be missed. Use $ or : to get all possible endings (e.g. comput:.mp. for computer, computers, computing, computed, etc.) Use # to replace exactly one character (wom#n.mp. for woman or women) Use ? to replace 0 or 1 character (labo?r.mp. for labor or labour) ExamplesU.S.BritishIn OVID, enter as: anemia/anaemia etiology/aetiology gynecology/gynaecology hemoglobin/haemoglobin -e- -ae- an?emia "etiology or aetiology" gyn?ecology "hemoglobin or haemoglobin" esophagus/oesophagus fetus/foetus diarrhea/diarrhoea -e- -oe- "esophagus or oesophagus" "fetus or foetus" diarrh?ea tumor/tumour -o- -ou-tumo?r organize/organise -z--s-organi#e counseling/counselling counseled/counselled -l- -ll- counse$ling for specific ending counsel sulfur/sulphur -f- -ph-sul#?ur fiber/fibre -er- -re-fib:

Steps to finding articles Identify the main concepts or keywords Determine the best resources Plan the search Document the search and cite Evaluate what you find

Example topic Your hospital wants to implement a policy of placing all HIV+ patients on INH prophylaxis therapy. You have been asked to do a review to see if that is successful in preventing tuberculosis, in particular in other African countries.

Identify the main concepts The easiest way to make your question searchable is to break it up into concepts For each concept, think of as many keywords/synonyms as you can A very popular method to use is PICO

Identify the main concepts PICO Method P – Population I – Intervention C – Comparison (Optional) O– Outcome

PICO Example Continued P – HIV positive in African countries I – INH prophylaxis therapy C – n/a O – decreased rates of tuberculosis Answerable Question: In African countries does INH prophylaxis therapy help reduce the rates of tuberculosis among HIV positive patients?

Think of synonyms or similar terms or ideas to use in your search PICOPICO conceptsPossible search terms Patient PopulationHIV positive patients in African countries HIV positive, HIV infection, human immunodeficiency virus, Africa, Ethiopia, Eastern Africa Intervention INH prophylaxis therapyINH prophylaxis therapy, INH preventive therapy, Isoniazid, IPT Comparison (if any) n/a OutcomeReduction of cases of tuberculosis Tuberculosis

Determine the best resources  There are hundreds of article databases available. Which one will you use?  Most popular databases are: 1. MEDLINE (accessible either through PubMed or Ovid) 2.Cochrane Library 3.EMBASE 4.Web of Science 5.Scopus 6.Google Scholar????

Plan the search Now you have your searchable questions and keywords. Where do you start? Each database has its own indexing system. Many have their own thesaurus or list of subject headings. If the database you are using has a thesaurus, match your keywords to the thesaurus for a more efficient search.

Using a database Once you’ve chosen a database, such as Medline or PubMed, search for each concept separately Use OR to combine synonyms or similar terms or concepts (HIV+ OR HIV positive) Use AND to combine separate concepts (HIV positive AND tuberculosis AND INH prophylaxis therapy )

Save your searches by creating an account in each database that you use Use a citation management tool such as Zotero, Medeley or Endnote Web to export your citations from multiple databases Document the search and cite

Please always evaluate the information you find, either by using given criteria or developing your own Evaluate what you find