1. Systematic Reviews: Theory and Practice
Searching for the Literature

2. By the end of this class, you will be able to:
Build a searchable question and piece out its main ideas
Understand the complexity and time-intensive nature of researching for a systematic review
Build a list of search terms, including synonyms
Build a search appropriate for a keyword database
Build a search appropriate for a controlled vocabulary database
Import references into a citation management program

3. Follow Along http://researchguides.library.tufts.edu/nutr369
Download slides from first page of the guide

4. What is a Systematic Review?
"A systematic review attempts to collate all empirical evidence that fits pre-specified eligibility criteria to answer a specific research question. It uses explicit, systematic methods that are selected to minimize bias, thus providing reliable findings from which conclusions can be drawn and decisions made. Meta-analysis is the use of statistical methods to summarize and combine the results of independent studies." - Cochrane Collaboration

5. Why are there so few systematic reviews?
Evidence Pyramid
Why are there so few systematic reviews?
Synthesized & Evaluated Literature
Primary Literature
Best Evidence
May or May not be Evidence-Based
Provided by HealthLinks, University of Washington,

6. Top of the Pyramid Resources
Have the most evidence to support their conclusions
Less abundant in the literature
Time
Effort
Most relevant for decision-making
How do I find them?
Search MEDLINE for systematic reviews, meta-analyses or individual study types e.g. RCTs
Search databases specific to your subject for reviews that include a search methodology

7. The EBM Cycle
1. Assess the patient: A clinical question arises from caring for a patient.
2. Ask the question: Construct a well-built foreground question derived from the case.
3. Acquire the evidence: Find the answer from the evidence presented in the medical literature and identify the best resource from among the many.
4. Appraise the evidence: Appraisal includes validity (closeness to truth) and applicability (usefulness in clinical practice).
5. Apply: Communicate the evidence to your patient and integrate the evidence with clinical expertise, patient preference and apply.
6. Self-evaluation: Evaluate the process and outcome.

8. Creating a Searchable Question
The first step is to state your topic in a detailed question
Next, you need to break that question down into the different ideas (typically the nouns, sometimes the verbs)
Example:
Does exercise improve diabetes?
Are the outcomes measurable?
Is the question specific enough?
Idea 1
Idea 2
Idea 3

9. Decide Resources to Search
Subject-specific? Date ranges of database? Keyword or controlled vocabulary?
Different databases require different search strategies & formulas
Keyword databases like Google require synonyms and more complex search formulas to be comprehensive
Multiple terms to capture different ways of stating same/similar ideas
If the database has it’s own thesaurus, you can usually do a comprehensive search more simply
Concept searching v. keywords
Some database recognize more commands and symbols than others

10. Keyword Database Searching
Remember: Computers are dumb (but fast).
You will need to think of a list of synonyms for each separate idea
Your job to think like all the different authors and search for the way they may have expressed the idea
Computers understand the world via math, so just like math you have operators and order of operations to deal with
AND, OR, NOT
“quotes” and (parenthesis)
Sometimes truncation symbols (* or $)

11. Controlled-Vocabulary Searching
›“… a carefully selected list of words and phrases, which are used to tag units of information (document or work) so that they may be more easily retrieved by a search…Controlled vocabularies reduce ambiguity inherent in normal human languages where the same concept can be given different names and ensure consistency.” –Wikipedia
Boolean operators still useful
Need to combine controlled terms with keywords

12. Stay Organized Interlibrary loan Vocabulary lists Search strategies
Time
Money
Vocabulary lists
Search strategies
# results, # of exclusions, date of searches, etc.
Citation management
Many options
Help you store and organize citations
Share citations among a group
Format citations for publication

13. practice