1. Shelly Warwick, MLS, Ph.D. 2012 – Permission is granted to reproduce and edit this work for non-commercial educational use as long as attribution is provided and the edited work is also available under the same terms of license.

2. Assumptions You have reviewed all the basic research modules And are familiar with: Types of publications The Information Life Cycle Know the CCRAP evaluation criteria Controlled vocabularies Keyword and field searching –plus filters/limits Combining terms using Boolean and proximity Developing a PICO Know the measurements used in evaluating search results

3. What Do you Do With All That? Use it to Develop a PICO Use it to create a search strategy Select the appropriate type of resource to search (primary, secondary, tertiary) Select the correct controlled vocabulary terms Use the correct Boolean operators Identify and search applicable fields Change your strategy to either broaden or narrow your search depending on your results Use it to evaluate the information you find Is the publication scholarly or popular? Does it pass the CCRAP test?

4. Turning All This Into A Search Strategy Start with your questions and turn it into a PICO From the PICO select the key words/terms to search Search the controlled vocabulary listing (MeSH) to find the proper term(s) to use Decide on what filters you need (such as sex, age, year of publication, publication type)

5. Translate Clinical Scenario into a PICO A 57-year-old man with type 2 diabetes presents with high blood pressure (157/98 mm Hg). The patient is asymptomatic and presented with no evidence of end-organ damage. The patient is not currently on any antihypertensive agents but has tried weight loss and a low-salt diet unsuccessfully; he has no other complications, and has good glycemic control. The patient is reluctant to start new drug therapy and asks you what would be the benefit of an antihypertensive agent.

6. PICO Breakdown of Question Patient/ Population/Problem = middle-aged man 57 years old; stage 1 hypertension + type 2 diabetes mellitus Intervention/Exposure = Antihypertensive agents Comparison = No treatment Outcome = Reduced risk of cardiovascular disease

7. Antihypertensive agents, Search Mesh = Antihypertensive agents, select Therapeutics from list of subheadings Search MeSH for Diabetes Select - Diabetes type 2 Search MeSH for Cardiovascular disease, Select prevention and control from list of subheadings Search Strategy

8. Add Filters Filters: (age) middle-aged 45-64 years, (sex) male Resulting Search strategy in PubMed ("Antihypertensive Agents/therapeutic use"[Mesh] AND "Diabetes Mellitus, Type 2"[Mesh]) AND "Cardiovascular Diseases/prevention and control"[Mesh] AND ("male"[MeSH Terms] AND "middle aged"[MeSH Terms]) As of July 19, 2013 this would yield 113 results

9. Narrowing Limit article types to: review, clinical trials, controlled clinical trials ("Antihypertensive Agents/therapeutic use"[Mesh] AND "Diabetes Mellitus, Type 2"[Mesh]) AND "Cardiovascular Diseases/prevention and control"[Mesh] AND ((Clinical Trial[ptyp] OR Review[ptyp] OR Randomized Controlled Trial[ptyp]) AND "male"[MeSH Terms] AND "middle aged"[MeSH Terms]) Reduce the results to 75 Adding a filter for the core clinical journals reduces the results to 20 – a number of articles for which you can easily read the abstracts and decide which would be appropriate to answer your question.

10. Broadening If you don’t find the information you’re looking for in the 20 articles you might want to broaden you search by first removing the “core clinical journals” filter (75) and if you still need to go broader removing the article type filters – which would bring you back to 113. In some cases there may not be research available on patients that correspond to yours in terms of age or gender and you may have to remove those filters as well.

11. Evaluation If you kept the core clinical journal filter you can be assured you have information from reliable peer review sources If you select an article that reports on a controlled clinical trial, then you know you have a good level of evidence However: you still need to critically read the article to determine if the claims are backed by the methods and results.