Lecture at Forskning ved fjæra, Holmsbu May 2015. Mainly about PICO, 6s model and sources to search.

1. How to search for literature
Holmsbu 19 May 2015
Hilde Strømme, senior adviser and librarian

2. Four steps
1. Formulate a question and put it into PICO
2. Choose sources to search
3. Prepare the search strategy and perform the
search
4. Review the search results and possibly revise the
search strategy
2

3. Step by step
1. Formulate a question and put it into PICO
2. Choose sources to search
3. Prepare the search strategy and perform the
search
4. Review the search results and possibly revise the
search strategy
3

4. The beginning of all wisdom does not lie in
the answer, but in the question.

5. PICO – 3 purposes
 Formulating a focused question
 Organizing search terms
 Choosing relevant articles from the search results

6. P I C O
Population
Patient
Problem
Intervention
or Exposure
Comparison/Control Outcome
Patients
who need a
urinary
catheter
Chlorhexidine Saline Urinary tract
infection
To prevent urinary tract infection in patients with urinary
catheters, is cleaning with chlorhexidine better than
cleaning with saline before insertion?

7. P I C O
Population
Patient
Problem
Intervention
or Exposure
Comparison/
Control
Outcome
Are brief questionnaires effective in
identifying problem drinking during
pregnancy?
Pregnant
women
Brief question-
naires
Identify problem
drinking

8. P I C O
Population
Patient
Problem
Intervention
or Exposure
Comparison/
Control
Outcome
Is light therapy effective in managing sleep
disorders, depression and behavioral
disorders in people with dementia?
People with
dementia
Light therapy Sleep disorders
Depression
Behavioral disorders

9. Step by step
1. Formulate a question and put it into PICO
2. Choose sources to search
3. Prepare the search strategy and perform the
search
4. Review the search results and possibly revise the
search strategy
9

10. ”use of current best evidence”
Requires a systematic literature search
 Searching the relevant databases
 Searching them the right way
(Sackett, 1996)

11. Systems
Summaries
Synopses of
syntheses
Syntheses
Synopses of single studies
Single studies

12. Systems
Point-of-Care Tools
EB Guidelines
Systematic Reviews
Original articles, single studies

13. Systems
Point-of-Care Tools
EB Guidelines
Where can I find them?
Point-of-Care Tools:
• Best Practice, UpToDate, DynaMed, Nursing Reference Center
Clinical guidelines:
• National Guideline Clearinghouse (US/int.), NICE (UK),
Helsedirektoratet (NO), Sundhedsstyrelsen (DK),
Socialstyrelsen (SE)
What are summaries?
• Point-of-Care Tools
• Evidence based clinical guidelines

16. DiCenso A, Bayley L & Haynes RB. (2009). ACP Journal Club. Editorial: Accessing preappraised evidence: fine-
tuning the 5S model into a 6S model. Annals of Internal Medicine, 151(6), JC3-2, JC3-3.

17. Systematic Reviews
What are systematic reviews?
Systematic reviews identify, compare and
summarise ALL relevant studies on a topic
Where can I find them?
• The Cochrane Library
• The Campbell Library
• Epistemonikos
• OTseeker
• PEDro

20. Systems
Original articles, single studies
What are single studies?
Original studies published in journals
Where can I find them?
• Cochrane Trials
• MEDLINE/PubMed
• Embase
• PsycINFO
• CINAHL
• AMED

21. Step by step
1. Formulate a question and put it into PICO
2. Choose sources to search
3. Prepare the search strategy and perform the
search
4. Review the search results and possibly revise the
search strategy
21

22. Plan your search
 Identify major ideas (key concepts) in your
question
 Find English terms for these key concepts
 Think of synonym terms to describe these key
concepts
22

23. P I C O
People with
dementia
Light therapy No
treatment
Sleep disorders
Depression
Behavioral disorders
Dementia
Demented
Alzheimer’s
Light therapy
Phototherapy
Sleep disorders
Insomnia
Dyssomnia
Hypersomnia
Depression
Depressive
Depressed
Behavioral problems
Behavioural problems
Behavioral disorders
Behavioural disorders

24. Where do I find search terms?
 Journal articles or books on the subject
 Colleagues and experts on the subject
 Dictionaries, e.g. http://www.merriam-
webster.com/browse/medical/a.htm
 MeSH database
http://www.ncbi.nlm.nih.gov/mesh
 SveMed+ http://svemedplus.kib.ki.se/

25. SveMed+ for å finne engelske søketermer
Skriv inn ett norsk, svensk, dansk eller
engelsk ord og trykk på søk

26. Klikk på en av titlene i trefflisten
Poenget med dette søket er ikke å finne svar på spørsmålet ditt, men å
finne engelsk betegnelse og synonymer.

27. To steder å se etter:
1. Engelsk tittel
2. Engelske MeSH-termer
Notér disse, og klikk så på
den engelske MeSH-
termen

28. Forklaring på begrepet Phototherapy på engelsk og svensk
Klikk på Alternate Forms for å finne synonymer på engelsk

29. Notér (eller kopier og lim inn i et word-dokument) synonymene.
Disse synonymene kan du bruke når du skal søke i f.eks. Cochrane Library for
å sikre at du får tak i alle relevante artikler.
OBS! Ikke ta med inverterte former som f.eks. «Therapy, Light». Hensikten
med å søke på synonymer er å fange opp det som står i titler og
sammendrag, og der er det ingen som skriver «therapy, light», de skriver
«light therapy».

32. Synonyms!

33. Truncation
dement*
-> dementia, demented
Behavi*r*
-> behavior, behaviour, behavioral, behavioural
33

34. Boolean operators
34
Dementia
AND
phototherapy
Light therapy
OR
phototherapy
AND OR NOT
Light therapy
NOT
Drug therapy

35. 35
From PICO to search strategy
OR
AND
Population Intervention Outcome
Patient
Patient
Patient
Intervention
Intervention
Intervention
Outcome
Outcome
Outcome
Outcome
Outcome

36. 1. Patient term 1
2. Patient term 2
3. 1 OR 2
4. Intervention term 1
5. Intervention term 2
6. 4 OR 5
7. Outcome term 1
8. Outcome term 2
9. Outcome term 3
10.Outcome term 4
11.7 OR 8 OR 9 OR 10
12.3 AND 6 AND 11

37. Cochrane Library search history
Patient
Intervention
Outcome

38. Ovid MEDLINE search history
Patient
Intervention
Outcome

39. Step by step
1. Formulate a question and put it into PICO
2. Choose sources to search
3. Prepare the search strategy and perform the
search
4. Review the search results and possibly revise the
search strategy
39

40. ”I found 2000 references!”

41. Specificity and sensitivity
Specificity
Sensitivity

42. How to reduce the number of hits
 Adding more terms using AND – e.g. searching for
one more element of PICO
 Search filters – e.g. Clinical Queries in PubMed,
MEDLINE, Embase, CINAHL
 Limits – publication year, languages etc.

47. Take home messages

48. Take home messages
1. PICO is your friend
2. Find synonyms
3. Don’t loose faith – search again