This presentation describes, in a nutshell, the concept of evidence-based research, and how far it is applied. It then dives into describing the systematic approach search in the literature.

1. HOW TO SEARCH IN THE LITERATURE,
SYSTEMATICALLY
Hosam Eldeen Elsadig Gasmalla
MBBS, M.Sc., PgDip.,MHPE,PhD
Assistant Professor of Human Anatomy – Faculty of Medicine – Al-Neelain University

2. CONTENTS
• What is evidence based-research?
• Is it applied properly?
• Systematic search in the literature.
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3. Evidence-
based
research
(EBR)
Research
Evidence-
based
medicine
(EBM)
EBM is based on research; thus, research need to be at
its best, by applying evidence-based research
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4. EBR
Systematic
search in the
literature:
systematic,
transparent
and accurate
identification,
evaluation and
use
of the best
evidence
currently
available
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5. NEW PAPERS MUST REFERENCE/REFER
TO/CITE PREVIOUS STUDIES
Previous
studies /
results
Referencing /
interpretation
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Current study /
results

6. CONTENTS
• What is evidence based-research?
• Is it applied properly?
• Systematic search in the literature.
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7. RIGHT?
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New papers must
reference refer to/cite
previous studies.
Right?

8. RANDOMIZED CONTROLLED TRIALS (RCTS)
CITATION OF PRIOR STUDIES IN NEW STUDIES
• Less than 25% of related studies were cited.
• A median of 2 RCTs was cited/each new RCTs.
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Robinson, K. A. (2011)

9. SYSTEMATIC REVIEWS ARE USED TO
JUSTIFY NEW STUDIES
• But:
• Analysis of RCTs published in high impact
anesthesiology journals between 2014 and 2016
revealed this:
• Less than 20% explicitly mentioned a systematic
review as justification for the new study.
• 44% did not cite a single systematic review.
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Engelking, A. (2018)

10. SYSTEMATIC REVIEWS ARE USED TO
DESIGN NEW STUDIES
• But:
• 41.7% of RCTs used information in the
systematic review in the design or planning of
the new study.
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Bhurke, S. (2015)

11. SYSTEMATIC REVIEWS ARE USED IN THE
INTERPRETATION OF NEW STUDIES RESULTS
• But:
• Analysis of all RCTs published in May 2012 in
Annals of Internal Medicine, BMJ, JAMA, Lancet, and
New England Journal of Medicine was done.
• The results of prior RCTs were not included in the
context of the new results.
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Clarke, M. (2013)

12. https://www.zotero.org/groups/338093/ebr_bibliography/collections/IGIHN4F2/items/C3EMUIRE/collec
tion

13. CONTENTS
• What is evidence based-research?
• Is it applied properly?
• Systematic search in the literature.
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14. SYSTEMATIC SEARCH IN THE LITERATURE
1. Formulate the research questions.
2. Define elements of PICO/PICOT/PEO.
3. Decide on Search Terms.
4. Develop a search strategy.
5. Select database(s).
6. Assess the preliminary results.
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15. QUESTIONS TYPES
• Prevention.
• Intervention/Treatment /Therapy
• Prognosis.
• Diagnosis.
• Etiology
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Guyatt, G. (2008). What is the question
Icahn School of Medicine

17. SYSTEMATIC SEARCH IN THE LITERATURE
1. Formulate the research questions.
2. Define elements of PICO/PICOT/PEO.
3. Decide on Search Terms.
4. Develop a search strategy.
5. Select database(s).
6. Assess the preliminary results.
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18. SYSTEMATIC SEARCH STARTS BY
FORMULATING THE RESEARCH QUESTION
PICO format
P (Problem or Patient or Population)
I (intervention/indicator)
C (comparison)
O (outcome of interest)
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19. OTHER FORMATS
PICOT (T: Time period)
PEO Population / Problem / Patient;
Exposure ; Outcome.
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20. DOES MELATONIN PROTECT THE RAT HIPPOCAMPUS
FROM TISSUE INJURY INDUCE BY DICLOFENAC?
P (Problem or Patient or Population):
Rat hippocampus
I (intervention/indicator):
Administration of melatonin
C (comparison):
Administration of diclofenac, no diclofenac
O (outcome of interest):
Protection from tissue damage
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21. DOES HAND WASHING AMONG HEALTHCARE WORKERS
REDUCE HOSPITAL ACQUIRED INFECTIONS?
P (Problem or Patient or Population):
Healthcare workers.
I (intervention/indicator) :
Hand washing.
C (comparison):
No hand washing; other solution; masks.
O (outcome of interest):
Reduced infection.
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22. HOW DOES SURGERY COMPARED WITH NOT UNDERGOING
SURGERY INFLUENCE LIFESPAN AND QUALITY OF LIFE IN ADULTS
WITH PROSTATE CANCER?
P (Problem or Patient or Population):
Adults with prostate cancer
I (intervention/indicator):
Surgery
C (comparison):
No surgery
O (outcome of interest):
The influence on lifespan and quality of life
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Teesside University

23. DOES A SORE THROAT CHECKLIST OR SCORECARD HELP GPS
DIFFERENTIATE BETWEEN BACTERIAL AND NON-BACTERIAL
INFECTION IN PATIENTS PRESENTING WITH A SORE THROAT?
P (Problem or Patient or Population):
Patients with sore throat
I (intervention/indicator):
Checklist or scorecard
C (comparison):
Throat swab
O (outcome of interest):
Accuracy in diagnosis
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CIAP

24. ARE FEMALE NON-SMOKERS WITH DAILY EXPOSURE TO SECOND-HAND
SMOKE OVER A PERIOD OF TEN YEARS OR GREATER MORE LIKELY TO
DEVELOP BREAST CANCER WHEN COMPARED WITH FEMALE NON-SMOKERS
WITHOUT DAILY EXPOSURE TO SECONDHAND SMOKE?
P (Problem or Patient or Population):
Female non smokers with daily second hand smoke exposure
C (comparison):
Female non smokers without daily second hand smoke exposure
O (outcome of interest):
Develop breast cancer
T (time period):
Ten years
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Claude Moore Health Science Library

25. SYSTEMATIC SEARCH IN THE LITERATURE
1. Formulate the research questions.
2. Define elements of PICO/PICOT/PEO.
3. Decide on Search Terms.
4. Develop a search strategy.
5. Select database(s).
6. Assess the preliminary results.
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26. DOES MELATONIN PROTECT THE RAT HIPPOCAMPUS
FROM TISSUE INJURY INDUCED BY DICLOFENAC?
P (Problem or Patient or Population):
Rat hippocampus
I (intervention/indicator):
Administration of melatonin
C (comparison):
Administration of diclofenac, no diclofenac
O (outcome of interest):
Protection from tissue damage
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27. SEARCH TERMS
•Hippocampus.
•Melatonin.
•Diclofenac.
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28. (MeSH) TERMS (IN PUBMED) COLLECT MANY
WORDS INTO ONE CONCEPT
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29. NEOPLASM (MeSH)
• Neoplasia
• Neoplasias
• Neoplasm
• Tumors
• Tumor
• Cancer
• Cancers
• Malignancy
• Malignancies
• Neoplasm, Benign
• Malignant Neoplasms
• Malignant Neoplasm
• Neoplasm, Malignant
• Neoplasms, Malignant
• Benign Neoplasms
• Neoplasms, Benign
• Benign Neoplasm
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Cancer

30. ARTHROPLASTY, REPLACEMENT, KNEE
(MeSH)
• Arthroplasties, Replacement, Knee
• Arthroplasty, Knee Replacement
• Knee Replacement Arthroplasties
• Knee Replacement Arthroplasty
• Replacement Arthroplasties, Knee
• Knee Arthroplasty, Total
• Arthroplasty, Total Knee
• Total Knee Arthroplasty
• Unicondylar Knee Arthroplasty
• Arthroplasty, Unicondylar Knee
• Knee Arthroplasty, Unicondylar
• Partial Knee Arthroplasty
• Knee Arthroplasty, Partial
• Unicondylar Knee Replacement
• Partial Knee Replacement
• Knee Replacement, Partial
• Unicompartmental Knee Replacement
• Knee Replacement, Unicompartmenta
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Total knee
replacement

31. HYPERSENSITIVITY (MeSH)
• Hypersensitivities
• Allergy
• Allergies
• Allergic Reaction
• Allergic Reactions
• Reaction, Allergic
• Reactions, Allergic
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Allergy

32. SYSTEMATIC SEARCH IN THE LITERATURE
1. Formulate the research questions.
2. Define elements of PICO/PICOT/PEO.
3. Decide on Search Terms.
4. Develop a search strategy.
5. Select database(s).
6. Assess the preliminary results.
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33. SEARCHING IN PUBMED
• Define elements of PICO/PICOT/PEO.
• Decide on Search Terms.
• Develop search strategy.
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34. DEVELOP A SEARCH STRATEGY
P I C O
Hippocampus Melatonin Diclofenac
Tissue
damage?
Protection?
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35. THE DIFFERENCE BETWEEN (OR) AND (AND)
Hippocampus
Melatonin
Diclofenac
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“AND”

36. THE DIFFERENCE BETWEEN (OR) AND (AND)
Conru
Ammonis
Ammons horn
Hippocampus
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“OR”

37. DEVELOP A SEARCH STRATEGY
P I C O
Hippocampus Melatonin Diclofenac
Tissue
damage?
Protection?
AND AND
AND
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43. SYSTEMATIC SEARCH IN THE LITERATURE
1. Formulate the research questions.
2. Define elements of PICO/PICOT/PEO.
3. Decide on Search Terms.
4. Develop a search strategy.
5. Select database(s).
6. Assess the preliminary results.
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44. WHERE TO
SEARCH?
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MEDLINE
Embase?
CINAHL?
Cochrane library?
Scopus (includes MEDLINE and
EMBASE)?
PubMed (includes MEDLINE)?
Web of Science?

45. WHERE TO
SEARCH?
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WHERE TO
SEARCH?

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WHERE TO
SEARCH?

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WHERE TO
SEARCH?

49. ARE
DATABASES
ENOUGH?
•Hand searching.
•Search the
journals, by
volumes and
issues, one by one.
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50. ARE
DATABASES
ENOUGH?
•Contact the experts
in the area.
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51. SEARCH IN
THE GREY
LITERATURE
• Committee reports.
• Dissertations.
• Government reports.
• Preprints.
• Proceedings.
• Standards.
• Technical reports.
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52. SYSTEMATIC SEARCH IN THE LITERATURE
1. Formulate the research questions.
2. Define elements of PICO/PICOT/PEO.
3. Decide on Search Terms.
4. Develop a search strategy.
5. Select database(s).
6. Assess the preliminary results.
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53. REFERENCES
• Bhurke, S., Cook, A., Tallant, A., Young, A., Williams, E., & Raftery, J. (2015). Using systematic reviews to inform NIHR HTA trial planning and design: a retrospective
cohort. BMC medical research methodology, 15(1), 108.
• Chiappelli, F., Prolo, P., Rosenblum, M., Edgerton, M., & Cajulis, O. S. (2006). Evidence-based research in complementary and alternative medicine II: the process of
evidence-based research. Evidence-based complementary and alternative medicine : eCAM, 3(1), 3–12. https://doi.org/10.1093/ecam/nek017
• Clarke, M., & Hopewell, S. (2013). Many reports of randomised trials still don't begin or end with a systematic review of the relevant evidence. Journal of the Bahrain Medical
Society, 24(3), 145-148.
• Clinical Information Access Portal (no date) Clinical examples using PICO. Available at https://www.ciap.health.nsw.gov.au/training/ebp-learning-modules/module2/clinical-
examples-using-pico.html (Accessed: 18 August 2020).
• Engelking, A., Cavar, M., & Puljak, L. (2018). The use of systematic reviews to justify anaesthesiology trials: A meta‐epidemiological study. European Journal of Pain,
22(10), 1844-1849.
• Guyatt, G., Meade, M. O., Richardson, S., & Jaeschke, R. (2008). What is the question. Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical
Practice.
• Robinson, K. A., & Goodman, S. N. (2011). A systematic examination of the citation of prior research in reports of randomized, controlled trials. Annals of internal medicine,
154(1), 50-55.
• Teesside University (no date) Developing Your Search Question using PICO/PIO/PEO. Available at https://tees.ac.uk/lis/learninghub/cinahl/pico.pdf (Accessed: 17 August
2020).
• Claude Moore Health Science Library (no date) PICO(TT): Definitions and Examples. Available at https://guides.hsl.virginia.edu/c.php?g=921177&p=6638623 (Accessed: 18
August 2020).
• Icahn School of Medicine at Mount Sinai (no date) Evidence Based Medicine Guide. Available at https://libguides.mssm.edu/ebm/EBM_Tutorial
• (Accessed: 18 August 2020).
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54. LINKS TO USEFUL SOURCES
https://learn.nlm.nih.gov/documentation/training-packets/T0042010P/
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