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PICO search strategies
Techniques and tips to answer well-developed clinical
questions using Embase
Wednesday, 22 April 2015
Maura Sostack, MLS, AHIP
EBM Librarian
Evidence-Based Medicine Center
Clinical Solutions
Elsevier Health Sciences
Learning Objectives
2
 Describe the three concepts that form the basis of a PICO
search strategy.
 Create search filters using natural language words and
phrases and controlled vocabulary terms.
 Identify study type with its corresponding PICO question.
Table of Contents
 Deconstruct a protocol
 PICO search strategy
 The building blocks of a PICO search
 Use Embase to answer a well-developed prognosis PICO
question
 Summary
3
DECONSTRUCT A PROTOCOL
4
EBM Center Protocol: title page
5
EBM Center Protocol: table of contents
6

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Embase webinar pico search strategies as of 042115v3

  • 1. PICO search strategies Techniques and tips to answer well-developed clinical questions using Embase Wednesday, 22 April 2015 Maura Sostack, MLS, AHIP EBM Librarian Evidence-Based Medicine Center Clinical Solutions Elsevier Health Sciences
  • 2. Learning Objectives 2  Describe the three concepts that form the basis of a PICO search strategy.  Create search filters using natural language words and phrases and controlled vocabulary terms.  Identify study type with its corresponding PICO question.
  • 3. Table of Contents  Deconstruct a protocol  PICO search strategy  The building blocks of a PICO search  Use Embase to answer a well-developed prognosis PICO question  Summary 3
  • 5. EBM Center Protocol: title page 5
  • 6. EBM Center Protocol: table of contents 6
  • 7. EBM Center Protocol: PICO question 7
  • 8. EBM Center Protocol: study eligibility 8
  • 9. EBM Center Protocol: exclusion criteria 9
  • 12. PICO search strategy A number of our PICO search strategies are comprised of three sets of separate and distinct controlled vocabulary and natural language terms: • Terms for the health condition of the patient(s) or population=P • Terms for intervention(s)=I • Terms for study type(s).
  • 13. PICO search strategy : step by step • Create P and I search strings. • Use the Boolean operator AND to create a P&I search string set. • Create a study specific search string or, if applicable, use a validated study hedge. • Use the Boolean operator AND to combine the study string set(s) with the P & I set. • Use the NOT Boolean operator to remove non-essential publication types and animal studies. • To reflect continuous updating, use the AND Boolean operator to add the ‘since date’ search string to create the search of record.
  • 14. PICO search strategy : caveat Generally speaking, it is inadvisable to search on every aspect of the clinical question within the confines of one search strategy session.
  • 15. THE BUILDING BLOCKS OF A PICO SEARCH 15
  • 16. What’s in a name? Hedges; optimal filters; quality filters; evidence-based filters=search strings • Hedges and filters are search strings that contain controlled vocabulary (EMTREE, MeSH, etc.) and natural language words and phrases. • A validated hedge or filter contains both controlled vocabulary and natural language words and phrases and has been put through a formal validation process. • Validated and un-validated hedges and filters are used to search for American and British spelling of concepts and terms and to find incorrectly indexed and e-pub ahead of print citations. • Sets are created within the database interface when these hedges and filters are used. 16
  • 17. Hedges and filters: +/∆ 17 + ∆ Hedges, filters  Control  Ensure retrieval of e-pub ahead of print and online first citations  Incorrectly indexed citations  Complex and require deep understanding of basic & advanced search techniques  Require time to develop  Require time to validate
  • 18. Hedges, filters, & search term resources McMaster University Health Information Research Unit (HIRU) Hedge Project: http://hiru.mcmaster.ca/hiru/HIRU_Hedges_home.aspx The InterTASC Information Specialists' Sub-Group Search Filter Resource: https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/ University of Pittsburgh MedTerm Search Assist: http://www.hsls.pitt.edu/terms/ HLWIKI International: http://hlwiki.slais.ubc.ca/index.php/Filters_(ie._hedges) 18
  • 19. Question type Question definition Study methodology Embase study string Diagnosis Diagnosis: the nature of a disease; the identification of an illness. Prospective, blind comparison to a gold standard (‘sensitivity and specificity'/de ) OR (specificity:ab,ti )OR ('sensitivity and specificity':ab,ti) Prevention Prevention: to avert, avoid or prevent the onset of disease. Randomized Controlled Trial (RCT) random*:ab,ti AND trial*:ab,ti OR 'randomized controlled trial'/de Prognosis Prognosis: The forecast of the probable outcome or course of a disease; the patient's chance of recovery. Prospective cohort; case- control; case series 'incidence'/de OR 'mortality'/de OR 'follow up'/de OR 'prognosis'/de OR 'prediction and forecasting'/exp OR 'cohort analysis'/exp OR incidence:ab,ti OR mortality:ab,ti OR 'follow up':ab,ti OR prognos*:ab,ti OR predict*:ab,ti OR cohort:ab,ti Embase: EBM Center’s study filters
  • 20. Question type Question definition Study methodology Embase study string Therapy / Treatment Therapy: the treatment of disease. Therapy is synonymous with treatment. Randomized Control Trial (RCT) (random*:ab,ti AND trial*:ab,ti) OR ('randomized controlled trial'/de) Harms A measure of patient safety considering errors or mistakes which result in harm to the patient. Observational studies; nationally representative prospective cohort studies with multivariate adjustment of adverse effects. multivar*:ab,ti OR adjust*:ab,ti OR 'multivariate analysis'/exp Embase: EBM Center’s study filters
  • 21. Embase: systematic review/meta- analysis filter 21 ('meta analysis'/de OR 'metaanalyses':ti OR 'metaanalysis':ti OR 'meta analysis':ti OR 'meta analyses':ti OR 'systematic review':ti OR 'systematic review'/de OR 'cochrane database of systematic reviews':jt)
  • 22. Embase: publication types We use this search string to NOT out specific publication types: 'letter'/de OR 'editorial'/de OR 'note'/de OR 'short survey'/exp 22
  • 23. Embase: animal studies We use this search string to eliminate animal studies from search results: 23 NOT ('animals'/exp NOT 'humans'/exp)
  • 24. Embase: ‘since date’ for citation indexing Search string to limit citations by a specific indexing date: [11-4-2011]/sd 24
  • 26. EBM Center Protocol: Prognosis PICO question 26
  • 28. 28
  • 29. Prognosis PICO: P search strings 29
  • 30. Prognosis PICO: P & I search stings 30
  • 32. Prognosis PICO: NOT publications, NOT animal studies and final results 32 Search conducted on 7 April 2015
  • 33. Prognosis PICO : combined harms, prognosis study and systematic review/meta searches 33 Search conducted on 21 April 2015
  • 34. Prognosis PICO: study search of record 34 'community acquired infection'/de OR 'community acquired infection':ab,ti OR 'community acquired disease':ab,ti AND ('pneumonia'/exp OR pneumonia:ab,ti) OR 'community acquired pneumonia'/de OR 'community acquired pneumonia':ab,ti AND ('pneumonia outcomes research team':ab,ti OR port:ab,ti OR 'smart- cop':ab,ti OR 'a-drop':ab,ti OR 'pneumonia severity index'/de OR 'pneumonia severity index':ab,ti OR 'psi':ab,ti OR 'curb 65 score':ab,ti OR 'scoring system'/de) AND ('incidence'/de OR 'mortality'/de OR 'follow up'/de OR 'prognosis'/de OR 'prediction and forecasting'/exp OR 'cohort analysis'/exp OR incidence:ab,ti OR mortality:ab,ti OR 'follow up':ab,ti OR prognos*:ab,ti OR predict*:ab,ti OR cohort:ab,ti) NOT ('animal'/exp NOT 'human'/exp) NOT ('letter'/de OR 'book'/de OR 'editorial'/de OR 'note'/de OR 'short survey'/exp) AND [7-4-2011]/sd
  • 35. 35 Prognosis PICO: harms search of record 'community acquired infection'/de OR 'community acquired infection':ab,ti OR 'community acquired disease':ab,ti AND ('pneumonia'/exp OR pneumonia:ab,ti) OR 'community acquired pneumonia'/de OR 'community acquired pneumonia':ab,ti AND ('pneumonia outcomes research team':ab,ti OR port:ab,ti OR 'smart-cop':ab,ti OR 'a-drop':ab,ti OR 'pneumonia severity index'/de OR 'pneumonia severity index':ab,ti OR 'psi':ab,ti OR 'curb 65 score':ab,ti OR 'scoring system'/de) AND (multivar*:ab,ti OR adjust*:ab,ti OR 'multivariate analysis'/exp) NOT ('letter'/de OR 'book'/de OR 'editorial'/de OR 'note'/de OR 'conference paper'/de OR 'short survey'/exp OR 'conference abstract'/it) NOT ('animals'/exp NOT 'humans'/exp) AND [7-4-2011]/sd
  • 36. 36 Prognosis PICO : systematic review and meta-analysis study search of record 'community acquired infection'/de OR 'community acquired infection':ab,ti OR 'community acquired disease':ab,ti AND ('pneumonia'/exp OR pneumonia:ab,ti) OR 'community acquired pneumonia'/de OR 'community acquired pneumonia':ab,ti AND ('pneumonia outcomes research team':ab,ti OR port:ab,ti OR 'smart- cop':ab,ti OR 'a-drop':ab,ti OR 'pneumonia severity index'/de OR 'pneumonia severity index':ab,ti OR 'psi':ab,ti OR 'curb 65 score':ab,ti OR 'scoring system'/de) AND ('meta analysis'/de OR 'metaanalyses':ti OR 'metaanalysis':ti OR 'meta analysis':ti OR 'meta analyses':ti OR 'systematic review':ti OR 'systematic review'/de OR 'cochrane database of systematic reviews':jt) NOT ('animal'/exp NOT 'human'/exp) NOT ('letter'/de OR 'book'/de OR 'editorial'/de OR 'note'/de OR 'short survey'/exp) AND [7-4-2011]/sd
  • 37. Summary Work with your investigators to: • Identify terms and preferred filter methodology. Deconstruct a protocol: • Select the important concepts expressed in the P and I portion of the PICO question. Develop search strings: • Use controlled vocabulary and natural language words and phrases of British and American derivation to construct search strings. Use validated hedges: • When applicable to your specific clinical question. 37