This document provides an overview of how to effectively search the medical literature from clarifying a research question to developing search strategies, managing references, and keeping search results up to date. It discusses translating topics into keywords, subject headings, Boolean logic, and search filters. Examples are provided of formulating search strategies in PubMed and Ovid MEDLINE. Tips are given for recording the search process, critically appraising sources, and getting help from medical librarians. The goal is to help readers get the most from literature searches and medical library resources.

1. CAMBRIDGE UNIVERSITY LIBRARY
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Diving for pearls…..
How to get the most from your
literature search & the Medical Library
Isla Kuhn
Deputy Medical Librarian

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• how to clarify the question(s) on which you need to
find literature
• selecting the databases and other resources you
will need to search
• devising the most comprehensive literature search
strategy so you know you’ve not missed any relevant
studies
• keeping up to date with new information appearing
between the initial search and write-up
• issues around management of process and results
• management of references (using software such as
RefMan), and getting hold of the full text article

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#1 Accidents/
#2 exp Accidents, Traffic/
#3 exp Accident Prevention/
#4 exp Motorcycles/
#5 motor-cycl* or motorcycl* or motor-bik* or motorbik* or scooter* or moped* or
moto or motocycl* or motocicl*
#6 trauma* or injur* or fatal* or accident* or crash* or prevent* or collide* or
collision*
#7 #1 or #2 or #3 or #4 or #5 or #6
#8 head near protect*
#9 head near shield*
#10 helmet*
#11 exp Head Protective Devices/
#12 #8 or #9 or #10 or #11
#13 #7 and #12

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http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD

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1 clinical trial.pt.
2 randomized.ab,ti.
3 placebo.ab,ti.
4 dt.fs.
5 randomly.ab,ti.
6 trial.ab,ti.
7 groups.ab,ti.
8 or/1-7
9 Animals/
10 Humans/
11 9 not (9 and 10)
12 8 not 11
13 dorsalgia.ab,ti.
14 exp Back Pain/
15 exp Low Back Pain/
16 backache.ab,ti.
17 (lumbar adj pain).ab,ti.
18 coccyx.ab,ti.
19 coccydynia.ab,ti.
20 exp Sciatica/
21 sciatica.ab,ti.
22 spondylosis.ab,ti.
23 lumbago.ab,ti.
24 or/13-23
25 exp Spine/
26 discitis.ab,ti.
27 exp Spinal Diseases/
28 (disc adj degeneration).ab,ti.
29 (disc adj prolapse).ab,ti.
30 (disc adj herniation).ab,ti.
31 spinal fusion.sh.
32 spinal neoplasms.sh.
33 (facet adj joints).ab,ti.
34 intervertebral disk.sh.
35 postlaminectomy.ab,ti.
36 arachnoiditis.ab,ti.
37 (failed adj back).ab,ti.
38 or/25-37
39 exp activities of daily living/
40 activities of daily living.tw.
41 day to day activ$.ti,ab.
42 daily activit$.ti,ab.
43 ordinary activit$.ti,ab.
44 normal activit$.ti,ab.
45 stay$ active.ti,ab.
46 exp Bed Rest/
47 bed rest.mp.
48 or/39-47
49 24 or 38
50 12 and 49
51 48 and 50

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From topic to search
• Topic -> question -> search strategy!
...”What is the epidemiology of death or serious injury caused
by road traffic accidents in Africa?” ….
Question
Keywords
Synonyms
MeSH / Subject Headings / sub-headings
Boolean Logic
Truncation / wildcards
Limits

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• ...”What is the epidemiology of death or serious injury caused by road
traffic accidents in Africa?”
From Topic to Results
Keywords / Themes / PICO
patient/ intervention /comparison/ outcome

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What is the epidemiology of death or serious injury caused by road traffic
accidents in Africa?”
Epidemiology
Road traffic accidents
Africa
Synonyms?
From Topic to Results

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What is the epidemiology of death or serious injury caused by road traffic
accidents in Africa?”
epidemiology / longitudinal study/ cohort study
road traffic accidents / car crash / road trauma/ road traffic injuries
Africa / Algeria/ Botswana / Cameroon/ Djibouti / Egypt
Synonyms?
From Topic to Results

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Boolean Logic
AND – to narrow the search by combining different topics
eg
“physiotherapy” and “stroke”
Both terms must be present in the results.
StrokePhysiotherapy

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Boolean Logic
OR – to broaden your search, by combining similar terms
eg
“exercise” or “physical activity”
Either term can be present in the resulting set of articles.
Physical activityExercise

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Boolean Logic
NOT – to restrict your search so that it does not contain a particular term
eg
“physical therapy” not “manual therapy”
The first, but not the second, term must be present.
Manual
Therapy
Physical
Therapy

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From Topic to Results
epidemiology OR longitudinal study OR cohort study
AND
road traffic accidents OR car crash OR road trauma OR road traffic injuries
AND
Africa OR Algeria OR Botswana OR Cameroon OR Djibouti OR Egypt

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Question:
1st
theme OR OR OR
AND
2nd
theme OR OR OR
AND
3rd
theme OR OR OR
AND
4th
theme? OR OR OR

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Mind map your question?
Research
question
1st
theme
4th
theme
3rd
theme
2nd
theme
synonym
synonym
synonym
synonym
synonym
synonym
synonym
synonym
synonym
synonym synonym
synonym

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From Topic to Results
epidemiology OR longitudinal OR cohort
AND
road traffic accident OR car crash OR road trauma OR road traffic injuries
AND
Africa OR Algeria OR Botswana OR Cameroon OR Djibouti OR Egypt

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1. epidemiolog*
2. longitudinal*
3. cohort
4. 1 or 2 or 3
5. road traffic accident*
6. car crash*
7. road trauma*
8. road traffic injuries
9. 5 or 6 or 7 or 8
10.Africa*
11.Algeria
12.Botswana
13.Cameroon
14.10 or 11 or 12 or 13
15.????

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Putting the theory into practice
http://wok.mimas.ac.uk

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• http://tinyurl.com/campubmed

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1 clinical trial.pt.
2 randomized.ab,ti.
3 placebo.ab,ti.
4 dt.fs.
5 randomly.ab,ti.
6 trial.ab,ti.
7 groups.ab,ti.
8 or/1-7
9 Animals/
10 Humans/
11 9 not (9 and 10)
12 8 not 11
13 dorsalgia.ab,ti.
14 exp Back Pain/
15 exp Low Back Pain/
16 backache.ab,ti.
17 (lumbar adj pain).ab,ti.
18 coccyx.ab,ti.
19 coccydynia.ab,ti.
20 exp Sciatica/
21 sciatica.ab,ti.
22 spondylosis.ab,ti.
23 lumbago.ab,ti.
24 or/13-23
25 exp Spine/
26 discitis.ab,ti.
27 exp Spinal Diseases/
28 (disc adj degeneration).ab,ti.
29 (disc adj prolapse).ab,ti.
30 (disc adj herniation).ab,ti.
31 spinal fusion.sh.
32 spinal neoplasms.sh.
33 (facet adj joints).ab,ti.
34 intervertebral disk.sh.
35 postlaminectomy.ab,ti.
36 arachnoiditis.ab,ti.
37 (failed adj back).ab,ti.
38 or/25-37
39 exp activities of daily living/
40 activities of daily living.tw.
41 day to day activ$.ti,ab.
42 daily activit$.ti,ab.
43 ordinary activit$.ti,ab.
44 normal activit$.ti,ab.
45 stay$ active.ti,ab.
46 exp Bed Rest/
47 bed rest.mp.
48 or/39-47
49 24 or 38
50 12 and 49
51 48 and 50

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1 clinical trial.pt.
2 randomized.ab,ti.
3 placebo.ab,ti.
4 dt.fs.
5 randomly.ab,ti.
6 trial.ab,ti.
7 groups.ab,ti.
8 or/1-7
9 Animals/
10 Humans/
11 9 not (9 and 10)
12 8 not 11
13 dorsalgia.ab,ti.
14 exp Back Pain/
15 exp Low Back Pain/
16 backache.ab,ti.
17 (lumbar adj pain).ab,ti.
18 coccyx.ab,ti.
19 coccydynia.ab,ti.
20 exp Sciatica/
21 sciatica.ab,ti.
22 spondylosis.ab,ti.
23 lumbago.ab,ti.
24 or/13-23
25 exp Spine/
26 discitis.ab,ti.
27 exp Spinal Diseases/
28 (disc adj degeneration).ab,ti.
29 (disc adj prolapse).ab,ti.
30 (disc adj herniation).ab,ti.
31 spinal fusion.sh.
32 spinal neoplasms.sh.
33 (facet adj joints).ab,ti.
34 intervertebral disk.sh.
35 postlaminectomy.ab,ti.
36 arachnoiditis.ab,ti.
37 (failed adj back).ab,ti.
38 or/25-37
39 exp activities of daily living/
40 activities of daily living.tw.
41 day to day activ$.ti,ab.
42 daily activit$.ti,ab.
43 ordinary activit$.ti,ab.
44 normal activit$.ti,ab.
45 stay$ active.ti,ab.
46 exp Bed Rest/
47 bed rest.mp.
48 or/39-47
49 24 or 38
50 12 and 49
51 48 and 50

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Advice to rest in bed versus advice to stay active for acute
low-back pain and sciatica
The objective of this review is to determine the effects of advice to rest in bed or stay active for patients
with acute low-back pain or sciatica.
The following comparisons will be made:
• Bed rest versus staying active
• Bed rest versus other treatments (besides staying active)
• Shorter periods of bed rest versus longer periods of bed rest
• Staying active versus other treatments (besides bed rest)
• Comparison between different forms of advice to stay active (e.g. avoiding bedrest, staying active)
http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD007612/pdf_fs.html

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From topic to search: filters
• http://www.sign.ac.uk/methodology/filters.html Observational Study Filters
Medline
1 Epidemiologic studies/
2 Exp case control studies/
3 Exp cohort studies/
4 Case control.tw.
5 (cohort adj (study or studies)).tw.
6 Cohort analy$.tw.
7 (Follow up adj (study or studies)).tw.
8 (observational adj (study or studies)).tw.
9 Longitudinal.tw.
10 Retrospective.tw.
11 Cross sectional.tw.
12 Cross-sectional studies/
13 Or/1-12
Embase
1 Clinical study/
2 Case control study
3 Family study/
4 Longitudinal study/
5 Retrospective study/
6 Prospective study/
7 Randomized controlled trials/
8 6 not 7
9 Cohort analysis/
10 (Cohort adj (study or studies)).mp.
11 (Case control adj (study or studies)).tw.
12 (follow up adj (study or studies)).tw.
13 (observational adj (study or studies)).tw.
14 (epidemiologic$ adj (study or studies)).tw.
15 (cross sectional adj (study or studies)).tw.
16 Or/1-5,8-15

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From topic to search: filters - translated
• http://www.sign.ac.uk/methodology/filters.html Observational Study Filters
Medline (via Pubmed)
#1 “Epidemiologic studies”[Mesh]
#2 “case control studies”[Mesh]
#3 “cohort studies”[Mesh]
#4 Case control[Text Word]
#5 (cohort stud*))[Text Word]
#6 Cohort analy*[Text Word]
#7 (Follow up AND (study or studies))[Text
Word]
#8 (observational AND (study or studies))[Text
Word]
#9 Longitudinal[Text Word]
#10 Retrospective[Text Word]
#11 Cross sectional[Text Word]
#12 “Cross-sectional studies”[Mesh]
#13 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR
#7 OR #8 OR #9 OR #10 OR #11 OR #12
Medline
1 Epidemiologic studies/
2 Exp case control studies/
3 Exp cohort studies/
4 Case control.tw.
5 (cohort adj (study or studies)).tw.
6 Cohort analy$.tw.
7 (Follow up adj (study or studies)).tw.
8 (observational adj (study or studies)).tw.
9 Longitudinal.tw.
10 Retrospective.tw.
11 Cross sectional.tw.
12 Cross-sectional studies/
13 Or/1-12

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http://library.medschl.cam.ac.uk/resources-training-support/databases/

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• Reference Manager
(or Endnote or EndnoteWeb, or Zotero, or Mendeley, or…?)
• LibrarySearch and/or e-journals@cambridge
(you might need RAVEN if “off campus” to get hold of the articles )
From strategy to references

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http://tinyurl.com/campubmed
http://wok.mimas.ac.uk
And other tools to help:
• Non-journal material (eg NGO websites, books, statistics, grey literature)
• CASP Critical Appraisal Checklists / Twitter Journal Club
/ other critical appraisal tools
• Qiqqa or PDF X-change
From strategy to references

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Keeping up to date
• alerts
• journal TOCs
• citation tracking
• Email alerts
• RSS fees

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Management of process & results
• What is the data you need to record?
• Where will you record it? Where will you store it?
• How will you record it?
• How will you share it?
When should all this start?
– more info on data management

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Searching – Do’s & Don’ts
• Don’t try to do the whole search in one line
• Don’t imagine that your first attempt will get all the articles you need
• Don’t give up!

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Searching – Do’s & Don’ts
• Do think of alternative ways of talking about your topic
• Do learn from your hits and your misses
• Do remember that you still have to critically appraise each article
• Do ask for help

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Help!
Isla Kuhn
Deputy Medical Librarian
Medical Library
Box 111
Addenbrooke’s Hospital
email: ilk21@cam.ac.uk
phone: (01223) (3)36750
web: http://library.medschl.cam.ac.uk
Thank you.
Available afternoon of
24th
October & 31st
October
(ahead of essay presentations
on 8th
November)