This document provides an overview of strategies for searching the medical literature, including developing a PICO question, using Boolean operators and truncation, searching databases like PubMed and Google Scholar, and accessing full text articles. Key tips include searching MeSH terms in PubMed to identify the most relevant subject headings, using limits to narrow search results to specific types of articles and populations, and taking advantage of library services to access full texts.

1. Literature Searching Susan Fowler, MLIS Medical Librarian [email_address] 314-362-8092 pg: 314-360-1069

2. Outline PICO Search Strategy Boolean and Other Nifty Tricks Google PubMed (MEDLINE) RefWorks

3. PICO(T) Patient or problem - How would I describe a group of patients similar to mine? Intervention - Which main intervention, prognostic factor, or exposure am I considering? Comparison (if appropriate)- What is the main alternative to compare with the intervention? Outcome - What can I hope to accomplish, measure, improve or affect? Type of Study – Based on my question, what type of study will provide the best answer?

4. Type of Study Type of Question Ideal Type of Study Therapy RCT Prevention RCT > Cohort > Case Control Diagnosis Prospective, blind controlled comparison to gold standard Prognosis Cohort > Case Control > Case Series/Case Report Etiology/Harm RCT > Cohort > Case Control

5. The Search Strategy Develop PICO question Identify keywords and terms from PICO Identify standardized subject headings Combine subject headings and keywords to narrow or broaden your search Evaluate your search results Revise the search in light of your results

6. Boolean George Boole (1815 –1864) was an English mathematician and philosopher. Invented Boolean logic which is the basis of modern digital computers. -AND -OR -NOT

7. Boolean Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic . Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.

8. Boolean Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic . Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.

9. Boolean and Nesting Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic . Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.

10. Truncation and Wild Cards Truncation is a searchable shortened form of a word. adolescen* will include adolescence adolescent adolescents, etc… Wild card characters are useful because of alternate spellings and other quirks in the English language. behavio?r, will include behaviour behavior Wom*n, will include women woman

11. Quotation Marks Using quotation marks for a phrase forces the database to return results where those words appear together. Without Quotations = 57,360 results With Quotations = 13,180 results

12. Google Scholar http://scholar.google.com/ Freely accessible database of a vast array of materials and media archived in the web Customizable to point to your full text available through your library Customizable to send citations to your citation manager Set up auto search alerts to track materials that match a specific search query

13. Go to “ Advanced Scholar Search”

14. Scholar Preferences

15. Scholar Preferences, cont… Activate links to locally held online full text. Send citations directly to your citation management program.

16. Advanced Scholar Search Use truncation Search exact phrases Use limits to narrow results by specific author, publication , and date range. Narrow by subject area

17. Set Up Alert Click the envelope to access the alert service.

18. Set Up Alert, cont… Alerts will automatically be sent to your email.

19. PubMed (Medline) Free resource developed and maintained by the National Center for Biotechnology Information (NCBI), at the U.S. National Library of Medicine (NLM), located at the National Institutes of Health (NIH). 20 million citations for biomedical literature from MEDLINE, life science journals, and online books. 5,400 worldwide journals in 60 languages Covers 1947 to the present with some older material.

20. Access Be sure to access PubMed from becker.wustl.edu to take advantage of library links to full text.

21. Create a My NCBI Account

22. Create a My NCBI Account, cont…

23. MeSH = Medical Subject Headings Choose MeSH from Pull Down Menu

24. MeSH in PubMed Enter your search terms one at a time…

25. MeSH cont… Choose the most applicable MeSH terms Click on the best term.

26. MeSH cont… Add to Search Builder Search PubMed You have not searched the literature yet. Searching MeSH is akin to searching a thesaurus for the best term.

27. Advanced Search Once you have searched each term separately, go to advanced search to combine them.

28. Advanced Search, cont… Enter search numbers and combine using Boolean operators.

29. Limits

30. Limits cont… For the most clinically applicable articles, limit to “Humans,” “English,” and “Type of Article”

31. Accessing Full-Text Articles NOT FREE FREE Avoid clicking on publisher icons unless they explicitly state that they are free or unless you are willing to pay $ 35.00 -65.00 dollars per article.

32. Accessing Full-Text Articles, cont… It is likely that your institution’s library has facilitated link-out in PubMed to link you directly to articles from journals to which they subscribe to. It is also likely that your institution’s library has an Inter-Library Loan service that will “borrow” the article you want from another library for you for a small charge (certainly less then $35.00!) or for free. Contact your librarian and find out what services are available and how to use them.

33. Send To You can email your results to yourself and your colleagues. From “Send to” drop down menu, choose “E-mail”

34. More PubMed Tutorials PubMed has tutorials available from their site…

35. 20 Minutes 660 S. Euclid 314-362-7085 Susan Fowler, 314-362-8092 Pg: 314-360-1069 [email_address] St. Louis Children’s Hospital Lauren Yaeger, 314-454-2768 [email_address] If 20 minutes have passed and you still have not found what you are looking for, stop and ask for help.