Searching the Literature
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Introduction
The following evidence-based resources can be great Open-Access sources of information:
- Bio Med Central
- Public Library of Science
- CMAJ
- Directory of Open Access Journals
- PubMed
- Cochrane
- Clinical Evidence
- Current Controlled Trials
- Other
PubMed
PubMed (dal) is an important medical database containing almost 5,000 journals that cover medicine, nursing, dentistry, and other health-related fields.
PubMed Searches
There are a number of parameters that may be modified to refine PubMed searches.
Medical Subject Headings
MeSH provides standardized subject headings that are used to categorize articles. The MeSH database may be accessed under the 'PubMedServices' toolbar. MeSH headings can be further refined using 'subheadings'.
Searches are executed under the 'links' button on the MeSH page.
MeSH will miss papers that have not yet been mapped to; keyword searches are thus necessary to find the most recent papers.
To view the MeSh headings for a given paper, select 'citation' under the article's display tab.
Combining Searches
Performed searches are listed in the 'History' tab of PubMed. They can be combined to further enhance a search's specificity.
Clinical Queries
Clinical queries, under the 'PubMed Services' bar, allows for searches based on etiology, diagnosis, therapy, prognosis, or clinical prediction.
Systematic reviews may also be searched, with MeSH headings and combined searches allowing refinement of simple keyword searches.
The Cochrane Library
The Cochrane Library provides high quality systematic reviews for clinical decision-making, with a focus on therapies.
Access to Cochrane reviews is available to Dalhousie students, and to all Nova Scotians. An important part of Cochrane's mandate is to provide accessible information to the public to assist them in decisions about their health.
Searching Cochrane
Cochrane may be searched using keywords or MeSH subjects. Due to the high specificity of MeSH headings, keywords should be used first when attempting to identify reviews of potential interest.
Clinical Evidence
clinical evidence (dal) from the British Medical Journal, provides succinct information about clinical questions often asked by family doctors. Treatment options are presented in easily understandable lists and well-referenced.
Current Controlled Trials
http://www.controlled-trials.com/
Other Evidence-Based Medical Databases
Embase - European database that includes PubMed-linked journals; especially good for searching for pharmacological questions
- PsycINFO
- Web of Science
- ACP Pier
- InfoPOEMs
- Oxford Centre for Evidence-Based Medicine
- Bandolier
- Critical Appraisals from CFPC
Framing the Question
It is important to approach and answer problems effectively, using well thought out, attainable, and directed questions.
There are several steps to be taken while framing an "answerable" question and then answering it:
- Identify what you need to know and apply the PICO model
- Consider what basic type of question (therapy, diagnosis, etiology/harm, prognosis) is being asked
- Decide what study type would best answer your question
- Choose a database or source and execute search
1) The PICO(T) Model
The PICO(T) model is used to identify relevant information and fashion it into a directed question.
| Population | How do I describe my patient's problem? |
| Intervention/Exposure | Treatment, test, exposure, or prognostic factor |
| Comparison/Control | Alternate treatment or gold standard |
| Outcome | What aspect of problem is being measured |
| Time for Outcome | Time Frame |
examples of PICO(T)
| Population | adult patients with stable angina |
| Intervention/Exposure | nicorandil |
| Comparison/Control | no treatment |
| Outcome | reduction of coronary events |
| Time for Outcome | 5 years |
In adult patients with stable angina, is nicorandil, versus no treatment, effective in reducing coronary events over the next five years?
Resources and References
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