Instructions

Searching PubMed for the Evidence: A Tutorial for Physician Assistants

by Cindy Schmidt, M.D., M.L.S. and Teresa Hartman, M.L.S.
Education and Research Services, McGoogan Library of Medicine

1. This tutorial WON'T WORK PROPERLY IN CHROME. Use Firefox. The tutorial may not show the McGoogan Library homepage in the window to the right.

2. Use the Arrow icons below the instruction screen to go forward and backward in the tutorial, such as in the illustration below.

3. If you want to skip between distant parts of the tutorial, you can use the button above the instruction screen (see arrow in screenshot below) to show the tutorial's "Table of Contents" and can click on the needed section of the tutorial.

 

4.  Clicking the Single-page View link (shown in figure above) will produce a printable transcript of the entire tutorial.

Objectives

Objectives
After completing this tutorial, you will be able to:

  • name the four steps in practicing evidence-based medicine,
  • name the type of article providing the highest quality evidence,
  • use search terms and filters to find systematic reviews in PubMed.

 

Intro to Evidence Based Medicine (EBM)

1 of 3A Quick Introduction to the Practice of Evidence Based Medicine

What are the steps involved in the practice of "evidence-based medicine"[1]?

  • Ask focused, answerable questions about your patient's care
  • Find the highest quality evidence that addresses each question
  • Critically appraise the validity, clinical relevance, and applicability of the evidence
  • Apply the evidence in practice: make clinical decisions based in part on the evidence, but also based on past experience, the patient's preferences, knowledge of the locally available medical resources, etc.

Most students find determining the quality of the evidence, step 2, to be one of the most difficult aspects of the EBM process. This tutorial will begin by defining the "highest quality evidence." It will then present a clinical situation that would benefit from an evaluation of the relevant evidence and, finally, it will guide you as you work through steps 1 and 2 of the EBM process for this clinical situation.

1 Centre for Evidence Based Medicine (CEBM). "The steps of practicing EBM" Oxford, UK: University of Oxford. https://www.cebm.ox.ac.uk/resources/medical-student-resources. Last updated 2022, accessed May 3, 2022.

Intro to Evidence Based Medicine (EBM)

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I. What is the highest quality evidence?

A well done, up-to-date, systematic review or meta-analysis is the highest quality evidence.  

Please, right click on this link and select the "new window" option to see the evidence-based medicine pyramid in a new window. Adjust the size of the tutorial window and size of the new window so that you can see the two side by side. You will see "systematic reviews" at the top of the EBM pyramid.

A.  Perhaps you're asking, "What's a systematic review?"
Authors of well-done, systematic reviews:

  • systematically search for and locate all the published, relevant, high quality studies,
  • critically evaluate all the high quality trials/studies,
  • when possible, combine the data from the evaluated studies and do an overall statistical analyses (a meta-analysis), and
  • make recommendations for practice and research.

B.  The McGoogan Library provides several resources that include systematic reviews and/or lists of systematic reviews.

Intro to Evidence Based Medicine (EBM)

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This tutorial will focus on the systematic reviews available in journals that are either licensed by the library or available through Interlibrary Loan. Specifically, this tutorial will give you a chance to search PubMed for systematic reviews and randomized controlled trials (the highest quality filtered/summarized and unfiltered/initially-reported evidence available) on one clinical topic. You will gain experience constructing medical-subject-heading-based, and keyword-based, search strategies and using appropriate search filters.

Instruction reminder

As you enter the PubMed portion of the tutorial, we'd like to remind you of the instructions that will get you past the hurdles that occasionally cause tutorial users to stumble:

  • Follow the instructions on each screen and then click the right-facing arrow.
  • Avoid getting ahead of the tutorial. Nearly every step in the search process is explained.
  • If you're confused, try going to the next screen; it may answer your question.
  • At one or two points in the tutorial, you will create search strategies on a Word document. Don't put your search terms in a PubMed search box until the tutorial tells you to do so.
  • Use the "contents" button above the instruction panel if you need to skip between distant portions of the tutorial.

 

Introduction to PubMed

Introduction to PubMed 

PubMed contains over 36 million records. Each record provides information about a single journal article.

Unfortunately, there is no single searching method that best fits all the records in PubMed. Why? PubMed searches different National Library of Medicine literature resources. All PubMed records contain the authors' last names and first initials, the article title, the journal title, the volume, the page numbers, the year of publication, and the publication language. However, only records in the MEDLINE record set are extensively indexed with the medical subject headings (MeSH) and with the publication type and subject characteristic tags that are so useful when focusing a search. The record types and their characteristics are listed below:

Indexed

  • MEDLINE

Unindexed

  • pre-MEDLINE and OLD MEDLINE
  • PubMed Central
  • Bookshelf
Open another window to access PubMed through the McGoogan Library. Right click on this link and open a new window, then log in using your Duo account information (if asked).

    

Indexed Records

1. Indexed records are MEDLINE records.  They form the bulk of PubMed.  A human indexer has assigned Medical Subject Headings (MeSH) and added information about the subject characteristics (human/animal, age, gender) and publication types (randomized controlled trial, review, etc.)

As an example, in the search box for PubMed on the right side of the screen, type this PMID # (PubMed ID number) : 21272701

In the "Abstract" view of a PubMed record, you can scroll down the page to see the information, including if it has MeSH terms added by the indexer.

 

 

 

Unindexed Records --PREMEDLINE

PREMEDLINE records are "as received from publisher" or "in process" records. These records may eventually be indexed and become MEDLINE records.

Enter just the PMID number: 35400843 in the search box. The article is also a PMC record. It may or may not be MeSH indexed in the future.

 

Unindexed -- non-MEDLINE records

 When full-text is freely available through PubMed Central (a full-text depository), a record will be added to PubMed even if the journal publishing the article is not currently indexed in MEDLINE. Also some publishers are beginning to submit records for their very old content (example: a record for a freely available 1885 article from Science). Records for such old articles are of potential interest to PubMed searchers, but not timely enough to deserve the attention of indexers.

 

Implications for differences in Indexed and Unindexed Data Sets

Indexed records/MEDLINE records are usually retrieved most easily and effectively with medical subject heading (MeSH) searches.

Unindexed records, in general, do not contain medical subject headings (MeSH) and, thus, cannot be retrieved using medical subject heading (MeSH) searches. The searcher must use keyword searches to retrieve these records.

Clinical Situation

This tutorial will guide you through a MeSH search for MEDLINE records (indexed records) and then a keyword search for both indexed and unindexed records. Both searches will be focused on a single clinical question.

Clinical Situation:
You have a patient who just watched a documentary about the use of capsaicin to treat peripheral neuropathy. Although she just watched the documentary, she knows it was produced several years ago. She wants to know whether results of clinical trials continue to support this treatment and whether she should give it a try.

Open a Word document and type a list of the important concepts in this question. (Some students find this easier if they are asked, instead, to list the words they might type into a quick Google search.) 

Outline Search -- Major Concepts

Does your list include the following two concepts?

capsaicin
peripheral neuropathy

If not, add these concepts to your list.

Outline Search: Limits

Have you also listed any of the following in your list of search concepts?

humans (humans vs. animals)
females (gender)
adult (age)
randomized controlled trials, practice guidelines, consensus statements (publication type)
English-language (publication language)

If so, type the word "Filter" next to these concepts.

When you are working on a MeSH search of MEDLINE, things like publication characteristics (language, publication type) and subject characteristics (human vs. animal, gender, age) are best applied as filters. You will not include these concepts in your initial search. Instead, you will apply filters corresponding to these concepts after running your initial MEDLINE search.

These concepts are best applied after a keyword search, also.

 

Go to PubMed

Now that you've outlined your search, it's time to actually look up the needed medical subject headings (MeSH) and construct your search.

You should still see PubMed in the other window you pulled up.

 

Go to MeSH Thesaurus

You should now see the PubMed homepage in your new browser window. On the far right under the blue area you will see "Explore" - click on "MeSH Database".

 

 

"Capsaicin" Heading

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Enter -- capsaicin -- in the MeSH Database search box and click on the search button.

 

"Capsaicin" Heading

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A list of about 5 MeSH headings will appear. These five headings appear because the descriptions of all these headings contain the word capsaicin.

In this case, you want to use the first heading in the list -- capsaicin. To see and select one of the subheadings available with the capsicin heading, you have to click on the heading.

Capsaicin subheadings

You can focus your search on specific aspects of the Capsaicin topic by using subheadings.

Look at the subheadings listed for Capsaicin).

What subheading/s, if any, do you want to use with the capsaicin heading? Use subheadings only when there are just a few aspects of the heading topic (1-3 aspects) that are central to your clinical question.

 

What subheading/s, if any, do you want to use with the capsaicin heading? Use subheadings only when there are just a few aspects of the heading topic (1-3 aspects) that are central to your clinical question.

Peripheral Neuropathy Heading

1 of 2Select --

"capsaicin/administration and dosage"[MeSH] "capsaicin/therapeutic use"[MeSH]

-- terms. On the right side of the screen, under PubMed Search Builder, change the drop-down "AND" to "OR" and click on "Add to search builder. The terms  should now appear in the PubMed search builder with an OR between them.

 

You now need to search for a peripheral neuropathy heading. Enter  --


peripheral neuropathy


-- in the MeSH search box and hit the "search" button.

Peripheral Neuropathy Heading

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Of the options that appear, the first option "peripheral nervous system diseases" is the most likely to include all forms of peripheral neuropathy. Click on the "peripheral nervous system diseases" heading.

 

"Peripheral Nervous System Diseases" Subheadings

1 of 4What subheading/s do you want to use with "peripheral nervous system diseases"?

What subheading/s do you want to use with "peripheral nervous system diseases"?

"Peripheral Nervous System Diseases" Subheadings

2 of 4Click the boxes in front of the "drug therapy" and "therapy" subheadings.

Before adding your terms to the PubMed search box, scroll down to the bottom of the screen. Toward the bottom of the screen you will see the broader and narrower headings that surround the "peripheral nervous system diseases" heading.

"Peripheral Nervous System Diseases" Subheadings

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It's always a good idea to check the broader and narrower heading lists (also called MeSH trees). You may want to switch to a broader or narrower heading. In the figure below, you can see part of the 'tree' for "Peripheral Nervous System Diseases." You can see the whole list in your MeSH database window.

Before you consider switching headings, it's important that you understand that PubMed "explodes" headings by default. What does this mean?

When you search with

"peripheral nervous system diseases/drug therapy"[mesh] OR "peripheral nervous system diseases/therapy"[mesh],

PubMed retrieves records indexed with the terms you've listed but it also retrieves all records indexed with the narrower headings in combination with the subheadings you've chosen. For example,

"peripheral nervous system diseases/drug therapy"[mesh] OR "peripheral nervous system diseases/therapy"[mesh]

will retrieve articles indexed with any of the following:

"peripheral nervous system diseases/therapy"[mesh]
"peripheral nervous system diseases/drug therapy"[mesh]
"acrodynia/therapy"[mesh]
"acrodynia/drug therapy"[mesh]
"diabetic neuropathies/therapy"[mesh]
"diabetic neuropathies/drug therapy"[mesh]
"causalgia/therapy"[mesh]
"causalgia/drug therapy"[mesh]
etc.

Should you switch to a broader or narrower heading or stay with your current choice?

"Peripheral Nervous System Diseases" Subheadings

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In this case, the --

"Peripheral Nervous System Diseases/drug therapy"[mesh] OR "Peripheral Nervous System Diseases/therapy"[mesh]

-- search that you've already selected is best.

Why? Because you want to retrieve the articles about treatment of peripheral nervous system diseases in general, as well as the articles about treatment of specific peripheral nervous system diseases that the exploded "peripheral nervous system" heading will retrieve. You don't want to retrieve the articles about non-peripheral-nervous-system-related "neuromuscular diseases" that would be included among the results retrieved by the broader "neruomuscular diseases" heading.

 

Joining Capsaicin to "Peripheral Nervous System Diseases"

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What conjunction (Boolean Operator) do you want to use to join the "peripheral nervous system diseases" concept to the "capsaicin" concept?

What conjunction (Boolean Operator) do you want to use to join the "peripheral nervous system diseases" concept to the "capsaicin" concept?

Joining Capsaicin to "Peripheral Nervous System Diseases"

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You will want to join the capsaicin concept to the peripheral neuropathy concept with AND because you want both concepts to be present in every record you retrieve. If you wanted either the capsaicin or the peripheral neuropathy concept to be present in each record retrieved, you would choose OR to join the concepts.

AND is the default setting for the Boolean Operator selection menu (red arrow in figure). If you've changed the setting, select AND.

Add the selected, "peripheral nervous system diseases," heading/subheading combinations to the PubMed search builder by clicking the "Add to search builder" button.

Review the search produced by the "PubMed Search Builder"

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Review the search you've created in the "PubMed Search Builder". Do you need to edit the parentheses or the ANDs, OR, or NOTs (the Boolean operators)?

First, look at the conjunction (Boolean operator) that has been used to join the two "capsaicin" heading/subheading combinations.

Then look at the conjunction (operator) that has been used to join the two "peripheral nervous system diseases" heading/subheading combinations.

"OR" has been used in each case.  Is this the best choice?

Review the search produced by the "PubMed Search Builder"

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When you choose multiple subheadings at the same time, the search builder will OR together the multiple heading/subheading combinations and will put the multiple combinations inside a set of parentheses.

The default use of OR is usually for the best, since the searcher rarely cares which of the two subheadings is present, he/she just wants one or the other of the two (or more) simultaneously selected subheadings.  

The parentheses around the OR'd together heading/subheading combinations are often for the best also. Parentheses work as they do in algebra. The PubMed search engine will do the operations inside a set of parentheses before doing the adjacent operations. Otherwise, the search engine reads from left to right.

Review the search produced by the "PubMed Search Builder"

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Do you know what would happen if there were no parentheses around 

("peripheral nervous system diseases/drug therapy"[mesh] OR "peripheral nervous system diseases/therapy"[mesh])

 

What would a search for --

 

("capsaicin/administration and dosage"[mesh] OR "capsaicin/therapeutic use"[mesh]) AND "peripheral nervous system diseases/drug therapy"[mesh] OR "peripheral nervous system diseases/therapy"[mesh]

 

-- retrieve?  Note the lack of parentheses around the OR'd together. 'peripheral nervous system diseases" heading/subheading combinations.

 

When you're happy with your search, click the "Search PubMed" button.

Add Filters

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You should now be looking at a list of over 240 PubMed search results. 

 

Now it's time to add any desired filters. One at a time, apply the desired filters by clicking the relevant links on the left-hand side of the page. You may have to click the "Additional Filters" link to add the filter you want to use the list of filters shown. Once the filter appears in the list on the left-hand side of the page, you can click it to apply it to your search results. You will have to wait for the page to refresh after clicking each filter.

For the purposes of this tutorial, use the "Randomized-Controlled Trials", "Systematic Reviews", "Humans", and "English" filters. If one of the needed filter categories is not shown, click the "Additional filters" link on the left-hand side of the page, wait for the needed filter category to appear, and select, one-at-a-time, the filters you wish to apply. After the filters appear in the left-hand column, you will have to click the desired filter options.

Add Filters

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Around 50 records will appear in your search results. The "Filters applied" alert will appear at the top of the screen.

 

Display "Abstract" view for full-text buttons

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To see the abstracts and full-text buttons, you will need to change the "Display Options." Click on the "Display Settings" drop-down menu. Select "Abstract" and then sort by "Publication Date" (instead of Best Match). Change "Per page" to 200 so you can search the entire page for specific terms or PMID numbers.

 

Display "Abstract" view for full-text buttons

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Look at the full-text buttons that appear under the abstracts. Under one record at the top you will see a "Read free full text at BMC" button. This article also has a "Free in PMC" (PubMed Central) button. If you want to see the full-text of an article that has a publisher's open access or "Free" button, try the "Open Access" or "Free" button first. If you find that the full-text is no longer free, you can always try the "GetIt!@UNMC" button later.

 

"GetIt!@UNMC" button

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Find the record with PMID 33198614.  You can use your browsers "find on page" feature (Windows computers Ctl f, Macs use command f) to find 33198614.  

Scroll down below the record until you find its "GetIt@UNMC" button. Click on the "GetIt!@UNMC" button. This will open a new window that takes you to the McGoogan Library's Primo catalog page. There is no full text link listed, so you can click on Request Item to request the article through Interlibrary Loan. Articles requested through Interlibrary Loan generally take 2 hours to 2 days to be delivered electronically to your account. You will receive an email notice saying the article is ready. Articles stay in your Interlibrary Loan account for 30 days to allow you plenty of time to download them to your computer.

 

"GetIt!@UNMC" button

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When you click a link to a full-text source, you will usually be taken to the abstract of the article and will have to look around for a link to the PDF version.

Occasionally, especially when the "GetIt!@UNMC" button only produces a "journal" link and no "article link", you will be taken to a homepage for the journal or full-text source and will have to search an archive of back issues to find the needed article. This happens frequently when an article has been published electronically before it appears in print.

"GetIt!@UNMC" button

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Go back to the window that has your PubMed results.

Find the PubMed record for PMID: 30472337

Click on this record's "GetIt!@UNMC" button.

 

"GetIt!@UNMC" button

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This time, the Primo catalog page lists full text availability through Elsevier SD Freedom Collection Journals. Click that red link and log in using your Duo credentials. You will see the article and also a link to the pdf.

 

Keyword search

The MeSH-based search you've just performed will only retrieve indexed records (MEDLINE records). These are the only records that contain medical subject headings (MeSH) and the only records that have assigned subject characteristics (age, gender, human/animal) and assigned publication types.

It's now time to search for unindexed records. To find all the relevant unindexed records, you will have to perform a comprehensive/exhaustive, keyword search. To perform a such a search, you have to try to think of every term an author might use to indicate that he/she is talking about the concept of interest to you. You've already outlined the important concepts in this search. Take a few seconds to try to think of one or two alternate terms an author might use to indicate that he/she is talking about the concepts of capsaicin or peripheral neuropathy. Did you come up with any alternate terms? It's often hard to think of synonyms. That's why it's important to consult sources that can help. The tutorial will guide you through this process.

Using the MeSH database to find alternate keywords/keyphrases

The MeSH database can actually be quite helpful. Why? For each MeSH heading there is a list of entry terms. This list includes other terms authors have used for the heading concept. The MeSH database may also contain narrower terms that should be included in your search.

It's important that you understand that you'll now be using the MeSH database to find new keywords -- you should not add terms with [mesh] tags to this search. (Do not use the "Add to Search builder" button while constructing this search).

Keywords for Capsaicin

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Close the new windows/tabs you opened as needed to get back to the original PubMed search page. Click on "MeSH database" under "Explore" on the right side below the blue area.

Enter capsaicin in the MeSH Database search box. Click the "Search" button.

 

Keywords for Capsaicin

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After reaching the MeSH search results, click on the "Capsaicin" link.

 

Keywords for Capsaicin

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Copy the "entry terms" list and paste it on to your Word document (the "entry terms" list is below the subject heading list).

Add your concept word, capsaicin, to the list in your Word document. Then delete all the multi-word phrases that contain the word capsaicin.

Keywords for Capsaicin

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Does your list include the following terms?

capsaicin
Capsaicine
8-Methyl-N-Vanillyl-6-Nonenamide
8 Methyl N Vanillyl 6 Nonenamide
Axsain
Zacin
Capsicum Farmaya
Capsidol
Zostrix
Capzasin
Gelcen
Katrum
NGX-4010
NGX 4010
NGX4010
Capsin

If not, correct your list of terms.

Then, on your Word document:

  • Put quotes around the multi-word terms (any terms containing spaces).
  • OR together the list of terms to make one search statement
  • Put parentheses around the OR'd together terms so that the PubMed search engine will use the terms to retrieve a set of results for the capsaicin concept before doing any adjacent operations.

Keywords for Capsaicin

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Did you end up with the following search statement/strategy? If not, make any needed corrections. Make sure you include the quotes and parentheses as shown below.

(capsaicin OR Capsaicine OR 8-Methyl-N-Vanillyl-6-Nonenamide OR "8 Methyl N Vanillyl 6 Nonenamide" OR Axsain OR Zacin OR "Capsicum Farmaya" OR Capsidol OR Zostrix OR Capzasin OR Gelcen OR Katrum OR NGX-4010 OR "NGX 4010" OR NGX4010 OR Capsin)

MeSH database "entry term" lists are good sources for alternate terms, but not the only such source. If time allowed, you would be asked to consult other resources that list alternate names for drugs and natural medicines.

Keywords for Peripheral Neuropathy

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You will not have enough time during this tutorial to list of all the names of the various kinds of peripheral neuropathies. Because of the time limitations, we ask that you just focus on the alternate names for neuropathy found in the "entry term" list for "Diabetic Neuropathy."

Begin by searching the MeSH database for -- diabetic neuropathy.

 

Keywords for Peripheral Neuropathy

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When you reach the MeSH entry for "Diabetic Neuropathies," scroll down to the "entry term" list. Copy the "entry term" list and paste the list into your Word document.

Remove all the extra words -- all the words that are not necessary to indicate that neuropathy is being discussed.

Keywords for Peripheral Neuropathy

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Did you end up with the following list? If not, correct your list.

Neuropathy
Neuropathies
Polyneuropathy
Polyneuropathies
Amyotrophy
Amyotrophies
Neuralgia
Neuralgias

If time allowed, we would ask you to construct a much longer and more comprehensive list that included the names of lots of specific, peripheral nervous system diseases.

Keywords for Peripheral Neuropathy

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Now that you have a list of alternate terms for the neuropathy concept, ask yourself whether your list includes the term variants listed below or includes truncated terms that would retrieve these variants:

Please note: the examples listed below are for future consideration and are not necessarily relevant to the tutorial search.

  • singular and plural forms of any nouns

ex. either --
neuropath*
-- or --
neuropathy OR neuropathies

  • all forms of any verbs

ex. ( example not relevant to this search) either --
erod*
-- or --
erode OR erodes OR eroded OR eroding

  • noun forms of any verbs

ex. ( example not relevant to this search) either --
erod* OR erosion*
-- or --
erode OR erodes OR eroded OR eroding OR erosion OR erosions

  • adjective forms of any nouns

ex. either --
neuropath*
-- or --
neuropathic OR neuropathy OR neuropathies

  • British as well as American spellings

ex. (not relevant to this search)
hematology OR haematology

  • nonhyphenated and hyphenated forms of words that are sometimes hyphenated

ex. ( example not relevant to this search)
post-operative OR postoperative

  • commonly used abbreviations as well as non-abbreviated terms

ex. ( example not relevant to this search)
ICU OR ICUs OR "intensive care unit" OR "intensive care units"

  • relevant opposites

e.g. If your search includes a safety concept, in addition to the safety words, you need to include danger/harzard/etc. words since authors may talk about "methods for avoiding inherent dangers" ( example not relevant to this search)

Add additional terms to your list until you can answer yes or not applicable to each of the above questions.

Keywords for Peripheral Neuropathy

5 of 7Listed below are neuropathy terms you should have 'harvested' from the MeSH database. Does your term list include either all 12 terms in the first list or all four  truncated terms in the second list? Truncation using the * directs the computer to search for terms that include letters after the * in the search.

The first list includes neuropathy, neuropathies, neuropathic, polyneuropathy, polyneuropathies, polyneuropathic, amyotrophy, amyotrophies, amyotrophic, neuralgia, neuralgias, or neuralgic

OR

This second list of terms includes neuopath*, polyneuropath*, amyotroph*, and neuralgi* 

Add any terms that you missed to your list.

Keywords for Peripheral Neuropathy

6 of 7 Create a search statement from your terms.
  • Enclose any multi-word terms (terms containing spaces) within quotation marks
  • Consider truncating any multi-syllable word that has multiple useful endings using * (e.g. polyneuropath* can replace polyneuropathy, polyneuropathies, and polyneuropathic).
  • Remove any search terms that are no longer needed.
  • Join the alternate terms for a single concept using OR.
  • Place parentheses around the OR'd together term list.

Keywords for Peripheral Neuropathy

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Did you come up with either of the following search strategies for your peripheral neuropathy concept?  (The first uses truncated terms; the second does not)

(Neuropath* OR Polyneuropath* OR Amyotroph* OR Neuralgi*)


- or -


(Neuropathy OR Neuropathies OR neuropathic OR Polyneuropathy OR Polyneuropathies OR polyneuropathic OR Amyotrophy OR Amyotrophies OR amyotrophic OR Neuralgia OR Neuralgias OR neuralgic)

If not, correct your search statement.

Joining the Capsaicin and Peripheral Neuropathy Concepts

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Now it's time to join the capsaicin keyword search statement to the neuropathy keyword search statement.  What Boolean Operator (AND, OR, or NOT) should be used for this operation?

What Boolean Operator (AND, OR, or NOT) should be used to join the capsaicin search strategy to the "peripheral nervous system" search strategy?

 

 

Joining the Capsaicin and Peripheral Neuropathy Concepts

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On your Word document, join your capsaicin and neuropathy search strategies using AND.

 Did you come up with a search strategy like either of the following:

With truncated terms:

(Neuropath* OR Polyneuropath* OR Amyotroph* OR Neuralgi*) AND (capsaicin OR Capsaicine OR 8-Methyl-N-Vanillyl-6-Nonenamide OR "8 Methyl N Vanillyl 6 Nonenamide" OR Axsain OR Zacin OR "Capsicum Farmaya" OR Capsidol OR Zostrix OR Capzasin OR Gelcen OR Katrum OR NGX-4010 OR "NGX 4010" OR NGX4010 OR Capsin)


--or--

Without truncated terms:


(Neuropathy OR Neuropathies OR neuropathic OR Polyneuropathy OR Polyneuropathies OR polyneuropathic OR Amyotrophy OR Amyotrophies OR amyotrophic OR Neuralgia OR Neuralgias OR neuralgic) AND (capsaicin OR Capsaicine OR 8-Methyl-N-Vanillyl-6-Nonenamide OR "8 Methyl N Vanillyl 6 Nonenamide" OR Axsain OR Zacin OR "Capsicum Farmaya" OR Capsidol OR Zostrix OR Capzasin OR Gelcen OR Katrum OR NGX-4010 OR "NGX 4010" OR NGX4010 OR Capsin)

If not, make any needed corrections.

Stop autocorrection

Now add an -- [all] -- tag to the end of your search strategy, as shown below:

Search With Truncation:

(Neuropath* OR Polyneuropath* OR Amyotroph* OR Neuralgi*) AND (capsaicin OR Capsaicine OR 8-Methyl-N-Vanillyl-6-Nonenamide OR "8 Methyl N Vanillyl 6 Nonenamide" OR Axsain OR Zacin OR "Capsicum Farmaya" OR Capsidol OR Zostrix OR Capzasin OR Gelcen OR Katrum OR NGX-4010 OR "NGX 4010" OR NGX4010 OR Capsin)[all]


--or--

Search Without Truncation:


(Neuropathy OR Neuropathies OR neuropathic OR Polyneuropathy OR Polyneuropathies OR polyneuropathic OR Amyotrophy OR Amyotrophies OR amyotrophic OR Neuralgia OR Neuralgias OR neuralgic) AND (capsaicin OR Capsaicine OR 8-Methyl-N-Vanillyl-6-Nonenamide OR "8 Methyl N Vanillyl 6 Nonenamide" OR Axsain OR Zacin OR "Capsicum Farmaya" OR Capsidol OR Zostrix OR Capzasin OR Gelcen OR Katrum OR NGX-4010 OR "NGX 4010" OR NGX4010 OR Capsin)[all]

The [all] will stop PubMed from attempting to autocorrect your search terms.  

Why stop autocorrection:

Autocorrection sometimes  changes correctly spelled, drug names to similarly spelled, but otherwise unrelated, words that are used more commonly than the drug name.

Return to PubMed

Now that you've constructed your keyword search you need to return to your original PubMed page. 

 

Remove Limits

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Many filters require the presence of tags or MeSH terms applied by indexers (humans, or randomized controlled trials, for example).  When you want your search to retrieve unindexed records you must be sure to avoid these filters. 

The filters used on your last search are probably still in force.  If so, click the "Clear all" link located at the end of the "Filters applied" alert.

 

 

Remove Limits

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Paste your search strategy into the search box and click the "Search" button.

 

Check for messages about your search

Check the area above the search results for messages.

1.  Sometimes single-word search terms that haven't been found in PubMed will be listed. If such a list is present, check the list to make sure none of the words in your search statement are misspelled.


2.  The "quoted phrase not found" messages could be important to your future search results. Always feel free to contact one of our reference librarians for help if your searches are not producing the expected results.

3. Is PubMed is offering you an 'auto-corrected' version of your search? Think a thousand times before clicking on such a linked search. The offered auto-corrections are usually undesirable. 

The Systematic Subset

This subset includes practice guidelines, consensus statements, meta-analyses, and systematic reviews.

To look at this subset, find the "Article Types" filters on the left-hand side of the page and select the "Systematic Reviews" filter. You may have to use the "more" link to request that the "Systematic Reviews" filter be shown and then select it. 

This is the only article type filter that doesn't depend on terms applied by indexers. Consequently, the systematic subset includes indexed and unindexed records.

Among the useful results of the systematic subset search is a 2011 systematic review by Edelsberg that looked at the various drugs (including capsaicin) that have been used to treat postherpetic neuralgia (PMID 22085778).

Be sure to remember to remove the systematic filter before going on to a different type of search.

Unindexed Records

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You can limit your search to unindexed records by

a.  adding -- NOT MEDLINE[sb] -- to the end of the search statement
The resulting search statement (for those who've truncated the neuropathy terms) is shown below:

(Neuropath* OR Polyneuropath* OR Amyotroph* OR Neuralgi*) AND (capsaicin OR Capsaicine OR 8-Methyl-N-Vanillyl-6-Nonenamide OR "8 Methyl N Vanillyl 6 Nonenamide" OR Axsain OR Zacin OR "Capsicum Farmaya" OR Capsidol OR Zostrix OR Capzasin OR Gelcen OR Katrum OR NGX-4010 OR "NGX 4010" OR NGX4010 OR Capsin)[all] NOT MEDLINE[sb]

b.  hitting the search button
c.  If you haven't already removed the "systematic reviews" filter and you wish to see article types outside the "systematic" subset, you must remove the"systematic reviews" filter now.

Unindexed Records

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The goal of this tutorial is to help you find the highest quality evidence on the issues of interest to you. We're using the "therapeutic efficacy of capsaicin in the treatment of painful peripheral neuropathy" search as an example of such a topic. For issues of therapeutic efficacy, articles in the systematic subset and randomized controlled trials are the highest quality summarized and primary evidence, respectively. So far you've retrieved --


1.  indexed systematic reviews and indexed randomized controlled trials (MeSH search limited to systematic reviews and RCTs)
2.  unindexed (and indexed) systematic reviews (keyword search limited to systematic reviews)

You haven't yet retrieved the PubMed records for any, as yet, unindexed randomized controlled trials.

Will adding a "randomized controlled trials" filter  to the NOT MEDLINE[sb] search that you've just created help you locate unindexed records reporting the results of RCTs?

Will adding a "randomized controlled trials" filter/limit to the NOT MEDLINE[sb] search that you've created help you locate these records?

Unindexed Records

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 As you now know, adding an RCT filter to a NOT MEDLINE[sb] search will usually just result in retrieval of zero results.  If you want to find unindexed RCTs, instead of adding an RCT limit to a "NOT MEDLINE[sb] search, you must browse through all the unindexed records retrieved by the "NOT MEDLINE[sb]" search looking for records that report the results of randomized controlled trials.

You will not have to time to browse through the unindexed records today.

Assignment

Congratulations, you have reached the end of the tutorial.

Assignment:

  • Click the "advanced" link below the PubMed search box.
  • Either:

Copy the entire search history table. and paste it into an e-mail message to thartman@unmc.edu.
--or--
Use the "Download history" link to download a .csv file and attach the .csv file to an e-mail message to thartman@unmc.edu.

  • Address the e-mail message to thartman@unmc.edu (Teresa Hartman in the UNMC e-mail address book).

Your search history will NOT be graded. We just want to find out whether students were able to follow the tutorial, complete the searches, etc.

 

Quiz

Which of the following is/are included in PubMed:

Which of the following statements about MeSH (Medical Subject Headings) is/are true?

The lists of "entry terms" in the MeSH database/thesaurus are a good source for alternate keywords.


The automatic explosion feature in PubMed may be defined as follows:  When searching PubMed using  a broader MeSH heading, records indexed with narrower MeSH headings are also retrieved.


Subheadings are used in combination with MeSH headings to further identify a particular aspect of a MeSH concept.

The truncation symbol (*) used after a root word searches for all terms that begin with that root word. A search for -- 

neuropath*

--, for example, retrieves records containing -- 

neuropathy OR neuropathies OR neuropathic

You want to search for articles about diseases caused by cat bites.  You, of course, also want to retrieve records that concern bites of cats (plural).  You decide to use the term -- 

cat*

-- to search for cat or cats.  Which of the following terms will your -- cat* -- search locate:

A student has searched for -- 

(cat OR cats OR dog OR dogs) AND bite OR bites OR wound*

-- his search is retrieving a lot of records concerning bites and wounds that have nothing to do with dogs or cats.  What's wrong with the search?

If you want to search for articles about the effects of any form of precipitation on allergies.  You are starting your search by joining the alternate terms for precipitation.  Which operator/conjunction (AND, OR, NOT) should be used to join the various precipitation terms (snow, rain, sleet, storm, etc.)