by Andrea Dinkelman, Pharm.D., M.L.S.  and Cindy Schmidt, M.D., M.L.S.

Updated July 2019

 

WARNING:

Do not use Internet Explorer to work on this tutorial. Instead, use Firefox or another browser.

 

Instructions:

Use the Arrow icons below the instruction screen to go forwards and backwards in the tutorial.

Do not work ahead of the instructions on the screen. As soon as you finish reading and responding to the instructions on a tutorial screen, hit the forward-facing arrow. Nearly every step in the search process is explained.

If you want to skip between distant parts of the tutorial, you can use the "Menu/Contents" button above the instruction screen to show the tutorial's "Table of Contents" and can click on the needed section of the tutorial.

If the "contents" menu jitters, right-click on the instruction panel header and select the "reload"/"refresh" option.  The menu should then function correctly.

Clicking the "Single-page view" link will produce a transcript of the entire tutorial.

Purpose

The purpose of this tutorial is to help the student master comprehensive, keyword searching.

Performing a truly comprehensive, keyword search is more difficult than performing a similarly thorough, subject heading search. We hope that this tutorial will make the steps involved in this complex process easier to understand and master.

Objectives

Upon completion of this tutorial you will be able to:

  • identify the important concepts in a clinical question
  • create a list of search terms for each concept you identify
  • use asterisks and quotation marks correctly when defining search terms
  • use AND and OR correctly to join search terms
  • use parentheses correctly to define groups of search terms
  • successfully complete keyword searches in PubMed

Clinical Question and Major Concepts

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Your hospital pharmacy director wants to initiate a proton-pump-inhibitor exchange program. He asks, "Which of the proton pump inhibitors can be administered through a nasogastric (NG) tube?" Your director specifies that he is not interested in any of the multi-drug, proton-pump-inhibitor preparations.

 

What are the major concepts in this question?

Clinical Question and Major Concepts

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The first major concept in this question is the specific category of drugs called "proton pump inhibitors."

 

The second major concept in the question is "nasogastric (NG) administration."

Finding Keywords Needed for a Drug Class Search

If you were going to complete an exhaustive search concerning the class of drugs "proton pump inhibitors," you would need to include all of the following terms:

  • drug class name/s
  • plural of the drug class name/s
  • abbreviation/s for the drug class name/s
  • plurals of the abbreviation/s for the drug class name/s
  • English generic name of each drug in the class (whether this would include drugs not approved for use in the U.S. would depend on the clinical question)
  • U.S. trade name/s of each drug
  • Foreign generic name of each drug
  • Investigational names of each drug
  • CAS registry numbers of each drug
  • International trade names of each drug

In practice the number of trade names is sometimes so enormous that the available search engines cannot handle a search that includes all of the brand/trade names. In that case, one must consider searching without trade names or only including the most important trade names.

For the purpose of this first, tutorial search, you will just complete a routine, relatively thorough (but not exhaustive) search and will include the types of terms listed above in bold-face.  Your pharmacy is located in the U.S., so you only need to investigate drugs that are approved in the U.S.

AHFS Drug Information (available at UNMC via LexiComp) can provide all of the bold-face terms for FDA-approved drugs and is organized by drug class.  Click here to open LexiComp in the adjacent screen.

Using AHFS Drug Information to Find Needed Terms

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Unfortunately, searching for a drug class in LexiComp will not result in retrieval of the relevant information in AHFS Drug Information. Instead you have to know how to access the Indexes in LexiComp.

  • Look at the right-hand side of the page.
  • Click on the "More Clinical Tools" drop-down.
  • Select "Indexes".

A screenshot of LexiComp's "more clinical tools" drop down showing selection of the "indexes" option.

Using AHFS Drug Information to Find Needed Terms

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  • Look at the left-hand side of the page.
  • Scroll down until you find the "AFHS DI (Adult and Pediatric)" section (NOT AHFS ESSENTIALS).

    A screenshot showing the "AHFS DI (Adult and Pediatric) section of the navigation screen with an arrow pointing to the "Pharmacologic/Therapeutic Category" section.

  • Click on "Pharmacologic/Therapeutic Category" link

Using AHFS Drug Information to Find Needed Terms

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The list of pharmacology/therapeutic categories will appear.

  • Scroll down to "Proton Pump Inhibitors" and click on the link to this class.

A screenshot of the section of the "therapeutic/pharmacologic category" list with an arrow pointing to "proton-pump inhibitors"

Using AHFS Drug Information to Find Needed Terms

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It's easiest to compose a keyword search in a Word document.


1.  Copy the name of the therapeutic category and paste it into your Word document.

A screenshot of the "Search results: Pharmacologic category is "proton-pump inhigitors" " page header with selection of the "proton-pump inhibitors" text in preparation for copying.

2.  Do you know of other names for this class of drugs, other spellings for the class name, or abbreviations for the class name? If so, add these to your Word document.

For instance, some authors hyphenate "proton-pump inhibitors"; others leave out the hyphen "proton pump inhibitors". These drugs are often called PPIs.

Using AHFS Drug Information to Find Needed Terms

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3.  Copy the listed generic names for the PPIs available in the U.S. and paste them into your Word document.

Screenshot showing selection of the names of the Proton pump inhibitor drugs in preparation for copying.

Using AHFS Drug Information to Find Needed Terms

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4.  Gather the U.S. brand names for each drug.

To find the U.S. brand name for the first drug:

a. place your cursor over the generic name,

b.  slide over to the "Jump to field" menu that appears

c.  click on the "Preparations" link.

You are only looking for single-drug preparations.  The "preparations" tables will have a "_____ Combinations" heading if multiple drug preparations are listed in the table.

 

A screenshot showing an arrow pointing to "dexlansoprazole" within the list of PPI generic names. The words "hover and slide" appear next to the arrow. The Jump to field column on the right-hand side of the page contains an arrow pointing to "Preparations" with the annotation "click".

Using AHFS Drug Information to Find Needed Terms

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d.  Copy the brand name/s that appear for any single agent preparations and paste them into your Word document. Do not include the trademark symbol.

The preparations table for dexlansoprazole is shown. The brand name "Dexilat" has been selecte in preparation for copying. An arrow points to the selected term. The trademark following "Deilant" is not selected.

Remember the pharmacy director is not interested in multi-ingredient preparations.  Do not copy the brand names of any "___ Combinations."

Using AHFS Drug Information to Find Needed Terms

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5.  Use your browser's back button to return to the list of generic names. Repeat steps 4 a-d for the next drug.  Continue until you've found all the U.S. brand names for single-agent preparations of all the PPIs.

Take out unneeded terms/words

Now that you have your list of needed class and drug names, look over the list.  Have you included any unneeded words?  If so, cross them out.

For instance, have you included words like drug, drugs, medication, medications, agent, agents etc. in the class names?

If so, remove these 'drug'-like term/s. Authors do not always include such words when they refer to a drug class and including all the synonyms for the 'drug'-like term/s (drug, drugs, medication, medications, agent, agents, therapy, therapies, etc) is a challenge best avoided.

Also remove words for specific types of preparations (e.g. tablet, capsule, Solutab, I.V., IV, over-the-counter, OTC, 24 hr, extended-release). 

Check your drug-class term list

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Did you remember to include all of these terms in your list?

proton pump inhibitor

proton-pump inhibitor

proton pump inhibitors

proton-pump inhibitors

PPI

PPIs

dexlansoprazole

Dexilant

esomeprazole

Nexium

lansoprazole

Prevacid

omeprazole

Prilosec

Zegerid

pantoprazole

Protonix

rabeprazole

Aciphex

Check your drug-class term list

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Have you included the trade names --

Vimovo, Prevpac?

These are drug combination preparations. Don't include them in your search.

Join Drug Concept Terms *, "", AND, OR, NOT, ()

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Use the concept 1 search terms you've listed, asterisks, quotation marks, Boolean operators (AND, OR, NOT) and parentheses to create a search statement.

Want help?  Click the relevant link below:

  • Help with quotation marks and asterisks
  • Help with Boolean operators - OR
  • Help with parentheses
  • Help with Boolean operators -- AND

 

Join Drug Concept Terms *, "", AND, OR, NOT, ()

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  • Did you remember to enclose multi-word phrases like "proton pump inhibitor" with double quotation marks?
  • Did you remember to truncate the term -- PPI* -- with an asterisk (or include both singular and plural forms in your search statement)?
  • Did you join all of the terms describing the proton pump inhibitor drug class using OR?
  • Did you enclose the OR'd together drug names and drug class names in a single set of parentheses()?

Drug Search Statement/Strategy

The search statement for your PPI concept should be similar to the statement below:

("proton pump inhibitor" OR "proton pump inhibitors" OR "proton-pump inhibitor" OR "proton-pump inhibitors" OR PPI* OR dexlansoprazole OR Dexilant OR esomeprazole OR Nexium OR lansoprazole OR Prevacid OR omeprazole OR Prilosec OR Zegerid OR pantoprazole OR Protonix OR rabeprazole OR Aciphex)

If necessary, correct your statement so that it includes all the other search terms shown above. The order of the terms is not important.

Search Terms for "Nasogastric administration"

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In your word document, type every term or phrase that an author might use to designate "nasogastric administration." Click here for help.

Search Terms for "Nasogastric administration"

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At a minimum, your term list should include the terms listed below:

NG tube
NG tubes
NG administration
nasogastric

If you included "ng" in your list of terms, please click here and read the information provided.

"Nasogastric Administration" Concept Punctuation and Operators *,AND, OR, NOT, ()

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Insert appropriate Boolean operators to join the NG terms and phrases.  For help, click here.

"Nasogastric Administration" Concept Punctuation and Operators *,AND, OR, NOT, ()

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  • Did you remember to enclose the multi-word phrases -- "NG tube", "NG tubes" and "NG administration" -- in double quotation marks?
  • Did you join all of the terms describing nasogastric administration using OR?
  • Did you enclose the OR'd together NG terms in parentheses ().

Warning:  "NG tube*" will not work as expected in PubMed.  In PubMed, you can only truncate single words like PPI*.  In PubMed, to get the results you want when searching for multi-word phrases, you will have to include all of the desired phrases:

"NG tube" OR "NG tubes"

Linking the "PPI" and "Nasogastric Administration" Search Terms

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You should now have the alternate terms for the PPI concept joined by OR's and enclosed in parentheses. The alternate terms for the nasogastric concept should, similarly, be joined by OR's and enclosed in parentheses.

( "proton pump inhibitor" OR "proton pump inhibitors" OR "proton-pump inhibitor" OR "proton-pump inhibitors" OR PPI* OR dexlansoprazole OR Dexilant OR esomeprazole OR Nexium OR lansoprazole OR Prevacid OR omeprazole OR Prilosec OR Zegerid OR pantoprazole OR Protonix OR rabeprazole OR Aciphex)

("NG tube" OR "NG tubes" OR "NG administration" OR nasogastric )

You have one more decision to make. Should you choose AND, OR or NOT to link the two search concepts? Use the appropriate Boolean operator to join the two concepts.

Linking the "PPI" and "Nasogastric Administration" Search Terms

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Did you use AND to link the two concepts?

If so you're correct! Your search should now look something like:

( "proton pump inhibitor" OR "proton pump inhibitors" OR "proton-pump inhibitor" OR "proton-pump inhibitors" OR PPI* OR dexlansoprazole OR Dexilant OR esomeprazole OR Nexium OR lansoprazole OR Prevacid OR omeprazole OR Prilosec OR Zegerid OR pantoprazole OR Protonix OR rabeprazole OR Aciphex) AND ("NG tube" OR "NG tubes" OR "NG administration" OR nasogastric )

Adding [all]

Add --

[all]

to the end of your search statement. This step will produce a search statement that looks something like:

( "proton pump inhibitor" OR "proton pump inhibitors" OR "proton-pump inhibitor" OR "proton-pump inhibitors" OR PPI* OR dexlansoprazole OR Dexilant OR esomeprazole OR Nexium OR lansoprazole OR Prevacid OR omeprazole OR Prilosec OR Zegerid OR pantoprazole OR Protonix OR rabeprazole OR Aciphex) AND ("NG tube" OR "NG tubes" OR "NG administration" OR nasogastric )[all]

This step is specific to PubMed. The [all] keeps PubMed from autocorrecting your search. If you don't add an [all] to the end of your search, PubMed may change infrequently used words to similarly spelled, irrelevant words. The [all] is most important when one is working on searches containing investigational and foreign drug names, searches like your "final search assignment" search.

Running Your PubMed Search

It's time to test your search in PubMed:

  • Copy the search statement from your Word document
  • To open PubMed in the adjacent screen, click here.
  • Paste your search strategy into the PubMed search box.
  • Hit the "Search" button.

Change the Display Settings

1.  Use the "Format" drop-down above the result list to select the "Abstract" view.

2.  Use the "Sort by" menu to select "Publication Date."

Review Your Results


1.  Did your search retrieve 130 or more records?

In July 2019, this search retrieved 136 records. Your search should retrieve this many, or more, records. If you are not retrieving this many records or are retrieving far more records, please ask for help.

2.  Look at the highlighted terms in in the first 5-10 records. Does each of these records appear to contain at least one of your "PPI" terms and at least one of your "NG administration" terms?

If not, please check to be sure you haven't missed a parenthesis or joined your NG and PPI concepts using an OR (the two concepts should be joined with an AND). If these checks don't diagnose your search problem, please ask for help.

3.  Look at the relationship between the nasogastric administration term/s and the PPI term/s in the first 20 records.  How many talk about nasogastric administration of PPI's (rather than other uses of a nasogastric tube)?

When this tutorial was updated in July 2019, there were four highly relevant records among the first 20 results . In other words, 8/10 of the results were not focused on the topic of interest. A thorough, well-crafted, comprehensive keyword search will usually retrieve a lot of results that are not focused on the topic of interest.

 

Assignment


Click on the "Advanced" link under the PubMed search box.

A screenshot showing an arrow pointing to the "Advanced" link under the search box.

After reaching the "Advanced Search" page, place your cursor to the left of the word "History," click and then drag to highlight the entire row containing your search statement (as shown in the figure below).

A screenshot showing selection of the "history" heading and the first row of the search history table in preparation for copying.

Copy the selected information. Any of the three methods listed below should work to copy:

  • use the browser's "Edit" menu to select "Copy"
  • simultaneously press on the Ctl and C keys
  • right click on top of the highlighted area and select "Copy."

Paste it into a Word document.  Any of the three methods listed below should work to paste:

  • use the browser's Edit" menu to select "Paste"
  • simultaneously press on the Ctl (Command key on a Mac) and v keys
  • right click in the body of the e-mail and select "Paste."

Save the changes to the document.

Submit the Word document through Canvas 

Review for the Test

We're not spending a lot of time on drug class searches during lecture, but you should know the following for the test:

1.  What is one resource that includes lists of all the names of FDA-approved members of various drug classes? AHFS Drug Information

2.  What names should you include in an exhaustive search for literature about a drug class?

  • drug class name/s
  • plural of the drug class name/s
  • abbreviation/s for the drug class name/s
  • plurals of the abbreviation/s for the drug class name/s
  • English generic name of each drug in the class (whether this would include drugs not approved for use in the U.S. would depend on the clinical question)
  • U.S. trade name/s of each drug
  • Foreign generic name of each drug
  • Investigational names of each drug
  • CAS registry numbers of each drug
  • International trade names of each drug

 3. Do not include words like drug, drugs, medication, medications, agent, agents, tablets, I.V., extended-release,  or 24 hr.  etc. in the class names when constructing a keyword search.

Prepare for Search #2

If you had needed to do an exhaustive search on the "nasogastric administration of PPIs" search, you would need to use Martindale's or another source to find foreign generic names, investigational names, CAS registry numbers, and foreign trade names for each of the drugs in the PPI class. You would also need to think about other ways that authors might refer to the "proton pump inhibitors"/PPIs as a class. We neither had the time for that level of searching on the first tutorial search nor was that level of searching necessary. Librarians, pharmacy students, and pharmacists, frequently perform relatively quick searches using English generic names OR'd with class names, and sometimes U.S. brand names. There are many situations in which these less thorough searches are appropriate - like this first tutorial search.

When you work on the second tutorial search, your "final search assignment" search, you will be working on an exhaustive search, a search that could be used to support a systematic review of the literature. Get ready to include all the terms needed in an exhaustive search.

Click here to open the second tutorial search.  You will need to click the "Start tutorial" button that appears.

 

 

 

 

 

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