planning the literature search - systematic reviews

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Planning the Literature Search

Systematic ReviewsCLARA S. FOWLERMSLS, AHIPResearch Services and Assessment ManagerResearch Medical LibraryUniversity of Texas MD Anderson Cancer Center

What is your experience with literature searching?

1) I search EMBASE or CINAHL or CENTRAL frequently2) I search MEDLINE using the Ovid interface frequently3) I search PubMed frequently4) Ive searched one or more of these databases infrequently5) Ive heard of these databases, but never searched themExperience?

1) Create a Searchable Question

2) Preliminary Searching Strategies

3) Search, Organize & Report Results


High-quality systematic reviews seek to:

Identify all relevant published evidence through systematic searching of multiple literature databases

Systematic Reviews

Use PICO formatCreate list of KEY CONCEPTSIdentify SYNONYMS & ACRONYMS

Create a Searchable Question

Glucocorticoids injections are known to relieve shoulder pain but their effect usually wears off after six to eight weeks. Traditionally, a doctor uses anatomic landmarks around the shoulder to guide the injection into the desired location.

Sometimes imaging techniques, such as ultrasound, are used to more accurately guide the injections into the specific sore part of the shoulder. It is not known if image-guided injection relieves the symptoms of shoulder pain more effectively than if the injection was delivered without imaging, either into the shoulder, or injected into muscle away from the shoulder (e.g., into the buttocks muscle).Clinical Scenario

In patients with shoulder pain, do image-guided glucocorticoid injections improve patient-relevant outcomes over landmark-guided or systemic intramuscular glucocorticoid steroid injections?

P (Patient): Shoulder painI (Intervention): Image-guided glucocorticoid injectionsC (Comparison): landmark-guided or systemic intramuscular glucocorticoid steroid injections O (Outcome(s)): Pain, function, range of motion, overall improvement, and reduction of adverse eventsCreate PICO Question

What are the most important elements of this search?

How can you make sure that your search is comprehensive?

P (Patient): Shoulder pain

Include conditions that would create shoulder pain as well as a search for shoulder pain

Shoulder pain: shoulder impingement syndrome, rotator cuff, bursitis, adhesive capsulitis, tendonitis, periarthritisIdentify SYNONYMS

I (Intervention): Image-guided glucocorticoid injections

Create a search for glucocorticoid injections, image-guided will be too restrictive a concept

Glucocorticoid: adrenal cortex hormones, steroid, subacromial, triamcinolone, methylprednisolone, prednisone, betamethasoneInjections: injected, injectIdentify SYNONYMS

Create a comprehensive list of keywords with alternate spellings

Use truncation

Use adjacencyglucocorticoid adj3 inject*



Executing the Search

Systematic ReviewsStehanie FultonMSIS, AHIPExecutive DirectorResearch Medical LibraryUniversity of Texas MD Anderson Cancer Center

Journal ArticlesMeeting AbstractsClinical TrialsWebsites

Publication Types

MEDLINEEMBASEWeb of ScienceCINAHLPsycINFOCENTRALOthers?Select Databases to Search

Cochrane LibraryPROSPEROCampbell LibraryPubMed Health

Most databases have a thesaurus or list of subject headings MeSH - MEDLINEEMTREE - EMBASECINAHL Headings

Look up all relevant subject headings for each concept in your search

Selectively explode terms

Subject Headings

Sample Search Term Spreadsheet

Create MEDLINE Strategy and review line-by-line with co-authors

Use PRESS checklist to review all key search methods

Draft Strategy

Cochrane LibraryMEDLINEEMBASEWeb of ScienceCINAHLPsycINFOPubMedGrey LiteratureTranslate Search Strategy into Other Databases

Databases & websites searchedDates of search Limits appliedNumber of references identified Full search strategy

Search Documentation

No consensus exists on searching reported methods for systematic reviews. J Clin Epidemiolg. 2008 (8): 748-754.Sampson M, McGowan J, Tetzlaff J, Cogo E, Moher D.


Run the Final Searches within 24 Hours

Save search strategy in database as well as in a .txt file

Last update search should be done within 6-months of submission for publication


Managing Results & Documentation

Systematic ReviewsLaurissa GannMSIS, AHIPEducation & Reference ManagerResearch Medical LibraryUniversity of Texas MD Anderson Cancer Center

1. Exporting to EndNote

2. Organizing Search Results

3. De-duplication with EndNote

Citation Management

Excel Workbook




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