Clara FowlerResearch Services & Assessment MangerResearch Medical Library

Systematic Reviews: Planning the Literature Search

EXPE

RIEN

CE? What is your experience

with literature searching?

1. I search EMBASE or CINAHL or CENTRAL frequently

2. I search MEDLINE using the Ovid interface frequently

3. I search PubMed frequently4. I’ve searched one or more of these

databases infrequently5. I’ve heard of these databases, but never

searched them

1) Create a Searchable Question

2) Preliminary Searching Strategies

3) Search, Organize & Report ResultsAGEN

DA

Systematic Reviews

High-quality systematic reviews seek to: Identify all relevant published

evidence through systematic searching of multiple literature databases

http://www.medicine.ox.ac.uk/bandolier/painres/download/whatis/syst-review.pdf

Create a Searchable Question

Use PICO format.

Create list of KEY CONCEPTS.

Identify SYNONYMS & ACRONYMS.

Approximately 5%-30% of the population age 50 and older suffers from dry eye disease impacting visual acuity, social and physical functioning, and workplace productivity. Patients incur medical costs through frequent visits to health care professionals, as well as from prescription and over-the-counter therapies.

The first line of treatment includes artificial tears and environmental coping strategies (frequent blinking and using humidifiers).

There are multiple secondary treatments including topical glucocorticoids, omega-3 fatty acids, acupuncture, and surgery. A new drug, Xiidra, was approved by the FDA in 2016 to treat dry eye disease.

Clinical Scenario

In patients with dry eye disease, does Xiidra improve patient-relevant outcomes over nonprescription artificial tears?

P (Patient): Dry Eye DiseaseI (Intervention): XiidraC (Comparison): artificial tearsO (Outcome(s)): improvement in ocular discomfort, eye dryness, and visual impairment

Create the PICO question

What are the most important elements of this search?

How can you make sure that your search is comprehensive?.

P (Patient): Dry Eye DiseasesInclude conditions that would create dry eye disease as well as synonyms for dry eye

Dry eye disease:   dry eye syndrome, dysfunctional tear syndrome, keratoconjunctivitis sicca, Sjögren's syndrome, aqueous tear-deficient dry eye,  lacrimal dysfunction, lacrimal ductal obstruction, reduced reflex sensory tear secretion, decreased tear production, tear film evaporation, ocular surface irritation, chronic eye irritation, excessive tearing, blepharitis, blink rate

Identify SYNONYMS

I (Intervention): XiidraCreate a search for the drug using all name variants

Brand: XiidraScientific: LifitegrastExperimental: SAR 1118, SAR1118, SAR-1118Class: lymphocyte function-associated antigen 1 (LFA-1) antagonist

Identify SYNONYMS

Artificial tears

How many synonyms can you think of to

use for this concept?

SearchExperience

C (Comparison): artificial tears

Lubricant eye drops, artificial tear drops, lubricating eye-drops,

Nonprescription drugs, non-prescription, over the counter, OTC, over-the-counter

Identify SYNONYMS

Scoping Search

Is this a new question?

Is there enough data available to complete a systematic review?

How much time will it take to complete?

1. Search PubMed Clinical Queries & Cochrane Library to see if there are exisiting systematic reviews

2. Search PROSPERO for registered systematic reviews

Select DatabasesTo Search

Cochrane LibraryCampbell LibraryMEDLINEEMBASEWeb of ScienceCINAHLPsycINFOCENTRALOthers?

Publication Types

JOURNAL ARTICLESMEETING ABSTRACTSCLINICAL TRIALSWEBSITES

Create a comprehensive list of keywords with

alternate spellings

Use truncationdecreas* tear* irritat*

Use adjacencylacrimal adj3 (dysfunction* OR

obstruct*)

Keywords

Most databases have a thesaurus or list of subject

headings

MeSH – MEDLINEEMTREE – EMBASECINAHL Headlines

Look up all the relevant subject headings for each

concept in your search

Selectively explode terms

Subject Heading

s

Draft Strategy

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

Use PRESS checklist to review all key search methods

PRESSCHECKLIST

REVIEW SEARCH

STRATEGIESSearchExperience

TranslateSearch Strategy into Other Databases

Cochrane LibraryMEDLINEEMBASEWeb of ScienceCINAHLPsycINFOPubMedOthers?

EMBASE

Try translating the MEDLINE strategy into the EMBASE

database

SearchExperience

IDENTIFICATION

Records identified through database searching

PRIS

MA

1. Hand Searching2. Grey Literature

3. Contacting Experts4. Proceedings

5. Clinicaltrials.gov6. Cited Reference

Searching7. pubstatusaheadofprint

Unpublished

Literature

IDENTIFICATION

Records identified through database searching

Additional records identified through other sources

PRIS

MA

TipsRun 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

1. Exporting to EndNote

2. Organizing Search Results

3. De-duplication with EndNote

Citation Manageme

nt

Search Tracking Spreadsheet

PRISMA Flow DiagramDocument

ation

IDENTIFICATION

Records identified through database searching

Additional records identified through other sources

SCREENING

Records after duplicates removed

PRIS

MA

Writing the SearchMethodology List databases and other resources searched

and include date search ended Describe search strategies and filters and

number of results Include other searching methods – hand

searching, reference searching, requesting data and articles

Provide a copy of the MEDLINE search for the appendix

Discussion Section: Include level of confidence that all available studies were located. Address whether search limits may have blocked retrieval of results or if other sources could have been searched.

http://eahil.eu/wp-content/uploads/2015/09/3-7-Foster.pdf

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