Department of Medicine

Searching

Course home Appraising information Keeping up Informatics principles Patients Searching Wiki help
log in with Proxy - ARS

Strategy

First, conciously formulate your question with the PICO format. This helps:
  • Dictates search terms and also what to look for in comparing articles
  • Directs assessment of validity (see assessing articles - above)
Traditional components of a clinical question. Is this component important when appraising validity of articles? But do you need to include this component in your search terms?
Patient, population Yes almost always
Intervention
(Treatment or test)		 Yes usually, but sometimes not needed if only a few articles remain after combining patient/population with filter
Comparison Yes rarely
Outcome Yes sometimes
  • Example: among patients with septic shock, does adjunct treatment with corticosteroids reduce mortality?

Next plan your search algorithm. This recommendation is loosely based on the 5S strategy of Haynes (see reference 6 below).

  1. Start with a textbook, preferably a 'systematic' one
  2. Find the most recent 1-2 systematic reviews or their equivalents (note that some practice guidelines include a systematic review)
  3. Find any relevant, high quality studies that are more recent than the search date of the systematic reviews (note that the search date of a systematic review is usually 6-12 months prior to the publication date).
Separate discussion is available for searching for drug information.

Online textbooks

Articles

  • Google
    • What is one factor that would advantage Google over PubMed?
    • What is one factor that would advantage Pubmed over Google?
  • Google Scholar
    • Currently has slow refresh
  • Clustering of search results
    • HighWire
      • Includes Vivismo (try broad topic like hypertension)
    • Clusty
      • (try broad topic like hypertension)
  • Text mining
  • Federated searching (meta-searching)

Diagnostic resources

Comparative review

References:

1. Googling for a diagnosis--use of Google as a diagnostic aid: internet based study.

2. The MEDLINE search as a diagnostic maneuver.

3. . . . And a diagnostic test was performed.

4. Performance of four computer-based diagnostic systems.

5. A computer-assisted medical diagnostic consultation service. Implementation and prospective evaluation of a prototype.

    Bankowitz RA, McNeil MA, Challinor SM, Parker RC, Kapoor WN, Miller RA.
    Ann Intern Med 1989;110(10):824-32. PMID: 2653156
    PubMed:
    - Abstract for PMID 2653156
    Fulltext options:
    - Find at UTHSCSA
    Summary: "Computer-aided diagnostic consultation, when provided by physicians familiar with the limitations of the system and capable of overriding inappropriate suggestions, was both accurate and educationally helpful in most cases. The system provided reasonable diagnostic suggestions not previously considered by the ward teams and these suggestions were valued sufficiently to cause alteration of the original differential diagnoses."

6. Of studies, syntheses, synopses, summaries, and systems: the "5S" evolution of information services for evidence-based health care decisions.