Best Practices for Efficient

and Effective Searching of the

Medical Literature

A deeper look inside the process of searching for information and the steps
involved in producing the best evidence.

Jessica DeCaro, MLIS

QUESTIONS
about
navigating the
library’s
website?
CHSL
PubMed
 Try searching different ways:
You can A-G Citation:
search • BJU Int 2017 May;119 Suppl 5:8-9
multiple ways H-P Author(s):
from the • Bolton DM Yaxley J
PubMed tab
in the Search O-T DOI:
• 10.1111/bju.13883
Box:
U-Z PMID:
• 28544296
If you don’t see these icons:
Check the eJournal portal on the
CHSL library’s homepage.
Look up by journal title.
Steps to a literature review:

Formulate your searchable question

Identify relevant terminology
Search the database(s)
Reassess and adjust search
Harvest citations
Citation management tools
Finding full text
• Read and synthesize the information
 SEARCHABLE QUESTIONS

Effective database searching requires beginning with a clearly defined question.

Clearly defined questions:

1. Focus your search so that it is efficient and effective.
2. Make it easier to find and combine appropriate terms.
3. Help you identify relevant results from irrelevant ones.
https://plymouth.libguides.com/systematicreviews/question
 PICO PICOT
Build your clinical question
using a framework for
transparency, PICOS SPIDER
reproducibility, and rigor.
WISER CIMO

https://guides.lib.unc.edu/pico/frameworks
CLIP ECLIPSE
https://plymouth.libguides.com/systemati
creviews/question
PEO PESICO
Start brainstorming like-terms for your clinical question.
List all like-terms for each concept vertically.
 Organizing Search Terms

Let’s say we want to look at the

literature published on healthcare
disparities in the LGBTQ population in
the US.

What are the concepts this search

can be broken down into?
These represent how the database
searches using OR and AND.
You’re not done yet!
 Free Text Searching:
When you enter terms into the search box without any
structure or directive.

You can quickly search PubMed This method of searching is

This function is better now
using “free” searching. This fine for exploration of the
than it used to be, but while it
kind of searching relies on the database but NEVER
is fast, it’s often not accurate.
database algorithms to find appropriate for the search
This is one of three ways we
what it thinks you’re looking strategy used in a systematic
search PubMed.
for. review
A BROAD SEARCH RESULTS IN HIGH RETRIEVAL
…MOST OF THE TIME
 CLICK ON
ADVANCED TO
SEE HOW
PUBMED
SEARCHED.
 So, what happened?

One function is called the

author format, which is a
PubMed has powerful
word with one or two letters So, how to we find articles
algorithms and functions at
after it. Any time the about brain CT’s?
work in the background.
database recognizes this
format, the function kicks in.
Free searching is fast and OK as a starting point,
but there are two better, more specific methods of searching:

Controlled
Keywords[tiab] Language
[MeSH]
 Searches:
• Natural language -how we speak and
write.
• Titles, abstracts, and author assigned
Keyword keywords.
• Acronyms, new terminology, and
Searching: phrases.

Always Check:
• The search results box for accuracy.
 You’ll Need To Remember:
• To use directives.
• Check to see if the phrases are searched as

Keyword phrases.
• Terms and acronyms have multiple meanings

Searching: which may skew the results of the search.

Finds:
• New terminology, jargon, acronyms, phrases.
• The NEWEST articles, not yet assigned MeSH
terms.
Keyword search using [tiab]:

• Any time you want to very specific and reproduceable

keyword/phrase search, use the directive [tiab] after
every word or phrase that you want to search
• Tiab stands for Title/Abstract
• Bonus – you get author assigned keywords, too

In the search box, where it says Brain CT, add the [tiab]
directive after the phrase. It should look like this:

Brain CT[tiab]
 • Acronyms / terms have multiple meanings:
• Orientation
Proprioception
Sexual orientation
Work/school orientation
Fiber orientation
When doesn’t • POP
Plaster of Paris
[tiab]work? Progestin only Pills
Pelvic Organ Prolapse

• Phrases:
[tiab] will search for phrases, but
sometimes the phrase is not found.
 Enter each term and run a search
without, and then with [tiab].
Compare the citations from each
variation:

Harry Potter vs Harry Potter[tiab]

[Tiab] practice
• Look in the advanced search
builder
• Check out the kinds of results
• What jumps out at you as odd?
MeSH Database

MeSH is a controlled language

index curated by subject MeSH stands for: Medical
specialists' indexers with Subject Headings.
PhD’s/MD’s.

MeSH is a separate database

It changes as language
from PubMed. We use the
changes and is thoughtfully
MeSH Index terminology to
and carefully designed.
search PubMed.
MeSH Database

Pros:
It’s very powerful and precise.

It’s reproducible.

Cons:
It takes 3+ months to index new publications with MeSH terms.

It’s not super intuitive for the user.

Navigating from PubMed to the MeSH Database
MeSH brings together the terminology and
synonyms of concepts so that they are grouped
under one umbrella term and are more
comprehensive:
• Teacher
• Professor
• Guest Lecturer
• Presenter
• Instructor
• Educator
Each hyperlink takes you to the specific MeSH record.
 Subheadings

Entry Terms= synonyms

Hierarchical Tree
The hierarchy is comprised of
live links that you can use to
navigate up or down the ‘tree’.

Note the + sign after Axis,

Cervical Vertebra. That indicates
that there are additional terms
that fall under that term in the
hierarchy.
PubMed Search
Builder is where
we tell the
MeSH database
what to do
Click on “Add to Search
Builder” to put the MeSH
term into the box. Then
click “Search PubMed”
This populates the search
box for you.
Click on “Add to Search
Builder” to put the MeSH
term into the box. Then
click “Search PubMed”
 SEARCH FOR LGBTQ IN MESH:
THE CORRESPONDING MESH TERM IS SEXUAL AND GENDER
MINORITIES.
THE CORRESPONDING MESH TERM FOR HEALTHCARE
DISPARITIES IS:
HEALTHCARE DISPARITIES
The next step is to search for MeSH and
[tiab] terms for each of the above terms.
 Gathering Terms:

Look for synonyms on Look at articles found

Evaluate Gold Standards
MeSH terms the MeSH record for through searching for
for MeSH terms
your term MeSH terms

Look in the
Look in the
literature/title/abstract
TIAB Keywords literature/title/abstract Look for acronyms
for spelling or
for keywords
formatting variations
 AND OR

Combine subjects/concepts using AND or OR in all caps

All like-concepts or Synonyms will be OR’d together

• “Sexual and Gender Minorities"[Mesh]

• Sexual and gender minorities[tiab]
• LGBTQ+[tiab]
• Lesbian[tiab]
• Gay[tiab]
• Bi-Sexual[tiab]
• Transgender*[tiab]
• A-Sexual[tiab]
Combining in the Advanced
Search Builder
To combine terms, click the three dots next to the term you’d
like to add and choose to add with AND or OR. Note that
healthcare disparities has been added to the Query box.
Search: (((((((((((((("Sexual and Gender Minorities"[Mesh]) 53,970
OR (lgbtq[tiab])) OR (lesbian[tiab])) OR (gay[tiab])) OR
(gays[tiab])) OR (lesbians[tiab])) OR (bi-sexual[tiab])) OR
(bisexuals[tiab])) OR (transgender)) OR Transgendered))
OR a-sexual[tiab])) OR asexual[tiab]) OR homosexual[tiab]
Search: ((((("Healthcare Disparities"[Mesh]) OR (health 22,876
care inequalities[tiab])) OR (health care inequality[tiab]))
OR (health care inequity[tiab])) OR (Health care
disparities[tiab])) OR (Health care disparity[tiab])
Search: (((US[tiab]) OR (united states[tiab])) OR 2,081,135
(America[tiab])) OR ("United States"[Mesh])
Full Example
 Demo
Type 36703143 into the PubMed search box and click search.
Practice
There are an
abundance of filters
available to narrow
a search. There are
some that are
always listed.

“Additional filters” Limiting

shows all filter
options.
your search

There are always 6

“Article Types”
listed

51
52
YOU CAN EXPORT CITATIONS USING THE
SEND TO BUTTON OR USING OTHER
TOOLS.

53
Cite and Share Feature

54
Finding Full Text
Check the ejournal portal from the CHSL library’s homepage.
Look up by journal title.

55
Still can’t https://case.edu/chslibrary/

access full
text?
Use Interlibrary
Loan
Things to remember about
searching in PubMed:

• All three methods of searching have pros

and cons.
• Carefully craft your question for more
accurate results.
• Each database is unique and has different
tricks/tips as well as journals they index.
• There are many fine points to learn about
searching – and we’re happy to teach those
to you.
Things to remember about
using the library:
• How to troubleshoot access
• Where to start in your search
for information
• You have people
QUESTIONS?
 Cleveland Health
Sciences Library

Thank you!
Don’t hesitate to reach
(216) 368-3218
out!

chslreference@case.edu