BUILDING EFFECTIVE &

EFFICIENT SEARCH STRATEGIES

IN SECONDARY RESOURCES
PUBMED

Besu Teshome, Pharm.D., M.Sc., BCPS

Assistant Professor of Pharmacy Practice

Objectives

Utilize PICO to clearly define a clinical question

Define medical subject headings (MeSH) and their subheadings

Describe commonly used search fields and their

advantages/disadvantages

Compare and contrast different types of Boolean Operators

Discuss how the filters affect the scope of a the search strategy

Objectives

Explain how different search fields and functions can alter the
sensitivity and specificity of a PubMed search

Given a clinical question be able to conduct a systematic and

efficient PubMed search that includes:

A clearly stated objective

Appropriate search terms, fields, and functions
Any appropriate filters

Finding Information

The ability to effectively answer questions using

evidence-based medicine is one of the most
essential components of the practice of
pharmacy

Asking an Answerable Question

P- Patient, population, problem

I- Intervention (treatment, test, monitoring strategy, etc)

C- Comparison intervention

O- Outcomes of interest

What is PubMed?

PubMed provides free online access to MEDLINE

MEDLINE is the National Library of Medicines (NLM) database

for biomedical literature from around the world

Contains over 26 million references dating back to the late 1940s

PubMed also contains a limited number of references

Using PubMed

Basic definitions

Controlled vocabulary: organized arrangement of terms indexed for

searching
A thesaurus of terms
Citation: the reference to an article
Field: individual components of a citation (author, journal, MeSH)

Single Citation Matcher

A way of finding a specific citation using a fill-in-the-blank format

Located under the PubMed Tools section on the home page

PubMed Single Citation Matcher

Enter the information you

have in as many of the blank
boxes you can

PubMed will then search for

the citation based on the
information provided

Medical Subject Headings (MeSH)

NLMs controlled vocabulary for

indexing articles

Provides a uniform and consistent

way to search biomedical literature

Lets you search all of the articles

on a specific topic, irrespective of
the terminology used by author

MeSH Terms for heart failure

MeSH Subheadings

Can be used to limit searches to a specific aspect of the MeSH

term

Rule of thumb: use all of them

Example of different types of subheadings for heart failure

MeSH Structure

MeSH terms arranged in hierarchical trees of related terms

Trees of subjects arranged with the most general terms to the left
Each level more specific terms indented below

PubMed Citation

Each red box

represents a
different search field

Search Fields

Search by MeSH terms

Search by Text Words

Pros: Consistent way to retrieve information

Cons: There isnt a MeSH for every topic, might miss some articles
Pros: useful when no apparent MeSH term
Cons: often results in broader scope than you might want, can miss
articles that dont have the text word in the title, abstract, or other search
fields, but would be indexed under related MeSH

Other common fields include searching by journal, author, title of

article

Hierarchy of Searches

General searches

MeSH or MeSH Major > Text word

Drug searches

MeSH > Supplementary concept > Text word

Supplementary concept is NOT a MeSH term

Those two terms are not interchangeable

Boolean Operators in the Advanced Search Builder

AND function

Both search terms must be

present
Only the articles where they
overlap

OR function

One or more of the search

terms must be present

NOT function (avoid using)

Search Filters

Means of limiting unwanted articles from a set of search results

The set resulting from applied limits is always smaller in number than the
original set
Types of filters include:

Article type
Publication date
Language
Species
Sex
Age group
Text availability

Putting it All Together (Using PICO)

P= disease state/condition [using Mesh if possible, Text Word if not]

AND

I= drug(s)

[Mesh> supplementary concept> Text Word]

AND/OR can be used if more than >1 drug

AND

This is just one example

of a search strategy

Search strategies should

be tailored based on each
question

C= drug(s) [Same rules as the Intervention drug(s)]

Use the correct Boolean Operators

Apply filters in the end, as appropriate

* Notice: Outcome (O) may or may not be included in the search

Performing a PubMed Search

1. Clearly define the question and terms that need to be used BEFORE

conducting the search

2. Develop a search strategy
i.

Determine most appropriate MeSH term for disease/condition, then search term in
PubMed

ii.

Repeat for intervention and comparison drugs

iii.
iv.

If term has no appropriate MeSH, use suitable Text Word

MeSH> supplementary concept> Text Word

Combine terms with appropriate Boolean Operators in PubMed Advanced Search Builder
Apply any necessary filters, at the end

3. Select the citations you want and consider if other searches are needed

Saving Search Strategy on Exams

First make sure the PubMed search and Moodle are opened
using Internet Explorer

Then follow these steps exactly

1.
2.
3.
4.

View the search history from the PubMed Advanced Search Builder page
Highlight information in box under History
Right click and copy the highlighted information
And paste the search history in the blank space on Moodle text box
(practice on blank MS Word page)

Example Scenario

During rounds, your attending asks you if you know of any

literature comparing acetaminophen to ibuprofen for osteoarthritis
that has come out in the last five years?

What is the PICO for this question?

What terms and filters (if necessary) should be used for the search
strategy?

Example Scenario

P = Patients with osteoarthritis

I = Acetaminophen

C = Ibuprofen

Terms that should be used for

search strategy

O = Management of osteoarthritis

Osteoarthritis
Acetaminophen
Ibuprofen

Filters (if necessary)

Published in the last five years

Step 1: Go to PubMed

Step 2: Go to advanced search link

Step 3:Make sure history and filters are clear, go back to PubMed
homepage

Step 4: Go to MeSH database

Step 5: Search for osteoarthritis in MeSH database

Step 6: Pick the correct osteoarthritis MeSH term

Step 7: Add osteoarthritis [Mesh] to search builder and search

PubMed

Step 8: Go back to advanced search to see your progress

Step 9: Go back to PubMed home then MeSH database

Step 10: Search for acetaminophen in MeSH database and pick

the correct MeSH

Step 11: Clear the previous search from PubMed search builder

Step 12: Add acetaminophen [Mesh] to search builder and search

PubMed

Step 13: Go back to advanced search to see your progress

Step 14: Repeat steps 9 through 13 for ibuprofen

Step 15: Combine terms using appropriate Boolean Operators

Using the Correct Boolean Operators

Osteoarthritis [Mesh]

Acetaminophen [Mesh]

Ibuprofen [Mesh]

Question asked for literature comparing the two drugs for

osteoarthritis so the appropriate combination is:

Osteoarthritis [Mesh] AND (Acetaminophen [Mesh] AND Ibuprofen [Mesh])

Step 16: Combine the two drugs then search PubMed

Step 17: Go back to advanced search to see your progress

Step 18: Combine terms using appropriate Boolean Operators and

search PubMed

Step 19: Now that the correct terms and Boolean Operators have
been used, it is time to see if any filters need to be applied.

Does a Filter Need to be Applied?

Example Scenario

This search requires a filter

During rounds, your attending asks you if you know of any literature
comparing acetaminophen to ibuprofen for osteoarthritis that has come
out in the last five years?
Published in the last five years

Important to note, that not all searches require filters

Step 20: Apply any filters if necessary and go back to the

advanced search builder.

Step 21: Search is now complete and there were 2 articles found.
At this point you would copy and paste the search history to blank
MS Word page

Questions?