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Evidence-Based Practice: How to search

Building a search strategy

After developing your PICO and well-formed focus clinical question you can begin to build your search strategy by translating the significant concepts of the PICO into a concept grid.  See below.

In children aged 2–59 months (P), what is the most effective antibiotic therapy (I,C) for severe pneumonia (O)?

Concept 1: pneumonia Concept 2:  Antibiotic therapy

It is useful to begin with a broad search using the Patient/Population and Intervention elements of the PICO.  If required, you may further refine your search by including the Comparator and then limit your results to the Study design. 

Combining search terms

You can structure your search using AND and OR to combine your keywords:

AND - use to combine keywords that reflect different concepts e.g. back pain AND paracetamol

OR - use to combine keywords that reflect similar concepts e.g. paracetamol OR panadol OR Tylenol

How to Search

The key concepts of your clinical question will be the keywords for your search.  Database searched will suggest the correct MESH terms (varies how each term is indexed within a database) for your entry.  You may use a combination of keywords and MESH for a broader and deeper search.

NOTE: not all concepts need to be included in your search - a typical search will include only population AND intervention AND/OR comparison 
Search for one concept (and its synonyms) at a time - combine all synonyms with OR
Combine concepts with OR/AND
Apply limits such as age, English language, year of publication

For example: For adolescents with neck pain is manual therapy better than exercise for reducing pain and improving function?
Step 1:  Identify the PICO elements from the patient dilemma
Step 2:  Use the PICO elements to formulate the clinical question

PICO worksheet

The following worksheet can be used to help in developing your search strategy.

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