Key concepts for searching evidence: an introduction for healthcare professionals

The currently abundant bibliography on healthcare can make the search process an exhausting and frustrating experience. For this reason, it is essential to learn the basic concepts of research question formulation, information sources, and search strategies to make this process more efficient and user-friendly. The search strategy is an iterative process that allows the incorporation of tools and terms in the strategy design to optimize evidence retrieval. Each strategy varies according to the questions, the language used, the source of information accessed, and the available tools. This article is part of a methodological series of narrative reviews on biostatistics and clinical epidemiology. This narrative review describes the essential elements for developing a literature search strategy and identifying the relevant evidence concerning a clinical question through familiar and accessible sources (such as Google and Google Scholar), as well as search interfaces and technical-scientific databases focused on biomedical knowledge (PubMed and The Cochrane Library).

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Neuroimaging Outcomes in Studies of Cognitive Training in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review

Current Alzheimer Research ◽

10.2174/1567205017666200624202425 ◽

2020 ◽

Vol 17 (5) ◽

pp. 472-486

Author(s):

Lucy Beishon ◽

Kannakorn Intharakham ◽

David Swienton ◽

Ronney B. Panerai ◽

Thompson G. Robinson ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Cognitive Impairment ◽

Search Strategy ◽

Web Of Science ◽

Cochrane Library ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Early Alzheimer’S Disease ◽

Magnetic Resonance Imaging Mri ◽

The Cochrane Library

Background: Cognitive Training (CT) has demonstrated some benefits to cognitive and psychosocial function in Mild Cognitive Impairment (MCI) and early dementia, but the certainty related to those findings remains unclear. Therefore, understanding the mechanisms by which CT improves cognitive functioning may help to understand the relationships between CT and cognitive function. The purpose of this review was to identify the evidence for neuroimaging outcomes in studies of CT in MCI and early Alzheimer’s Disease (AD). Methods: Medline, Embase, Web of Science, PsycINFO, CINAHL, and The Cochrane Library were searched with a predefined search strategy, which yielded 1778 articles. Studies were suitable for inclusion where a CT program was used in patients with MCI or AD, with a structural or functional Magnetic Resonance Imaging (MRI) outcome. Studies were assessed for quality using the Downs and Black criteria. Results: Medline, Embase, Web of Science, PsycINFO, CINAHL, and The Cochrane Library were searched with a predefined search strategy, which yielded 1778 articles. Studies were suitable for inclusion where a CT program was used in patients with MCI or AD, with a structural or functional Magnetic Resonance Imaging (MRI) outcome. Studies were assessed for quality using the Downs and Black criteria. Conclusions: CT resulted in variable functional and structural changes in dementia, and conclusions are limited by heterogeneity and study quality. Larger, more robust studies are required to correlate these findings with clinical benefits from CT.

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The Association Between COVID-19 and Thyroxine Levels: A Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.779692 ◽

2022 ◽

Vol 12 ◽

Author(s):

Yiru Chen ◽

Xiuneng Li ◽

Yu Dai ◽

Jingjing Zhang

Keyword(s):

Meta Analysis ◽

Serum Levels ◽

Thyroid Stimulating Hormone ◽

Cochrane Library ◽

Free Triiodothyronine ◽

Time Restrictions ◽

Literature Search Strategy ◽

The Difference ◽

Set Up ◽

The Cochrane Library

ObjectivesRecently, a number of reports have described the potential relationship between COVID-19 and thyroid hormones, but the results were conflicting. We performed a meta-analysis to evaluate the effect of the severity of COVID-19 on thyroid-related hormones and the effect of thyroid-related hormones on the outcome of COVID-19 in order to try to confirm the association between the serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) and the severity or mortality of coronavirus-19 patients.MethodsThe methodology was already registered in the International Prospective Register of Systematic Reviews (PROSPERO) database, and the protocol number is CRD42021269246. Systematic searches were carried out on the Cochrane Library, Embase, PubMed and Web of Science databases on November 15, 2021. We set up the literature search strategy based on the following keywords: [(T3 OR FT3 OR triiodothyronine) or (T4 OR FT4 OR thyroxine) or (TSH or thyrotropin)] and (COVID-19 OR SARS-CoV-2), without time restrictions.ResultsTwenty studies satisfied the inclusion/exclusion criteria and were included in the meta-analysis. A total of 3609 patients were enrolled in the study. From the analysis of the included studies, the incidence of thyroid-related hormone abnormalities was higher in patients with severe COVID-19, and the serum levels of FT3 and TSH were lower than those of patients with nonsevere COVID-19. However, the difference in the FT4 levels was not significant. Similar characteristics were shown between survivors and nonsurvivors. In addition, the outcomes of the meta-analysis showed that patients with abnormal thyroid-related hormones had greater mortality.ConclusionsLow FT3 serum levels, low FT4 serum levels and low TSH serum levels may increase the mortality of COVID-19 patients during admission. On the other hand, the higher the severity level of COVID-19, the higher the probability of decreases in the FT3, FT4, TSH levels.

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Systematic Review of Questionnaires Measuring Patient Satisfaction in Ambulatory Anesthesia

Anesthesiology ◽

10.1097/aln.0b013e31819db079 ◽

2009 ◽

Vol 110 (5) ◽

pp. 1061-1067 ◽

Cited By ~ 59

Author(s):

Pratamaporn Chanthong ◽

Amir Abrishami ◽

Jean Wong ◽

Francisco Herrera ◽

Frances Chung

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Literature Search ◽

Search Strategy ◽

Cochrane Library ◽

Anesthesia Care ◽

Ambulatory Anesthesia ◽

Multiple Item ◽

The Cochrane Library ◽

Questionnaire Construction

Background Patient satisfaction has become an important component of quality improvement in ambulatory anesthesia services. However, it is difficult to measure due to its subjective and complex psychological construct. Psychometric methodology has been successfully used to evaluate this outcome. The authors conducted a systematic review to evaluate questionnaires to measure patient satisfaction with ambulatory anesthesia. Methods A systematic literature search of The Cochrane Library, MEDLINE, EMBASE, CINAHL, HAPI, PsycINFO, and Dissertation Abstracts was performed to identify studies on questionnaires evaluating patient satisfaction after ambulatory anesthesia. The authors included the articles that used multiple-item questionnaires, and the questionnaires were assessed with the strategy of psychometric questionnaire construction, validity, reliability, and acceptability. Results The authors scanned 131 articles yielded by our search strategy. Eleven articles were included in the study. Two questionnaires, IOWA Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, fulfilled the criteria, but the latter was not developed specifically for ambulatory anesthesia, whereas Iowa Satisfaction with Anesthesia Scale was designed only for monitored anesthesia patients. Conclusions In a large number of trials, patient satisfaction has been evaluated using overall satisfaction or nonvalidated questionnaires. Only a few studies have developed questionnaires with rigorous psychometric methods to measure patient satisfaction with anesthesia care. At this time, there is still no valid or reliable questionnaire for measuring patient satisfaction in ambulatory anesthesia. Further study should be conducted to develop standardized instruments to measure this outcome.

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Nurses’ perceptions of factors influencing treatment engagement among patients with cardiovascular diseases: a systematic review

BMC Nursing ◽

10.1186/s12912-021-00765-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Amineh Rashidi ◽

Lisa Whitehead ◽

Prachi Kaistha

Keyword(s):

Systematic Review ◽

Search Strategy ◽

Treatment Engagement ◽

Cochrane Library ◽

Patient Motivation ◽

Mesh Terms ◽

Treatment Plans ◽

Nurses Perceptions ◽

Assess Quality ◽

The Cochrane Library

Abstract Background Nurses are key to the success of patient engagement, yet we know little about nurses’ perceptions on treatment engagement and how they can contribute to treatment engagement. Qualitative evidence to identify factors that influence treatment engagement among patients with CVD from nurse’s perspective is limited. Methods This systematic review of qualitative research was based on the PRISMA reporting guidelines. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality by two reviewers independently. Data were collected from Medline, Web of Science, CINAHL, PsychINFO, Embase- Non-Medline, Scopus, and the Cochrane Library, were systematically searched from 2001 to 2020. The search strategy included keywords and MeSH terms to identify relevant studies written in English. Results Eight articles were included in the review. Four key themes were synthesised from the findings: nurses need training and up to date information, providing support for patients, patient motivation to engage with treatment plans and perceived lack of time. Conclusion Nurses described the importance of training to help them support patients to engage as effectively as possible and their role in providing social and psychological support. They also described the importance of patient motivation to engage in a treatment and plan and sustain engagement and time.

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Data Contained in Electronic Health Records Associated with Risk of Lung Cancer: A Protocol for a Systematic Review

10.21203/rs.3.rs-910471/v1 ◽

2021 ◽

Author(s):

Lamorna Brown ◽

Frank Sullivan ◽

Tom Kelsey ◽

Utkarsh Agrawal

Keyword(s):

Lung Cancer ◽

Electronic Health Records ◽

Search Strategy ◽

Data Extraction ◽

Cochrane Library ◽

Eligibility Criteria ◽

Health Records ◽

Risk Modelling ◽

Electronic Health ◽

The Cochrane Library

Abstract Background: Lung cancer is one of the most common and aggressive forms of cancer, resulting in a low survival and high mortality rate. To improve cancer related outcomes, high-risk subpopulations should be identified to reduce overdiagnosis of lung cancer and aid in the implementation of interventions. Electronic Health Records (EHRs) have been effective in identifying cohorts and phenotyping diseases. To identify whether EHR data can be used in risk modelling for lung cancer, this review will seek to identify data features that are contained in EHRs and related to lung cancer. Methods: A search strategy was developed and then applied to MEDLINE via Ovid, Web of Science, Scopus and the Cochrane library. The titles and abstracts of studies will be identified and screened independently by reviewers. Reviewers will read the full texts of studies that appear to meet the eligibility criteria after initial screening. Articles that meet the criteria at this stage, will have their bibliographies examined for relevant studies. Data extraction will then be performed independently by reviewers and a narrative synthesis will be carried out.Discussion: While risk factors for lung cancer have been extensively researched, there has to date been no effort to identify whether information that relates to these factors are available in EHRs and can be modelled with. As such, the results of the review will seek to broaden knowledge around the use of EHRs in lung cancer risk modelling and inform researchers of the variables that are available in EHRs.Registration: PROSPERO CRD42021246781, Registered on 26/04/21.

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Paramedics working in general practice: a scoping review

HRB Open Research ◽

10.12688/hrbopenres.13250.1 ◽

2021 ◽

Vol 4 ◽

pp. 34

Author(s):

David Xi ◽

Geoff McCombe ◽

Gina Agarwal ◽

Matthew Booker ◽

Walter Cullen ◽

...

Keyword(s):

General Practice ◽

Scoping Review ◽

Emergency Care ◽

Research Question ◽

Cochrane Library ◽

Inclusion Criteria ◽

Patient Health ◽

Context Specific ◽

The Cochrane Library ◽

The Impact

Background: The term ‘paramedic’ has traditionally related to a healthcare professional trained to provide pre-hospital emergency care; however, paramedics are increasingly taking on novel additional non-emergency roles. General practice is facing unprecedented demand for its services related to rising expectations, an aging society and increased prevalence of chronic disease. Paramedics may be recruited to work in general practice to meet some of these demands. We undertook a scoping review to map the current literature considering paramedics working in general practice and inform follow-on research. Methods: We employed the six-stage scoping review framework developed by Arksey and O’Malley. Our research question was ‘to identify the scope of practice, nature of training/qualifications, challenges faced, and impacts of paramedics working in general practice’. Results: After searching PUBMED (Medline, n = 487), EMBASE (n = 536) and the Cochrane Library (n = 0) in June 2020, we identified eleven full-text articles that met our inclusion criteria. The literature suggests that paramedics have diverse skills that enable roles within general practice, some of which are context specific. Additional training is considered necessary to facilitate the transition from emergency care to general practice. We found no research that quantitatively assessed the impact of paramedics working in general practice on healthcare expenditure or patient health outcomes. Conclusions: There is a paucity of empiric scientific literature considering paramedic working in general practice. Further research is needed to inform training pathways, the structure of clinical practice and to measure outcomes.

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The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour & improve safety

BMJ Quality & Safety ◽

10.1136/bmjqs-2020-012283 ◽

2021 ◽

pp. bmjqs-2020-012283

Author(s):

Oliver Cerqueira ◽

Mohsain Gill ◽

Bishr Swar ◽

Katherine Ann Prentice ◽

Shannon Gwin ◽

...

Keyword(s):

Patient Outcomes ◽

Search Strategy ◽

Outcome Measure ◽

Time Lapse ◽

Current Evidence ◽

Cochrane Library ◽

Order Entry ◽

Rapid Transition ◽

Collection Form ◽

The Cochrane Library

BackgroundPrescribing alerts of an electronic health record are meant to be protective, but often are disruptive to providers. Our goal was to assess the effectiveness of interruptive medication-prescriber alerts in changing prescriber behaviour and improving patient outcomes in ambulatory care settings via computerised provider order entry (CPOE) systems.MethodsA standardised search strategy was developed and applied to the following key bibliographical databases: PubMed, Embase, CINAHL and The Cochrane Library. Non-comparison studies and studies on non-interrupted alerts were eliminated. We developed a standardised data collection form and abstracted data that included setting, study design, category of intervention alert and outcomes measured. The search was completed in August 2018 and repeated in November of 2019 and of 2020 to identify any new publications during the time lapse.ResultsUltimately, nine comparison studies of triggered alerts were identified. Each studied at least one outcome measure illustrating how the alert affected prescriber decision-making. Provider behaviour was influenced in the majority, with most noting a positive change. Alerts decreased pharmaceutical costs, moved medications toward preferred medications tiers and steered treatments toward evidence-based choices. They also decreased prescribing errors. Clinician feedback, rarely solicited, expressed frustration with alerts creating a time delay.ConclusionThe current evidence shows a clear indication that many categories of alerts are effective in changing prescriber behaviour. However, it is unclear whether these behavioural changes lead to improved patient outcomes. Despite the rapid transition to CPOE use for patient care, there are few rigorous studies of triggered alerts and how workflow interruptions impact patient outcomes and provider acceptance.

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Searching and selecting the best evidence efficiently: a tool for clinicians, professors and dental students

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-8637201800020000660200172 ◽

2018 ◽

Vol 66 (2) ◽

pp. 172-176

Author(s):

Paulo NADANOVSKY ◽

Ana Paula Pires dos SANTOS

Keyword(s):

Oral Health ◽

Search Strategy ◽

Clinical Intervention ◽

Dental Students ◽

Cochrane Library ◽

Evidence Based ◽

Randomized Controlled ◽

The One ◽

The Cochrane Library ◽

Clinical Queries

ABSTRACT The aim of this article was to offer an efficient systematic search strategy appropriate for clinicians, professors and dental students, for when they have a question regarding the effectiveness of clinical intervention. We adapted the “6-S System” proposed for Medicine in order to build a search strategy focused on oral health, which is speedy, easy to use and arrives at the appropriate evidence. With a focus on validity and search efficiency, the following searching sequence is proposed: critical abstracts of systematic reviews (SR) of randomized controlled trials (RCTs), SR of RCTs, critical abstracts of RCTs, and RCTs. These can be searched in the Cochrane library; evidence-based journals; websites and blogs; and in Pubmed using the tool Clinical Queries. This strategy can enhance the ability to quickly retrieve evidence that is important to dental education, clinical practice and delivery of oral health care. The adoption of strategies such as the one proposed in this paper is likely to increase evidence based dental practice.

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Efficacy of compression stockings in preventing post-thrombotic syndrome in patients with deep venous thrombosis: a systematic review and metaanalysis

VASA ◽

10.1024/0301-1526/a000508 ◽

2016 ◽

Vol 45 (2) ◽

pp. 141-147 ◽

Cited By ~ 7

Author(s):

Jakob Martin Burgstaller ◽

Johann Steurer ◽

Ulrike Held ◽

Beatrice Amann-Vesti

Keyword(s):

Systematic Review ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Cochrane Library ◽

Compression Stockings ◽

Post Thrombotic Syndrome ◽

Study Results ◽

Preventive Efficacy ◽

One Year ◽

The Cochrane Library

Abstract. Background: Here, we update an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials. The aims are to synthesize the results of the original studies, and to identify details to explain heterogeneous results. Methods: We searched the Cochrane Library, PubMed, Scopus, and Medline for original studies that compared the preventive efficacy of active compression stockings with placebo or no compression stockings in patients with diagnosed proximal DVT. Only randomized controlled trials (RCTs) were included. Results: Five eligible RCTs with a total of 1393 patients (sample sizes ranged from 47 to 803 patients) were included. In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, we refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. Conclusions: At this time, it does not seem to be justifiable to entirely abandon the recommendations regarding compression stockings to prevent PTS in patients with DVT. There is evidence favoring compression stockings, but there is also evidence showing no benefit of compression stockings.

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Barriers and facilitators to conducting research by early career psychiatrists: a literature review

Global Psychiatry ◽

10.2478/gp-2019-0018 ◽

2019 ◽

Vol 2 (2) ◽

pp. 135-154

Author(s):

Katja Koelkebeck ◽

Maja Pantovic Stefanovic ◽

Dorota Frydecka ◽

Claudia Palumbo ◽

Olivier Andlauer ◽

...

Keyword(s):

Research Participation ◽

Early Career ◽

Cochrane Library ◽

Inclusion Criteria ◽

Research Career ◽

Hand Search ◽

Electronic Search ◽

Conducting Research ◽

The Cochrane Library ◽

To Receive

AbstractObjectivesTo understand and identify factors that promote and prevent research participation among early career psychiatrists (ECPs), in order to understand what would encourage more ECPs to pursue a research career.MethodsWe conducted an electronic search of databases (PubMed and the Cochrane library) using the keywords ‘doctors’, ‘trainees’, ‘residents’, ‘physicians’ and ‘psychiatric trainees’ as well as ‘research’ (MeSH) and ‘publishing’ (MeSH). This search was complemented by a secondary hand search.ResultsWe identified 524 articles, of which 16 fulfilled inclusion criteria for this review. The main barriers included lack of dedicated time for research, lack of mentoring and lack of funding. The main facilitators were opportunities to receive mentorship and access to research funding.ConclusionsAction is needed to counteract the lack of ECPs interested in a career in research. Specific programs encouraging ECPs to pursue research careers and having access to mentors could help increase the current numbers of researching clinicians in the field.

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