Abstract
BackgroundPhysicians are often encouraged to locate answers for their clinical queries via an evidence-based literature search approach. The methods used are often not clearly specified. Inappropriate search strategies, time constraint and contradictory information complicate evidence retrieval.AimsOur study aimed to develop a search strategy to answer clinical queries among physicians in a primary care settingMethodsSix clinical questions of different medical conditions seen in primary care were formulated. A series of experimental searches to answer each question was conducted on 3 commonly advocated medical databases. We compared search results from a PICO (patients, intervention, comparison, outcome) framework for questions using different combinations of PICO elements. We also compared outcomes from doing searches using text words, Medical Subject Headings (MeSH), or a combination of both. All searches were documented using screenshots and saved search strategies.ResultsAnswers to all 6 questions using the PICO framework were found. A higher number of systematic reviews were obtained using a 2 PICO element search compared to a 4 element search. A more optimal choice of search is a combination of both text words and MeSH terms. Despite searching using the Systematic Review filter, many non-systematic reviews or narrative reviews were found in PubMed. There was poor overlap between outcomes of searches using different databases. The duration of search and screening for the 6 questions ranged from 1 to 4 hours.ConclusionThis strategy has been shown to be feasible and can provide evidence to doctors’ clinical questions. It has the potential to be incorporated into an interventional study to determine the impact of an online evidence retrieval system.
Highlights
The practice of evidence based medicine (EBM) involves recognizing uncertainties and formulating these as an answerable question, searching for the literature evidence, appraising the evidences, and applying the acquired knowledge to the patient
A higher number of systematic reviews were obtained using a 2 PICO element search compared to a 4 element search
Despite searching using the Systematic Review filter, many non-systematic reviews or narrative reviews were found in PubMed
Summary
The practice of evidence based medicine (EBM) involves recognizing uncertainties and formulating these as an answerable question, searching for the literature evidence, appraising the evidences, and applying the acquired knowledge to the patient. Doctors usually seek answers from colleagues since it is easier and faster [2]. They search for medical information by using their national guidelines which are often out of date [3]. Increasing access to clinical evidence improves the adoption of evidence-based practice among primary care physician [4]. This has been shown to have a positive impact on medical decision making which lead to quality patient [5]. Inappropriate search strategies, time constraint and contradictory information complicate evidence retrieval
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