To acquire the evidence, you must develop an effective search strategy. Search strategies may vary from one database to another. Searching for the evidence-based literature is an iterative process and will involve one or more of these strategies: identifying synonyms and subject terms for each concept, trying broad and narrow concept searching, adding and subtracting concepts to decrease or increase, respectively, the number of results, and filtering results according to particular parameters such as dates published, if important.
Once again, the clinical question is: For a 55 year old woman with osteoporosis, is a regimen of calcium, vitamin D, and/or weight bearing exercise as effective as treatment with bisphosponates in preventing additional bone loss?
Here is an example of a search strategy:
1. I start by plugging the search terms into the PubMed Clinical Queries search box:
2. In the results, I notice an article that has the MeSH term "osteoporosis, postmenopausal." Remembering that our patient is postmenopausal, I use that specific term to focus the search and give me a more manageable set of results. Thus my new search is:
Osteoporosis, postmenopausal AND bisphosphonates AND (weight bearing exercise OR vitamin d OR calcium).
There are a variety of article databases in which to search for the evidence-based literature. Click on the various tabs on this webpage to access the library resources available through UT Libraries.
Use article databases to search for primary research articles, systematic reviews, meta-analyses, and clinical practice guidelines.
On the search results page, results are categorized by type of article, including "Guidelines."
These types of resources use an appraisal process to review and evaluate primary research studies, systematic reviews, and meta-analyses and apply scaled ratings or graded recommendations. When physicians use a point-of-care tool, they know that studies have been vetted for quality, validity, and relevance, and thus, they can feel confident in utilizing the information right away at the point of care with a patient.
ACP Journal Club - a monthly feature in the journal Annals of Internal Medicine. Research staff and clinical editors rigorously appraise original studies and systematic reviews from more than 110 journals and summarize them in value-added abstracts. Ten journal club appraisals are published monthly. Included studies need to meet specific study design quality criteria and are rated on a scale from 1 to 7 on clinical relevance and newsworthiness in its field.
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