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Review Writing in Health and Medicine

Using a Librarian

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Librarians endeavor to provide expert information services to faculty, staff, and students in academic departments and Wegner Partners.

Contacting your librarian is encouraged before and during your review process. Librarians are happy to help you throughout the review process, including scoping the literature, building search strategies, assisting with database selection, and more.

If you are unsure of who the librarian liaison is for your department, this list is organized by college and department.

Choosing the Right Review

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One of the first things to consider when preparing to write a review is deciding which type of review you should choose. The type of review you choose is important and you should consider a variety of factors, such as your goals for the study, the size of your team or if it will be a solo work, and your timeline for completion. The following resources can assist you in the decision. If you are still unsure of which review type is best for you, contact your librarian.

Developing a Search Strategy

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Framing Your Research Question

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You don't want your question to be too broad or narrow. You may want to do a quick scope of the literature to get a sense of how your question should be focused. Using a framework can help organize your research question into searchable concepts and clarify the criteria for selecting relevant studies. A common framework is PICO.

P I C O
Patient, Problem, Population Intervention Comparison/Control Outcomes

In addition to being at risk for a health problem, the patient is a member of a population. Therefore, age, sex, ethnicity, socioeconomic status and other demographic variables may need to be taken into consideration when structuring the search and considering the retrieved evidence. 

Ask yourself:

  • How would you describe a group with a similar problem?
  • How would you describe the patient to a colleague?
  • What are important characteristics of this patient?
  • What is the primary problem, main concern, or the patient's chief complaint?
  • Think about the patient's age, race, sex, previous ailments, or current medications and whether these characteristics should be considered as you search for evidence.

The intervention is the main consideration for that patient or client. In the intervention part of the PICO, it is important to identify what you plan to do for that patient. Your intervention should not be “best practices.” Not only is "best practices" not searchable, but it is too broad of an idea. You want to use specifics in your intervention.

Interventions may include:

  • Specific diagnostic test
  • Treatment
  • Adjunctive Therapy
  • Medication
  • Product
  • Procedure
The comparison is the main alternative you are considering. It should be specific and limited to one alternative choice to facilitate an effective computerized search. The comparison is an optional component in the PICO framework. You can look at the intervention without having an alternative. Also, it is not always possible to define a comparison or control for the PICO.

The outcome specifies the result(s) of what you plan to accomplish, improve or affect and must be measurable and, ideally, should measure quality of life and clinical well-being, not just laboratory test results. 

Outcomes may consist of:

  • Relieving or eliminating specific symptoms
  • Improving or maintaining function
  • enhancing esthetics

Specific outcomes will yield better search results and allow you to find the studies that focus on the outcomes you are searching for. When defining the outcome, "more effective" is not acceptable unless it describes how the intervention is more effective (e.g., more effective in preventing pressure ulcers or in decreasing pain).

It is not usually advisable to use the ‘Outcomes’ element of PICO in a search strategy. This is because it can reduce the recall of the search, which risks excluding potentially relevant studies (e.g., those that measured the outcome of interest but did not report it in the published paper). It also introduces bias in the results.

The PICO framework is mostly used for interventional topics or questions of effectiveness. Not every question is comparing two treatments or interventions, so you may not always have a comparison. 

 

Relationship Between Question Type and PICO

This chart shows the relationship between question type and the type of information that will help answer your PICO framework. Note in the prevention, prognosis, and etiology question types, you may not have a comparison.  

Chart

 

Other Frameworks

red lineThere are a variety of frameworks available. Therefore, if your question doesn't fit the PICO framework, you may want to try another one. Here are a few additional options.

CoCoPop: Condition, Context, Population

ECLIPSE: Expectation, Client Group, Location, Impact, Professionals, Service

FINER: Feasibility, Interesting, Novel, Ethical, Relevant

PCC: Population, Concept, Context

PEO: Population, Exposure of Interest, Outcome (or response)

PICo: Population, Interest, Context

PICOS: Population/Problem, Intervention/Exposure, Comparison/Control, Outcome, Study Type

PICOT: Population/Problem, Intervention/Exposure, Comparison/Control, Outcome, Time

PIE: Population, Intervention, Effect

PIRD: Population, Index Test, Reference Test, Diagnosis of Interest

SPICE: Setting, Perspective, Intervention, Comparison, Evaluation

SPIDER: Sample, Phenomenon of Interest, Design, Evaluation, Research Type

Keywords vs. Controlled Vocabulary

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Keywords

  • All the ways to say the same thing
  • Valuable when there is no controlled vocabulary for your search term
  • Catches new articles that have not been indexed with controlled vocabulary
  • Keywords = synonyms, acronyms, antonyms, free text, natural language, user-selected terms, professional lingo, etc.
  • Words must appear in the title, abstract, or other text field in the citation record

When thinking about keyword selection:

British English spelling AND American English spelling

  • Pediatric = Paediatric
  • Orthopedic = Orthopaedic
  • Behavior = Behaviour
  • Hospitalization = Hospitalisation
  • Operating Room = Operating Theatre (Theater)
  • Unit = Ward

Alternative Spellings

  • Healthcare = Health care
  • Outpatient = Out-patient

Drugs Names 

  • Brand names
  • Generic Names
  • Alternate names
  • Acetaminophen = Tylenol = Paracetamol

Acronyms

  • ECMO
  • ICU
  • ACL
  • CHF

 

Controlled Vocabulary

  • A master list of topics in a database
  • Provides a consistent, precise way to retrieve information when different natural language words/phrases (synonyms) are used for the same concept
  • Helps differentiate ambiguous meanings or spelling variations, like British vs. American spellings
  • Accounts for words not mentioned in the title or abstract
  • Also known as: "Subject Headings" and "Thesaurus"

Many subject databases (e.g., PubMed, CINAHL) have controlled vocabulary. However, multidisciplinary databases, such as Web of Science, do not have a controlled vocabulary and you will need to search them using keywords only.

The chart below shows a select set of databases and what their controlled vocabulary is called.

table chart

Boolean Operators

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Boolean operators are the terms used to combine concepts and keywords in your search strategy. Boolean operators are typically capitalized in most databases. Boolean operators include AND, OR, and NOT.

 

AND

AND is used to link concepts or ideas together when you want to see both ideas or concepts in your search results. AND narrows the search.

venn diagram

 

OR

OR is used between like terms (synonyms, acronyms, spelling variations) within the same concept or idea. OR broadens the search.

venn diagram

 

NOT decorative

NOT is used to exclude specific keywords from the search. Use NOT with caution because you may end up excluding something important. Consulting a librarian is recommended if you are considering using NOT in your search.

venn diagram

 

 

Proximity and Adjacency Operators

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Proximity and adjacency operators allow you to search terms that near or next to each other.

Near Operators

Near or Adjacency find words within n words of one another, regardless of the order in which they appear. 

Common Near operators with the example of "patient education" will find results like the following: "patient education", "patient safety education", "education of patient", "education for the patient", etc.

  • CINAHL -- Nn
    • ​​​​​​​​​​​​​​Example: patient N3 education
  • The Cochrane Library -- NEAR/n
    • ​​​​​​​​​​​​​​​​​​​​​Example: patient NEAR/3 education
  • JBI -- ADJn
    • ​​​​​​​Example: patient ADJ3 education
  • PubMed - [tiab:~n]
    • ​​​​​​​Example: "patient education"[tiab:~3]

Next Operators

Next or Within finds words within n words of one another in the exact order in which they have been entered.

Common Next operators with the example of television violence will find results like the following: "television violence", "television and movie violence", "television ratings for violence", etc.

  • CINAHL -- Wn
    • ​​​​​​​​​​​​​​Example: television W3 violence
  • The Cochrane Library -- NEXT/n
    • ​​​​​​​​​​​​​​​​​​​​​​​​​​​​Example: television NEXT/3 violence
  • JBI -- Use ADJ without a variable
    • ​​​​​​​​​​​​​​Example: television ADJ violence

Search Filters

red lineSearch filters, or search hedges, are strategies that have been pre-developed on a specific topic or study type. Using a validated search filter is recommended because they are tested for reliability and accuracy.

Do NOT confuse these with the limits found in databases, such as the limits on the left-hand side of PubMed. Be cautious if you use those as they have special algorithms that only pull references using database-specific controlled vocabulary. 

Validated search filters can be found in the following sites:

Documenting

red lineYour search should be reproducible and transparent so others know how you retrieved your results and can replicate the search to get the same results. More often, publishers and journals will request a copy of your search strategy as an appendix or supplementary material with your manuscript.

Documenting your search will also save you time when you need to rerun, revise, or update the search strategy.

When documenting your search, you should keep track of the following information:

  • The databases searched and their respective strategies
  • The date you searched
  • The filters you used
  • The number of results you retrieved
  • Any additional evidence found through other means, e.g., handsearching

Use whatever software or program with which you are comfortable documenting and saving your searches. Some commonly used:

  • Word processing software
  • Spreadsheet software programs
  • Text editors

Choosing Databases

red lineMore than one database should be searched when doing any type of review. Databases index different resources and vary in their scope and coverage. When it is time for database selection, you want to look at all the aspects of your topic.

  • What are the main concepts?
  • What are the underlying concepts?
  • Are there parts of the research question that are not being used in the strategy, but can help identify a subject-focused database to search?

Do not confuse databases with platforms. Platforms are search interfaces, like search engines or hosts for databases. Mentioning only the platform that was used is not reproducible nor transparent. Platforms include EBSCOhost, ProQuest, and Ovid. You will want to note which database within a platform you have searched, not just the platform. Examples: EBSCOhost CINAHL and Ovid Medline.

The following chart gives examples of subject-focused databases; this list is not exhaustive. To view databases by subject, visit USD's database list and filter by a specific subject. 

Reporting Guidelines

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