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Physiotherapy: Searching for Evidence
La Trobe University Library
Latrobe.edu.au/library
The Research Question
• You cannot conduct an effective search without a well
formulated question.
• Think about the concepts within your research question
• Identify and list the keywords and their synonyms that
identify the concepts
• Consider the ‘level of evidence’ to be sought – the research
methodologies that will help eliminate bias
La Trobe University Library 2
Levels of Evidence
La Trobe University Library 3
Developing a search strategy: PICO
1. Break the research question down into concepts:
• Population
• Intervention
• Comparison
• Outcome
• Research / Study design - Consider adding another column
for the Research Design ie. which study type will give the
highest level of evidence to answer the question
2. Identify for each facet:
• Synonyms
• Spelling variants
• Subject headings
La Trobe University Library 4
PICO example
Do water therapies reduce or relieve pain in people with rheumatoid arthritis?
La Trobe University Library 5
Note: The PICO formula doesn’t always apply and that all elements don’t
always need to be present. It is a useful way to structure and focus your
question – makes it easier to identify search concepts
Population/
Problem
Intervention Comparison Outcome Research
Design
(if applicable)
rheumatoid
arthritis
water therapy n/a pain If applicable:
which study type
will give the
highest level of
evidence to
answer the
question?
Useful search tips
• Spelling variations: paediatrics or pediatrics
• Terminology: physiotherapy or physical therapy
• truncation *: rehabilitat* will find rehabilitate/s, rehabilitated
or rehabilitation
• Wildcard (? or #): Depending on the database a wildcard can
be either ? or # symbol e.g. organi?ation
• phrase searching “….”: e.g. “cerebral palsy”
• check the database online help guide for further information
La Trobe University Library 6
Linking terms: BOOLEAN operators
• AND retrieves records containing both of two
terms:
– Back pain AND exercise
• OR retrieves records containing any of the
terms (OR retrieves more records):
– Back pain OR back ache
La Trobe University Library 7
Example of a completed PICO map
La Trobe University Library 8
Population/
Problem
Intervention Comparison Outcome Research
Design
(if
applicable)
“rheumatoid
arthritis”
or
RA
“water
therap*”
or
hydrotherap*
or
“aquatic
therap*”
n/a pain
or
ache
Therapy
AND
O
R
Databases
• Electronic Indexes that help you identify journal
articles in your research area
• NO single database indexes every journal possible
in a subject area - only those that match their
selection criteria
• Efficient, effective and less biased searching
therefore requires multiple database searching
La Trobe University Library 9
Types of databases
• Citation databases:
Entries have the citation, subject headings and often an abstract,
sometimes they link to full text. Examples: CINAHL, Embase, MEDLINE
• Full Text databases:
Entries have the citation and abstract and in most cases the full text of an
article. Examples: Health & Medical Complete (Proquest), Informit Health
• Pre-appraised evidence databases:
– The Cochrane Library is a multi-database resource which varies in
output e.g. the Cochrane Database for Systematic Reviews contains
complete systematic reviews
– BMJ Best Practice incorporates Clinical Evidence which summarises
the current state of knowledge and uncertainty about the prevention
and treatment of clinical conditions, based on thorough searches and
appraisal of the literature.
La Trobe University Library 10
Accessing Physiotherapy databases
• On Campus:
– Library Web Page
> Databases
> Subject Area - Health Sciences
> Physiotherapy
• Off Campus: authentication as a La Trobe University
student required:
– University username and password
La Trobe University Library 11
Systematic Searching
• Systematic searches are a combination of using
the terminology of the database (Subject
Headings) combined with free text or keyword
searching (alternate terms encountered in the
literature).
• While there may be some overlap, you will also
find many different articles when using both ways
of searching for the same concept.
• Comprehensive systematic searching requires
subject heading and keyword searching!
La Trobe University Library 12
Systematic searching: Why use both methods?
Controlled Vocabulary (Subject Searching) Keyword Searching
MEDLINE, Embase, CINAHL (amongst others) are
indexed by subject experts who assign a subject
heading (or ‘tag’) that best describes the article.
These subject headings are from a fixed list of
terms that are arranged in a hierarchical structure
that show the relationships between terms. This
allows searching at various levels of specificity.
Words not taken from a specific list. Can use
words that you would normally use when
searching. Need to account for variations for
spelling, terminology & clinical descriptions.
More efficient & precise way of searching where
you retrieve only those records which list the
subject heading for your concept.
Broader way of searching where you will retrieve
records which mention your keywords but may or
may not be specifically about your concept.
Searches only the subject field. Searches words used by the author in other fields
such as the title or abstract.
Provides consistency in the description of the
content of the articles.
Useful for searching for a specific term or phrase
when there is not an appropriate subject heading.
Do not need to think of synonyms for your topic. Useful for searching topics that use new concepts
or terminology (subject headings take a while to
be developed)
13
Database aids:
Controlled vocabulary & scope notes
• Subject Headings (Controlled vocabulary or Thesauri): used
to overcome differences in individual authors’ use of
terminology. e.g. back pain (CINAHL and MEDLINE), backache
(Embase)
– Click on the Subject Heading, scroll down to the ‘used for’.
Provides ideas for other keywords to use!
• Scope note: describes how the term is used in the database,
the “scope” of the term; the history of the indexing
• ‘Exploding’ a term: results will include the ‘exploded’ term
(e.g. back pain) plus the conceptually narrower terms in the
tree (low back pain)
La Trobe University Library 14
Use limits to refine your search
For example:
• Clinical Queries
• Time frame
• Language, gender, age, population
• Publication types
– CINAHL e.g. clinical-trial; masters-thesis; research; review;
systematic-review
– MEDLINE - e.g. controlled clinical trial; meta analysis; randomised
controlled trial; review literature; review, academic; review
La Trobe University Library 15
Decreasing results
Too many results?
• Apply limits
• Use keywords which are more specific
• Ask for help with finding subject headings.
• Search for keywords in particular fields like
abstract or title.
La Trobe University Library 16
Increasing results
Not enough results?
• Try another keyword(s)
• Use broader search term(s)
• Remove the least important concept
• Consider possible variants of terms and use
truncation or wildcard
• Remove a date limit or any other limits you have
selected
• Try another database
La Trobe University Library 17
Search results – finding the full text!
• Some databases will have the Full Text Finder icon or pdf link
• If not, search by the title of the journal via the Journal tab on
the library home page and follow the links to the full text:
– sometimes the library may only have a print copy
• If not held by the Library, request the article via Document
Delivery Services
La Trobe University Library 18
Cochrane Library
• To access a variety of search options, click on Search, Search Manager or
Medical Terms (MeSH) to be directed to the appropriate search tab.
• Further information at: latrobe.libguides.com/healthdatabases >
Cochrane
La Trobe University Library 19
PEDro - www.pedro.org.au
• PEDro is the Physiotherapy Evidence Database
with over 23,000 randomised trials, systematic
reviews and clinical practice guidelines in
physiotherapy
La Trobe University Library 20
Google Scholar - scholar.google.com/
• Search scholarly literature for articles, theses, books,
abstracts, professional societies, online repositories,
universities and other web sites across the world of
scholarly research.
• You can access items held in the Library through
Google Scholar. See instructions
La Trobe University Library 21
• Click on the ‘Show conditions’ tab to browse information on the
management of a patient
• Under ‘Treatment’ click on ‘Evidence’ to view information from BMJ Clinical
Evidence (systematic reviews of key clinical questions)
BMJ Best Practice
Useful library guides
• Physiotherapy
• Critical Appraisal
• EndNote
• Grey Literature for Health Sciences
• Systematic Reviews
• Health Databases
La Trobe University Library 23

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Physiotherapy: Searching for Evidence

  • 1. Physiotherapy: Searching for Evidence La Trobe University Library Latrobe.edu.au/library
  • 2. The Research Question • You cannot conduct an effective search without a well formulated question. • Think about the concepts within your research question • Identify and list the keywords and their synonyms that identify the concepts • Consider the ‘level of evidence’ to be sought – the research methodologies that will help eliminate bias La Trobe University Library 2
  • 3. Levels of Evidence La Trobe University Library 3
  • 4. Developing a search strategy: PICO 1. Break the research question down into concepts: • Population • Intervention • Comparison • Outcome • Research / Study design - Consider adding another column for the Research Design ie. which study type will give the highest level of evidence to answer the question 2. Identify for each facet: • Synonyms • Spelling variants • Subject headings La Trobe University Library 4
  • 5. PICO example Do water therapies reduce or relieve pain in people with rheumatoid arthritis? La Trobe University Library 5 Note: The PICO formula doesn’t always apply and that all elements don’t always need to be present. It is a useful way to structure and focus your question – makes it easier to identify search concepts Population/ Problem Intervention Comparison Outcome Research Design (if applicable) rheumatoid arthritis water therapy n/a pain If applicable: which study type will give the highest level of evidence to answer the question?
  • 6. Useful search tips • Spelling variations: paediatrics or pediatrics • Terminology: physiotherapy or physical therapy • truncation *: rehabilitat* will find rehabilitate/s, rehabilitated or rehabilitation • Wildcard (? or #): Depending on the database a wildcard can be either ? or # symbol e.g. organi?ation • phrase searching “….”: e.g. “cerebral palsy” • check the database online help guide for further information La Trobe University Library 6
  • 7. Linking terms: BOOLEAN operators • AND retrieves records containing both of two terms: – Back pain AND exercise • OR retrieves records containing any of the terms (OR retrieves more records): – Back pain OR back ache La Trobe University Library 7
  • 8. Example of a completed PICO map La Trobe University Library 8 Population/ Problem Intervention Comparison Outcome Research Design (if applicable) “rheumatoid arthritis” or RA “water therap*” or hydrotherap* or “aquatic therap*” n/a pain or ache Therapy AND O R
  • 9. Databases • Electronic Indexes that help you identify journal articles in your research area • NO single database indexes every journal possible in a subject area - only those that match their selection criteria • Efficient, effective and less biased searching therefore requires multiple database searching La Trobe University Library 9
  • 10. Types of databases • Citation databases: Entries have the citation, subject headings and often an abstract, sometimes they link to full text. Examples: CINAHL, Embase, MEDLINE • Full Text databases: Entries have the citation and abstract and in most cases the full text of an article. Examples: Health & Medical Complete (Proquest), Informit Health • Pre-appraised evidence databases: – The Cochrane Library is a multi-database resource which varies in output e.g. the Cochrane Database for Systematic Reviews contains complete systematic reviews – BMJ Best Practice incorporates Clinical Evidence which summarises the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. La Trobe University Library 10
  • 11. Accessing Physiotherapy databases • On Campus: – Library Web Page > Databases > Subject Area - Health Sciences > Physiotherapy • Off Campus: authentication as a La Trobe University student required: – University username and password La Trobe University Library 11
  • 12. Systematic Searching • Systematic searches are a combination of using the terminology of the database (Subject Headings) combined with free text or keyword searching (alternate terms encountered in the literature). • While there may be some overlap, you will also find many different articles when using both ways of searching for the same concept. • Comprehensive systematic searching requires subject heading and keyword searching! La Trobe University Library 12
  • 13. Systematic searching: Why use both methods? Controlled Vocabulary (Subject Searching) Keyword Searching MEDLINE, Embase, CINAHL (amongst others) are indexed by subject experts who assign a subject heading (or ‘tag’) that best describes the article. These subject headings are from a fixed list of terms that are arranged in a hierarchical structure that show the relationships between terms. This allows searching at various levels of specificity. Words not taken from a specific list. Can use words that you would normally use when searching. Need to account for variations for spelling, terminology & clinical descriptions. More efficient & precise way of searching where you retrieve only those records which list the subject heading for your concept. Broader way of searching where you will retrieve records which mention your keywords but may or may not be specifically about your concept. Searches only the subject field. Searches words used by the author in other fields such as the title or abstract. Provides consistency in the description of the content of the articles. Useful for searching for a specific term or phrase when there is not an appropriate subject heading. Do not need to think of synonyms for your topic. Useful for searching topics that use new concepts or terminology (subject headings take a while to be developed) 13
  • 14. Database aids: Controlled vocabulary & scope notes • Subject Headings (Controlled vocabulary or Thesauri): used to overcome differences in individual authors’ use of terminology. e.g. back pain (CINAHL and MEDLINE), backache (Embase) – Click on the Subject Heading, scroll down to the ‘used for’. Provides ideas for other keywords to use! • Scope note: describes how the term is used in the database, the “scope” of the term; the history of the indexing • ‘Exploding’ a term: results will include the ‘exploded’ term (e.g. back pain) plus the conceptually narrower terms in the tree (low back pain) La Trobe University Library 14
  • 15. Use limits to refine your search For example: • Clinical Queries • Time frame • Language, gender, age, population • Publication types – CINAHL e.g. clinical-trial; masters-thesis; research; review; systematic-review – MEDLINE - e.g. controlled clinical trial; meta analysis; randomised controlled trial; review literature; review, academic; review La Trobe University Library 15
  • 16. Decreasing results Too many results? • Apply limits • Use keywords which are more specific • Ask for help with finding subject headings. • Search for keywords in particular fields like abstract or title. La Trobe University Library 16
  • 17. Increasing results Not enough results? • Try another keyword(s) • Use broader search term(s) • Remove the least important concept • Consider possible variants of terms and use truncation or wildcard • Remove a date limit or any other limits you have selected • Try another database La Trobe University Library 17
  • 18. Search results – finding the full text! • Some databases will have the Full Text Finder icon or pdf link • If not, search by the title of the journal via the Journal tab on the library home page and follow the links to the full text: – sometimes the library may only have a print copy • If not held by the Library, request the article via Document Delivery Services La Trobe University Library 18
  • 19. Cochrane Library • To access a variety of search options, click on Search, Search Manager or Medical Terms (MeSH) to be directed to the appropriate search tab. • Further information at: latrobe.libguides.com/healthdatabases > Cochrane La Trobe University Library 19
  • 20. PEDro - www.pedro.org.au • PEDro is the Physiotherapy Evidence Database with over 23,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy La Trobe University Library 20
  • 21. Google Scholar - scholar.google.com/ • Search scholarly literature for articles, theses, books, abstracts, professional societies, online repositories, universities and other web sites across the world of scholarly research. • You can access items held in the Library through Google Scholar. See instructions La Trobe University Library 21
  • 22. • Click on the ‘Show conditions’ tab to browse information on the management of a patient • Under ‘Treatment’ click on ‘Evidence’ to view information from BMJ Clinical Evidence (systematic reviews of key clinical questions) BMJ Best Practice
  • 23. Useful library guides • Physiotherapy • Critical Appraisal • EndNote • Grey Literature for Health Sciences • Systematic Reviews • Health Databases La Trobe University Library 23

Editor's Notes

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