Don’t panic. You could go back to Search Strategy #1. That would be wise.

But you’re short on time & don’t know what to do.

Here’s one strategy.

(1) Search for your terms in the title of an article. The easiest way to do this is to use the [ti] field tag with each term in the search box. Run the search.

(2) Look for an on-target indexed citation. All citations with this tag (highlighted in yellow) are indexed:

Indexed for MEDLINE

Once you’ve located a useful indexed citation, display the citation in the Citation format by changing the Display setting:

Citation Display Option

This display format will show the MeSH terms used to index the citation. MeSH terms describe content. Use them as search terms (do not tag these with the [ti] tag).

Just a quick example: You want to find information about doctors who abuse alcohol. Your searches so far have yielded all kinds o information, but none of it particularly focused on the doctor as the one who has the problem.

Try this search: doctors[ti] alcohol[ti] abuse[ti]

Today, I get 4 results from that search and all of them are right on target. The first result I see is an indexed citation:

Displayed in the Citation Format, I see the following MeSH terms:

MeSh Terms for the citation

From here, I can easily see terms that should be used in my search:

• Physician impairment
• Alcoholism —> this term is a specific illness
• Substance-related disorders –> this is the broader term

My new, more effective search?

Physician impairment AND (alcoholism OR substance-related disorders)

Just one of many ways to work with what you’ve got in PubMed.

Figure out what you’re looking for.

A fuzzy question leads to fuzzy results. You probably don’t want fuzzy.

Defining your research question is the most important part of doing successful literature searching — in PubMed or any other database.

How to define the question?

Any method that gets you thinking in specific terms about what you’re looking for will be useful.

The goal: frame your question in a single sentence.

PICO is often cited as a methodology for helping people frame their research question concisely. Works like this:

• Patient
• Intervention
• Comparison
• Outcome

This works well for medical/health related questions. UMDNJ has a really nice one-page explanation of PICO. See it here. (There are many, many sites on the web that discuss PICO in the context of Evidence Based Medicine. Simply do a search for PICO and EBM and you’ll see what I mean.)

PICO can be helpful in non-medical situations, also. Simply reframe:

• Patient becomes Subject: who or what is this all about?
• Intervention becomes Action: what is it that the who/what is doing? This is place for the verb.
• Comparison becomes Options: Choice A or Choice B
• Outcome becomes Results: What happens when who/what does said verb? What measure or value term defines the result of the subject’s actions + options?

Not a neat little mnemonic like PICO, but you get the picture.

Rather than doing a search for adolescents and drugs, look for adolescents abusing ritalin and their risk of suicide.

It’s all about structuring the question. It’s all about precision of thought. It’s all about specificity.

So, I’ve got my PICO or my SAOR set up (or whatever methodology you’ve chose to clarify your research question). Now what? That’s where your search terms come from.

Use those terms to construct a search. In PubMed, you can simply put the terms in the search box and hit go. Let PubMed do its Automatic Term Mapping. This is a good first-pass search strategy.

Eyeball your results. Look at a page or two of results. Do they look good?  Save the citations of interest to the Clipboard.

Now, refine your search. Check the Details of the search – how, exactly did PubMed map your terms? Use the MeSH terms as search terms. Use urticaria, not hives, for example.

Make changes to your search, run it, eyeball the results. Save citations of interest to the Clipboard.

Repeat as necessary.

When you’re done, go to the Clipboard and deal with the chosen citations. You can save them indefinitely in a Collection in your My NCBI account. You can print them. You can email them. Whatever you need to do.

Searching is an iterative process. But it all starts with defining the research question.

1. Share Collections
2. Customize search filters

These are terrific new developments for your My NCBI account. What’s it mean for you?

Share Collections

Have you ever wanted to share PubMed citations with a group of people? Say you’re all working together on the same project and you’ve been charged with doing the literature search. You’ve got all these great citations but….what? How do you get them to everyone in your group?

• Save the citations as a Collection in your My NCBI account
• Mark the Collection “public”
• Copy the resulting URL
• Email the URL to all the members of your group
• Everyone now has access to the citations in the Collection!

Your collection is not static. If you add additional citations, anyone using your link will see the new additions, too. If you delete citations from the Collection, link users will see the edited list.

Customized Search Filters

When you search PubMed, the default search filters for the results are “All” and “Review.” Through your My NCBI account, you can set additional useful filters.

• Want to see only articles in English? Set a filter for that.
• Want to see only articles published in the last 5 years? Set a filter for that.
• Want to see only articles that are clinical trials? Set a filter for that.

But, what if the filter you want isn’t available?

Maybe it would be really helpful to you if you could just see the articles from a few select journals.  Or maybe you want articles that are clinical trials AND in english? Prior to these changes in My NCBI, you couldn’t set search filters for those. Now you can. Here’s how:

• Access your My NCBI account
• Click on the Search Filters link on the left hand side of the page
• Choose your database (here, we’re talking about PubMed)
• Click on the tab toward the top of the page that says “Custom Filters” and follow the “create a new one” link
• Now, enter your search strategy. Every search filter is a search strategy – that’s how they work
• Name your filter
• Save your filter

It’s that easy.

So, for example, a search filter that would filter (group together) items in your result set that are reports of the results of clinical trials  (publication type) and published in English would have a search that looks like this:

clinical trial [pt] AND eng[la]

This filter was named “Clinical Trial and English”

In the search results, you would see the following:

A filter that would group together items in your result set that are only from JAMA or NEJM or Lancet would look like this:

jama[ta] OR n engl j med [ta] OR lancet [ta]

This filter was named “My Journals”

Here’s what you’d see in the search results when this customized filter is activated:

Unsure how to structure your search? Ask a librarian.

Read more about the changes in the NLM Technical Bulletin article Share your PubMed collection and customize filters with My NCBI. The article contains the step-by-step instructions necessary to use these innovations

Links and Information

Wikis in Medicine:

• Ask Dr. Wiki: A “medical wiki with the goal of creating a collective online memory for physicians, nurses, and medical students.”
• Ganfyd: A “free medical knowledge base that anyone can read and any registered medical practitioner may edit. Ganfyd is a collaborative medical reference by medical professionals and invited non-medical experts.” (Ganfyd = Get A Note From Your Doctor)
• Medpedia: A “repository of up-to-date unbiased medical information, contributed and maintained by health experts around the world, and freely available to anyone.” Produced in association with Harvard Medical School, Stanford School of Medicine, the Berkeley School of Public Health, and the University of Michigan Medical School
• Radiopaedia: Radiology wiki supported by Toshiba that aims to “gather a small fraction of our collective knowledge…in a single site which can act as a digital reference, without subscription fees, or copyright. A true peer reviewed site, where errors can be found and corrected, discussion on difficult or controversial topics can be had, and images submitted and used. “
• An entire list of medical wikis is maintained by David Rothman, medical librarian and blogger, and can be found here.

Build your own wiki:

• Wetpaint: They call these “social websites” but it’s a wiki format and completely free to set up and use. As with other free websites, this one comes with advertising, so consider that.
• Wikispaces: Offering basic services for free and premium services at varying prices.
• PBWorks (was PBWiki): offers basic services for free and premium services at varying prices
• Blackboard has a wiki tool.
• The above websites are by no means the only ones — a quick web search will reveal more!

Readings about wikis:

• Medical Wikis 101: What, exactly, is a medical wiki, and, for that matter, a wiki in general? Are these resources useful to you and your patients? Online article that gives a nice overview of wikis & medical wikis in particular by Frank Ferrara, freelance medical writer and former MDNG editor.
• 7 Things You Should Know about Wikis. From Educause

Blogs

There are, literally, millions of blogs. Here are some that may be of interest to those in the health professions:

• Kevin MD: Kevin Pho, MD, a primary care physician board certified in internal medicine and practicing in Nashua, NH. Probably one of the more quoted medical blogs.
• Quanta Vie: Written by Tim Sturgill, MD JD, a board certified emergency physician who is interested in health 2.0, health informatics, emergency medicine, and web 2.0, plus more….
• Emergiblog: “The Life and Times of an ER Nurse” written by Kim, a nurse in the San Francisco Bay area.
• Dr. Wes: Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist practicing in Evanston, IL and is an Associate Professor of Medicine at the Feinberg School of Medicine, Northwestern University. Always interesting.
• EfficientMD: Written by a practicing nephrologist who says: “Being a good doctor depends not only on who you are and what you know, but on the systems you use.”
• Running a Hospital: Written by Paul Levy, President and CEO of Beth Israel Hospital in Boston. I think this was one of the first blogs written by someone in his position.
• Clinical Cases & Images: “Case based curriculum of clinical medicine.” Sort of a hybrid between a blog and a wiki.
• Anne T.-V.: Written by a Canadian medical librarian, this blog offers “current awareness for CE providers and medical/health educators, including chiropractors. Notices of new articles and Web resources, and tips and techniques for practising safe searching on the Internet.”
• The WSJ Health Blog: “The Wall Street Journal Health Blog offers news and analysis on health and the business of health. The lead writers are Journal reporters Jacob Goldstein and Sarah Rubenstein. The blog also includes contributions from other staffers at the Journal, WSJ.com and Dow Jones Newswires.”
• Sharing Mayo Clinic: An example of how an institution is using blogging to further its mission.
• Find more blogs — about healthcare and other topics — by checking the “blogrolls” of bloggers you enjoy reading.

Become a blogger:

• Bloggger
• WordPress
• Blackboard also has a blogging tool

Legal issues for bloggers:

• Blogger’s Legal Guide: From the Electronic Frontier Foundation – excellent source of information about legal aspects of becoming a blogger

Readings about Blogs

• 7 Things You Should Know About Blogs [pdf] from Educause
• An Introduction to Blogs and Blogging by Clay Shirky and Kate Monahan
• Information Awakening. Nielsen, M. Nature Physics. 2009 April; 5(4):238-240.

RSS & Aggregators or Feed Readers

In order for blogs to be useful, a methodology for easily accessing their content is necessary. RSS feeds provide that convenience.

• 7 Things You Should Know about RSS [pdf] from Educause
• RSS in Plain English. Video by Common Craft. Accessible via YouTube.com.
• News Feeds from the BBC offers a nice explanation of RSS and a listing of some of the available feed readers
• Some of the most commonly used Aggregators or Feed Readers:
  • Bloglines
  • Google Reader
  • NewsOnFeeds.com = an extensive list of aggregators
  • Even Microsoft Office will aggregate feeds.

RSS feeds aren’t just for blogs – they are on most any website that updates content on any sort of regular basis.

Social & Professional Networking

• Facebook: The famous site you’ve heard so much about. Originally developed for college students, the fastest growing Facebook demographic is now the over 25 set.
• Sermo: Social networking site just for physicians
• LinkedIn: Professional networking

How-to information for Social Networking

• 10 Privacy Settings Every Facebook User Should Know. Every Facebook user needs to know these ten things. And everyone who advises students needs to know them, too.
• Facebook Survival Guide for Awkward Adults. Interesting and amusing tutorial on how to “behave” on Facebook with the subtitle: “What you need to know to avoid embarrassing your kids (and yourself).”
• How to get Started with LinkedIn. Step by step guide for using LinkedIn. Aimed at business people but the principles are sound.

Readings about Social Networking

• Online Social Networking on Campus from Inside Higher Ed
• Medical Students’ and Residents’ Use of Online Social Networking Tools: Implications for Teaching Professionalism in Medical Education. Ferdig, Dawson, Black, et al in First Monday, Sept. 2008, 13(9).
• The Intersection of Online Social Networking with Medical Professionalism. Thompson, Dawson, Ferdig, Black, et al. Journal of General Internal Medicine, 2008 July; 23(7):954-7. PMID 18612723.
• Letter to the Editor regarding the previous article. Letter written by Gorrindo T, Groves JE, and Gorrindo PC. Journal of General Internal Medicine, 2008 December; 23(12):2155. PMID 18830759.
• Why the Medical Record Needs to Become More Like Facebook. Robert Wachter, MD writes the blog “Wachter’s World.”

Twitter

Answer the question: “What are you doing?”

• Twitter: Here’s a link to the site
• TweetDeck: Another way to view Twitter
• Twhirl: Another way to view Twitter
• FriendFeed: Combine Twitter with Facebook and Google & what do you get? This app.

Some Twitter How-Tos

• Twitter for Beginners. An e-book that explains it all by Charlene Kingston of Crow Information Design.
• 13 Twitter Tips & Tutorials for Beginners: Blogger Darren Rowse puts ‘em all together. Well, not all of them, but 13 pretty useful ones.
• 7 Things You Should Know About Twitter: [pdf] From Educause
• Twitter: An Introduction to Microblogging for Health Librarians: [pdf] Guistini & Wright. JCHLA. 2009 March; 30(1):11-17. Written for librarians but don’t let that fool you – it’s a well written introduction to Twitter.
• 140 Health Care Uses for Twitter: Blogger Phil Baumann wrote this list in his “Health is Social” blog. While I’m not sure I think all 140 are really useful, check them out and see what you think.
• 9 Ways to use Twitter. Written by John C. Dvorak for PCMagazine, this short article sums up the most common uses of Twitter. “Disregard the hype and the haters; Twitter is a powerful platform with plenty of practical uses.”
• Twitter in the classroom. See here for info on how a history professor at the University of Texas at Dallas used Twitter.

Social Bookmarking

Do you have a list of favorite websites bookmarked on your computer? If so, how do you access it when you’re not working on that computer? Social bookmarking is web-based so anywhere you have access to the web, you have access to your list of favorites. It also allows you to share your bookmarked sites with others.

• Delicious: One of the more famous of the social bookmarking sites.
• Simpy: Similar to Delicious
• Diigo: Adds highlighting and the ability to add sticky notes to websites that you’ve tagged.
• Connotea: Developed by the New Technology Group of Nature Publishing Group specifically for use by the scientific community, this is a step beyond social bookmarking. Yes, it allows users to tag and save anything on the web, but it can be especially useful for scientific papers because it will recognize many (not all) scientific journals and will automatically save bibliographic information.

Readings and information about Social Bookmarking

• 7 Things You Should Know About Social Bookmarking[pdf]from Educause
• Social Bookmarking in Plain English. Video by Common Craft. Access via YouTube.

Web 2.0: General Readings

• Medicine in the Era of Web 2.0 Physicians Discover the Benefits (and Downsides) of Social Networking.  Nice overview of Facebook, Sermo, and Twitter by Melissa Rethlefsen,  education librarian at Mayo Clinic and Colin Segovis, an MD/PhD student at Mayo Clinic.
• Take Two Aspirin and Tweet Me in the Morning: How Twitter, Facebook, and Other Social Media are Reshaping Health Care. Hawn, Carleen. Health Affairs, 2009 Mar-April; 28(2): 361-368.
• Pew Internet & American Life Project “aims to be an authoritative source on the evolution of the internet through surveys that examine how Americans use the internet and how their activities affect their lives.” Their reports are available on their website.
• The Horizon Report 2009 The New Media Consortium’s Emerging Technologies Initiative “charts the landscape of emerging technologies for teaching, learning and creative expression” and produces the annual Horizon Report. Each report reviews technologies to watch along with key trends and critical challenges.