Pre-Hospital Emergency Care OLD Sep 23: Literature Searching Help

In this section, you will find answers to commonly asked questions regarding:

• Searching databases
• Formulating your research question using frameworks which can help develop your literature search strategies

Things to Remember

When formulating your own research question and conducting your literature search, please do bear the following in mind:

1) Don't make your research question overly complex or incorporate too many components. Having a lengthy research question does not guarantee success or higher marks, and could make the literature searching process more complicated. Instead, make sure you have created a well-defined clinical question with clear outcomes so you have a strong idea of what it is that you want to find out. 

2) Database searching is not an exact science. Searching databases is all about experimentation; whether it's swapping the keywords you search, understanding when to apply AND and OR, or applying different limits in order to refine your search, database searching is a little unpredictable (you never really know what's going to appear unless you start searching!) 

3) Don't worry. If you're searching databases and the literature you are expecting to find isn't appearing, follow the tips in the 'What happens if my search isn't working' box below to apply different techniques, or you may need to revisit and tweak your research question slightly.

4) Expect to read a lot! Researching is time-consuming and in order to find evidence which supports your research question, you will have to engage in a lot of reading. Some of the journal articles you find on subject-specific databases may, at first, seem irrelevant (perhaps the title may not be exactly what you are looking for). But if you read the abstract and the discussion/conclusion, you may find that what you first thought was irrelevant turns out to be relevant. 

There are various reasons why your search strategy might not be working and not all of them are obvious! An important thing to remember is not to worry as we can all encounter and experience difficulties when trying to find relevant literature (even the most experienced of us!) and there is no such thing as a perfect literature search. 

Below, I have outlined a few useful tips that you may want to consider using if you are experiencing any of the following:

Too many results

• Have you applied the Boolean operator AND to combine/search for topics together (e.g. emergency care AND cardiac arrest). This will help to refine your search and will retrieve literature which addresses both of these topics - your results will therefore be more relevant. 
• Is your question too broad / not specific enough? Sometimes if you haven't clearly identified either a condition or intervention, and instead searched generic terms (e.g. psychology or mental health), you may find that you end up with too many results. Try to focus your question and the keywords you search for more useful results.

Not enough results

• Are the keywords you are searching too focused? Or do you have a particularly long or complex research question with many components? Sometimes it's better to have a simpler question with fewer components to ensure you are retrieving more than a couple of articles. 
• Have you applied the Boolean operator OR to search for synonyms (alternative phrases)? For example, searching cardiac arrest OR heart attack OR myocardial infarction OR acute coronary syndrome will retrieve more results than a search for cardiac arrest because you are searching for literature which contains any of these terms.
• Is your question too specific, or niche? It may be that the area you are investigating is under researched meaning there is very limited literature which already exists on that topic. 

Irrelevant results

• Are you using the correct keywords? Sometimes if you choose a word which is a bit vague or generic (e.g. mental health) when you're really interested in a particular condition (e.g. anxiety), will retrieve lots of results unrelated to anxiety (e.g. depression, schizophrenia, etc.).
• Are you applying AND and OR in the correct way? OR is used to search synonyms (alternative phrases) and is used when are you are performing a more broader search for keywords. AND is used to combine different components of the question together (e.g. traumatic brain injury AND paediatrics) to refine your search and retrieve literature that is relevant to your research question.

For your dissertation / final project, you will be expected to create your own research question. Being able to formulate and answer a well-defined clinical question using the strategies of Evidence-Based Practice (EBP) is crucial for all healthcare students.

But where to start? 

Firstly, you will probably want to identify a topic or area which is of particular interest to you. Is there a specific condition and / or form of therapy you want to know more about? If so, write these down and then consider what, in particular, do you wish to find out? Is there a specific outcome or do you want to compare two interventions to determine which is the most effective in treating a condition?

You may not have a definitive research question at this point but there are some frameworks you can use which can help you structure your research question:

PICO

P - Population/Problem - this is the group of people or particular condition you are investigating

I - Intervention - this is the treatment, what you are going to implement in order to alleviate the condition / help the population

C - Comparison/Control - this is the comparator; if you are investigating two types of drugs or therapies

O - Outcome - this is what you are measuring; the desired effects you expect to see as a result of implementing the intervention to  alleviate the condition / help the population 

EXAMPLE - In elderly diabetic patients admitted with stage III foot ulcers (P), is negative pressure wound therapy (I) more effective than standard moist wound therapy (C) in treating wounds (O)? 

SPICE (mainly used for qualitative studies) 

S - Setting - where? For example, emergency room 

P - Perspective - who? Are these staff, patients or relatives?

I - Intervention/Interest - what? This is the treatment you are going to implement

C - Comparison - compared with what? This is the comparator; if you are investigating two types of drugs or therapies

E - Evaluation - with what result? This is what you are intending to find as a result of conducting the study / research

SPIDER

S - Sample  - the who of your study, population 

P I - Phenomenon of Interest - the what of your research; the topic of investigation 

D - Design - how are you going to gather your data? e.g. interview, survey, questionnaire, etc. 

E - Evaluation - the result / outcome; e.g. experiences, perceptions, views, etc.

R - Research Type - qualitative, quantitative or mixed-methods 

Research Articles

• Presents the findings of original research (primary research)
• Usually up to date research which has recently been carried out
• Provides specific and detailed information to enable others to conduct the same research following the steps outlined in the article
• Published in a peer-reviewed academic journal 

Review Articles

• Provides detailed summaries of research in a particular area or topic
• Not primary research as it's one author’s opinion and analysis of the research
• Useful introduction to key research in your chosen topic
• Sometimes referred to as survey articles or overview articles