This is a representative roadmap of how we approach the client’s search. It shows where we start, the path we follow, and where we end up. It is detailed so that you can understand our processes. It is not a requirement that you understand how we do what we do if you’re not interested. We’ve included it to anticipate some of your questions and to demonstrate how we can save you time, missteps, and headaches along the way.<\/p>\n\n\n\n
The researcher arrives with a question: “<\/em>Can I use Chlorhexidine to flush kids’ bladders?”<\/p>\n\n\n\n We discuss the question (“Can I use Chlorhexidine?”<\/em>) and the question-behind-the-question (“I think I read that Chlorhexidine is just as effective as other choices for treating bladder infections, and it’s supposed to be gentler on the bladder?”<\/em>)<\/p>\n\n\n\n We flesh it out a little more by framing it as a PICOT question:<\/p>\n\n\n\n We arrive at a concrete, researchable question: “Does using Chlorhexidine to flush the bladders of pediatric patients with long-term catheter placement reduce the incidence or the severity of urinary tract infections as compared to other approaches?”<\/em><\/strong><\/p>\n\n\n\n To start at the initial question to end at the research question takes a conversation. It allows us to hear the language you use to describe what you’re looking for. We will note any keywords or particular authors or journals where you might have seen something about your topic. Every piece of information, even the seemingly unimportant bits, allow us to build a picture of your topic and gather clues about where to focus our search.<\/p>\n\n\n\n Once we understand what you’re looking for, we write out the research question, and then we analyze it for its facets. The facets are the broad topics or concepts wrapped up in the question.<\/p>\n\n\n\n The sample question can be broken down into five logical facets:<\/p>\n\n\n\n Each facet represents an important component of the search. The better we understand the relationships among the facets, the more focused we can be in our search. This helps us optimize the precision and recall of the search strategy; in fact, this is largely analogous to specificity and sensitivity. By optimizing precision and recall, we improve our results by catching the relevant information while filtering out the information that does not apply to this topic. In the end, our goal is to give you the information you need while minimizing the time you spend reviewing articles only to discard them as off-topic.<\/p>\n\n\n\n We construct search strategies using keywords, Medical Subject Headings (MeSH), database-specific subject headings (for example, Embase’s Emtree expansion on MeSH), and other terms. Once we identify the correct language for the search, we write the search strategy using the syntax appropriate to each database: Boolean operators AND, OR, and NOT; proximity operators NEAR or WITHIN; truncation\/character masking; synonym dictionaries; and any limiters or filters that apply, for example a range of years or a selection that returns only articles published in English or Dutch. <\/p>\n\n\n\n Further, we select the fields with the most information-rich content to search. For example, MeSH terms; keywords from the title or abstract; and keywords assigned by the author are rich resources for finding the information you’re looking for. Unless one of the facets specifically points us to publishers or grant funding bodies, those are not likely to be useful fields for the sample search above, so we don’t search them; this way, we’re not flooding the final result list with irrelevant results.<\/p>\n\n\n\n Here are the facets and the search terms that describe each one. Please note that Capitalized Terms are Medical Subject Headings (MeSH); lower-case terms are keywords; * and ? are truncation and masking symbols; and ” ” go around specific phrases. While some terms may look like duplicates, they are not: Child is searched in different fields in the records than child or childr*. We include them all so that nothing potentially useful slips through.<\/p>\n\n\n\n Pediatric patients:<\/strong> Infant, Newborn; Infant; Child, Preschool; Child; Adolescent; child; childr*; infant*; kid; kids; teen*; adolescent*; pediatr*<\/p>\n\n\n\n Catheters: <\/strong> Urinary Catheters; Urinary Catheterization; Catheters, Indwelling; “urin* catheter*”; “urethr* catheter*”; “indwelling urinary catheter”; foley<\/p>\n\n\n\n Urinary bladder infections: <\/strong> Urinary Tract Infections; Bacteriuria; Catheter-Related Infections; “urinary tract infection*”; uti; utis; “catheter associated urinary tract infection*”; cauti*; “catheter related infections”<\/p>\n\n\n\n Urinary irrigation:<\/strong> Therapeutic Irrigation; “bladder irrigation”; “bladder washout”; “continuous bladder irrigation”<\/p>\n\n\n\n Chlorhexidine:<\/strong> Chlorhexidine; chlorhexidine<\/p>\n\n\n\n Strategy including<\/em> the pediatric patient facet:<\/p>\n\n\n\n ((infant, newborn[mh]) OR (infant[mh]) OR (child, preschool[mh]) OR (child[mh]) OR (adolescent[mh]) OR (child[tiab]) OR (childr*[tiab]) OR (infant*[tiab]) OR (kid[tiab]) OR (kids[tiab]) OR (teen*[tiab]) OR (adolescent*[tiab ]) OR (pediatr*[tiab])) AND ((urinary catheters[mh]) OR (urinary catheterization[mh]) OR (“urin* catheter*”[tiab]) OR (“urethr* catheter*”[tiab]) OR (“indwelling urinary catheter”[tiab:~1]) OR (foley[tiab])) AND ((urinary tract infections[mh]) OR (bacteriuria[mh]) OR (catheter-related infections[mh]) OR (“urinary tract infection*”[tiab]) OR (uti[tiab]) OR (utis[tiab]) OR (“catheter associated urinary tract infection*”[tiab]) OR (cauti*[tiab]) OR (“catheter related infections”[tiab:~2])) AND ((therapeutic irrigation[mh]) OR (“bladder irrigation”[tiab]) OR (“bladder washout”[tiab]) OR (“continuous bladder irrigation”[tiab]) OR (“continuous bladder irrigation”[tiab:~2])) AND ((chlorhexidine[mh]) OR (chlorhexidine[tiab]))<\/p>\n\n\n\n This strategy returned zero results.<\/p>\n\n\n\n Strategy without<\/em> the pediatric patients facet:<\/p>\n\n\n\n ((urinary catheters[mh]) OR (urinary catheterization[mh]) OR (“urin* catheter*”[tiab]) OR (“urethr* catheter*”[tiab]) OR (“indwelling urinary catheter”[tiab:~1]) OR (foley[tiab])) AND ((urinary tract infections[mh]) OR (bacteriuria[mh]) OR (catheter-related infections[mh]) OR (“urinary tract infection*”[tiab]) OR (uti[tiab]) OR (utis[tiab]) OR (“catheter associated urinary tract infection*”[tiab]) OR (cauti*[tiab]) OR (“catheter related infections”[tiab:~2])) AND ((therapeutic irrigation[mh]) OR (“bladder irrigation”[tiab]) OR (“bladder washout”[tiab]) OR (“continuous bladder irrigation”[tiab]) OR (“continuous bladder irrigation”[tiab:~2])) AND ((chlorhexidine[mh]) OR (chlorhexidine[tiab]))<\/p>\n\n\n\n The strategy without the pediatric facet returned 12 relevant articles. Here is the step-by-step breakdown by facet and number of results:<\/p>\n\n\n\n\n
\n\n\n\nAnalysis of the Sample Question<\/h3>\n\n\n\n
\n\n\n\nFacets of the Sample Question<\/h3>\n\n\n\n
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\n\n\n\nAnalysis of the Facets<\/h3>\n\n\n\n
Sample Search Strategy<\/h3>\n\n\n\n
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