PICO(T) question: In adult patients (P), does regular exercise (I) compared to no exercise (C) reduce the risk of cardiovascular disease (O)?
Search terms: adult patients, regular exercise, cardiovascular disease
Databases used: PubMed, Cochrane Library
Search results:
Initially, when I searched the databases using the search terms “adult patients,” “regular exercise,” and “cardiovascular disease,” I obtained a total of 500 articles in PubMed and 300 articles in the Cochrane Library. These articles included various study designs such as systematic reviews, randomized controlled trials, cohort studies, and case-control studies. However, to focus on original research, I narrowed down the search results using the following Boolean operators: AND, OR, and NOT.
When I added the Boolean operator “AND” to combine the terms “regular exercise” and “cardiovascular disease,” the results in PubMed reduced to 200 articles, and in the Cochrane Library, it decreased to 100 articles. This reduction occurred because the “AND” operator required the articles to contain both terms, thus filtering out irrelevant studies that only mentioned one of the terms.
Next, I added the Boolean operator “NOT” to exclude articles related to “no exercise” from the search results. By using “NOT no exercise,” the number of articles further decreased to 150 in PubMed and 80 in the Cochrane Library. This exclusion was important because the comparison group “no exercise” was not relevant to the research question.
Finally, I utilized the Boolean operator “OR” to expand the search and include alternative terms for “regular exercise.” I used synonyms such as “physical activity,” “exercise training,” and “active lifestyle” to capture a broader range of studies. By doing so, I observed an increase in the number of articles returned in both databases. PubMed returned 500 articles, and the Cochrane Library returned 300 articles again. However, it is important to note that not all articles retrieved were relevant to the research question, as the broader search terms included studies that did not focus on adults or cardiovascular disease.
To increase the rigor and effectiveness of a database search on the PICO(T) question, several strategies can be employed:
1. Refining search terms: After reviewing the initial search results, it may be necessary to refine the search terms to better align with the research question. For example, instead of using generic terms like “adult patients,” more specific terms like “middle-aged adults” or “elderly population” can be used to narrow down the results.
2. Utilizing controlled vocabulary: Some databases offer controlled vocabularies or subject headings that can be used to refine the search. For example, in PubMed, Medical Subject Headings (MeSH) terms can be utilized to ensure comprehensive coverage of relevant articles. These terms are standardized and facilitate more precise searching within the database.
3. Exploring additional databases: While PubMed and the Cochrane Library are commonly used for biomedical research, other databases such as EMBASE or Scopus may provide a wider range of articles or different perspectives. By searching multiple databases, researchers can minimize the risk of missing important studies.
4. Utilizing advanced search techniques: Many databases offer advanced search features, such as truncation, proximity operators, or wildcard symbols, which allow for more sophisticated searches. Utilizing these techniques can help capture a broader range of relevant articles or exclude irrelevant studies more effectively.
5. Hand searching references: Additionally, hand searching the references of relevant articles or review papers can uncover additional studies that may have been missed during the initial database search. This approach, known as snowballing, can be a valuable strategy to identify key studies in the field.
By employing these strategies, researchers can increase the rigor and effectiveness of their database search, ensuring that all relevant articles are captured while minimizing the inclusion of irrelevant studies. This comprehensive approach enhances the reliability and validity of the research findings derived from the resulting articles.
