PubMed Clinical Queries

PubMed Clinical Queries searching tips:

Select a study category and an emphasis category using the appropriate radio buttons. If you are looking for systematic reviews, select the radio button on the corresponding section of the Clinical Queries screen. After choosing your category, type your search terms in the box labeled, “Enter subject search” and press “Go.”

PubMed articles are indexed using Medical Subject Headings or MeSH, a system of “controlled vocabulary” terms that ensures uniformity, consistency and more productive searching. Most times, the term you enter is automatically mapped to the corresponding MeSH heading. For example, if you enter “heart attack” it will be translated as a search for “myocardial infarction”. However, if you have a problem with the mapping, try your word or phrase in the MeSH Database search box to view suggestions for more relevant terms. You can then enter those MeSH terms into the search box on the Clinical Queries page.

• Enter the search terms postherpetic neuralgia AND antidepressants. The default settings (therapy and specificity) are fine for this search and do not need to be changed.

• Click on “Go.” The pre-defined set of terms for this clinical filter will be combined with your search terms.

• Enter the search terms postherpetic neuralgia AND (lidocaine OR capsaicin). The parentheses are necessary here for PubMed to process the terms in the correct combination. Once again, the default settings (therapy and specificity) are fine for this search and do not need to be changed.

• Click on “Go.”

We now have two sets, with references to evidence analyzing the use of antidepressants or the two specific topical treatments that are used for postherpetic neuralgia. To combine these two sets for browsing, click on History under the main search box. Then enter the command, #1 OR #2.

Our summary display screen shows 25 evidence-based articles that examine the efficacy and safety of the treatment options under consideration.

The clinical queries feature helps to select the best evidence from the millions of articles referenced in the MEDLINE database. While out of the scope of this tutorial, remember that it is still important to critically appraise these studies before making decisions about clinical care.

Systematic reviews are considered the best source for evidence in considering treatment options. A systematic review is a summary of the medical literature that uses well-defined methods to search, critically appraise and synthesize research studies on given topics. We have already looked at these kinds of reviews from the Cochrane Collaboration. However, other groups also publish systematic reviews. We can use our second option on the PubMed Clinical Queries to locate references to these.

After clicking on Clinical Queries on the PubMed sidebar, change the default search by clicking in the box next to the phrase Systematic Reviews. Since there are only a limited number of these summaries, we can use a broader strategy than the one we used for our first Clinical Queries search. Enter the terms postherpetic neuralgia AND treatment in the search box and click on Go.

Our review of the content of four key evidence-based sources has shown that relevant literature for our sample clinical question can be found in all but the Cochrane Database of Systematic Reviews. UpToDate offered current background information on using topical treatments as an alternative to antidepressants for post-herpetic neuralgia. An article in ACP Journal Club provided commentary on a discussion of the range of treatment options for this painful condition. Using the PubMed Clinical Queries feature, we were able to locate over 50 relevant studies or reviews discussing our topic. While locating the most relevant evidence is only one component of the EBM process, it is a crucial step in providing the best patient care.

Searching the Medical Literature for the Best Evidence

© 2003 Health Sciences Library, UNC Chapel Hill