Tips for Confidently Searching for Primary Literature

by Amy Smith (as part of her Green Oncology series)

The Issue:

Complex patient issues require us to dig into the primary literature to solve the problem at hand but searching databases with thousands of clinical trials can be daunting and time consuming.   Below are four tips for streamlining your search.   

The Advice:

1)     Define your question.

What do you really want to know?  A clearly defined your clinical question will help streamline your search.  Consider structuring your clinical question in a PICO format (Patient, Intervention, Comparator, Outcome).  Your search will be much more efficient once you know what you are looking for.

2)     Validity

After finding a few articles that you think may be useful, consider the trials individually.  First carefully consider if each study meets your checklist for a well-conducted clinical trial.  Did they use intention to treat analysis?  Were there large drop out rates or have a large number of patients lost to follow up?  If a study was poorly conducted, does it even matter what the results say?  No – because the results are likely not valid so toss that paper out.

3)     Importance

With valid results, we now consider if the results are important.  They may be statistically significant but are they clinically significant? Will these results be important to your patient?  If the results are not going to make a difference to your patient, then time to toss that study as well. 

4)     Applicability

Lastly consider the applicability of the results to your individual patient.  Would your patient have met the trial’s inclusion criteria?  If your patient would not have been involved in the study, it might be worth your efforts to find something more applicable.  However, there are situations where literature that includes your exact patient population is unavailable. This situation requires your clinical judgment to determine if extrapolating the available evidence to your patient is appropriate. 

The Bottom Line:

You may find yourself scanning the primary literature seeking answers to some of your toughest clinical questions.  Before your read through hundreds of articles consider defining your clinical question using a PICO format.  Once you have articles you believe are worth reading, review those articles for validity, importance, and applicability.  Hope these tips help you confidently search through primary literature.  

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Amy Smith is a graduate of the College of Pharmacy at the University of Saskatchewan.  After completing a hospital residency program with the Regina Qu’Appelle Health Region, Amy began working with the Saskatchewan Cancer Agency in Saskatoon as a pediatric oncology pharmacist.  She is now attending the U of T post-baccalaureate PharmD program . During her time away from work, Amy enjoys traveling, volunteering and participating in a various athletics including powerlifting and running. Amy is a member of CAPhO's Communication Committee.