1. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
Systematic Literature Reviews:
A 'How To' Guide
Isla Kuhn
Reader Services Librarian
Medical Library

2. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• how to clarify the question (or perhaps questions) on which you need to find
literature
• selecting the databases and other resources you will need to search
• devising the most comprehensive literature search strategy so you know
you’ve not missed any relevant studies
• keeping up to date with new information appearing between the initial search
and write-up
• issues around management of process and results
• management of references (using software such as EndNote), and getting
hold of the full text article

3. 1 clinical trial.pt. 24 or/13-23 46 exp Bed Rest/
CAMBRIDGE UNIVERSITY LIBRARY
2 randomized.ab,ti. MEDICAL LIBRARY
47 bed rest.mp.
25 exp Spine/
3 placebo.ab,ti. 26 discitis.ab,ti. 48 or/39-47
4 dt.fs. 27 exp Spinal Diseases/ 49 24 or 38
5 randomly.ab,ti. 28 (disc adj degeneration).ab,ti. 50 12 and 49
6 trial.ab,ti. 29 (disc adj prolapse).ab,ti. 51 48 and 50
7 groups.ab,ti. 30 (disc adj herniation).ab,ti.
8 or/1-7 31 spinal fusion.sh.
9 Animals/ 32 spinal neoplasms.sh.
10 Humans/ 33 (facet adj joints).ab,ti.
11 9 not (9 and 10) 34 intervertebral disk.sh.
12 8 not 11 35 postlaminectomy.ab,ti.
13 dorsalgia.ab,ti. 36 arachnoiditis.ab,ti.
14 exp Back Pain/ 37 (failed adj back).ab,ti.
15 exp Low Back Pain/ 38 or/25-37
16 backache.ab,ti. 39 exp activities of daily living/
17 (lumbar adj pain).ab,ti. 40 activities of daily living.tw.
18 coccyx.ab,ti. 41 day to day activ$.ti,ab.
19 coccydynia.ab,ti. 42 daily activit$.ti,ab.
20 exp Sciatica/ 43 ordinary activit$.ti,ab.
21 sciatica.ab,ti. 44 normal activit$.ti,ab.
22 spondylosis.ab,ti. 45 stay$ active.ti,ab.
23 lumbago.ab,ti.

4. What do you actually have to produce? CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• http://www.prisma-statement.org/2.1.2%20-%20PRISMA%202009%20Chec

5. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
introducing the research topic
• clarifying the question
• setting parameters (inclusion/exclusion criteria not built into
search?)
lose marks through sloppy references
Question
Keywords
Synonyms
MeSH / Subject Headings / sub headings
Boolean Logic
Truncation / wildcards
Limits

6. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• Topic -> question -> keywords/synonyms
Diabetes, especially the impact of patient education …..
”Is patient education effective in improving blood sugar control
in teenage diabetics?”
…………………keywords???.... synonyms???........................
Themes?

7. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
”Is patient education effecting in improving blood sugar control
in teenage diabetics?”
1 – teenagers
2 – patient education
3 – blood sugar
PICO ?
Patient/Problem/Population
Intervention
Synonyms?
Comparison
Outcome
(time?)

8. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
”Is patient education effecting in improving blood sugar control
in teenage diabetics?”
1 – teenagers teens adolescents
2– patient education patient information
3 – blood sugar blood glucose hypoglycaemia hyperglycaemia

9. Boolean Logic CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
AND – to narrow the search by combining different topics
eg
“physiotherapy” and “stroke”
Both terms must be present in the results.
Physiotherapy Stroke

10. Boolean Logic CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
OR – to broaden your search, by combining similar terms
eg
“exercise” or “physical activity”
Either term can be present in the resulting set of articles.
Cerebral-vascular
Stroke
Accident

11. Boolean Logic CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
NOT – to restrict your search so that it does not contain a particular term
eg
“physical therapy” not “manual therapy”
The first, but not the second, term must be present.
Physical Manual
Therapy Therapy

12. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
”Is patient education effecting in improving blood sugar control
in teenage diabetics?”
teenagers OR teens OR adolescents
AND
patient education OR patient information
AND
blood sugar OR blood glucose OR hypoglycaemia OR hyperglycaemia

13. Question: CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
1st theme OR OR OR
AND
2nd theme OR OR OR
AND
3rd theme OR OR OR
AND
4th theme? OR OR OR

14. Mind map your question? CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
synonym synonym synonym synonym
1st 2nd
theme theme synonym
synonym
Research
question
synonym
synonym
3rd 4th
theme theme
synonym
synonym synonym
synonym

15. Truncation CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
Treatment
treat
treats
treating • Treat*
treated • Treat?
treater • Treat$
treatment
treatments

16. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
Truncation / wildcards?
1 – teenagers OR teens OR adolescents
AND
2 – patient education OR patient information
AND
3 – blood sugar OR blood glucose OR hypoglycaemia OR hyperglycaemia

17. Task CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• Go to http://wok.mimas.ac.uk
• Open Web of Science
• Type a key word, and search by “topic”
• How many hits?
• Type the keyword with some truncation (use *)
• How many hits?

18. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• Where in the article record do you want the terms/keywords to appear?
• Title?
• Abstract?
• All/any field?
• Impact on sensitivity/specificity?

19. Task CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• Go to http://wok.mimas.ac.uk
• Open Web of Science
• Type a key word, and search by “topic”
• How many hits?
• Type a keyword and search by “title”
• How many hits?

20. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY

21. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
http://www.ncbi.nlm.nih.gov/pubmed/201

22. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
MeSH
1 – teen* OR adolesce* OR "Adolescent"[Mesh]
AND
2 – patient education OR patient information OR "Patient Education as
Topic"[Mesh]
AND
3 – blood sugar OR blood glucose OR hypoglycae* OR hyperglyca* OR
"Blood Glucose"[Mesh] OR "Hypoglycemia"[Mesh]

23. From topic to search CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
Inclusion / exclusion criterion?
teen* OR adolesce* OR "Adolescent"[Mesh]
AND
patient education OR patient information OR "Patient Education as Topic"[Mesh]
AND
blood sugar OR blood glucose OR hypoglycae* OR hyperglyca* OR "Blood Glucose"[Mesh] OR
"Hypoglycemia"[Mesh]
Year of publication? Humans vs Animals?
Type of publication? Language of publication?

24. 1 clinical trial.pt. 24 or/13-23 46 exp Bed Rest/
CAMBRIDGE UNIVERSITY LIBRARY
2 randomized.ab,ti. MEDICAL LIBRARY
47 bed rest.mp.
25 exp Spine/
3 placebo.ab,ti. 26 discitis.ab,ti. 48 or/39-47
4 dt.fs. 27 exp Spinal Diseases/ 49 24 or 38
5 randomly.ab,ti. 28 (disc adj degeneration).ab,ti. 50 12 and 49
6 trial.ab,ti. 29 (disc adj prolapse).ab,ti. 51 48 and 50
7 groups.ab,ti. 30 (disc adj herniation).ab,ti.
8 or/1-7 31 spinal fusion.sh.
9 Animals/ 32 spinal neoplasms.sh.
10 Humans/ 33 (facet adj joints).ab,ti.
11 9 not (9 and 10) 34 intervertebral disk.sh.
12 8 not 11 35 postlaminectomy.ab,ti.
13 dorsalgia.ab,ti. 36 arachnoiditis.ab,ti.
14 exp Back Pain/ 37 (failed adj back).ab,ti.
15 exp Low Back Pain/ 38 or/25-37
16 backache.ab,ti. 39 exp activities of daily living/
17 (lumbar adj pain).ab,ti. 40 activities of daily living.tw.
18 coccyx.ab,ti. 41 day to day activ$.ti,ab.
19 coccydynia.ab,ti. 42 daily activit$.ti,ab.
20 exp Sciatica/ 43 ordinary activit$.ti,ab.
21 sciatica.ab,ti. 44 normal activit$.ti,ab.
22 spondylosis.ab,ti. 45 stay$ active.ti,ab.
23 lumbago.ab,ti.

25. 1 clinical trial.pt. 24 or/13-23 46 exp Bed Rest/
CAMBRIDGE UNIVERSITY LIBRARY
2 randomized.ab,ti. MEDICAL LIBRARY
47 bed rest.mp.
25 exp Spine/
3 placebo.ab,ti. 26 discitis.ab,ti. 48 or/39-47
4 dt.fs. 27 exp Spinal Diseases/ 49 24 or 38
5 randomly.ab,ti. 28 (disc adj degeneration).ab,ti. 50 12 and 49
6 trial.ab,ti. 29 (disc adj prolapse).ab,ti. 51 48 and 50
7 groups.ab,ti. 30 (disc adj herniation).ab,ti.
8 or/1-7 31 spinal fusion.sh.
9 Animals/ 32 spinal neoplasms.sh.
10 Humans/ 33 (facet adj joints).ab,ti.
11 9 not (9 and 10) 34 intervertebral disk.sh.
12 8 not 11 35 postlaminectomy.ab,ti.
13 dorsalgia.ab,ti. 36 arachnoiditis.ab,ti.
14 exp Back Pain/ 37 (failed adj back).ab,ti.
15 exp Low Back Pain/ 38 or/25-37
16 backache.ab,ti. 39 exp activities of daily living/
17 (lumbar adj pain).ab,ti. 40 activities of daily living.tw.
18 coccyx.ab,ti. 41 day to day activ$.ti,ab.
19 coccydynia.ab,ti. 42 daily activit$.ti,ab.
20 exp Sciatica/ 43 ordinary activit$.ti,ab.
21 sciatica.ab,ti. 44 normal activit$.ti,ab.
22 spondylosis.ab,ti. 45 stay$ active.ti,ab.
23 lumbago.ab,ti.

26. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
Advice to rest in bed versus advice to stay active for acute
low-back pain and sciatica
The objective of this review is to determine the effects of advice to rest in bed or stay active for patients
with acute low-back pain or sciatica.
The following comparisons will be made:
• Bed rest versus staying active
• Bed rest versus other treatments (besides staying active)
• Shorter periods of bed rest versus longer periods of bed rest
• Staying active versus other treatments (besides bed rest)
• Comparison between different forms of advice to stay active (e.g. avoiding bedrest, staying active)
http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD007612/pdf_fs.html

27. From topic to search: CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
same strategy, different words
Moving from one database to another…..

28. From topic to search: CAMBRIDGE UNIVERSITY LIBRARY
same strategy, different words MEDICAL LIBRARY
Medline (via OVID) Embase (via OVID)
1 Epidemiologic studies/ 1 Clinical study/
2 Exp case control studies/ 2 Case control study
3 Exp cohort studies/ 3 Family study/
4 Case control.tw. 4 Longitudinal study/
5 (cohort adj (study or studies)).tw. 5 Retrospective study/
6 Cohort analy$.tw. 6 Prospective study/
7 (Follow up adj (study or studies)).tw. 7 Randomized controlled trials/
8 (observational adj (study or studies)).tw. 8 6 not 7
9 Longitudinal.tw. 9 Cohort analysis/
10 Retrospective.tw. 10 (Cohort adj (study or studies)).mp.
11 Cross sectional.tw. 11 (Case control adj (study or studies)).tw.
12 Cross-sectional studies/ 12 (follow up adj (study or studies)).tw.
13 Or/1-12 13 (observational adj (study or studies)).tw.
14 (epidemiologic$ adj (study or studies)).tw.
15 (cross sectional adj (study or studies)).tw.
16 Or/1-5,8-15
• http://www.sign.ac.uk/methodology/filters.html Observational Study Filters

29. From topic to search: CAMBRIDGE UNIVERSITY LIBRARY
same strategy, different words MEDICAL LIBRARY
Medline (via OVID) Medline (via Pubmed)
1 Epidemiologic studies/ #1 “Epidemiologic studies”[Mesh]
2 Exp case control studies/ #2 “case control studies”[Mesh]
3 Exp cohort studies/ #3 “cohort studies”[Mesh]
4 Case control.tw. #4 Case control[Text Word]
5 (cohort adj (study or studies)).tw. #5 (cohort stud*))[Text Word]
6 Cohort analy$.tw. #6 Cohort analy*[Text Word]
7 (Follow up adj (study or studies)).tw. #7 (Follow up AND (study or studies))[Text Word]
8 (observational adj (study or studies)).tw. #8 (observational AND (study or studies))[Text
9 Longitudinal.tw. Word]
10 Retrospective.tw. #9 Longitudinal[Text Word]
11 Cross sectional.tw. #10 Retrospective[Text Word]
12 Cross-sectional studies/ #11 Cross sectional[Text Word]
13 Or/1-12 #12 “Cross-sectional studies”[Mesh]
#13 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR
#7 OR #8 OR #9 OR #10 OR #11 OR #12
• http://www.sign.ac.uk/methodology/filters.html Observational Study Filters

30. Keywords CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
introducing the research topic
reviewing relevant literature
• identifying keywords and synonyms and MeSH
• structuring your search strategy with boolean logic
References
• DON’T plagiarise!
• Don’t lose marks through sloppy references

31. Sensitivity vs Specificity CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY

32. Sensitivity vs Specificity CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY

33. Sensitivity vs Specificity CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY

34. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
introducing the research topic
reviewing relevant literature
Identify relevant sources (and then search them!)
• http://www.lib.cam.ac.uk/electronicresources/
databases?
• Google? Search by Organisation
websites?
hand searching? • Which journals are key to your work?
snowballing? • WoK or Scopus
books? • LibrarySearch or COPAC or GoogleBooks
grey literature? • Google: blog search; SIGLE;
conference proceedings
ongoing trials?
• Trials registers

35. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
introducing the research topic
CASP http://www.casp-uk.net
reviewing relevant literature
Identify relevant sources (and then search them!) “How to read a paper” Trish
Greenhalgh
References & PDFs WB 18.343 – in the Medical Library
or http://tinyurl.com/bmj-trish
• Critically appraising
Zotero
Mendeley
• managing EndnoteWeb
Endnote
• storing Reference Manager
RefWorks
• using them (cite while you write) Papers
• Data extraction Pdf xchange
Prisma

36. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
introducing the research topic
reviewing relevant literature
Identify relevant sources (and then search them!)
References
Keeping up to Date
• alerts
Email alerts
• journal TOCs RSS fees
• citation tracking

37. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
introducing the research topic
reviewing relevant literature
Identify relevant sources (and then search them!)
References
Keeping up to Date
Management of process and results – more info on data management
• What is the data you need to record?
• Where will you record it? Where will you store it?
• How will you record it?
• How will you share it?
When should all this start?

38. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
introducing the research topic
reviewing relevant literature
Identify relevant sources (and then search them!)
References
Keeping up to Date
Management of process and results
Writing Up
• what did you actually do?
• and where did you do it? (750 words?)
• Search log/diary
• Results matrix
• Tidying up your strategy
• What did you find, where?
• Explicit criterion = reproducable methodology

39. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
http://www.bmj.com/content/328/7446/991.full.pdf
http://jech.bmj.com/content/61/12/1069.full.pdf

40. Books that might help CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• http://search.lib.cam.ac.uk/?itemid=|cambrdgedb|1258728
http://search.lib.cam.ac.uk/?itemid=|cambrdgedb|317470
http://search.lib.cam.ac.uk/?itemid=|cambrdgedb|4750307
http://search.lib.cam.ac.uk/?itemid=|cambrdgedb|4850812

41. Stopping CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
• Repetition
• Change in ratio of “good” : ”bad” articles retrieved
• Boundaries/Parameters?
• Databases are not infinite:
• if your strategy is good enough,
and your current awareness strategy is in place, trust it, and stop.

42. CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY

43. Help! CAMBRIDGE UNIVERSITY LIBRARY
MEDICAL LIBRARY
Isla Kuhn
Reader Services Librarian
Medical Library
Box 111
Addenbrooke’s Hospital
email: ilk21@cam.ac.uk
phone: (01223) (3)36750
web: http://library.medschl.cam.ac.uk
Thank you.