Pharmacy and Pharmacology

Begin with a well-focused research question, which you may often have to create from a clinical scenario.

In patients undergoing cardiac surgery, is amiodarone more effective than beta blockers in preventing arrhythmias such as atrial fibrillations?

What are the main terms in this question?

cardiac surgery / amidarone / beta blockers / arrythmias

Cardiac surgery, as well as heart surgery, maps to both thoracic surgery and cardiac surgical procedures--which is too broad. Go to the MeSH Database or check details and pick out cardiac surgical procedures to search on

Synonyms, words that mean the same thing or are closely related to your main search terms, can help expand your search appropriately.  

Boolean operators such as AND & OR are used to connect synonyms & concepts.

• Use OR to connect synonyms to appropriately expand your search for a concept. Your search results will contain citations for each term.  Place parentheses around the search terms when you use OR so that the database searches them together. 
• Use AND to connect concepts.  This will narrow your search results, giving you just the articles that include all terms, that is,  the intersection of the search terms you've used.  Remember:  Databases assume AND between terms, so you don't have to use it.
• Always capitalize boolean operators; if you don't, they'll be ignored

Here is the search string that can be used to search the database:

(cardiac surgery OR heart surgery) AND (amiodarone OR adrenergic beta-antagonists OR beta blockers) AND (arrhythmias)

• amiodarone, adrenergic beta-antagonists & beta blockers are synonyms for the second concept.  I decided to use both terms; arrhythmias is the third concept.  All concepts are connected with AND.
• I've left some synonyms out of the search for now.  If my results are large, I'll add add them later. 
• I'll first try to find articles that compare the 2 drugs using a filter, such as Reviews, Systematics Reviews, or Randomized Controlled Trials after I've run my search. If I was considering a specific age range, for example, I would apply a filter also.  Filters are usually the best way to limit your search by age, sex, language & other factors.
• Remember, you may not create the best search the first time around.  Based on your search results, you may need to think of new search terms & revise your search.

Sometimes, you'll need to search for a phrase rather than a word.  If you use quotation marks around the the phrase, you could run into problems.  Using quotation marks can mean that no part of that phrase will map to an indexing term, so you may miss important articles.  On the other hand, sometimes quotation marks can help your search, especially if there is no relevant indexing term for a concept. 

For example, in PubMed, dietary intake doesn't map to a MeSH term; instead, dietary is searched as a keyword, & mapped to diet & intake is mapped as a separate keyword & MeSH term.  This results in thousands of inappropriate results.  When "dietary intake" is searched as a phrase, you get a smaller number of highly relevant results.

Quotation marks can also be used to search phrases as keywords, even when a MeSH term exists.  For example, in PubMed, vegan maps to the MeSH term  Diet, Vegtarian. In addition to using vegan as a keyword, you can also use "plant-based diet" as a keyword phrase.