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Systematic Reviews

This guide introduces the process of conducting a systematic review of the literature.

PICO for the research question

Research topic: Is osteopathic treatment effective for adults with acetabular labrum tear experiencing pain and limited hip function?

Translate the research topic into problem, intervention, comparator, and outcome (PICO).

The following clinical question shows the various PICO components.

How would you begin searching for this topic?

The PICO model may be used to develop an effective search strategy.

Using PICO to identify concepts and build search terms

A systematic review requires an extensive search to ensure that ALL literature has been captured and considered for the review. 

STEP 1  -  Analyse your research topic and determine the key concepts.

For the following research question:

In adults suffering an acetabular labrum tear is osteopathic treatment compared to no treatment effective in decreasing pain and improving hip function?

Four main concepts have been identified:

  • acetabular labrum tear
  • osteopathic treatment
  • pain
  • hip function

STEP 2  -   Think of keywords for each of these concepts. These may be synonyms, acronyms or related terms.

STEP 3  -  Use the database thesaurus to find other relevant terms. Many databases use subject headings when adding an article to the databases index. 

For example, the PubMed database uses the controlled vocabulary Medical Subject Headings (MeSH). Experts review articles and choose MeSH terms that describe the content.

To do an exhaustive search of the literature you should include both keywords and database subject headings for your search queries.

CONCEPT 1

Acetabular labrum tear

CONCEPT 2

Osteopathic treatment

CONCEPT 3

Pain

CONCEPT 4

Hip function

Keywords

Acetabular labrum tear
Acetabular labral tear
Acetabular labrum
Acetabular labral
Acetabulum
Labrum tear
Labral tear

MeSH terms

Acetabulum
Cartilage
Lacerations
Acetabulofemoral Joint

Keywords

Osteopathy
Osteopathic

 

 

 

MeSH terms

Manipulation, Osteopathic
Osteopathic Medicine

Keywords

Pain

 

 

 


MeSH terms

Pain

Keywords

Hip
Hip flexibility
Hip mobility
Hip function

 


MeSH terms

Hip
Hip Joint
Pliability
Range of Motion, Articular

Developing a search statement

After identifying your keywords, you need to define the relationship between them using the Boolean operators OR and AND. All databases, and even Google, use Boolean operators to set up a flexible search.

OR » finds records that contain ANY of the terms

When looking for references that contain the term 'acetabulum' or an alternative term like 'labral tear', use the OR operator to define the relationship between the terms. ie. acetabulum OR labtral tear. OR is used for alternative or synonymous terms. Using the OR operator broadens your search. The more alternative terms you use, the larger the number of references you retrieve.

AND » finds records that contain BOTH terms

When looking for references about 'hip function' of a 'labral tear,' use the AND operator to narrow your search results and to specify that both terms must appear in the references retrieved. ie. labral tear AND hip function. When you join two words or phrases together with AND, the database will retrieve only those records which contain both terms.


For the following research question:

In adults suffering an acetabular labrum tear is osteopathic treatment compared to no treatment effective in decreasing pain and improving hip function?

The search query may look like this if searching the PubMed database. Note this example uses PubMed which uses MeSH. Other databases use a different controlled vocabulary / thesaurus / subject headings.

 

 

 


Applying limits to the search query

Many databases offer limits (the PubMed database calls them filters) to further enhance the search results. Some of the PubMed database filters include:

  • article types
  • publication dates
  • species
  • language
  • age

For the research question:

In adults suffering an acetabular labrum tear is osteopathic treatment compared to no treatment effective in decreasing pain and improving hip function?

a particular focus is the population group of adults, therefore the following age filter could be applied to the search results.