How to Perform a Literature Search

Purpose: Evidence based clinical practice seeks to integrate the current best evidence from clinical research with physician clinical expertise and patient individual preferences. We outline a stepwise approach to an effective and efficient search of electronic databases and introduce the reader to resources most relevant to the practicing urologist. Materials and Methods: The need for additional research evidence is introduced in the context of a urological clinical scenario. This information need is translated into a focused clinical question using the PICOT (population, intervention, comparison, outcome and type of study) format. This PICOT format provides key words for a literature search of pre-appraised evidence and original research studies that address the clinical scenario. Results: Available online resources can be broadly categorized into databases that focus on primary research studies, ie randomized, controlled trials, cohort studies, case-control or case series, such as MEDLINE® and those that focus on secondary research that provides synthesis or synopsis of primary studies. Examples of such sources of pre-appraised evidence that are becoming increasingly relevant to urologists include BMJ Clinical Evidence, ACP Journal Club, The Cochrane Library and the National Guideline Clearinghouse™. Conclusions: The ability to search the medical literature in a time efficient manner represents an important part of an evidence based practice that is relevant to all urologists. The use of electronic databases of pre-appraised evidence can greatly expedite the search for high quality evidence, which is then integrated with urologist clinical skills and patient individual circumstances.