Getting Started
In this guide, we'll walk you through how to find information for policy questions, such as comparing brands of catheters or infusion methods – anything used for organizational procedures.
If you're an MGH or MEE employee, you're in luck! Your librarians can quickly find information to update any policy, and you won't need to do any searching. Below are links to the libraries in the system:
But if you're coming from a hospital in the system without a library, you'll have to perform your own search. However, you will have access to the resources you'll need to search via MGB's subscriptions.
ClinicalKey
When you search in ClinicalKey, limit to practice guidelines. You can access ClinicalKey through the MGB Handbook (VPN required). Keep your terms as simple as possible. Then, filter to guidelines using the limits on the left.
If the policy you're updating already exists in Ellucid, try using their suggested keywords (listed at the top of the page) as your keywords.
As we see in this next example, limiting to guidelines takes us from over 1,000 results on chemotherapy desensitization to just 12:
Trip Database
Trip is a free database that can be used to find high-quality research evidence such as guidelines, meta-analyses, etc. Type in your search term and then click the bubble on the left to limit to guidelines as demonstrated in the image below. Trip will also give each result a score on a spectrum from "narrative based" (i.e., more opinion based) to "evidence based." You'll want the ones that are evidence-based.
CINAHL
You can also conduct a search in CINAHL. While PubMed is suitable for most questions, CINAHL is a better place if your policy has anything to do with nursing (infusions, for example). To access CINAHL, click the link in the MGB Handbook. You'll need to be on the VPN for this to work.
Looking Beyond PICO
You've probably been taught the PICO method for searching. While this works well for questions with a clear treatment and comparator, policy questions often don't fall into that category. For many of these queries, the comparator is something like "in comparison to standard practice" which is too vaguely defined to search for. Instead, we'll be breaking the rules you've been taught since in many cases, we're trying to find a needle in a haystack.
The PICO method teaches you to break your question into concepts, by making each letter of your question framework a concept. You'll do something similar but instead you'll be looking for the most unique part of your question. If your question concerns a brand name, that will be enough to search for on its own. For example, for a question about using Prevena Plus for wound formulary, the brand name Prevena Plus is likely sufficient.
Formatting Your Terms
Always use quotation marks around each phrase or word. If you don’t, CINAHL will start to make guesses about what you're looking for -- and will often get it wrong. For example, Prevena without quotes finds 142,510 papers because CINAHL has switched the word to "prevent":
Conversely, "Prevena" with quotes finds 23 papers:
Back to the prior example, looking for "Prevena Plus" finds only one article. So what do we do? We make it even simpler. We look for just "Prevena" instead. Always avoid broad terms like "treatment" or "best practice." Remember that you're looking for the most unique term and a broad term won't be unique.
Limiting Your Search
If you find your search is yielding too much, try limiting to high-level evidence like so:
"keyword" AND (TI "systematic*" OR TI "meta-analysis" OR TI "guideline*")
If that doesn't limit things enough, add one more word to the query using the word AND like so:
"Prevena" AND "wound"
PubMed
Again, you'll be looking for the most unique phrase or term within your query. And like CINAHL, you'll need to put all terms and phrases into quotes. PubMed does something called automatic term mapping which is a fancy way of saying it will guess at what you're looking for, just like CINAHL.
To avoid that, search with each term in quotes like the image below. Notice that I didn't put the whole search in quotes ("neonatal CPAP"). Instead, I put each individual word in quotes. If I put all of the terms in quotes, no results would be returned. Next, look for "My Custom Filters" on the left:
Look for the filters for article types:
Click See all article type filters then scroll to find guidelines. You can also check off things like systematic reviews, meta-analyses or RCTs. Make sure to limit to high-level evidence. Once you're done click apply. If the results haven't been trimmed enough, uncheck some of the study designs:
