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Literature Searching

Developing a medical research question involves identifying a specific, measurable, and clinically relevant problem based on gaps in existing literature or practice. This process requires refining the question to ensure it is feasible, ethical, and aligned with the intended study design and population.

Why is an answerable question important?

  • defines the parameters or scope of your search
  • identifies essential concepts such as the population of interest
  • helps you to select appropriate places to search

Step-by-step worksheet

You can fill out the Library's worksheet as you work your way through each step. The appendix includes real-world examples.

Worksheet - Literature Searching: Step by step

Background research is the process of collecting existing information from reliable sources to gain foundational knowledge about a topic. It helps understand what is already known, identify gaps in knowledge, and refine the research question before diving deeper into research.

Why is it important?

  • Clarify definitions
  • Investigate concepts you may not fully understand
  • Identify keywords and phrases associated with your topic
  • Develop an initial understanding of the existing literature 

Where to find background research

Library Catalogue

You can use a variety of sources, such as those listed below. 

  • Textbooks
  • Encyclopaedias
  • Dictionaries

Clinical Decision Support Tools

Visit the Library website for a full list of clinical support tools and information on how to access them onsite and remotely.

Expand search - AI tools

Artificial intelligence (AI) tools can also help you quickly gain an overview of a topic and identify gaps in research.

Collect highly relevant articles

Such papers may be recommended by subject matter experts, supervisors, or peers. Keep track of highly relevant articles you find as they will help:

  • identify relevant search terms
  • test your search for effectiveness

The PICO framework is a tool used in evidence-based practice to develop focused clinical research questions by breaking them down into four components: Patient/Problem, Intervention, Comparison, and Outcome. It helps guide literature searches and ensures that clinical questions are specific, relevant, and answerable.

Why is using a framework important?

  • supports the development of he question
  • identifies essential concepts to each type of research question
  • helps to ensure important elements to the research question are included

How to use PICO

To use PICO -- or an alternative question framework -- think carefully about your research topic and define each letter or concept. Be as specific and explicit as possible to create an effective PICO.

  1. define your 'P' by determining which specific patient group or population you are focusing on.
  2. define your 'I' by describing the particular intervention including strength, dose or frequency
  3. define your 'C' by identifying a comparator, this can also be a placebo or control
  4. define your 'O' by targeting particular outcome that can be measured

If your research question has a different focus -- such as prevalence, risk, experiential data, or cost-effectiveness -- see the Other question frameworks section below for alternative frameworks for building your question.

PICO Variations

In PICOT, the 'T' is for a specified time period, e.g. "over 5 years" or "24 hours after surgery". It can also be a type of study - - e.g. qualitative study -- or test.
 

Here, the 'S' stands for study type or study design. Depending on your question, certain study types may be more appropriate clinical evidence than others. E.g. RCTs for therapy questions. 
 

The 'C' is for context (or place), e.g. "the ED", "teaching hospitals", or "high-income countries".

Examples

Recommended Resources

Research question frameworks are structured approaches used to formulate clear, focused, and answerable questions in various types of research, including qualitative, quantitative, and mixed methods studies. These frameworks help guide the design, methodology, and literature search strategies of a study

Why is using the correct framework important?

  • ensures the answers match your question
  • better target the priorities of your question

How to use question frameworks

If your research topic is not related to clinical effectiveness, it may be better suited to one of the question frameworks below instead of PICO.

Etiology and/or risk Prevalence or Incidence Diagnostic test accuracy
PEO
P = Population
E = Exposure (independent variable)
O = Outcome (dependent variable)		 CoCoPop
Co = Condition
Co = Context
Pop = Population		 PIRD
P = Population
I = Index test
R = Reference test
D = Diagnosis of interest

The below frameworks may be more suitable for questions relating to service improvement, cost-effectiveness, or similar.

Cost effectiveness Service Improvement

ECLIPS

E = Expectation
C = Client group 
L = Location 
I = Impact 
P = Professional(s) 
S = Service 

CLIP

C = Client
L = Location
I = Improvement
P = Professional(s) 

These frameworks may be more appropriate for qualitative questions, such as those investigating experiences or perspectives.

Experiences Qualitative research design Perspectives
PICo
P = Population
I = phenomenon of Interest
Co = Context		 SPIDER
S = Sample
PI = Phenomenon of Interest
D = Design
E = Evaluation
R = Research type		 SPICE
S = Setting
P = Perspective
I = Intervention
C = Comparison
E = Evaluation

Recommended resources

After developing a clear research question, consider whether your search will be more comprehensive or more targeted. Read on to learn more about the differences between each approach and the practical implications for your search process.

Why should you decide on a comprehensive or targeted search?

  • The scope of your research question
  • The type of research you want to conduct
  • The resources and time you have to complete the research

How to choose a comprehensive or targeted question.

Comprehensive

Definition

A comprehensive search that retrieves the maximum amount of relevant studies, but which requires additional time and resources for filtering and screening results. As comprehensiveness increases, so does the number of results.

A highly comprehensive (or sensitive) search casts a wide net and therefore has lower precision.
Usage
  • Literature reviews
  • Systematic reviews
  • Meta-analyses
  • Searches/questions that require thoroughness and there is time set aside to screen and analyse the search results
  • Multifaceted clinical queries with broad and complex concepts, such as, "What practices prevent transmission of infections from the hospital environment onto healthcare workers' clothing and the personal items they bring to work?"
Tips
  • Spend as much time as possible in the planning phase.
  • Ensure you combine subject headings with keywords.
  • Add synonyms for each of your key concepts.
  • Only apply limits if they can be fully justified.
  • Search multiple databases and grey literature.
  • Check the indexed terms for your 'gold set' articles (6-10 articles that are most relevant) and add these to your search.
  • Conduct hand searching and reference checking.​

Targeted

Definition

A targeted search that captures the most relevant studies, but does not necessarily locate every single piece of relevant literature.

A very targeted (or precise) search risks missing relevant studies -- as it casts a small net -- but this approach is still suitable in many situations.
Usage
  • TipsClear questions with singular, simple concepts.
  • When looking for a recent review on a specific condition or topic
  • To locate a couple of key articles to stimulate further discussion in a journal club
  • For some narrative literature reviews with a very defined scope
Tips
  • Tightly refine your question to ensure it is direct and focused.
  • When finding terms (Stage #3 of this guide), add synonyms judiciously, ensuring that they are highly relevant.
  • Restrict keywords to the fields for title, abstract, and author provided keywords (e.g. .tw,kf. in MEDLINE).
  • Use database tools that restrict results to studies containing your search terms as the main subjects only (e.g. focus in MEDLINE).
  • Add limits such as the last 5 years and/or certain levels of evidence.

Examples

  • A comprehensive literature search on the effectiveness of therapies for stable COPD would find papers on any therapy used to treat stable COPD in any patient. The search would find a very high number of papers relevant to this broad scope.
  • A targeted literature search on the effectiveness of pulmonary rehabilitation in the management of stable COPD in older adults would find papers focused on this specific topic. The search would find fewer papers -- and you would miss papers on e.g. other therapies for stable COPD -- but the papers found are likely to be highly relevant to this narrow scope.