In the last tutorial, I showed you how to access OvidSP, and gave you an overview of OvidSP's main search page. Starting from today, I'm going to be showing you how to actually run an effective search in OvidSP. We usually start our literature searches We usually start our literature searches with questions in mind, and we hope to find the answers to those questions in the literature. with questions in mind, and we hope to find the answers to those questions in the literature. In clinical practice, a physician typically has many questions passing through their minds when seeing patients. It is important that these questions be asked in a way that helps identify its key components. A well-built, focused, answerable clinical question is key to developing good search strategies in the literature. Therefore, formulating your question becomes your first step in running a literature search in OvidSP. In this tutorial, I'm going to be showing you how to formulate your questions for an effective search in OvidSP. The PEE-COH, or PIE-COH format, is widely used to formulate answerable clinical questions, and identify key terms for literature search. "P" represents "patients", "population", or "problem". You know who are the patients, how would you describe them, what are their most important characteristics? Sometimes their gender, or age, or ethnicity, might also be relevant. What is the health concern? This may include the primary problem, disease, or co-existing conditions. "I" represents "intervention", "prognostic factor", or "exposure". Which main therapeutic, diagnostic, or preventative intervention are you considering for the patient? Prescribe a drug? Order a test? A surgery? What factor may influence the prognosis of the patient? Age? Co-existing problems? What was the patient exposed to? "C" represents "comparison of intervention". Is there a comparison to be evaluated against this intervention? What is the main alternative method of treatment or diagnosis? Are you trying to decide between two drugs? A drug and no medication, or a placebo? Or two diagnostic tests? The comparison part is optional. Your clinical question may not always have a specific comparison. "O" represents "outcome" you would like to measure or achieve. What do you hope to accomplish, measure, improve, or affect? Is it the relief or elimination of the symptoms? Is it to improve certain test scores? Is it to prevent adverse effects. Or is it to diagnose a disease? Now lets look at some examples, and see how the PICO model can help identify key components in these clinical questions. Okay, question number one: "For patients with type two diabetes, do routine eye exams reduce the occurrence of blindness?" In this question, obviously the "P" is "patients with type two diabetes". The intervention, "I", is "routine eye exams". And the outcome, "O", is "reduce the occurrence of blindness". There is no "C", comparison, in this example. Question number two: "Among children with minor head injury, does the use of CT scan versus other clinical findings affect the identification and diagnosis of intracranial hemorrhage?" This is quite easy, too. "P" is "children with minor head injury". And the main intervention, "I", is "the use of CT scan". The comparison intervention, "C", is "other clinical findings". And the outcome, "O", is "the identification and diagnosis of intracranial hemorrhage". Question number three: "In elderly patients with high blood pressure, are ACE inhibitors more effective than beta-blockers in controlling blood pressure and minimizing adverse effects?" In this example, the "P" "elderly patients with high blood pressure". The main intervention, "I", is "ACE inhibitors". and the comparison intervention, "C", is "beta-blockers". And the outcome, "O" is controlling blood pressure and minimizing adverse effects". The PICO format provides a good model for building focused questions for an effective literature search. It's especially good for answering therapy, treatment, or diagnosis-type questions. The primary focus of this tutorial is OvidSP, so we only have time to talk a little bit about constructing better questions for effective literature searches. If you are interested in learning more about this topic, such as the various types of questions, how to match your questions with the various types of study designs in the literature, or simply the various library resources that can help you answer your questions... please contact your librarian for some training in evidenced-based practice, or EBP, information resources. You can also refer to my "Find It Fast!" series of video tutorials. Now that we know how to build a focused question, and identify the key components of a question using the PICO model, we can proceed to learn how to use OvidSP and MEDLINE to find literature that can answer the question. In the following tutorials, I'm going to be using our last example to demonstrate how to conduct searches in OvidSP. I'll see you next time.