Panning for Applied Clinical Research Gold

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Health care literature, though better organized than other knowledge areas, is still cumbersome enough to make effective searching difficult and large retrievals commonplace. Subject searching (for drugs and diseases) is useful for searching an entire database, but a different approach is needed to limit retrieval to articles that health professionals should use for patient care.

Many different groups, such as basic scientists, clinical researchers, health practitioners, eductors, and administrators, produce publications. Their written work ranges from idea papers, which include editorials and case reports, to wet laboratory and animal experimental studies, to small early studies with humans.

Another important category is the reports in the applied clinical literature about the large, carefully controlled trials done in hospitals and institutions with human participants. These trials are the studies that health care professionals should rely on to keep up-to-date and solve patient care problems. These trials have actual evidence that the changes in health care under investigation are proven advances. The applied clinical trials answer the following questions:

1. What caused the disease or disorder? (etiology)

2. How can I decide what the disease or disorders is? (diagnosis)

3. What happens to people with the disease over time? (prognosis/natural history)

4. How can I treat (or prevent) the disease/disorder? (therapy)

Only a fraction of the millions of citations in MEDLINE, CINAHL, EMBASE, and other related databases actually are of reports of applied clinical trials that address the four questions above. Most citations are reports of preparatory work completed before the applied clinical trials can be done. Applied clincal studies are unique in the manner in which they are produced (their study methods).

Authors refer, in their titles and abstracts, to the methods used in the research, and database indexes index these methodologies as keywords describing the articles. Searchers can use the methods textwords and subject headings to only retrieve papers that have sound research methods and can, therefore, be used directly in patient care. We will describe the study methodologies used in each category, list appropriate index and textwords (Table 1), and …