Consider which concepts are necessary for the search. A comprehensive search usually has 2-3 concepts combined with AND. Consult with a librarian and your team to determine which concepts to include.

Example PICO: In adult ICU settings, do noise reduction strategies improve the patient experience?

There are two methods of searching. For reviews that demand a comprehensive approach, both methods should be used.

 SUBJECT HEADINGS 

An assigned term that represents a concept; also known as "controlled vocabulary." For example, any study about pressure sores found in PubMed will be assigned a Medical Subject Heading (MeSH) term pressure ulcers. A search for pressure ulcers will capture results about this concept regardless of which exact word/phrase is used. Most databases have a list of vocabulary but they are different from one another. This means that your search strategies will be different for the subject heading component for each database searched.

KEYWORDS/PHRASES

Terms used in everyday language. Sometimes there is not a subject heading that represents a concept, the article is not categorized yet (indexed), or the article is not categorized correctly. This is when keywords/phrases can capture results that a subject heading search may miss.

This is usually a team process and may take a few days to months, depending on how exhaustive the search needs to be. Some tips follow:

• start with a list of relevant records and review the subject terms assigned
• read relevant articles and list professional terminology found in titles and abstracts that capture the concepts
• review reviews on similar topics and read the search strategies
• obtain feedback from your team, your librarian, and consult other subject experts
• Use an online word processing program for keeping track of search terms

  • Example Search Term List

    Concept 1: ICU	Concept 2: Noise reduction	Concept 3: Patient experience
    MeSH terms intensive care units critical illness critical care	MeSH terms Noise Ear protective devices	MeSH terms patient satisfaction pain sleep
    Keywords/phrases ICU intensive care unit(s)	Keywords/phrases quiet time earplugs noise reduction quiet interventions	Keywords/phrases patient report patient experience patient complaint(s)