Karen Goodell, MLSKaren Goodell, M.L.S.

Although a clinician might not turn to PubMed as a first choice to answer a clinical question, PubMed still plays an important role in finding the most up-to-date health care information. However, with over 20 million citations, how does a busy clinician find the most relevant articles for his/her question?

One way to do this is to build your search using the MeSH (Medical Subject Heading) database. The disadvantage of a typical keyword search is that it will retrieve results for the topic in question, but will also call up many articles that may mention that keyword only briefly, not as the actual subject of the article. Constructing your search using the MeSH database allows you to take advantage of subheadings and search terms as major concepts. Using MeSH headings and subheadings should narrow your yield and help ensure that the articles you find relate closely to your topic.

The MeSH database can be accessed in 1 of 2 ways. On PubMed’s opening search screen, there is a link in the right hand column under “More Resources.” Also, you can use the pull-down menu just above the search box to change from “PubMed” to “MeSH.”

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In the resulting search box, enter your search term. You may get an exact match after running the search, or PubMed may map it to its closest subject heading. For example, if you enter “frozen shoulder,” the MeSH database maps that concept to “bursitis.” If there is no MeSH heading close to the term or phrase you entered, you will get the message “No items found,” and you will need to think of a synonym or more specific term to search.

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Once you have identified the subject heading you want to use in your search strategy, you can search that as a major concept (meaning all the articles retrieved will deal with that concept as the subject of the article), or you may choose subheadings from the available list to narrow your focus further. Let’s go back to the example of “bursitis” [Mesh]. If you were interested in only therapy and rehabilitation for frozen shoulder, you could check the boxes in front of “therapy” and “rehabilitation” in the subheading list for bursitis, add those to the Search Builder Box and press the “Search PubMed” button.

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The resulting search would be restricted to articles that dealt only with those aspects of bursitis.

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You can also format a search strategy in the Search Builder box by adding other subject headings as well. Suppose you were interested in finding articles on spondylolysis with associated sciatica; you could search the MeSH database for both those concepts and add each to the Search Builder before clicking on “Search PubMed.” Adding subheadings to either or both of the concepts would narrow the search even further.

The PubMed database contains a wealth of information, but it may seem unwieldy or intimidating unless you make use of some of the tools it offers. Using subject headings and subheadings through the MeSH database is just one way to make PubMed work better for you.

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