EP 569 Focused Literature Searching Through Clinical Question Framing Improves Efficiency of Evidence Synthesis
Zeneera Yusuf, Yasuko MaedaAbstract
Aim
Traditional evidence collation often relies on broad “scoop-all” searches and ranking evidence primarily by study design, generating large volumes of heterogeneous and often low-relevance studies. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) is a globally adopted methodology for guideline development, underpinned by focused evidence synthesis using the PICO framework to ensure relevance of populations and outcomes. We compared a traditional keyword-based search with a focused search guided by a PICO-framed clinical question.
Methods
A clinical question, “Does tranexamic acid (TXA) improve outcomes in lower gastrointestinal bleeding (LGIB)?”, was reframed using PICO: Population—adults with LGIB; Intervention—TXA; Comparator—placebo or alternative interventions; Outcomes—mortality, re-bleeding, thrombosis, blood transfusion, or need for surgery. A clinician-performed PubMed search (“tranexamic acid” AND “lower gastrointestinal bleeding”) was compared with a PICO-guided search of MEDLINE and Embase conducted by an information specialist librarian. Time required for searching and screening was recorded.
Results
The PubMed search produced 259 titles within two minutes and required 244 minutes of screening. The PICO-guided approach generated 21 titles in 90 minutes, with 18 minutes of screening (56% reduction in total time and 93% reduction in screening time; p<0.05). Both approaches identified the same key studies (three randomised controlled trials and one large observational study).
Conclusions
Framing clinical questions to guide focused literature searching markedly reduced screening burden without loss of key evidence. The ability to rapidly identify pertinent studies may be useful for day-to-day clinical decision-making, updating existing guidance, and informing practice where formal guidelines are not available.