Literature Searching

Angeline Tancherla 01071170034

Search evidence for the best treatment for peptic ulcer disease for an adult patient.
1. Define your PICO with alternative terms and limits
P - Adult with peptic ulcer
I - The best treatment for peptic ulcer
C - Other treatments for peptic ulcer
O - Cured peptic ulcer

Alternative terms : Ulcer/s, Peptic; Gastroduodenal Ulcer/s; Ulcer/s, Gastroduodenal;

Marginal Ulcer/s; Ulcer/s, Marginal
Study design : Meta-analysis
Limits : Adults, Humans, 2010-2017
Subheadings : Therapy, Surgery, Drug therapy, Radiotherapy

2. Compose your Boolean Operators

(((('Peptic Ulcer/therapy'' OR "Peptic Ulcer/surgery" OR "Peptic Ulcer/drug therapy" OR
"Peptic Ulcer/radiotherapy") NOT "prevention") NOT "protective") AND "adult") AND
"human")

3. Describe your process with the MeSH and search engine you used (PubMed)
Firstly, I opened the PubMed website. From the PubMed homepage, in the resource section, I
clicked on the Mesh Database. Then I typed 'peptic ulcer' in the search bar and pressed enter.
Several suggestions appeared and I proceeded to click on peptic ulcer. The new page displayed
the definition of peptic ulcer, subheadings and additional information about the term. To narrow
the search, I checked on the subheadings that would be included in the search. For example, I
checked therapy, surgery, drug therapy and radiotherapy. Then I clicked the 'add to search
builder' button (on the upper right region), followed by the Boolean operators (AND, OR,
NOT). The search builder would display :
(("Peptic Ulcer"[Mesh]) OR "Peptic Ulcer/drug therapy"[Mesh]) OR ("Peptic
Ulcer/radiotherapy"[Mesh] OR "Peptic Ulcer/surgery"[Mesh] OR "Peptic
Ulcer/therapy"[Mesh]).
If I were to click search PubMed, the page will display many results. Thus, I needed to be more
specific in searching. To add the limitations, I used the advanced search. After clicking the
advance search, I was redirected to a new page. In the table below, my previous search builder
 would be displayed, and I clicked 'add' to add it on my latest search builder. In the provided bar,
I typed the limitations, such as 'adults' and 'humans'. I also used the Boorlean operators. I used
'AND' for adults and humans. While for 'protective' and 'preventive', I excluded them and chose
'NOT'. And for the date of publication, I decided to limit from 2010 until present, so that it will
be up to date. After typing the limitations and using the Boorlean operators, the search builder
displayed:
((((((((("Peptic Ulcer"[Mesh]) OR "Peptic Ulcer/drug therapy"[Mesh]) OR
("Peptic Ulcer/radiotherapy"[Mesh] OR "Peptic Ulcer/surgery" [Mesh] OR
"Peptic Ulcer/therapy"[Mesh]))) AND "humans") AND "adult") NOT
"preventive") NOT "protective")) AND ("2010 "[Date -Publication] :
"3000"[Date - Publication])
a. I clicked search, and more specific results were displayed.
b. For a more significant study, I had limit the study design into Meta-Analysis, by choosing
Meta-Analysis as the article type at the left upper part of the webpage.
c. 61 search results were shown at the webpage. And I started reading the titles of the studies
that would be related to the PICO questions.
d. After reading the titles of the studies, I found a meta-analysis, with the title of "Efficacy and
safety of Jianzhong decoction in treating peptic ulcers: a meta-analysis of 58 randomized
controlled trials with 5192 patients". And it is the most relevant to the PICO questions.

4. Describe your answers regarding the PICO questions.

From the journal of 'Efficacy and safety of Jianzhong decoction in treating peptic ulcers: a
meta-analysis of 58 randomized controlled trials with 5192 patients', I found out that the Jianzhong
decoction increased the total effective rate and helicobacter pylori eradication rate, and lowered the
recurrence and adverse reaction rates. The result of the study has a total effective rate, odds ratio
[OR] = 4.29, 95% confidence interval [CI]: 3.51-5.23, P = 0.000; helicobacter pylori eradication
rates, OR =2.10, 95% CI: 1.69-2.61, P = 0.000; recurrence rate, OR =0.23, 95% CI: 0.18-0.29, P =
0.000; and adverse reaction rate, OR =0.20, 95% CI: 0.12-0.33, P = 0.000. Jianzhong
decoction is the liquor resulting from concentrating the essence of a substance by heating or boiling
the Chinese herbal medicine, Jianzhong. It is a common treatment used to treat peptic ulcers. But,
it's effectiveness is still questionable, because there have been no studies that can prove if it's
effective or not in treating peptic ulcers. Therefore, the researchers decided to conduct this study.
The study is also a meta-analysis, which is a high level of evidence. In addition, it analyses
58 randomized control trials. So, we can be sure that the result of the study is valid. Therefore, we
can reconstruct the PICO questions according to the study:
P - Adult with peptic ulcer
 I - Jianzhong decoction therapy
C - Conventional Western medicine therapy
O - More effective in treating peptic ulcer and lower the risk of recurrence.

And we can now conclude that Jianzhong decoction therapy is more effective than
conventional Western medicine therapy, in treating the adult patients with peptic ulcer. The results
of this study would be a useful guide for the future treatments of peptic ulcers.

Attachments

https://www.ncbi.nlm.nih.gov/pubmed/28410586