School of Medicine Resources

Using the "5 As" to Answer Clinical Questions

ACQUIRE Your Evidence - Doing the Literature Search

Tips for Searching MEDLINE Using PICOTTT

You have access to two versions of the MEDLINE Database to search - Ovid MEDLINE and PubMed, in addition to many other databases such as Web of Science from the Medical Student Portal Page.

PICO Question: In an adult hypertensive male (P), does a lower sodium diet (I) reduce hypertension (O)?

T for TIME = This question does not specify any "TIME Factor"

T for Type of Question = This is a "Therapy" question 

​T for Type of Study = A Systematic Review or Meta-Analysis of multiple Randomized Controlled Trials would be desirable, but we would also accept individual RCTs from our MEDLINE search


Ovid MEDLINE Search Steps for this PICO Question

2. Maps to the Medical Subject Heading (MeSH) term = HYPERTENSION

3.You can apply "SUBHEADINGS" to your MeSH terms to get at the "TYPE OF QUESTION in your PICOTTT" as there are subheadings for diagnosis, etiology, therapy, prevention & control, and more.
4.This question is a "THERAPY" question, so I apply the "therapy" subheading to the HYPERTENSION MeSH term
5.Search for LOW SODIUM DIET
6.Maps to the Medical Subject Heading (MeSH) term = DIET,SODIUM-RESTRICTED
7.No need to apply a subheading to this MeSH term
8.Combine the two MeSH terms with an AND
9.As a last step, apply LIMITS

  • MALE
  • "PUBLICATION TYPES" - these will help you limit to the last of the Ts in PICOTTT - Type of Study
  • Many Publication Types are included as Limits. However, they do not include: Case-Control Studies and Cohort Studies - these two must be searches as MeSH terms and added to your other search terms during your search.
  • I would select "Randomized Controlled Trial" in this case as it is a strong study design for therapy questions
  • But there are many other study designs to select from, such as Systematic Review and Meta-Analysis







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