Enhance your searching skills by participating in the You Ask #PEDroAnswers campaign in 2021:
- About the campaign
- Short videos illustrating how to use the PEDro Advanced Search
- Tips on how to use the PEDro Advanced Search
- Submit a question
Portuguese and French versions of the launch video
An essential element of evidence-based practice is searching to find the best high-quality research to answer your clinical questions.
Despite the importance of searching, just one in three physiotherapists perform a database search each month.
Skill is an obstacle to searching. We think physiotherapists would do more searching if they could increase their competency and efficiency.
With PEDro providing easy access to over 49,000 articles evaluating the effects of physiotherapy interventions, it is time for this to change.
The You Ask #PEDroAnswers campaign is designed to encourage physiotherapists to develop their searching skills and perform more database searching to find high-quality research to inform practice. In this campaign we will help you to improve your searching skills using the PEDro Advanced Search.
We invite the global physiotherapy community to submit clinical questions using a contact form at the bottom of this page, by tagging us with your question in a Tweet or through Facebook by posting your question as a comment on a You Ask #PEDroAnswers post or sending us your question via Messenger. Remember to include all the PICO elements in your question. That is, the Patient, Intervention, Comparator and Outcome.
Each month in 2021 we will share short videos illustrating how to use the PEDro Advanced Search to find the best research to answer these clinical questions. The videos will focus on searching for high-quality research using PEDro, they will not be providing recommendations for treatment. You can submit your questions in any language but, at least initially, the videos illustrating PEDro searching will be in English.
Throughout 2021 we will also be sharing some tips on how to use the PEDro Advanced Search.
This campaign is supported by World Physiotherapy, the Australian Physiotherapy Association, the Asociación Española de Fisioterapeutas, Physio Deutschland, the Società Italiana Fisioterapia and the Société Française de Physiothérapie.
Please join us on the You Ask #PEDroAnswers campaign in 2021 to develop your searching skills.
Video 01: In older people living at home, does telephone motivational interviewing with a physiotherapist increase physical activity compared to providing written advice?
Video 02: In stroke survivors, does mirror therapy improve upper limb function more than usual care?
Video 03: In people with a cervical disc herniation, does computerised traction reduce pain more than exercise therapy?
Video 04: In musicians with musculoskeletal injuries, does trigger point therapy decrease the time to return to playing an instrument compared to rest and advice?
Video 05: In older people with urinary incontinence who live in residential aged care facilities, does pelvic floor muscle training combined with mobility training reduce episodes of incontinence compared to mobility training alone?
TIP 1: ask a PICO question before you search
In order to answer your clinical question, it is helpful to break it down into four essential components using the ‘PICO’ framework. In this memory aid, P stands for patient, I stands for intervention, C stands for comparison, and O stands for outcome. Taking the time to clearly define the question will help you work out the best search terms to use, which in turn will make finding the best research to answer your question less daunting or time-consuming.
For questions about the effects of interventions, your PICO question should include all four elements:
P (patient): what is the condition or population group of interest, are you interested in a particular subgroup (eg, acute stroke) or sociodemographic group (eg, workers)? Are you working with older people, children, athletes, people that have had a traumatic brain injury or stroke?
I (the intervention): what treatment are you interested in?
C (the comparison): are you interested in comparing your intervention to placebo, usual care, or another intervention (eg, aquatic versus land-based exercise)?
O (the outcome): what measurable outcome(s) are you interested in improving? Is the outcome important to patients? Outcomes could be events (eg, falls), symptoms (eg, pain), functional measures (eg, walking speed) and quality of life. Harmful effects and the cost of treatment are also important outcomes to consider.
An example of a PICO question about the effects of an intervention is: “In people with Parkinson’s disease, does training using visual or auditory cues reduce the risk of having a fall compared to usual care?”
PICO can also be used to frame diagnostic questions, but here “I” takes on a new meaning:
I (the “issue”): this could be a diagnostic test, a combination of physical tests, or a clinical prediction rule.
C (the comparison): what do you want to compare your diagnostic test to? This could be a reference test or the gold standard test.
O (for outcome): this is usually a measure of the test utility like specificity or sensitivity. This gives you an idea of both the rate of false positives (diagnosing the condition in those that do not have it) and false negatives (missing the diagnosis in those that do).
An example of a PICO question about a diagnostic test is: “In female soccer players with knee injuries, what is the accuracy of the anterior draw test compared to medical resonance imaging for detecting an anterior cruciate ligament injury?”
Elements of PICO can help you ask questions about the prognosis of a condition. With prognostic questions “I” takes on a new meaning and the “C” is dropped:
P (patient): when specifying this element it is useful to include the duration or severity.
I (for “time”): over what time span are you interested in, the short- or long-term?
O (for outcome): these should be both quantifiable and important to patient’s goals and priorities. Examples include the rate of disease progression or a positive outcome (eg, return to work or sport).
An example of a PIO question about prognosis is: “For people with an episode of back pain resulting in 4 weeks off work, what is the likelihood that they return to work in their previous role at 6 months?”
We’ve recently revised the PEDro video tutorial on posing clinical questions about interventions.
TIP 2: don’t enter search terms for each element of the PICO question
The first search video for the “You Ask #PEDroAnswers” campaign illustrated how using terms for the patient and intervention can quickly identify relevant research. The question was: “in older people living at home, does telephone motivational interviewing with a physiotherapist increase physical activity compared to providing written advice?” The Search terms used were ‘gerontology’ in the Subdiscipline field for the patient and ‘motivational interview*’ in the Abstract & Title field for the intervention.
The best PICO elements to use to generate search terms will vary for different questions. Before you start your search think, which of the PICO elements will inevitably and uniquely be associated with the articles that I wish to find? Enter terms for those elements in your PEDro search.
TIP 3: use the PEDro Advanced Search (not Simple)
The PEDro Advanced Search page has 13 fields that you can use to enter the search terms generated from your clinical question. But it is important to note that you do not need to enter search terms in EVERY field. Specifying terms in one to three fields is usually sufficient.
Six fields have pull-down lists that you can choose from (Therapy, Problem, Body Part, Subdiscipline, Topic and Method). These are indicated by the arrow symbol. For example, the pull-down list for the Body Part field contains the different anatomical regions that might be the focus of your intervention, from the head or neck down to the foot or ankle. This field is particularly useful if your clinical question relates to the treatment of a musculoskeletal condition. You can select a term by clicking on it. You can only select one term in a pull-down list.
Three fields let you enter numbers or dates. These let you identify articles that are published in or after a particular year, added to PEDro since a particular date or, for trials only, have a minimum cut-off value for the total PEDro score.
Four fields allow you to type text into them (Abstract & Title, Author/Association, Title Only and Source). For example, you can search for words that appear in the abstract or title of an article in the Abstract & Title field. Generally it is most efficient to search by typing one or two words into the Abstract & Title field.
You need to use English words in text fields because most of the database behind PEDro is in English. For example, searching for incontinência in the Abstract & Title field will return no articles. In contrast, searching for incontinence returns hundreds of articles. If you type non-English letters into text fields you will receive an error message reminding you to remove any non-English letters.
Those who are new to searching may like to begin with the Simple Search, which contains a single text field. Patients and other users of physiotherapy can access the Consumer Search, which has less technical language.
We’ve recently revised the PEDro video tutorial on how to perform an Advanced Search in PEDro.
TIP 4: use wildcards (truncation)
An asterisk (*) can be used to replace any number of letters (including no letters) that form part of the start or end of a word.
Truncation is most commonly used by placing an asterisk at the end of a full or shortened word to permit alternative endings. So searching with ambula* will retrieve articles that contain the words ambulate, ambulant or ambulation. Other examples include:
- Parkinson* will retrieve articles that contain Parkinson, Parkinson’s or Parkinsonism.
- cue* will retrieve articles that contain cue, cues or cueing.
- fall* will retrieve articles that contain fall, falls or falling.
Alternatively, an asterisk can be placed at the beginning of a word. So searching with *feedback will retrieve articles that contain biofeedback or myofeedback, as well as just feedback. Other examples include:
- *edema will retrieve articles that contain oedema, lymphedema or lymphoedema.
- *continence will retrieve articles that contain continence or incontinence.
Another type of wildcard is the @ symbol. It can be used in the place of one letter within a word, allowing any letter to fill that position. This can be useful for searching for words that have spelling variants in English. For example, searching with mobili@ation will retrieve articles that contain mobilisation or mobilization.
The @ wildcard can also be useful when searching for a particular article if you are unsure of the exact spelling of the author’s name. For example, searching with Peters@n would retrieve articles that contain Peterson or Petersen.
We’ve recently revised the PEDro video tutorial on how to perform an Advanced Search in PEDro.
TIP 5: use phrase searching
Let’s use lateral epicondylitis as an example. When you search for lateral epicondylitis without quotation marks, you will retrieve articles that contain both words (lateral AND epicondylitis) in their abstract or title, but not articles containing just lateral OR just epicondylitis.
Adding quotation marks (“lateral epicondylitis“) will make your search more specific to the construct. You will retrieve articles that contain all words between the double quotation marks together and in that order (eg, ‘treatment of lateral epicondylitis’). You will NOT retrieve articles containing the words separately (eg, ‘treatment of epicondylitis’) or in a different order (eg, ‘treatment of epicondylitis of the lateral elbow’).
In other words, using phrase searching will make your search become more precise, as you will be looking specifically for articles that have two or more words combined in the abstract or title. However, you might end up missing articles that use a different nomenclature for lateral epicondylitis (eg, epicondylitis only or epicondylalgia).
Phrase searching cannot be combined with wildcards, such as * or @. If you want to use wildcards to identify articles that use different variants of the word epicondylitis (eg, epicond*), make sure you don’t use these wildcards in conjunction with phrase searching (eg, “lateral epicond*”). Using wildcards in conjunction with phrase searching will return no articles. More information on how to use wildcards is available in tip 3, above.
Phrase searching can be used in text fields in both the Simple Search and Advanced Search in PEDro. Three more examples of phrase searching are:
- “multiple sclerosis“
- “patellofemoral pain“
- “blood pressure“.
We’ve recently revised the PEDro video tutorial on how to do an Advanced Search.