Your patient presents to the emergency department at a large city hospital with chest pains. You have heard that there is a new diagnostic test (Troponin I assay) which can be used to diagnose acute myocardial infarction within 3 hours after presentation, and you are eager to learn more about the diagnostic accuracy of this test. Find a 2012 study on this topic.
Data from Kwazulu Natal, South Africa, suggest that almost all patients with multi-drug-resistant (MDR) tuberculosis are HIV-positive, with a fatal outcome. Since, there are few data for the treatment-related outcomes of MDR tuberculosis in settings with a high HIV prevalence, you are asked to find an article investigating the associations of these diseases in settings where patients do not have access to HAART to formulate recommendations for control programmes.
Take home message: You will get different results from different resources. Finding the evidence requires that you learn to search them all. Some resources will be better suited to research than clinical practice; and vice versa. Experience helps in deciding which resource to use, so the more you practise, the easier it becomes.
P - Myocardial infarction
I - Troponin I assay
C - None
O - Diagnostic accuracy
Different databases will use slightly different strategies. Try running the same search from PICO 1 in another database
See what happens when you search using Myocardial infarction AND Troponin I assay
Then refine your results by selecting the Diagnosis option on the left of the screen.
P - South African patients with MDR Tuberculosis
I - No access to HAART
C - None
O - Prognosis