Skill: ivangdavila/pubmed (version 1.0.0)

--- name: PubMed description: Search and evaluate biomedical literature with effective queries, filters, and critical appraisal. metadata: {"clawdbot":{"emoji":"🔬","os":["linux","darwin","win32"]}} --- # PubMed Research Rules ## Query Construction - Use MeSH terms for precise searching — controlled vocabulary ensures you find related concepts regardless of wording - Boolean operators must be uppercase: AND, OR, NOT — lowercase is ignored - Phrase searching with quotes: "heart failure" not heart failure — unquoted searches terms separately - Field tags narrow searches: [Title], [Author], [MeSH Terms] — example: aspirin[Title] AND prevention[MeSH] - Truncation with asterisk: therap* finds therapy, therapies, therapeutic ## Essential Filters - Article type matters: Clinical Trial, Systematic Review, Meta-Analysis — filter by study design - Publication date for recent evidence — older studies may be superseded - Free full text filter if access is limited — but don't ignore paywalled high-quality studies - Humans filter excludes animal studies — relevant for clinical questions - Language filter if translation isn't feasible ## Study Hierarchy - Systematic reviews and meta-analyses synthesize multiple studies — start here for established topics - Randomized controlled trials (RCTs) are gold standard for interventions — but not all questions are answerable by RCT - Cohort studies for long-term outcomes and rare exposures - Case-control for rare diseases - Case reports are lowest evidence — interesting but not generalizable - Guidelines synthesize evidence into recommendations — check who wrote them and when ## Critical Appraisal - Sample size matters — small studies may show effects that don't replicate - Check confidence intervals, not just p-values — narrow CI with meaningful effect size beats p<0.05 - Funding source and conflicts of interest affect interpretation — industry-funded studies favor sponsors - Primary vs secondary outcomes — cherry-picking significant secondary outcomes is common - Intention-to-treat vs per-protocol analysis — ITT is more conservative and realistic ## Common Traps - Abstract conclusions may oversell results — read methods and results sections - Single studies rarely settle questions — look for replication and systematic reviews - Statistical significance isn't clinical significance — 1% improvement may not matter to patients - Retracted papers still appear in searches — check Retraction Watch for controversial papers - Predatory journals publish low-quality research — verify journal reputation - Preprints haven't been peer-reviewed — useful for speed but not vetted ## Search Strategy - PICO framework: Patient/Population, Intervention, Comparison, Outcome — structures clinical questions - Start broad, then narrow with filters — missing relevant papers worse than sorting through extras - Save searches for ongoing monitoring — PubMed can email when new papers match - Related Articles feature finds similar papers — useful after finding one good paper - Citation tracking: who cited this paper? — follow research forward in time ## Evaluating Sources - Impact factor indicates journal prestige, not individual paper quality - First and last authors typically did the work and led the project - Corresponding author handles questions — contact for clarifications - Check author affiliations — institutional reputation matters - Methods section determines if results are trustworthy — results are only as good as methods ## For Specific Questions - Treatment efficacy: RCTs and systematic reviews first - Diagnosis accuracy: sensitivity/specificity studies - Prognosis: cohort studies with long follow-up - Etiology/harm: cohort or case-control studies - Prevention: RCTs when available, cohort otherwise ## Practical Tips - PubMed is free but full text often isn't — check institutional access, Unpaywall, or request from authors - PMID is the unique identifier — use it for precise citations - Export to reference manager (EndNote, Zotero) — manual citation is error-prone - Clinical Queries filter pre-filters for clinical relevance — therapy, diagnosis, prognosis, etiology - Similar Articles and Cited By expand discovery — algorithm finds related work ## Red Flags in Papers - No control group for intervention studies - Conclusions not supported by data presented - Missing or inadequate statistical analysis - Selective reporting of outcomes - Conflicts of interest not disclosed - Extraordinary claims without extraordinary evidence


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