How to Research Health Conditions & Natural Therapies

Recently, I have been non-stop researching databases for a final Masters subject (yay!) and wanted to share with you, how you can find high quality articles on a reputable database such as PubMed on the internet. There are many different forms of information on the information; opinionated articles, case studies, but if you want to have a look at what clinical studies and randomised controlled trials (RCTs) have been analysed on a particular health condition or intervention, such as Chinese Herbal Medicine or Hormone Replacement Therapy (HRT), then read on.

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For this example, the aim is to find high quality studies that have analysed the effectiveness of Chinese Herbal Medicine (CHM) in reducing the severity in menopause-related signs and symptoms. Given menopause is the queried health condition, you need to start with a MesH search in the PubMed database (Table 1). On the main page of PubMed, at the very top, just click the drop down menu (that says PubMed) and select MeSH to do this. Table 1 are the results of what came up when I MeSH searched the word “menopause”. The suggestions from MeSH now indicate what other words that I can look for related to menopause.

Table 1. MeSH Search Results
WORD SEARCHED SUGGESTIONS FROM MeSH SEARCH
Menopause Menopause
Menopause, premature
Postmenopause
Premenopause

The suggestions from the MeSH analysis indicated that menopause, and premenopause would be considered along with perimenopause can be used for further searching (Table 2). For this search, I only want to know about premenopause and menopause, so I can consider that when I search in future I can use NOT for postmenopause and NOT premature menopause.

Table 2. Preparing to perform the Search regarding Chinese Herbal Medicine for Menopause
POPULATION INTERVENTION TYPES OF STUDIES
Women with Menopause Chinese Herb Randomised Controlled Trials
Women who are premenopausal Herbal Medicine
Women who are perimenopausal Chinese Herbal Medicine

The search terms in Table 2 were used to conduct the PubMed Advanced Search Builder. To select this just choose Advanced search on the PubMed page. The results of this with various combinations of Boolean operator terms were queried (Table 3).

Table 3. Search Strategy Results with the Boolean Operator (OR, AND, NOT) in the PubMed Advanced Search Builder
Search Number Search terms used for the Query Number of Articles Found
1 ((Menopause) AND Chinese Herbs) AND Randomised Controlled Trial 8
2 ((Menopause) AND Chinese Herbal Medicine) AND Randomised Controlled Trial 38
3 ((Menopause) AND Herbal Medicine) AND Randomised Controlled Trial 55
4 ((Menopause) AND Chinese Medicine) NOT Acupuncture) AND Randomised Controlled Trial 75
5 ((Premenopause) AND Chinese Herbal Medicine) AND Randomised Controlled Trial 1
6 ((Premenopause) AND Chinese Herb) AND Randomised Controlled Trial 0
7 ((Premenopause) AND Herbal Medicine) AND Randomised Controlled Trial 2
8 ((Perimenopause) AND Chinese Herb) AND Randomised Controlled Trial 1
9 ((Menopause) OR Chinese Herbal Medicine) OR Randomised Controlled Trial 665,471

Table 3 illustrates that search number 9 which all used with AND brings over 665,000 articles. So to refine the search you need to use OR.

The most accurate search was number 3 given it found 38 RCTs regarding Chinese herbal medicine and menopause. To find this record I used the terms ((Menopause) AND Herbal Medicine) AND Randomised Controlled Trial in the PubMed

These 38 articles can then considered with the listed inclusion and exclusion criteria if you want to get very choosy on what studies you want to consider (Table 4).

Table 4. Study Inclusion and Exclusion Criteria regarding Chinese Herbal Medicine and Menopause-related Signs and Symptoms
INCLUSION EXCLUSION
Studies published within the last decade (2008-2018) Studies older than ten years (2007 or older)
Diagnosed as any stage and type of premenopause, Peri-Menopause or Menopause Diagnosed as postmenopausal, or Premature menopausal: ovarectimised, primary amenorrhoea or no diagnosis
Participants are adult and females Participants that are men, teenagers or paediatric
Study must be published in English All studies other than those published in English
Full text studies Conference Abstracts
Data Type: Must Include Primary Data Data Type refers to Secondary or other data
Study Design must be original, Randomised Controlled Trials (RCTs) Reviews, Editorials, Letters and Pilot studies, non-randomised controlled trials
Duration of Condition- At least 3 months
Menopause Diagnosis Criteria – NICE
Outcome measures
Geographic location can be anywhere in the world.

 

Ultimately, in research they say Randomised Controlled Trials (RCTs) are the best research available, especially if there are many participants so you can see how effective it really is. There are always other things to consider though, such as who funded the study? Was it a pharmaceutical company? If so this adds bias to the results.

In Chinese medicine, it is good to see that research is done but we never work in an isolated manner and prescribe formula X for all cases of menopause for example. We always consider the patient’s underlying condition and then presenting signs and symptoms to get the best holistic treatment available.

At Ilana Sowter Acupuncture Murrays Bay, Auckland, expect the best holistic health consultation, tailored treatment and advice with 8 years experience supporting wellbeing with acupuncture and Chinese herbs. Call Ilana on 020 4159 8393 or send her an email to info@ilanasowter.com for more information.

@North Shore Acupuncture & Vitality, Murrays Bay, Auckland, New Zealand 2018