10 © 2020 American Dental Association Searching Workflow We suggest searching several databases searching a combination of databases helps to ensure that information is not missed that might influence the answer to the clinical question at hand. While the exact databases searched will depend on the question/topic/need, the importance of finding high levels of evidence calls for, at a minimum, Cochrane, Trip, and PubMed to be searched. Information about many additional available databases are listed in the Resources section of this chapter. To avoid missing important results, use all three resources: there is less overlap among them than one would imagine, they cover different types of materials, and the content in each is updated on different cycles. Each resource has a unique architecture, vocabulary, and results algorithm and, therefore, will return unique results. Searching Cochrane, Trip, and PubMed is free, but the full text of results is not always available without a subscription to source material, which is typically provided when operating in an academic setting. For those in clinical practice outside academic settings, the American Dental Association (ADA) Library and Archives offers members access to full-text articles identified through these databases. All three resources are relatively easy to search and provide up-to- date information. By using these three databases, the oral health practitioner will have searched the gold standard for evidence-based information (Cochrane), the best “preappraised” resource (Trip), and the most comprehensive medical literature search engine (PubMed). We recommend framing the search strategy using the PICO framework to articulate the clinical question. PICO assists clinicians in creating a clear, focused clinical question by breaking down the question into four components: Population – Who is being treated? What specific characteristics does this population have? Intervention – What treatment or therapy is being considered? Comparison – What is the gold standard? The comparison can also be no comparison, or a placebo. Outcomes – What improvements or changes are hoped for? Of course, PICO will not fit every clinical question because not all questions are ones of therapy the framework can be modified depending on the type of question. For instance, if it is a question of harm, the clinician will frame the question by considering what exposure, rather than what intervention, to search for. We recommend that clinicians refer to the framework as a starting point and modify as necessary for individual research needs. Using the PICO framework is likely to result in the return of relevant results because the framework encourages clarity and specificity and it breaks down the clinical question into easily searchable components. Using the PICO framework to articulate the question will save the clinician time when conducting the search and better enable the clinician to review the results of the search for relevance and applicability to clinical practice (or to a particular patient) (Table 2.1). Searching a combination of databases helps to ensure that information is not missed that might influence the answer to the clinical question at hand.