Searching for specific adverse effects
Named adverse effects can be searched for as both indexing terms and text words. For example in MEDLINE OvidSP sudden death can be searched using the following approach;
#1 exp Death, Sudden/
#2 (sudden adj2 death$).ti,ab.
#3 #1 or #2
Key
exp denotes exploding the succeeding indexing term
adj is the proximity operator in OvidSP, and adj2 denotes within 2 words
$ is the truncation symbol in OvidSP
ti, ab denotes searching in the title and abstract
In some instances subheadings may be available to focus the search on the outcome as an adverse effect (rather than, for example, a consequence of the disease). For example in MEDLINE the subheading ‘chemically induced’ is available and a search for vision disorders as an adverse effect may be carried out as follows:
#1 exp Vision Disorders/ci [chemically induced]
It should be noted, however, that for truly sensitive searches suitable text words will need to be added (for example, vision disorder$.ti,ab), this could be in combination with adverse effects terms (for example, vision disorder$.ti,ab and complication$.ti,ab etc)
In addition to terms for named adverse effects it may also be appropriate (due to poor reporting in papers and indexing in databases) to add generic adverse effect search terms as for a general search for all adverse effects associated with an intervention (see below).
Searching with generic adverse effects terms
If none of the adverse effects are known at the time of searching then a sensitive search strategy in MEDLINE OvidSP would include a combination of MeSH floating subheadings and text words for generic adverse effects terms for example;
#1 ae.fs. OR co.fs. OR de.fs.
#2 (safe OR safety OR side effect$ OR undesirable effect$ OR treatment emergent OR tolerability OR toxicity OR adrs OR (adverse adj2 (effect or effects or reaction or reactions or event or events or outcome or outcomes))).ti,ab
#1 OR #2
Key
ae denotes the subheading ‘adverse effects’
co denotes the subheading ‘complications’
de denotes the subheading ‘drug effects’
.fs denotes ‘floating’ the preceding subheading (ie searching for the subheading attached to any indexing term).
Many papers on adverse effects will not contain any generic adverse effects terms in the title, abstract or indexing. In instances where the adverse effects are unknown at the time of searching, it may be possible to identify potential adverse effects to use as search terms from tertiary sources such as the BNF and Meyler’s Side Effects of Drugs.