A skill any doctor should have and why

To survive in the information deluge we need to know how to search effectively

A sense of being overwhelmed accompanies any attempt to find information on the Internet. There is way too much for us to handle and make sense of. The fault may be largely our own. We don’t know how to use strategies that can sharpen the focus of search results. This post will show you how the use of a four part search question can vastly improve the value of stuff that is thrown back at you.


At no time in human history has so much information accumulated in such short periods. What’s more, the rate at which information is doubling keeps picking up pace: from 50 years in 1950 to a projected 75 days in 2020! 

Why do we even bother to keep up?

How do we keep up? It appears futile to even try. Still, if we are to remain successful in practice we have to keep up with what is current.


The key to obtaining focussed results when doing an Internet search is framing a question that consists of 4 parts. 

4-part question

The population: 

The first part is defining the population that makes up the subjects that you are interested in. There has to be clarity on this issue. This is vital if the results of a study are to be applied in day to day practice; the study population, has to match the clinical situation in which a reader is likely to use the results of the study.

Indicator variable:

This is the main item of interest in the study. It may be an observation, an intervention or a diagnostic test. Once again, it has to be clearly and precisely defined.

Outcome variable:

What is the result that we are looking at? There will always be a primary outcome. Secondary outcomes may also be stated.


This element is optional but can increase the sharpness of the results. The present item of interest – the indicator variable – could be compared against a known, existing gold standard.


There’s nothing like trying this exercise for yourself. The following steps will take you through a series of searches which will demonstrate how you can improve and refine your searches. I will use influenza vaccination as an example.

  1. Start with only “influenza” in the search bar. Thousands of results, all mixed up, with no ordering or classification, will show up. Note how difficult it is to look for the specific item of interest. The familiar sensation of being overwhelmed sets in.
  2. Now search with “influenza vaccine” with no structuring. Some improvement but still too many and too scattered.
  3. Now, use the 4 part structure: “elderly AND influenza vaccine AND mortality AND unprotected”. (population = elderly; indicator = influenza vaccine; outcome = mortality; comparison = unprotected). See the difference?
  4. FURTHER REFINEMENTS: You can increase focus still more by using the search modifier, “filetype”, to limit your search to specific file types. Search now with “elderly AND influenza vaccine AND mortality AND unprotected filetype:PDF” — this will get you pieces that are specifically in the well known PDF format. Repeat the process with other formats such as “PPT” or “JPG” to get only PowerPoint files or image files in the .jpg format.

Repeat this exercise with other specific topics and see the difference.

One reply on “A skill any doctor should have and why”

  1. K.Nirmal kumar on

    Dear Arjun
    Well , this is good training for all ,not necessarily only for Docs!! Second step is to train IBM Watson with specific domains and Doctors and health professional can vet and refine the data. True it is going to be a hard data , manually entered at least with five papers initially , then Watson is likely to take over with thousands of articles past and current too and our knowledge will be too good to believe as the knowledge itself getting outdated every passing day?
    with best wishes.

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