Development of a highly sensitive search strategy for the retrieval of reports of controlled trials using PubMed

OBJECTIVE: To develop, through revision of the Cochrane Collaboration search strategy for OVID-MEDLINE, a highly sensitive search strategy to retrieve reports of controlled trials using PubMed. METHODS: The original highly sensitive Cochrane strategy was revised to take into account additional Medical Subject Headings (MeSH) and other terminology as well as the current unique features of PubMed. We compared the retrieval of the revised strategy with that of the original Cochrane strategy before and after translation of the strategies into PubMed format. Finally, we used a gold standard database of reports of controlled trials identified by electronic and hand search of selected journals to test the revised strategy in PubMed format. RESULTS: The revised strategy included a search statement modified for increased precision, and added 'Cross-over Studies' as a MeSH term and the term 'latin square' as a text word. Compared to the original Cochrane strategy, the revised strategy identified 53 additional reports of controlled trials accessing MEDLINE through OVID. When the revised strategy and original Cochrane strategy were translated into PubMed format, the revised strategy retrieved 90 reports of controlled trials not identified by the original strategy. Finally, the revised strategy in PubMed format retrieved all of the reports of controlled trials in the gold standard database. Ninety-eight per cent of the gold standard reports of controlled trials were retrieved by Phase 1 of the optimal PubMed search strategy. CONCLUSIONS: Failure to identify all relevant trials for systematic review could result in bias. We developed a highly sensitive search strategy for the retrieval of reports of controlled trials for use with PubMed that retrieves more relevant citations (greater sensitivity) and fewer non-relevant citations (greater precision) than the original Cochrane search strategy.     

Tutorial on Diarrhea and Enteral Nutrition: A Comprehensive Step‐By‐Step Approach

This tutorial suggests a current strategy toward a multiprofessional therapy based upon a comprehensive step‐by‐step approach to the course of intensive care unit diarrhea episodes. Evidence published in the last 10 years, obtained through a database search (PubMed), shows that its prevalence is quite variable. Although multicausal, it is often erroneously associated with the supply of enteral nutrition. Several complications affect not only nutrition status but also the development of skin lesions, which can become the focus of infections, and the length of hospital stay. Here, we propose an early, objective, directed, and multimodal approach, aiming at optimizing care for these patients. In a dynamic walkthrough, the reader will find a guide for the general diagnosis and for colitis resulting from Clostridium difficile infections, as well as current instructions and recommendations for drug treatment and supportive therapy for these 2 modalities. We also bring together ways to prevent and treat associated skin lesions in this setting. Because it is neglected in the critical environment, diarrhea is still a poorly addressed disease, and its complications bring about a significant worsening in quality of life and hospital stay.     

The pitfalls of a systematic MEDLINE review in palliative medicine: symptom assessment instruments

The Medical Literature Analysis and Retrieval System Online (MEDLINE) database provides many references for reviews, but many relevant articles are missed, especially when the topic is complex. Reported here is the detailed methodology of a PubMed search of MEDLINE augmented by a related articles link search. Of 1181 citations identified, through a PubMed search, 10 articles met the inclusion criteria. Fifty-one were identified through the related articles link; of which 43 were not detected by standard searches using medical subject heading terms. More than 50% were identified using the related articles link. Only 14% of relevant articles were identified using the standard PubMed MEDLINE search. The related articles link is not included in methodologic recommendations for systematic literature reviews but this experience suggests that it is a useful tool in PubMed for reviewing complex evidence. Related links searches are proposed in any systematic PubMed MEDLINE literature review in palliative medicine.     

Principles for Effective PubMed Searching

Abstract

PubMed is a window to the esteemed biomedical citation database MEDLINE, developed at the National Institutes of Health in Bethesda, Maryland. The PubMed interface has evolved into a robust system with enhanced search features and is freely available on the Internet. However, to utilize PubMed effectively, the user must understand how to take full advantage of its less than intuitive tools. Each of the PubMed Advanced Search features is described and illustrated with a sample search. Important MEDLINE syntax is explained as well. In addition, elements for best search practices are suggested. Finally, an appendix to online resources for PubMed facts and instruction is provided.     

PubMed perspective of family medicine research: where does it stand?

OBJECTIVE: The aim of this study was to obtain a view of family medicine research by analyzing PubMed citations from 1960-2003. METHOD: Family practice (FP) citations in PubMed from 1960 to 2003 were downloaded in MEDLINE format. This was written into relation database using 'PubMed Grabber/Analyzer' software developed at University of Kelaniya, Sri Lanka. Search Query Language (SQL) and online PubMed queries were used for further analysis. RESULTS: There were 50288 FP citations from 80 countries. Of these, 33712 (67%) citations were from 15 FP journals. United Kingdom (18760), United States (13584), Australia (3262), Canada (1848), Germany-west (1340) were the five countries which had the most citations and 22 countries had less than 5 citations. Van Weel C (118), Geyman JP (116), Olesen F (87), Jones R (83) and Knottnerus JA (82) were numerically, the top five authors. Only 921 authors had more than 10 citations and the vast majority of authors had only one citation. Letters (5121), review (2715), editorial (2259), randomized controlled trials-RCT (1585) and Meta-analysis (44) were the top publication types. 40 citations found under 'qualitative research'. Discussion. The relatively few PubMed FP citations (50288) are by a small number of academics in developed countries. Citations showed an upsurge from the mid 1980s to the late 1990's but reached a plateau in the new millennium. Compared to PubMed citations from 1960-2003 in other specialties such as 2737655 for public health, 1151194 for cardiology & cardiovascular diseases and 318538 for medical informatics, the 50288 FP citations were paltry. Paucity of RCT (1585) and meta-analysis (44) was noted. The low 'qualitative research' citations (44) could have been due to the late introduction of the MeSH concept in 2003. CONCLUSIONS: Priority should be given to increase FP research and also to ensure the indexing of FP journals that are not currently indexed in PubMed. Efforts to increase citations in Medline may not give the desired results because of low priority given primary care specialties such as family medicine in the USA. Alternative solution of a separate bibliographic database for FP similar to PsycInfo may be too costly.     

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition

This document represents the first collaboration between 2 organizations—the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine—to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2–3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment—particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The role of supplemental parenteral nutrition has been highlighted, and a delayed approach appears to be beneficial. Immunonutrition cannot be currently recommended. Overall, the pediatric critical care population is heterogeneous, and a nuanced approach to individualizing nutrition support with the aim of improving clinical outcomes is necessary.     

The growth of health-related meta-analyses published from 1980 to 2000

A MEDLINE search was conducted to estimate trends in the growth of health-related meta-analyses published during the past two decades. Employing a more specific than sensitive search strategy, and not supplementing these results with known sources of published meta-analyses or manual search strategies, 3,025 probable meta-analyses were selected from the 5,128 citations identified. The data showed a definitive upward (and generally linear) trend across time with no evidence for this genre of research either leveling off or decreasing.     

The benefits of flexibility: the pedagogical value of instructions to adopt multifaceted diagnostic reasoning strategies

Objectives Building on the advice of previous research to avoid parsing diagnostic strategies too finely, recent studies have shown that teaching novices to utilise analytic and non‐analytic reasoning strategies yields higher diagnostic accuracy than teaching either in isolation. This study assesses the extent to which students spontaneously adopt a combined approach and compares its benefits with those experienced with a contrastive learning strategy known to enhance analogical transfer. Methods A sample of 48 naïve students were trained to identify features on electrocardiograms (ECGs) and assign diagnoses. Half the participants learned in a standard manner, encountering diagnoses (and their associated features) in sequence. The remaining participants were explicitly instructed to draw comparisons between the diagnostic category being learned and another confusable diagnostic category (contrastive learning). Half the participants in both groups were further instructed to carefully identify all features while trusting guidance provided by feelings of familiarity (a combined reasoning strategy). The remaining participants were given no instructions on how to approach the diagnostic task. Results Greater diagnostic accuracy was achieved following both contrastive learning and instructions to use a combined reasoning strategy relative to the control conditions. These variables did not interact with each other, nor did they interact with novelty of the test case. The effects were observed immediately after learning and following a 1‐week delay. Discussion The results emphasise the importance of explicitly empowering students to utilise multiple diagnostic strategies, including non‐analytic approaches. In addition, this study reveals the benefit that can be gained from contrastive learning in a medical domain.     

Risks and Preventive Strategies for Clostridioides difficile Transmission to Household or Community Contacts during Transition in Healthcare Settings

The burden of Clostridioides difficile infection (CDI) has greatly increased. We evaluated the risks for CDI transmission to community members after hospitalized patients are discharged. We conducted a systematic literature review in MEDLINE/PubMed, EMBASE, CINAHL plus EBSCO, Web of Science, Cochrane Library, and gray literature during January 2000‒February 2019 and identified 4,798 citations were identified. We eliminated 4,554 citations through title and abstract screening; 217 additional citations did not meet full criteria. We reviewed texts for the 27 remaining articles qualitatively for internal/external validity. A few identified studies describing risks to community members lacked accurate risk measurement or preventative strategies. Primary data are needed to assess efficacy of and inform current expertise-driven CDI prevention practices. Raising awareness among providers and researchers, conducting clinical and health services research, linking up integrated monitoring and evaluation processes at hospitals and outpatient settings, and developing and integrating CDI surveillance systems are warranted.     

End-Stage Renal Disease in Nursing Homes: A Systematic Review

Objectives/IntroductionDemand for nursing home (NH) care by patients with end-stage renal disease (ESRD) is likely to increase with growing numbers of older adults initiating chronic dialysis. We completed a systematic review to summarize the literature on NH residents with ESRD.MethodsMEDLINE, CINAHL, EMBASE, and relevant conference proceedings were searched to identify articles using the following MESH terms or related key words in the title or abstract: “residential facilities”, “renal dialysis”, “renal replacement therapy”, and “chronic kidney failure”. We selected case control, cohort studies, and clinical trials that included older adults with ESRD (defined as those receiving chronic dialysis or those with stage 5 chronic kidney disease) living in residential care facilities. We abstracted information on study design, quality, and results.ResultsOf 198 unique citations identified by the search strategy, 14 articles met eligibility criteria. Most articles were multicenter studies that were conducted in the 1990s. One study focused on patients with stage 5 chronic kidney disease, and the remaining 13 studies focused on patients receiving chronic dialysis, of which eight studies included only those receiving peritoneal dialysis, four studies included patients receiving both peritoneal dialysis and hemodialysis, and one study included only patients receiving hemodialysis. All studies were observational, no clinical trials were identified, and study design limitations and heterogeneity within study populations were common. Summarizing results across these studies suggests that NH residents with ESRD have limited survival, particularly early after dialysis initiation. Functional impairment is highly prevalent in this population and independently associated with poor outcomes.ConclusionsNH residents with ESRD appear to be a particularly vulnerable population, but current information on their prevalence, characteristics, and outcomes is limited. Further research is needed to provide a better understanding of modifiable predictors of survival and functional decline in this population.     

American Society for Parenteral and Enteral Nutrition Guidelines for the Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration

This document represents the American Society for Parenteral and Enteral Nutrition (ASPEN) clinical guidelines to describe best practices in the selection and care of central venous access devices (CVADs) for the infusion of home parenteral nutrition (HPN) admixtures in adult patients. The guidelines targeted adults >18 years of age in which the intervention or exposure had to include HPN that was administered via a CVAD. Case studies, non‐English studies, or studies of CVAD no longer available in the United States were excluded. In total, 564 abstract citations, 350 from Medline and 214 from PubMed/non‐MEDLINE databases, were scanned for relevance. Of the 564 citations, 13 studies addressed at least 1 of the 6 guideline‐related questions, and none of the studies were prospective and randomized. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria were used to adjust the evidence grade based on assessment of the quality of study design and execution. Recommendations for the CVAD type, composition, or number of lumens to minimize infectious or mechanical complications are based on a limited number of studies and expert opinion of the authors, all very experienced in home infusion therapy. No studies were found that compared best solutions for routine flushing of lumens (eg, heparin versus saline) or for maintaining catheters in situ while treating CVAD mechanical or infectious complications. It is clear that studies to answer these questions are very limited, and further research is needed. These clinical guidelines were approved by the ASPEN Board of Directors.     

A meta‐ethnography of the facilitators and barriers to successful implementation of patient complaints processes in health‐care settings

Objective

To synthesize experiences of the patient complaints process for patients and health‐care professionals to identify facilitators and barriers in the successful implementation of patient complaints processes. This will assist the development of cultural change programmes, enabling complaints managers to incorporate stakeholder perspectives into future care.

Design

Systematic literature search and meta‐ethnography, comprising reciprocal syntheses of “patient” and “professional” qualitative studies, combined to form a “line‐of‐argument” embodying both perspectives.

Data sources

MEDLINE, CINAHL and PsycINFO (database inception to April 2015) were searched to identify international literature in primary and secondary health‐care settings, involving qualitative data collection and analysis. Further studies were identified from hand‐searching relevant journals, contacting authors, article reference lists and Google Scholar.

Results

A total of 13 papers, reporting 9 studies from the United Kingdom, Sweden, Australia and New Zealand, were included in the synthesis. Facilitators and barriers to the successful implementation of patient complaints processes were identified across the perspectives of both patients and health‐care professionals. Patients sought to individualize the complaints process by targeting specific professionals who engaged in practices that undermined the identity of patients. In contrast, professionals obscured their own individualism through maintaining a collective identity and withholding personal judgement in relation to patient complaints.

Conclusions

Complainants recognized health‐care professionals as bearers of individual accountability for unsatisfactory care, in opposition to the stance of collective responsibility endorsed by professionals. Implementation of patient complaints processes must reconcile the need for individualized resolution, whilst striving to improve the future provision of health care through a collaborative approach between patients and professionals.     

Errors in search strategies were identified by type and frequency

OBJECTIVE: Errors in the electronic search strategy of a systematic review may undermine the integrity of the evidence base used in the review. We studied the frequency and types of errors in reviews published by the Cochrane Collaboration. STUDY DESIGN AND SETTING: Data sources were MEDLINE searches from reviews in the Cochrane Library, Issue 3, 2002. To be eligible, systematic reviews must have been of randomized or quasi-randomized controlled trials, reported included and excluded studies, and used one or more sections of the Cochrane Collaboration's Highly Sensitive Search Strategy. MEDLINE search strategies not reported in enough detail to be assessed or that were duplicates of a search strategy already assessed for the study were excluded. Two librarians assessed eligibility and scored the eligible electronic search strategies for 11 possible errors. Dual review with consensus was used. RESULTS: Of 105 MEDLINE search strategies examined, 63 were assessed; 31 were excluded because they were inadequately reported, and 11 were duplicates of assessed search strategies. Most (90.5%) of the assessed search strategies contained > or =1 errors (median 2, interquartile range [IQR] 1.0-3.0). Errors that could potentially lower recall of relevant studies were found in 82.5% (median 1, IQR 1.0-2.0) and inconsequential errors (to the evidence base) were found in 60.3% (median 1, IQR 0.0-1.0) of the search strategies. The most common search errors were missed MeSH terms (44.4%), unwarranted explosion of MeSH terms (38.1%), and irrelevant MeSH or free text terms (28.6%). Missed spelling variants, combining MeSH and free text terms in the same line, and failure to tailor the search strategy for other databases occurred with equal frequency (20.6%). Logical operator error occurred in 19.0% of searches. CONCLUSION: When the MEDLINE search strategy used in a systematic review is reported in enough detail to allow assessment, errors are commonly revealed. Additional peer review steps are needed to ensure search quality and freedom from errors.     

Simplified search strategies were effective in identifying clinical trials of pharmaceuticals and physical modalities

BACKGROUND AND OBJECTIVES: Assess the efficacy of simplified search strategies and identify the best electronic bibliographic database for clinical trials in the field of musculoskeletal disorders and pain. METHODS: Clinical trials within selected reviews from the Cochrane Back, Musculoskeletal, and PaPaS Review Groups were searched using MEDLINE, EMBASE, CINAHL, and CENTRAL to identify which database included the highest percentage of trials. Simplified search strategies for each review were devised and compared to the original, more complex strategy for sensitivity, specificity and precision. RESULTS: Individually, MEDLINE, and EMBASE included 90 and 89% of the relevant studies respectively, and 94% when combined. CENTRAL contained 87% and CINAHL 31%. Generally, simplified search strategies (two to four lines) had higher specificity than the original strategies (approximately 27 lines). Sensitivity was also high, but varied according to intervention. Super simple search strategies (one to two lines) proved as sensitive, but were slightly less specific, depending on the intervention. Both simple and super simple search strategies were often more precise than the original. CONCLUSION: Simplified search strategies are an effective, efficient way to search for clinical trials. They work best when the intervention is a pharmaceutical or a well-defined physical treatment. Their sensitivity, however, is not adequate for conducting systematic reviews.     

PubMed search strings for the study of agricultural workers' diseases

Background

Several optimized search strategies have been developed in Medicine, and more recently in Occupational Medicine. The aim of this study was to identify efficient PubMed search strategies to retrieve articles regarding putative occupational determinants of agricultural workers' diseases.

Methods

We selected the Medical Subjects Heading (MeSH) term agricultural workers' diseases and six MeSH terms describing farm work (agriculture, agrochemicals NOT pesticides, animal husbandry, pesticides, rural health, rural population) alongside 61 other promising terms. We estimated proportions of articles containing potentially pertinent information regarding occupational etiology to formulate two search strategies (one “more specific,” one “more sensitive”). We applied these strategies to retrieve information on the possible occupational etiology among agricultural workers of kidney cancer, knee osteoarthritis, and multiple sclerosis. We evaluated the number of needed to read (NNR) abstracts to identify one potentially pertinent article in the context of these pathologies.

Results

The “more specific” search string was based on the combination of terms that yielded the highest proportion (40%) of potentially pertinent abstracts. The “more sensitive” string was based on use of broader search fields and additional coverage provided by other search terms under study. Using the “more specific” string, the NNR to find one potentially pertinent article were: 1.1 for kidney cancer; 1.4 for knee osteoarthritis; 1.2 for multiple sclerosis. Using the sensitive strategy, the NNR were 1.4, 3.6, and 6.3, respectively.

Conclusion

The proposed strings could help health care professionals explore putative occupational etiology for agricultural workers' diseases (even if not generally thought to be work related). Am. J. Ind. Med. 56:1473–1481, 2013. © 2013 The Authors. American Journal of Industrial Medicine published by Wiley Periodicals, Inc.     

Is this health campaign really social marketing? A checklist to help you decide

Issue addressed

Social marketing (SM) campaigns can be a powerful disease prevention and health promotion strategy but health‐related campaigns may simply focus on the “promotions” communication activities and exclude other key characteristics of the SM approach. This paper describes the application of a checklist for identifying which lifestyle‐related chronic disease prevention campaigns reported as SM actually represent key SM principles and practice.

Methods

A checklist of SM criteria was developed, reviewed and refined by SM and mass media campaign experts. Papers identified in searches for “social marketing” and “mass media” for obesity, diet and physical activity campaigns in the health literature were classified using the checklist.

Results

Using the checklist, 66.6% of papers identified in the “SM” search and 39% of papers identified from the “mass media” search were classified as SM campaigns. Inter‐rater agreement for classification using the abstract only was 92.1%.

Conclusions

Health‐related campaigns that self‐identify as “social marketing” or “mass media” may not include the key characteristics of a SM approach. Published literature can provide useful guidance for developing and evaluating health‐related SM campaigns, but health promotion professionals need to be able to identify what actually comprises SM in practice.

So what?

SM could be a valuable strategy in comprehensive health promotion interventions, but it is often difficult for non‐experts to identify published campaigns that represent a true SM approach. This paper describes the application of a checklist to assist policy makers and practitioners in appraising evidence from campaigns reflecting actual SM in practice. The checklist could also guide reporting on SM campaigns.

     

Does Parenteral Nutrition Increase the Risk of Catheter‐Related Bloodstream Infection? A Systematic Literature Review

Background: Central venous access devices (CVADs) are used for parenteral nutrition (PN) delivery. We systematically reviewed research‐based publications that reported comparative rates of catheter‐related bloodstream infection (CRBSI) in patients with CVADs who received PN vs those who did not receive PN therapy. Materials and Methods: The literature search included the Cochrane Library, MEDLINE, CINAHL, and PubMed up to July 14, 2015, to identity studies that compared patients with a CVAD who did and did not have PN therapy. Results: Eleven observational studies were identified, comprising 2854 participants with 6287 CVADs. Six studies produced significant results in favor of non‐PN, 4 studies showed no evidence of a difference between PN and non‐PN, and 1 study produced significant results in favor of PN when analyzed per patient with multiple CVADs. Incidence ranged from 0 to 6.6 CRBSIs per 1000 CVAD days in the PN patients and 0.39 to 3.6 CRBSIs per 1000 CVAD days in the non‐PN patients. The Cochrane risk of bias assessment tool for nonrandomized studies of interventions was used. Eight studies were rated as moderate risk of bias, 2 as serious, and 1 as critical. Conclusion: The data presented in this systematic review are not sufficient to establish whether patients receiving PN are more at risk of developing CRBSI than those who do not. Future PN studies needs to adjust for baseline imbalances and improve quality and reporting.     

Connectivity,contest and the ties of self‐management support for type 2 diabetes: a meta‐synthesis of qualitative literature

This paper presents a meta‐synthesis of the literature on community‐based self‐management to support experiences of people diagnosed with type 2 diabetes. The aim was to synthesise findings on both formal and informal self‐management support with particular reference to the relevance and influence of the social context operating at different levels. The review forms part of EU‐WISE, a project financed through EU's 7th Framework Programme. The review was performed by systematically searching MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO and Web of Science for English language publications between 2005 and 2014 presenting research conducted in Europe on the experiences and perspectives of self‐management concerns of patients diagnosed with type 2 diabetes. The search yielded 587 abstracts, which were reduced through search strategy refinement and eligibility and quality criteria to 29 papers that were included in the review. This review highlights the relevance of contextual factors operating at micro‐ and macro‐levels. The synthesis yielded six second‐order thematic constructs relating to self‐management: sense of agency and identity, the significance and meaning of social networks, minimal disruption of everyday life, economic hardship, the problem of assigning patients’ responsibility and structural influences of primary care. Using a line of argument synthesis, these themes were revisited, and a third‐order construct, connectivity emerged which refers to how links in daily life are interwoven with peoples’ social networks, local communities, economic and ideological conditions in society in a way which support self‐management activities. This meta‐synthesis indicates a need to heed the notion of connectivity as a means of mobilising and supporting the self‐management strategies of people with type 2 diabetes in everyday life.     

Complementary and alternative medicine in rural communities: current research and future directions

Contexts: The consumption of complementary and alternative medicine (CAM) in rural areas is a significant contemporary health care issue. An understanding of CAM use in rural health can provide a new perspective on health beliefs and practice as well as on some of the core service delivery issues facing rural health care generally. Purpose: This article presents the first review and synthesis of research findings on CAM use and practice in rural communities. Methods: A comprehensive search of literature from 1998 to 2010 in CINAHL, MEDLINE, AMED, and CSA Illumina (social sciences) was conducted. The search was confined to peer‐reviewed articles published in English reporting empirical research findings on the use or practice of CAM in rural settings. Findings: Research findings are grouped and examined according to 3 key themes: “prevalence of CAM use and practice,”“user profile and trends of CAM consumption,” and “potential drivers and barriers to CAM use and practice.” Conclusions: Evidence from recent research illustrates the substantial prevalence and complexity of CAM use in rural regions. A number of potential gaps in our understanding of CAM use and practice in rural settings are also identified.