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Occupational Therapy

A resource guide for occupational therapy students.


evidence pyramidSecondary Evidence:

These studies analyze, summarize, synthesize, interpret or evaluate primary studies in order to present the current state of knowledge on a given topic.

Primary Evidence:

These studies report on an experiment, a research trial, or research project.




CFCF, CC BY-SA 4.0 <>, via Wikimedia Commons

evidence pyramid

Primary evidence presents the detailed findings or results from an original research project, observation, or experiment. 

In searching, use the Publication Type (Article Type) limits or filters in databases to locate the following types of primary evidence

  • randomized controlled trials 
  • clinical trials
  • cohort studies 
  • controlled case studies
  • observational studies (like prospective and retrospective studies.)

Secondary evidence is synthesized or summarized findings from one or more studies. 

Use the Publication Type (Article Type) limits or filters in databases to locate the following types of secondary evidence:

  • systematic review
  • meta-analysis
  • review 
  • guideline or practice guideline.


In CINAHL, use the database limits under Refine Results.

Research Article Limit (checkbox): This will filter your results for research articles, both quantitative and qualitative.  However, BOTH primary AND secondary research articles will be retrieved, so you will need to examine your results carefully.

Publication Type Limit (scrolling box): Try Clinical Trial, Randomized Controlled Trial, or another publication type appropriate for the studies you need.

EBSCO refine results button

research article filter button
















In PubMed, use the Article Type Filters at the left of the search results. 

Add additional filters to see and select primary types of articles like Randomized Control Trial, Controlled Clinical Trial, Pragmatic Clinical Trial, Multicenter Study or Observational Study or secondary study types Meta-Analysis or Systematic Review

To find qualitative studies that are primary or secondary evidence, you may wish to add the following search string to your search: 

 AND qualitative research [MeSH] OR qualitative[tiab] OR themes[tiab]


pub med article type filter button




Documentation of search strategies, details, and results is often wise. Most databases have a Search History feature that can assist with tracking searches and building the search documentation table. A search documentation table or spreadsheet will minimally track the following details.

  • Database name
  • Date search was conducted
  • Search terms (keywords and subject terms)
  • Limits or filters applied
  • Results
  • Modifications or search notes

Searches can also be documented and tracked using PRISMA flow diagram. The search table can be used to fill in your PRISMA flow chart. 

Database Date Terms Limits Results Notes
PubMed 11/12/2021 ("aged"[MeSH Terms] OR "aged"[All Fields] OR ("older"[All Fields] AND "adult"[All Fields]) OR "older adult"[All Fields]) AND ("independent living"[MeSH Terms] OR ("independent"[All Fields] AND "living"[All Fields]) OR "independent living"[All Fields] OR ("community"[All Fields] AND "dwelling"[All Fields]) OR "community dwelling"[All Fields]) AND ("food safety"[MeSH Terms] OR ("food"[All Fields] AND "safety"[All Fields]) OR "food safety"[All Fields] OR ("food handling"[MeSH Terms] OR ("food"[All Fields] AND "handling"[All Fields]) OR "food handling"[All Fields])) Date<5 yr 81 Added term "community dwelling" to initial strategy
CINAHL Complete 11/13/2021 ( food safety OR food handling ) AND ( community dwelling or home environment )  SubjectAge: - aged: 65+ years 70

What is PRISMA?

PRISMA stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

It is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses. Its purpose is to improve the quality of research used in decision-making in healthcare. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram.

PRISMA Templates

In PRISMA 2020, there are template options depending on where you searched and whether you are updating a review. Version 1 of PRISMA 2020 includes databases and clinical trial or preprint registers.  Version 2 includes additional sections for elaborating on your grey literature search, such as searches on websites or in citation lists.

Version 1: Databases and Registers

Version 2: Databases, Registers, and Grey Literature

For additional templates, see:

Help with PRISMA

University of North Carolina Libaries have a Step by Step Guide for filling in the PRISMA flow chart. 

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