What’s NOT: More About the Boolean Operator “NOT”

Boolean Operators (AND, OR, NOT) are tools for combining search terms and are inherent part of online database searching. While experienced searchers will use Boolean Operators directly in their search strategies, even novice searchers that just enter a string of terms into a database’s search box will end up indirectly using the Boolean operator AND, as each space between words will be treated by the database as AND, thus combining each term together into a search strategy that would retrieve results that have all terms present.

Image Source: https://sru.libguides.com/english/librarybasics/booleanoperators

Most search strategies will either use just AND or a combination of both AND and OR. The third Boolean operator, NOT, is much more complicated and requires some understanding to use properly in a search.

Using the Boolean Operator NOT

The Boolean operator NOT can be used when a term or terms needs to be excluded from your search strategy.

For example, if you were interested in articles that looked at children with cancer, but you did not want articles that looked specifically at infants, you could create a search strategy like this:

cancer AND child* NOT infant*
— or —
(cancer AND child*) NOT infant*

The Problem with NOT

When using the Boolean operator NOT to exclude terms, it can become problematic when the database excludes records that contain both the term(s) you want to exclude and the term(s) you want in your search.

In the above example, not only articles about cancer in infants will be excluded from the results but it will also exclude any articles about cancer in both children and infants.

Information professionals (librarians and informationists) advise using the Boolean operator NOT with extreme caution when conducting searches. It’s better to reach out to an information professional for assistance with complex search techniques and how to best proceed with a search when there is a term you want to avoid.

Variations Across Databases

Not all databases function the same way, and using the Boolean operator NOT is no different. While most databases allow for using simply NOT to exclude terms, depending on the database or platform, you might need to use the operator AND NOT instead (Scopus), or once the search is performed use the Exclude button found within the Refine Search panel (also in Scopus).

Takeaway

The Boolean operator NOT should be used with extreme caution. It is best to consult a Librarian on its use in your search.

Search Smarter with the Latest Technology

The amount of published biomedical literature has been growing exponentially for decades, and that trend is not slowing down anytime soon. With this explosion of published content, it can be overwhelming to find exactly what you are looking for.

The 21st Century Digital Age

The start of the 21st century was heralded as the “digital age”, and the growth of content shifted from a linear to an exponential growth model. There were approximately 13 million citations in PubMed at the start of the 21st century. Within the first decade that number rose to 20 million. Today there are over 36 million citations in PubMed. 

Growth of PubMed citations from 1986 to 2010
Source: Lu Z. PubMed and beyond: a survey of web tools for searching biomedical literature. Database (Oxford). 2011;2011:baq036. Published 2011 Jan 18.

Zhiyong Lu, from the National Center for Biotechnology Information (NCBI), wrote about going beyond PubMed back in 2011, and shared an initial overview of web-based tools available that work alongside or on top of PubMed to provide more search functionality to users.

From the Digital Age to the Age of Artificial Intelligence

Today, as we now inch closer to the quarter-century point, digital technology has literally begun taking on a life of its own. With the advent of machine-learning and generative artificial intelligence, suddenly technology itself can create its own content! And while there are plenty of ethical issues surrounding the use and abuse of AI that cover nearly all aspects of life, this technology allows for considerable benefits as well.

New tools have emerged to help us better navigate, digest, and synthesize the overwhelming amount of digital information available, including biomedical literature. Many of these tools are web-based resources that either overlay or work in conjunction with PubMed to provide functionality that goes beyond basic search and retrieval.

Last month, Zhiyong Lu and several of his colleagues from NCBI published an update to his 2011 overview; PubMed and beyond: biomedical literature search in the age of artificial intelligence. This update focused on how user search needs have expanded and AI tools can provide search functionality to address these different needs.

Overview of five specialised search scenarios in biomedicine
Source: Jin Q, Leaman R, Lu Z. PubMed and beyond: biomedical literature search in the age of artificial intelligence. EBioMedicine. 2024;100:104988. 

They looked at five specific types of specialized search needs, and addressed the various tools and resources that can provide necessary functionality to support those search needs: evidence-based medicine, precision medicine, semantic searching, recommendations, and text mining.

Harness Technology with these Search Tools

Using these five identified search needs categories, below are selected resources to assist users in navigating and digesting the ever-expanding field of biomedical research.

Evidence-Based medicine

PubMed Clinical QueriesThis PubMed tool uses predefined filters to help you quickly refine PubMed searches on clinical or disease-specific topics.
Cochrane Clinical AnswersCCA provides readable, digestible, clinically focused actionable point-of-care information directly from Cochrane Reviews.
Joanna Briggs Institute (JBI) EBP DatabaseThe JBI EBP Database provides the latest research and evidence-based guidelines regarding patient care, treatment options, and interventions to empower clinicians and healthcare administrators to make informed, confident decisions. 
TRIP DatabaseTRIP is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Precision Medicine & Genomics

OncoSearchOncoSearch is a text mining search engine that searches Medline abstracts for sentences describing gene expression changes in cancers. 
LitVarLitVar normalizes different forms of the same variant into a unique and standardized name so that all matching articles can be returned regardless of the use of a specific name in the query.
DigSeeDigSee is a text mining search engine to provide evidence sentences describing that “genes” are involved in the development of “disease” through “biological events”. With a query of (disease, genes, events), Medline abstracts with highlighted evidence sentences will be retrieved.

Semantic Searching

LitSenseLitSense is a unique search system for making sense of the biomedical literature at the sentence level. Given a query, LitSense finds the best-matching sentences based on overlapping terms as well as semantic similarity via a cutting-edge neural embedding approach.
AskMEDLINESearch PubMed using free-text and natural language
BioMed ExplorerBioMed Explorer applies semantic understanding of the content of the papers to pull out answers and highlight snippets and evidence for the user. 
Semantic ScholarSemantic Scholar provides free, AI-driven search and discovery tools, and open resources for the global research community. 

Literature Recommendations

LitSuggestAdvanced machine learning and information retrieval techniques are utilized for finding and ranking publications pertinent to a topic of interest. 
Connected PapersConnected Papers is a unique, visual tool to help researchers and applied scientists find and explore papers relevant to their field of work.

Text Mining

PubTator PubTator Central (PTC) is a Web-based system providing automatic annotations of biomedical concepts such as genes and mutations in PubMed abstracts and PMC full-text articles. 
PubMedKBPubMedKB combines a multitude of state-of-the-art text-mining tools optimized to automatically identify the complex relationships between biomedical entities in the PubMed abstracts.

As technology evolves, so will the research environment, and it’s imperative that we are able to leverage technology to keep up. It’s also important to understand these new technologies, how they work, and how they can be used to make work more efficient. But it’s also important to understand their limitations and the ethical issues that could arise when using these technologies without further human insight.

Don’t Let Your Search Get Lost In Translation

When conducting a literature search on a topic, many times the search is conducted in more than one database for more comprehensive results. And in the case of systematic reviews, such a practice is required.

Even more challenging, when it comes to systematic reviews, is that the searches in each database should be as similar to one another as possible. The process of taking an original search strategy from one database and making only necessary changes (controlled vocabulary, syntax, field codes), adapt the strategy to another database is referred to as “search translation.”

The Parts of a Search

There are several parts to complex literature searches that combine multiple elements: Boolean operators, nesting, controlled vocabulary, field codes, quotations, proximity, and special operators.

Boolean Operators

Boolean Operators (AND, OR, and NOT) are the basis of how to combine concepts to create a search.

While nearly all databases use Boolean operators in the same manner and meaning, it’s important to know when capitalization is necessary and when it is not.

Nesting

Nesting uses parentheses much in the same way they are used in Algebra — that is, whatever is inside the pair of parentheses must be done first, and from there a search (just like math), will be conducted from left-to-right.

Since nesting is about how to read and execute a search, it typically will not change between databases.

Controlled Vocabulary

Controlled vocabulary refers to the set dictionary of terms for that database, such as MeSH (Medical Subject Headings) and EmTree. MeSH is the National Library of Medicine’s controlled vocabulary, and they create the MeSH terms for PubMed. These terms may not always be identical to the MeSH terms found in MEDLINE on another platform though, and they require different identification.

Unfortunately there is no easy way to translate these terms, but using the built in databases (MeSH Database, MEDLINE Term Finder, EmTree Database, etc) you can quickly find the most closely aligned term to use.

Field Codes

Field codes are essentially the special codes for each database that tell the database where to search for that term. For example [tiab] in PubMed tells the database to search that term in the title and abstract fields only. In MEDLINE the title/abstract field code is .ti,ab, whereas in Embase it is :ti,ab.

Quotations

In order to search for a specific phrase searches must use quotations. However, depending on the database, they may require double quotations (“smart quotes”), straight quotations, or single quotations.

Proximity

Proximity operators (also called adjacency in some databases) are essentially a middle-ground between searching across an entire record and specific quotations. They allow the user to select how close they want to two terms to appear in a record. Every database uses slightly different proximity operators and syntax, and some have strict rules with how they can be used.

Special Operators

Special Operators are operators that can be added to search terms to modify what is searched. Examples of special operators are truncation and wildcards, which expand the variations of the specified term that are searched. An asterisk (*) is the common operator for truncation in many databases.

Where to Start

All the information on how to search each database according to its own rules and/or the rules of an online platform it resides on can be found in the database/platform’s Help section.

Typically, this translation of search strategies is done by a librarian manually but automated/semi-automated tools are being gradually introduced. A beta version of such tool (Query Translation) is currently available in Embase.com, the Elsevier interface of the Embase database. It will assist in “translating” PubMed searches into the Embase.com search syntax.

The tool allows entering a search term or the whole search strategy (query) and get it translated to Embase syntax.