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Clinical trials

Clinical trials (updated 29 February 2024)

Note: This includes articles about the practice of trials as well as articles in which the study methodology is some type of trial.

("Adaptive Clinical Trial" [PTYP:NoExp] OR "Clinical Trial" [PTYP:NoExp] OR "clinical trial, phase i"[PTYP] OR "clinical trial, phase ii"[PTYP] OR "clinical trial, phase iii"[PTYP] OR "clinical trial, phase iv"[PTYP] OR "controlled clinical trial"[PTYP] OR "Equivalence Trial"[PTYP] OR "multicenter study"[PTYP] OR "pragmatic clinical trial"[PTYP] OR "randomized controlled trial"[PTYP] OR "adaptive clinical trials as topic"[MeSH:noexp] OR "Clinical Studies as Topic"[mesh:noexp] OR "Clinical Trials as Topic"[mesh:noexp] OR "clinical trials, phase i as topic"[MeSH:noexp] OR "clinical trials, phase ii as topic"[MeSH:noexp] OR "clinical trials, phase iii as topic"[MeSH:noexp] OR "clinical trials, phase iv as topic"[MeSH:noexp] OR "controlled clinical trials as topic"[MeSH:noexp] OR "Double-Blind Method"[Mesh] OR "early termination of clinical trials"[MeSH:noexp] OR "Equivalence Trials as Topic"[MeSH:noexp] OR "Intention to Treat Analysis"[MeSH:noexp] OR "multicenter studies as topic"[MeSH:noexp] OR "Non-Randomized Controlled Trials as Topic"[MeSH:noexp] OR "Pragmatic Clinical Trials as Topic"[MeSH:noexp] OR "randomized controlled trials as topic"[MeSH:noexp] OR "2 arm"[TIAB] OR "two arm"[TIAB] OR "3 arm"[TIAB] OR "three arm"[TIAB] OR "4 arm"[TIAB] OR "four arm"[TIAB] OR "clinical studies"[TIAB:~3] OR "clinical study"[TIAB:~3] OR "clinical trial"[TIAB:~3] OR "clinical trials"[TIAB:~3] OR "controlled studies"[TIAB:~3] OR "controlled study"[TIAB:~3] OR "controlled trial"[TIAB:~3] OR "controlled trials"[TIAB:~3] OR ("cross-over"[TIAB] AND "over trial"[TIAB:~3]) OR ("cross-over"[TIAB] AND "over trials"[TIAB:~3]) OR "crossover trial"[TIAB:~3] OR "crossover trials"[TIAB:~3] OR "equivalent study"[TIAB:~3] OR "equivalent trial"[TIAB:~3] OR "equivalent trials"[TIAB:~3] OR intervention[TI] OR "pragmatic study"[TIAB:~3] OR "pragmatic trial"[TIAB:~3] OR "pragmatic trials"[TIAB:~3] OR "randomised cross"[TIAB] OR "randomised crossover"[TIAB] OR "randomized cross"[TIAB:~3] OR "randomized crossover"[TIAB:~3] OR "randomised studies"[TIAB:~3] OR "randomised study"[TIAB:~3] OR "randomised trial"[TIAB:~3] OR "randomised trials"[TIAB:~3] OR "randomized studies"[TIAB:~3] OR "randomized study"[TIAB:~3] OR "randomized trial"[TIAB:~3] OR "randomized trials"[TIAB:~3] OR "stepped wedge"[TIAB] OR ("window opportunity"[tiab:~1] AND trial[tiab]) OR "phase I"[TIAB] OR "phase II"[TIAB] OR "phase III"[TIAB] OR "phase IV"[TIAB] OR "phase 1"[TIAB] OR "phase 2"[TIAB] OR "phase 3"[TIAB] OR "phase 4"[TIAB] OR "single blind"[TIAB] OR "single blinded"[TIAB] OR "single mask"[TIAB] OR "single masked"[TIAB] OR "double blind"[TIAB] OR "double blinded"[TIAB] OR "double mask"[TIAB] OR "double masked"[TIAB] OR "triple blind"[TIAB] OR "triple blinded"[TIAB] OR "triple masked"[TIAB] OR "tripled blinded"[TIAB])


Clinical trials with comparative studies incorporated using "OR" (1 March 2024)

Note: This links comparative studies with terms related to trials.

("Adaptive Clinical Trial" [PTYP:NoExp] OR "Clinical Trial" [PTYP:NoExp] OR "clinical trial, phase i"[PTYP] OR "clinical trial, phase ii"[PTYP] OR "clinical trial, phase iii"[PTYP] OR "clinical trial, phase iv"[PTYP] OR "controlled clinical trial"[PTYP] OR "Equivalence Trial"[PTYP] OR "multicenter study"[PTYP] OR "pragmatic clinical trial"[PTYP] OR "randomized controlled trial"[PTYP] OR "adaptive clinical trials as topic"[MeSH:noexp] OR "Clinical Studies as Topic"[mesh:noexp] OR "Clinical Trials as Topic"[mesh:noexp] OR "clinical trials, phase i as topic"[MeSH:noexp] OR "clinical trials, phase ii as topic"[MeSH:noexp] OR "clinical trials, phase iii as topic"[MeSH:noexp] OR "clinical trials, phase iv as topic"[MeSH:noexp] OR "controlled clinical trials as topic"[MeSH:noexp] OR "Double-Blind Method"[Mesh] OR "early termination of clinical trials"[MeSH:noexp] OR "Equivalence Trials as Topic"[MeSH:noexp] OR "Intention to Treat Analysis"[MeSH:noexp] OR "multicenter studies as topic"[MeSH:noexp] OR "Non-Randomized Controlled Trials as Topic"[MeSH:noexp] OR "Pragmatic Clinical Trials as Topic"[MeSH:noexp] OR "randomized controlled trials as topic"[MeSH:noexp] OR "2 arm"[TIAB] OR "two arm"[TIAB] OR "3 arm"[TIAB] OR "three arm"[TIAB] OR "4 arm"[TIAB] OR "four arm"[TIAB] OR "clinical studies"[TIAB:~3] OR "clinical study"[TIAB:~3] OR "clinical trial"[TIAB:~3] OR "clinical trials"[TIAB:~3] OR "controlled studies"[TIAB:~3] OR "controlled study"[TIAB:~3] OR "controlled trial"[TIAB:~3] OR "controlled trials"[TIAB:~3] OR ("cross-over"[TIAB] AND "over trial"[TIAB:~3]) OR ("cross-over"[TIAB] AND "over trials"[TIAB:~3]) OR "crossover trial"[TIAB:~3] OR "crossover trials"[TIAB:~3] OR "equivalent study"[TIAB:~3] OR "equivalent trial"[TIAB:~3] OR "equivalent trials"[TIAB:~3] OR intervention[TI] OR "pragmatic study"[TIAB:~3] OR "pragmatic trial"[TIAB:~3] OR "pragmatic trials"[TIAB:~3] OR "randomised cross"[TIAB] OR "randomised crossover"[TIAB] OR "randomized cross"[TIAB:~3] OR "randomized crossover"[TIAB:~3] OR "randomised studies"[TIAB:~3] OR "randomised study"[TIAB:~3] OR "randomised trial"[TIAB:~3] OR "randomised trials"[TIAB:~3] OR "randomized studies"[TIAB:~3] OR "randomized study"[TIAB:~3] OR "randomized trial"[TIAB:~3] OR "randomized trials"[TIAB:~3] OR "stepped wedge"[TIAB] OR ("window opportunity"[tiab:~1] AND trial[tiab]) OR "phase I"[TIAB] OR "phase II"[TIAB] OR "phase III"[TIAB] OR "phase IV"[TIAB] OR "phase 1"[TIAB] OR "phase 2"[TIAB] OR "phase 3"[TIAB] OR "phase 4"[TIAB] OR "single blind"[TIAB] OR "single blinded"[TIAB] OR "single mask"[TIAB] OR "single masked"[TIAB] OR "double blind"[TIAB] OR "double blinded"[TIAB] OR "double mask"[TIAB] OR "double masked"[TIAB] OR "triple blind"[TIAB] OR "triple blinded"[TIAB] OR "triple masked"[TIAB] OR "tripled blinded"[TIAB] OR (("comparative study"[PT:NOEXP] OR comparative[TI] OR "comparative analysis"[TIAB:~2] OR "comparative outcome"[TIAB] OR "comparative outcomes"[TIAB] OR "comparative study"[TIAB:~4] OR "compared to"[TIAB] OR "compared with"[TIAB] OR comparing[TI] OR "comparison between"[TI] OR "comparison of"[TI] OR versus[ti] OR vs[ti] OR "superiority analysis"[TIAB:~2]) AND (controlled[TIAB] OR inferiority[TIAB] OR randomised[TIAB] OR randomized[TIAB] OR trial[TI] OR trials[TI])))

Clinical trials: Animals & plants removed

Remove plant and animal studies (updated 1 March 2024)

Without comparative studies

  • It's not possible to remove all plant and animal studies using the NOT-NOT filter at the end of the search statement, but it will remove a significant number of them. Also, as you add other terms/concepts to the search, more of the non-relevant results will be removed.

("Adaptive Clinical Trial" [PTYP:NoExp] OR "Clinical Trial" [PTYP:NoExp] OR "clinical trial, phase i"[PTYP] OR "clinical trial, phase ii"[PTYP] OR "clinical trial, phase iii"[PTYP] OR "clinical trial, phase iv"[PTYP] OR "controlled clinical trial"[PTYP] OR "Equivalence Trial"[PTYP] OR "multicenter study"[PTYP] OR "pragmatic clinical trial"[PTYP] OR "randomized controlled trial"[PTYP] OR "adaptive clinical trials as topic"[MeSH:noexp] OR "Clinical Studies as Topic"[mesh:noexp] OR "Clinical Trials as Topic"[mesh:noexp] OR "clinical trials, phase i as topic"[MeSH:noexp] OR "clinical trials, phase ii as topic"[MeSH:noexp] OR "clinical trials, phase iii as topic"[MeSH:noexp] OR "clinical trials, phase iv as topic"[MeSH:noexp] OR "controlled clinical trials as topic"[MeSH:noexp] OR "Double-Blind Method"[Mesh] OR "early termination of clinical trials"[MeSH:noexp] OR "Equivalence Trials as Topic"[MeSH:noexp] OR "Intention to Treat Analysis"[MeSH:noexp] OR "multicenter studies as topic"[MeSH:noexp] OR "Non-Randomized Controlled Trials as Topic"[MeSH:noexp] OR "Pragmatic Clinical Trials as Topic"[MeSH:noexp] OR "randomized controlled trials as topic"[MeSH:noexp] OR "2 arm"[TIAB] OR "two arm"[TIAB] OR "3 arm"[TIAB] OR "three arm"[TIAB] OR "4 arm"[TIAB] OR "four arm"[TIAB] OR "clinical studies"[TIAB:~3] OR "clinical study"[TIAB:~3] OR "clinical trial"[TIAB:~3] OR "clinical trials"[TIAB:~3] OR "controlled studies"[TIAB:~3] OR "controlled study"[TIAB:~3] OR "controlled trial"[TIAB:~3] OR "controlled trials"[TIAB:~3] OR ("cross-over"[TIAB] AND "over trial"[TIAB:~3]) OR ("cross-over"[TIAB] AND "over trials"[TIAB:~3]) OR "crossover trial"[TIAB:~3] OR "crossover trials"[TIAB:~3] OR "equivalent study"[TIAB:~3] OR "equivalent trial"[TIAB:~3] OR "equivalent trials"[TIAB:~3] OR intervention[TI] OR "pragmatic study"[TIAB:~3] OR "pragmatic trial"[TIAB:~3] OR "pragmatic trials"[TIAB:~3] OR "randomised cross"[TIAB] OR "randomised crossover"[TIAB] OR "randomized cross"[TIAB:~3] OR "randomized crossover"[TIAB:~3] OR "randomised studies"[TIAB:~3] OR "randomised study"[TIAB:~3] OR "randomised trial"[TIAB:~3] OR "randomised trials"[TIAB:~3] OR "randomized studies"[TIAB:~3] OR "randomized study"[TIAB:~3] OR "randomized trial"[TIAB:~3] OR "randomized trials"[TIAB:~3] OR "stepped wedge"[TIAB] OR ("window opportunity"[tiab:~1] AND trial[tiab]) OR "phase I"[TIAB] OR "phase II"[TIAB] OR "phase III"[TIAB] OR "phase IV"[TIAB] OR "phase 1"[TIAB] OR "phase 2"[TIAB] OR "phase 3"[TIAB] OR "phase 4"[TIAB] OR "single blind"[TIAB] OR "single blinded"[TIAB] OR "single mask"[TIAB] OR "single masked"[TIAB] OR "double blind"[TIAB] OR "double blinded"[TIAB] OR "double mask"[TIAB] OR "double masked"[TIAB] OR "triple blind"[TIAB] OR "triple blinded"[TIAB] OR "triple masked"[TIAB] OR "tripled blinded"[TIAB]) NOT ((animals[mesh] OR plants[mesh]) NOT humans[mesh])


Remove plant and animal studies (updated 1 March 2024

With comparative studies

("Adaptive Clinical Trial" [PTYP:NoExp] OR "Clinical Trial" [PTYP:NoExp] OR "clinical trial, phase i"[PTYP] OR "clinical trial, phase ii"[PTYP] OR "clinical trial, phase iii"[PTYP] OR "clinical trial, phase iv"[PTYP] OR "controlled clinical trial"[PTYP] OR "Equivalence Trial"[PTYP] OR "multicenter study"[PTYP] OR "pragmatic clinical trial"[PTYP] OR "randomized controlled trial"[PTYP] OR "adaptive clinical trials as topic"[MeSH:noexp] OR "Clinical Studies as Topic"[mesh:noexp] OR "Clinical Trials as Topic"[mesh:noexp] OR "clinical trials, phase i as topic"[MeSH:noexp] OR "clinical trials, phase ii as topic"[MeSH:noexp] OR "clinical trials, phase iii as topic"[MeSH:noexp] OR "clinical trials, phase iv as topic"[MeSH:noexp] OR "controlled clinical trials as topic"[MeSH:noexp] OR "Double-Blind Method"[Mesh] OR "early termination of clinical trials"[MeSH:noexp] OR "Equivalence Trials as Topic"[MeSH:noexp] OR "Intention to Treat Analysis"[MeSH:noexp] OR "multicenter studies as topic"[MeSH:noexp] OR "Non-Randomized Controlled Trials as Topic"[MeSH:noexp] OR "Pragmatic Clinical Trials as Topic"[MeSH:noexp] OR "randomized controlled trials as topic"[MeSH:noexp] OR "2 arm"[TIAB] OR "two arm"[TIAB] OR "3 arm"[TIAB] OR "three arm"[TIAB] OR "4 arm"[TIAB] OR "four arm"[TIAB] OR "clinical studies"[TIAB:~3] OR "clinical study"[TIAB:~3] OR "clinical trial"[TIAB:~3] OR "clinical trials"[TIAB:~3] OR "controlled studies"[TIAB:~3] OR "controlled study"[TIAB:~3] OR "controlled trial"[TIAB:~3] OR "controlled trials"[TIAB:~3] OR ("cross-over"[TIAB] AND "over trial"[TIAB:~3]) OR ("cross-over"[TIAB] AND "over trials"[TIAB:~3]) OR "crossover trial"[TIAB:~3] OR "crossover trials"[TIAB:~3] OR "equivalent study"[TIAB:~3] OR "equivalent trial"[TIAB:~3] OR "equivalent trials"[TIAB:~3] OR intervention[TI] OR "pragmatic study"[TIAB:~3] OR "pragmatic trial"[TIAB:~3] OR "pragmatic trials"[TIAB:~3] OR "randomised cross"[TIAB] OR "randomised crossover"[TIAB] OR "randomized cross"[TIAB:~3] OR "randomized crossover"[TIAB:~3] OR "randomised studies"[TIAB:~3] OR "randomised study"[TIAB:~3] OR "randomised trial"[TIAB:~3] OR "randomised trials"[TIAB:~3] OR "randomized studies"[TIAB:~3] OR "randomized study"[TIAB:~3] OR "randomized trial"[TIAB:~3] OR "randomized trials"[TIAB:~3] OR "stepped wedge"[TIAB] OR ("window opportunity"[tiab:~1] AND trial[tiab]) OR "phase I"[TIAB] OR "phase II"[TIAB] OR "phase III"[TIAB] OR "phase IV"[TIAB] OR "phase 1"[TIAB] OR "phase 2"[TIAB] OR "phase 3"[TIAB] OR "phase 4"[TIAB] OR "single blind"[TIAB] OR "single blinded"[TIAB] OR "single mask"[TIAB] OR "single masked"[TIAB] OR "double blind"[TIAB] OR "double blinded"[TIAB] OR "double mask"[TIAB] OR "double masked"[TIAB] OR "triple blind"[TIAB] OR "triple blinded"[TIAB] OR "triple masked"[TIAB] OR "tripled blinded"[TIAB] OR (("comparative study"[PT:NOEXP] OR comparative[TI] OR "comparative analysis"[TIAB:~2] OR "comparative outcome"[TIAB] OR "comparative outcomes"[TIAB] OR "comparative study"[TIAB:~4] OR "compared to"[TIAB] OR "compared with"[TIAB] OR comparing[TI] OR "comparison between"[TI] OR "comparison of"[TI] OR vs[ti] OR "superiority analysis"[TIAB:~2]) AND (controlled[TIAB] OR inferiority[TIAB] OR randomised[TIAB] OR randomized[TIAB] OR trial[TI] OR trials[TI]))) NOT ((animals[mesh] OR plants[mesh]) NOT humans[mesh])

Other experimental & quasi-experimental study types

Terms for non-randomized trials/quasi-experimental

To guide vocabulary development, I used the following article:

  • Harris AD, McGregor JC, Perencevich EN, Furuno JP, Zhu J, Peterson DE, Finkelstein J. The use and interpretation of quasi-experimental studies in medical informatics. J Am Med Inform Assoc. 2006 Jan-Feb;13(1):16-23. doi: 10.1197/jamia.M1749. Epub 2005 Oct 12. PMID: 16221933; PMCID: PMC1380192.

"Controlled Before-After Studies"[Mesh:NoExp] OR "Interrupted Time Series Analysis"[Mesh:NoExp] OR (("before after"[TIAB:~2] AND intervention[TIAB])) OR "interrupted time"[TIAB] OR "non randomised"[TIAB:~1] OR "non randomized"[TIAB:~1] OR nonequivalent[TIAB] OR nonrandomised[TIAB] OR nonrandomized[TIAB] OR ("one group"[TIAB] AND ("post test"[TIAB] OR "pre test"[TIAB] OR pretest[TIAB] OR posttest[TIAB])) OR ((pretest[TIAB] OR ("pre intervention"[TIAB:~4] OR "pre posttest"[TIAB:~4] OR "pre test"[TIAB:~4])) AND (posttest[TIAB] OR "post intervention"[TIAB:~4] OR "post test"[TIAB:~4])) OR "pretest posttest"[TIAB:~4] OR quasiexperimental[TIAB] OR "quasi experimental"[TIAB:~1] OR ("single group"[TIAB:~1] AND "group study"[TIAB:~1]) OR "uncontrolled studies"[TIAB:~1] OR "uncontrolled study"[TIAB:~1]


Comparative studies (updated 1 March 2024)

NLM scope note:

  • “Comparison of outcomes, results, responses, etc for different techniques, therapeutic approaches or other inputs”

One could argue that clinical trials, by definition, are comparative studies, even if the comparison is against a placebo or sham, so figuring out the right terms is complicated. Consider this a high-yield start to a search filter with probably a somewhat lower sensitivity (we're guessing ~80%) and higher specificity. Also note that comparative studies can be experimental or not.

There are currently 2 versions as we continue testing:

Limit to trials: reduces the number of observational studies

("comparative study"[PT:NOEXP] OR comparative[TI] OR "comparative analysis"[TIAB:~2] OR "comparative outcome"[TIAB] OR "comparative outcomes"[TIAB] OR "comparative study"[TIAB:~4] OR "compared to"[TIAB] OR "compared with"[TIAB] OR comparing[TI] OR "comparison between"[TI] OR "comparison of"[TI] OR vs[ti] OR "superiority analysis"[TIAB:~2]) AND (randomised[TIAB] OR randomized[TIAB] OR trial[TI] OR trials[TI]) 

Without limiting to trials: much broader

("comparative study"[PT:NOEXP] OR comparative[TI] OR "comparative analysis"[TIAB:~2] OR "comparative outcome"[TIAB] OR "comparative outcomes"[TIAB] OR "comparative study"[TIAB:~4] OR "compared to"[TIAB] OR "compared with"[TIAB] OR comparing[TI] OR "comparison between"[TI] OR "comparison of"[TI] OR versus[ti]  OR vs[ti] OR "superiority analysis"[TIAB:~2])


Program evaluation/quasi-experimental studies (Updated 22 March 2024)

Use the trials filter for experimental studies.

(evaluation study[PT:NOEXP] OR "evaluation studies as topic"[MESH:NOEXP] OR "program evaluation"[MESH:NOEXP] OR "reproducibility of results"[MESH:NOEXP] OR validation study[PT:NOEXP] OR "validation studies as topic"[MESH:NOEXP] OR "pre post"[TIAB:~5] OR "pretest posttest"[TIAB:~5] OR ("intervention effectiveness"[TIAB:~4] OR "intervention evaluate"[TIAB:~4] OR "intervention evaluated"[TIAB:~4] OR "intervention evaluates"[TIAB:~4] OR "intervention evaluating"[TIAB:~4] OR "intervention evaluation"[TIAB:~4] OR "intervention evaluations"[TIAB:~4] OR "intervention evaluator"[TIAB:~4] OR "intervention evaluators"[TIAB:~4] OR "intervention reliability"[TIAB:~4] OR "intervention reproducibility"[TIAB:~4] OR "intervention validity"[TIAB:~4] OR ("before after"[TIAB:~2] AND intervention[tiab]) OR "program effectiveness"[TIAB:~4] OR "program evaluate"[TIAB:~4] OR "program evaluated"[TIAB:~4] OR "program evaluates"[TIAB:~4] OR "program evaluating"[TIAB:~4] OR "program evaluation"[TIAB:~4] OR "program evaluations"[TIAB:~4] OR "program evaluator"[TIAB:~4] OR "program evaluators"[TIAB:~4] OR "program reliability"[TIAB:~4] OR "program reproducibility"[TIAB:~4] OR "program validity"[TIAB:~4] OR "programs effectiveness"[TIAB:~4] OR "programs evaluate"[TIAB:~4] OR "programs evaluated"[TIAB:~4] OR "programs evaluates"[TIAB:~4] OR "programs evaluating"[TIAB:~4] OR "programs evaluation"[TIAB:~4] OR "programs evaluations"[TIAB:~4] OR "programs evaluator"[TIAB:~4] OR "programs evaluators"[TIAB:~4] OR "programs reliability"[TIAB:~4] OR "programs reproducibility"[TIAB:~4] OR "programs validity"[TIAB:~4] OR ("quasi experimental"[TIAB] AND ("experimental effectiveness"[TIAB:~4] OR "experimental evaluate"[TIAB:~4] OR "experimental evaluated"[TIAB:~4] OR "experimental evaluates"[TIAB:~4] OR "experimental evaluating"[TIAB:~4] OR "experimental evaluation"[TIAB:~4] OR "experimental evaluations"[TIAB:~4] OR "experimental evaluator"[TIAB:~4] OR "experimental evaluators"[TIAB:~4] OR "experimental reliability"[TIAB:~4] OR "experimental reproducibility"[TIAB:~4] OR "experimental validity"[TIAB:~4]))))


Quality improvement (Updated 22 March 2024)

QI studies are hard to categorize as some will be randomized trials, some are pre-post studies, and some are continuous improvement projects. The article below describes the life cycle of a QI project.

  • Likosky DS. Developing and executing quality improvement projects (concept, methods, and evaluation). J Extra Corpor Technol. 2014 Mar;46(1):38-44. PMID: 24779118; PMCID: PMC4557509.

(("Quality Improvement"[Mesh] OR "implementation research"[TIAB] OR "improve quality"[TIAB] OR "improving quality"[TIAB] OR "knowledge translation"[TIAB] OR "lean methodology"[TIAB:~2] OR "lean principles"[TIAB:~2] OR "lean tools"[TIAB:~2] OR "pay for performance"[TIAB] OR "performance improvement"[TIAB] OR "quality assurance"[TIAB] OR "quality improvement"[TIAB] OR "quality improvements"[TIAB] OR "quality indicator"[TIAB] OR "quality indicators"[TIAB] OR "quality measure"[TIAB] OR "quality measures"[TIAB] OR "quality metric"[TIAB] OR "quality metrics"[TIAB] OR ("rapid cycle"[TIAB:~0] AND ("cycle change"[TIAB:~0] OR "cycle changes"[TIAB:~0])) OR "report card"[TIAB] OR "right care"[TIAB] OR "six sigma"[TIAB] OR ("six sigma"[TIAB:~1] AND quality[tiab]) OR squire[TIAB]))