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Keywords matter

A critical factor in getting published work discovered

Pearce, Patricia F. MPH, PhD, FNP-BC, FAANP, FNAP (Professor)1; Hicks, Rodney W. PhD, RN, FNP-BC, FAAN, FAANP (Assistant Dean for Administration and Research, Professor)2; Pierson, Charon A. PhD, GNP, FAAN, FAANP (Executive Editor, JAANP)

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Journal of the American Association of Nurse Practitioners: April 2018 - Volume 30 - Issue 4 - p 179-181
doi: 10.1097/JXX.0000000000000048
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Nurse practitioner authors are scholars who make meaningful contributions to the science of advanced practice nursing. Advancing the science requires disseminating scholarly works in order that other scholars can read, contemplate, and integrate findings and create and disseminate new works. An important tool available to scholars and integral to the process of advancing knowledge is the use of Keywords. Keywords matter! Keywords are increasingly critical in everyday life, and most especially in publications. Keywords are critical triggers for the discovery and use of scholarly publications. With increasing dependency on electronic databases of scholarly work, such as PubMed (PubMed/National Library of Medicine, 2018) and CINAHL (CINAHL, 2018), the use of keywords is pivotal in electronic searches of the literature (Facchiano & Snyder, 2012; George, Ferguson, & Pearce, 2014). Keywords are notably linked in abstracts and represent terms that are used precisely throughout the abstract and manuscript (National Information Standards Organization [NISO], 2015; Pearce & Ferguson, 2017; Pierson, 2016). Every new project or research endeavor typically begins with a keyword search and ends with selecting appropriate keywords that link back to the dissemination of the new work as well (George et al., 2014). The purpose of this editorial is to provide a definition of the term “keyword,” highlight the importance of keywords, provide examples and emphasize the precision needed to select keywords, and provide options for leveraging keywords to best highlight an author's work.

Definition of keyword

Keywords are the primary terms, or index descriptors, used to identify and highlight the article's salient points. Keywords are the search terms included in a manuscript and tagged in electronic systems to link the published work for searchers. Keywords are usually made up of a single word (e.g., nurse, diabetes) or coupled words or phrase (e.g., nurse practitioner, diabetes mellitus, cardiovascular disease). Terms can reflect substance (e.g., disease or situation), process (e.g., research design, project method), populations of interest (e.g., adolescents, elderly), or theory base or conceptual foundations (e.g., Mishel Theory of Uncertainty, Diffusion of Innovation, and Health Belief Model). Keywords are generally required by the publisher and are submitted with an abstract (Pearce & Ferguson, 2017) and manuscript for publication. The use of multiple keywords for a manuscript is most common practice, and the terms are best used as repeated terms throughout the abstract and manuscript (NISO, 2015; Pearce & Ferguson, 2017; Pierson, 2016). Assuring repetition of relevant terms throughout every aspect of the publication assists with database search location and dissemination. Because of the structure of manuscript development and publication processes, the author has predominant capability and responsibility to influence keyword use in a manuscript and should assure integration of relevant keywords through the writing process. The author controls the use of terms in generating the manuscript, editors and publishers add keywords in review and publishing period, and indexing agencies (e.g., PubMed, CINAHL) add keywords following publication. In JAANP articles in 2016, there was an average of five keywords (SD = 1.2) included for each published article. The number of terms assigned is not limited in indexing in PubMed (U. S. National Library of Medicine, 2018b) or in CINAHL (CINAHL, 2018).

The U.S. National Library of Medicine (2015) uses keywords drawn from a controlled vocabulary thesaurus known as Medical Subject Headings or MeSH listing (U. S. National Library of Medicine, 2018a). Indexing in CINAHL (2018) follows similar MeSH patterns as in PubMed (2018). Such controlled vocabulary allows for a hierarchical approach to organize keywords that range from very general to highly specific. The control also allows for new terms to be added as needed, while retaining the history and evolution of the terms. The thesaurus approach allows mapping between words to yield a consistent descriptor. For example, “Vitamin B6” would map to “pyridoxine,” thus a search using either term would lead to the articles indexed with either term. The MeSH term “nurse practitioner” maps to “nurse practitioner,” “family nurse practitioner,” and “pediatric nurse practitioner,” but no other type of nurse practitioner. Thus, any article using the keyword “nurse practitioner” would be mapped to only those terms. Other organizations with publication indexes often generate their own controlled terms. Moving from index to index can be challenging, but it is useful to understand the terms and their use. Research librarians are highly educated and experienced in navigating the differences between controlled vocabularies.

Google and Google Scholar searches are increasingly used by searchers to explore what is available for a topic, and like PubMed and CINAHL, are based, linked, or tagged to a published work and are activated with proprietary algorithms. Searches in Google provide a great start in exploring the literature but result in far too much information for the searcher to sort through reasonably. Currently, the searches in Google cannot be honed as finely as searches in systems with controlled vocabularies with assigned keywords and MeSH headings. In addition, commercial sites are included in Google searches. For example, searching for scholarly work on the topic of “Vitamin B6 (Pyridoxine)” would produce sales of the vitamin, dictionary definitions, self-help sites, over-the-counter options for purchasing, pictures of packaging, and essentially pages and pages of websites linked to the terms. Attempting to locate scholarly articles published on the use of Vitamin B6 in the search results would be a time-consuming endeavor. Information varies in GoogleScholar and has some overlap with PubMed and CINAH. Google Scholar is more refined than Google itself, and search terms can be finessed for a more precise search but with limitations in keyword use. Searches in GoogleScholar will provide results that are more scholarly than in Google, and that include other than health and science articles (Younger, 2016).

Importance of accurate keywords

Accurate keywords are critical to support the discovery of the published literature, but the function of keywords varies from the perspective of the author, the publisher, and the end user. Today most literature searches are performed electronically. Thus, the discovery of published articles is possible through electronic databases that use controlled vocabularies. Benefits of an electronic search lie in the rapid ability to examine large volumes of sometimes disparate information and locate specific information of interest. Authors are in the best position to identify the most appropriate keywords to represent the manuscript being published; thus, authors set the stage for having others discover their work (NISO, 2015; Pearce & Ferguson, 2017; Pierson, 2016). Editors and indexing staff evaluate relevance of keywords provided by authors, but also add additional keywords in the process of publishing. Further keywords are added in indexing, such as in PubMed. Results for searchers will be more precise and relevant with a tightly crafted list of keywords.

Learning to leverage keywords

Exploring the MeSH heading information in PubMed is a first step in understanding keywords and their mappings and is best accompanied by looking at keywords in published journal articles. A highly useful tutorial is available online at start understanding MeSH terms as keywords (U. S. National Library of Medicine, 2018b). Three of the mechanisms for exploring include a MeSH browser that supports searching in multiple ways on any one term, which is useful for understanding term history and mapping. There is a new “MeSH on Demand” mechanism programmed to match MeSH terms with words in the submitted abstract and provide that information to the person requesting the information in the MeSH on Demand system (U. S. National Library of Medicine, 2018c). The hierarchical tree of MeSH headings is also available and useful in understanding the overall categories for MeSH headings (navigate from treetop is listed also as link at the top of the browser page) (U. S. National Library of Medicine, 2018d). Exploring the MeSH listings is one of the best ways to learn about MeSH headings as keywords for published work, to help understand the importance of using keywords, and to develop skill in identifying keywords for manuscripts. Developing a sense of the keywords listed in existing published articles is helpful in learning more about how to leverage keywords in publication. The keywords listed in a publication combine the authors' keyword selections, editor and publishing staff additions, and those keywords added when indexed in databases such as PubMed and CINAHL. When developing a manuscript for publication, the keywords used in the citations included in the manuscript for publication are excellent indicators of keywords that might be used for the manuscript in progress. Any experience at reviewing keywords, searching for literature, and understanding the use of controlled vocabularies in indexes like PubMed and CINAHL will heighten an author's skill in use of keywords. The more exploration, the better the understanding of keywords, and the more useful the information will become.


Embrace keywords in your work. Precise and appropriate use of keywords by scholars leads the way for information searchers to locate relevant published manuscripts, to pin down the categories of work for others to see, and to assure discoverability of their work. Moving science ahead is an imperative for all; thus, enhancing the probability of discovery of published work is critical. Discovery is required for any work to be used. Every journal requires identification of keywords by authors, and often additional keywords are added to manuscripts by editors or others involved in publishing activities. Authors have the capacity to refine the keywords relevant to their work and work together with editors and staff in developing keyword use for maximal discovery in electronic searches.


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