Writing strategies for improving the access of medical literature

Table 1 Disadvantages of Medical Subject Headings

Disadvantages of MeSH
1 MeSH terms are manually assigned to articles after an article is made available on PubMed. Manually assigned MeSH terms are not available for recently published articles. This is a time-consuming process, and hence, these articles fail to appear in search results when only MeSH terms are used for searching
2 In a scenario where no appropriate MeSH term is found while searching for a concept, it becomes important to search for relevant words in the title and abstract as well
3 Mesh search allows us to restrict our PubMed search to only find articles where the MeSH term is the main topic. In this way, articles in which the term and any selected subheadings are indexed as a major topic are displayed. For example, searching for "mechanical ventilation"[Majr] will exclude articles where this topic is covered to a lesser extent from the search results
4 Since PubMed only contains abstracts of articles, not full texts, searching the entire article for words is not possible with the use of MeSH
5 Sometimes, PubMed might fail to automatically match the exact MeSH term with the search
6 Additionally, some readers might not be comfortable using Boolean operators and logic. Boolean operators are not recognized by all databases, and the availability of all operators in a database might also be questionable
7 Moreover, databases also differ in their way of using syntax to enter a Boolean operator. For example, in Scopus, “NOT” is entered as “AND NOT.”
8 Certain databases or search systems do not affect search results based on whether the terms are entered in uppercase or lowercase, but some engines like Google Scholar may require capitalized Boolean operators for proper functioning

MeSH: Medical Subject Headings.

Table 2 Search engine optimization strategies and corresponding adapted medical writing strategies

S. No.	SEO strategies	Corresponding medical writing strategies
1	Backlinks to share link equity	1 Citations of articles that enhance the credibility of articles
		2 Blog about the article on forums like WordPress and link to it
		3 Diversified media coverage, including social media articles linking the article, podcasts, and videos
		4 Use opportunities to target different web areas like YouTube, podcast portals, social media, blogging portals, news, etc.
2	Organizing information into categories, pages, and subpages on a website and linking them to each other is called site architecture or information architecture	Have impactful headings using keywords within the headings
3	The flatter the site’s structure is (requiring a lesser number of clicks to reach the desired information), the better its opportunity to rank well	MeSH terms and keywords search a manuscript by searching its abstract. Also, the abstract is commonly the only publicly available resource of an article, making it easily searchable for those on Google. Hence, incorporate critical keywords in the abstract of the article
4	The title tag is the most important on-page element to optimize for keywords, so the post has the best chance of ranking for a given keyword if that keyword appears at the beginning of the title tag (often the post headline). Also, make sure other posts linking to this one use this keyword as their link text (what SEOs call “anchor text”)	Incorporate keywords in the title of the article. Give it some thought and brainstorm with the writing team about what keywords a potential researcher will search for. Use alternative terms and broader terms throughout the text to describe the concepts the authors are writing about because too specific terms may not filter in the search method
5	An average user looks at two things before opening a webpage: headlines and meta descriptions. The latter is always displayed below the webpage title in Google search results. Search engines highlight keywords in the meta description, thus making it a genuine call-to-action booster—it encourages people to click the link and check out the content	Meta description corresponds to the abstract of the article, particularly the objective and the initial three to four sentences
6	Carefully-designed keyword strategies to make more impact on Google’s search engine algorithms	Research and integrate MeSH terms and keywords
7	Any time someone visits the website, we want them to have a positive user experience and engage with the site content	Lucid story-telling and point-to-point writing methodology
8	Visuals: when setting up pages, it is important to ensure that the pictures are always readable. “Alt” tags provide valuable details for the target audience. Google cannot understand images solely as image files	Explain the paper and integrate good-quality images and tables. Develop “at-a-glance” infographics covering key messages on the manuscript in a snapshot. Utilize digital designers, draw on easy digital tools like procreate, or hand draw and scan high-resolution images and convert them digitally to digitized images. Purchase editable vector images and templates. Determine figure legends judiciously, incorporating the keywords and MeSH terms, so their searchability is enhanced on Google Images
9	Internal linking is one of the SEO fundamentals that influence the dwell time of the target audience on the page	Generate the interest of the readers and direct them to various sections of the article by numbering the sections and structuring the topic well to enhance the time they spend on the page and article

MeSH: Medical Subject Headings; SEO: Search engine optimization.