Comparison of top-performing strategies for detecting clinically sound treatment studies and systematic reviews in MEDLINE and EMBASE

School of Nutrition, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3 Canada.
Journal of the Medical Library Association JMLA (Impact Factor: 0.99). 11/2006; 94(4):451-5.
Source: PubMed

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    • "We designed and applied the search strategy using sensitivity criteria potentially capturing RCTs of vit D use in both breast cancer prevention and treatment. To this aim, we combined terms for vit D and cancer (Appendix 1) with search filters for RCTs [25]. We also screened the references of included studies and used the “Related Article” feature in PubMed to identify additional articles. "
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    ABSTRACT: In recent years, the scientific evidence linking vitamin D status or supplementation to breast cancer has grown notably. To investigate the role of vitamin D supplementation on breast cancer incidence, we conducted a systematic review and meta-analysis of randomized controlled trials comparing vitamin D with placebo or no treatment. We used OVID to search MEDLINE (R), EMBASE and CENTRAL until April 2012. We screened the reference lists of included studies and used the "Related Article" feature in PubMed to identify additional articles. No language restrictions were applied. Two reviewers independently extracted data on methodological quality, participants, intervention, comparison and outcomes. Risk Ratios and 95% Confident Intervals for breast cancer were pooled using a random-effects model. Heterogeneity was assessed using the I(2) test. In sensitivity analysis, we assessed the impact of vitamin D dosage and mode of administration on treatment effects. Only two randomized controlled trials fulfilled the pre-set inclusion criteria. The pooled analysis included 5372 postmenopausal women. Overall, Risk Ratios and 95% Confident Intervals were 1.11 and 0.74-1.68. We found no evidence of heterogeneity. Neither vitamin D dosage nor mode of administration significantly affected breast cancer risk. However, treatment efficacy was somewhat greater when vitamin D was administered at the highest dosage and in combination with calcium (Risk Ratio 0.58, 95% Confident Interval 0.23-1.47 and Risk Ratio 0.93, 95% Confident Interval 0.54-1.60, respectively). In conclusions, vitamin D use seems not to be associated with a reduced risk of breast cancer development in postmenopausal women. However, the available evidence is still limited and inadequate to draw firm conclusions. Study protocol code: FARM8L2B5L.
    PLoS ONE 07/2013; 8(7):e69269. DOI:10.1371/journal.pone.0069269 · 3.23 Impact Factor
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    • "EMBASE covers pharmacology, pharmaceutical science and clinical research as its main areas of interest. In comparison with MEDLINE, it provides more extensive coverage of European and non-English language publications [10] as well as conference abstracts [9]. "
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    ABSTRACT: Background Medications are frequently prescribed outside their regulatory approval (off-label) by physicians particularly where appropriate therapies are not available. However, the risk/benefit ratio of drugs in off-label use needs to be critically appraised because it may differ from approved on-label usage. Therefore, an extensive exploration of current evidence on clinical data is well-advised. The objective of this study was to develop a search strategy that facilitates detection of the off-label drug use documents in EMBASE via OvidSP. Methods We constructed two sets of gold standards from relevant records to off-label drug use by a sensitive search of MEDLINE and EMBASE. Search queries, including search words and strings, were conceived based on definition of off-label use of medications as well as text analysis of 500 randomly selected relevant documents. The selected terms were searched in EMBASE (from 1988 to 2011) and their retrieval performance was compared with the gold standards. We developed a sensitivity-maximizing, and a sensitivity- and precision-maximizing search strategy. Results From 4067 records relevant to off-label drug use in our full gold standard set, 3846 records were retrievable from EMBASE. “off label*.af.” was the most sensitive single term (overall sensitivity 77.5%, sensitivity within EMBASE 81.9%, precision 88.1%). The highest sensitive search strategy was achieved by combining 36 search queries with overall sensitivity of 94.0% and precision of 69.5%. An optimal sensitive and precise search strategy was yielded precision 87.4% at the expense of decreasing overall sensitivity to 89.4%. Conclusion We developed highly sensitive search strategies to enhance the retrieval of studies on off-label drug use in OvidSP EMBASE.
    BMC Medical Research Methodology 12/2012; 12(1):190. DOI:10.1186/1471-2288-12-190 · 2.27 Impact Factor
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    • "For PubMed, the filter "Therapy/Narrow[filter]," which is accessed via the PubMed interface [24], is used for the precise search. In EMBASE, the precise filter "high specificity strategies" developed by McMaster University's Health Information Research Unit [25] can be accessed via Ovid. "
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    ABSTRACT: Over the past few years, information retrieval has become more and more professionalized, and information specialists are considered full members of a research team conducting systematic reviews. Research groups preparing systematic reviews and clinical practice guidelines have been the driving force in the development of search strategies, but open questions remain regarding the transparency of the development process and the available resources. An empirically guided approach to the development of a search strategy provides a way to increase transparency and efficiency. Our aim in this paper is to describe the empirically guided development process for search strategies as applied by the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, or "IQWiG"). This strategy consists of the following steps: generation of a test set, as well as the development, validation and standardized documentation of the search strategy. We illustrate our approach by means of an example, that is, a search for literature on brachytherapy in patients with prostate cancer. For this purpose, a test set was generated, including a total of 38 references from 3 systematic reviews. The development set for the generation of the strategy included 25 references. After application of textual analytic procedures, a strategy was developed that included all references in the development set. To test the search strategy on an independent set of references, the remaining 13 references in the test set (the validation set) were used. The validation set was also completely identified. Our conclusion is that an objectively derived approach similar to that used in search filter development is a feasible way to develop and validate reliable search strategies. Besides creating high-quality strategies, the widespread application of this approach will result in a substantial increase in the transparency of the development process of search strategies.
    Systematic Reviews 02/2012; 1(1):19. DOI:10.1186/2046-4053-1-19
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