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© 2016 The Royal College of Midwives. Evidence Based Midwifery 14(1): 29-34 29
Mc Elhinney H, Taylor B, Sinclair M, Holman MR. (2016) Sensitivity and specificity of electronic databases: the example
of searching for evidence on child protection issues related to pregnant women. Evidence Based Midwifery 14(1): 29-34
Sensitivity and specificity of electronic databases: the example
of searching for evidence on child protection issues related to
pregnant women
Helena Mc Elhinney1 MSc, BSc. Brian Taylor2 Phd, PGCert, PGDip, BSc. Marlene Sinclair3 Phd, RM, RN, RNT. Mary Rose
Holman4 MSc, BA, PGChep.
1. PhD student, Institute of Nursing and Health Research, Maternal Fetal and Infant Research Centre, Ulster University, Belfast BT37 0QB Northern Ireland.
Email: mc_elhinney-h@email.ulster.ac.uk
2. Professor of social work, Institute for Research in Social Sciences, Ulster University, Belfast BT37 0QB Northern Ireland. Email: bj.taylor@ulster.ac.uk
3. Professor of midwifery research, Institute of Nursing and Health Research, Maternal Fetal and Infant Research Centre, Ulster University, Belfast BT37 0QB Northern
Ireland. Email: m.sinclair1@ulster.ac.uk
4. Subject assistant librarian, Life and Health Sciences, Ulster University, Belfast BT37 0QB Northern Ireland. Email: mr.holman@ulster.ac.uk
The authors would like to acknowledge the PhD scholarship received by Helena Mc Elhinney from the Department of Employment and Learning in Northern Ireland.
Abstract
Background. There are increasing demands on health and social care (HSC) professionals to make decisions based on best
evidence to inform their practice. To do this, they must be skilled in searching the literature. A robust approach to literature
reviewing that results in optimal outcomes is highly desirable in a climate where time and resources are limited.
Aim. This paper explores the processes of undertaking a structured literature search and measuring the effectiveness of five
commonly used health and social care databases.
Method. A review question was posed using the qualitative version of PICO (Population, Interest, Context and Outcome): ‘How
do HSC professionals (P) make decisions (I) in relation to pregnant women (C) where there is a safeguarding concern (O) regarding
an unborn child?’ Databases selected for review were: ASSIA, CINAHL Plus, Ovid MEDLINE, PsycINFO and Social Care Online.
Searches were undertaken from October 2014 to April 2015. A rapid update was undertaken in March 2016 prior to publication.
Papers were screened for their suitability for inclusion using a screening tool developed by the research team. Papers were required
to report empirical research; to have been published in peer-reviewed journals, as an indicator of a measure of quality; and to be
available in the English language. Full-text papers were chosen if the data were gathered from or about decision-making regarding
safeguarding in pregnancy by midwives, nurses, social workers and professional managers. The quality of the chosen databases
was determined by sensitivity (capacity to retrieve a satisfactory number of papers), precision (to prevent the retrieval of too many
irrelevant papers) and Numbers Needed to Read (NNR) – number of papers needed to read to find one paper to include.
Results. A total of 866 papers were identified, titles and abstracts were reviewed by the researcher and full-text papers were
further reviewed by the research team, both using a screening tool. These results were discussed and nine papers were identified
for review. Sensitivity was greatest on CINAHL Plus and Ovid MEDLINE. Precision scores were generally low; CINAHL Plus
scored the highest at 4%. CINAHL Plus was found to be most effective with an NNR score of 26%, followed by PsycINFO with
an NNR score of 36% and Ovid MEDLINE was the lowest precision with an NNR score of 45%.
Implications. The challenges of robust searching for literature indicate that if evidence-based practice is to become a reality,
regular training for midwives, social workers and other healthcare professionals in database searching is essential
Key words: Search methodology, systematic literature searching, sensitivity and precision, decision-making, child safeguarding,
pregnancy, evidence-based midwifery
Introduction
This paper discusses the methodology for searching the
literature to retrieve papers using an example of professional
decision-making around child safeguarding in pregnancy.
It specifically focuses on sensitivity and precision measures
of database quality, appropriateness and effectiveness of
the search strategy and its ability to be replicated by future
researchers in this area of study (Taylor et al, 2007). With the
increasing demand on midwives and social workers to make
decisions based more explicitly on best evidence, effective and
efficient strategies need to be available to facilitate access to
online resources for research (Beall, 2007).
Background
Service provision is grounded in a solid foundation of
evidence-based practice. The term ‘evidence-based practice’
indicates the quality, robustness or validity of evidence
and is applied to current issues within the health service
(Hoagwood et al, 2001). The importance of combining
clinical and research knowledge is imperative in professional
decision-making in order to deliver effective services or
indeed improve current service provision (McCullough et
al, 2014) as many research questions emerge from clinical
practice issues (Polit and Tatano Beck, 2014).
There is growing demand on those in the health and social
care professions to further develop their skills in collating,
synthesising and critiquing information for the advancement
of their profession and for use within clinical practice (Rees,
2011). There is increasing pressure from government,
taxpayers and managers of health and social care services for
evidence of money well spent and efficient delivery of services
(Taylor and Campbell, 2011). Both the code (NMC, 2015)
30 © 2016 The Royal College of Midwives. Evidence Based Midwifery 14(1): 29-34
Mc Elhinney H, Taylor B, Sinclair M, Holman MR. (2016) Sensitivity and specificity of electronic databases: the example
of searching for evidence on child protection issues related to pregnant women. Evidence Based Midwifery 14(1): 29-34
for midwives and nurses and the code of ethics for social
work (BASW, 2012) for social workers make it clear that
professionals are responsible for maintaining and improving
their knowledge, skills and practice and must act with the
best evidence possible at that time. Therefore, there is an
assumption that all professionals should learn core skills,
such as literature searching of databases, and regularly
update their knowledge in this area.
In the process of undertaking scientifically robust research,
careful consideration must be given to analysing the evidence
that exists within the literature. A systematic approach to
literature searching has the potential to provide robust data
and this evidence will subsequently inform clinical practice
(Taylor et al, 2007). This approach must be undertaken
in an unambiguous, transparent and replicable manner,
beginning with a comprehensive literature search strategy
(Arthur et al, 2012). Careful scrutiny of the literature will
aid in the identification of the body of knowledge that
currently exists on a topic and also highlight the gaps where
further investigation is needed (Ford and Pearce, 2010).
However, the enormity of this task should not be
underestimated. The advancement of technology has seen a
move away from the use of traditional print journals towards
journals based on electronic bibliographic databases that are
accessible online (Best et al, 2014). Ironically, accessibility of
journals may be improved through their availability online
but the process of identifying and wading through material
can be time consuming, and a daunting task (Rowley and
Johnson, 2013). This requires a skilled researcher, librarian
or search coordinator with a carefully designed search
strategy and the ability to identify the relevant papers from
those that are irrelevant (Creaser et al, 2006).
Method
Data sources
In consultation with a subject librarian at the university,
five electronic databases (ASSIA, CINAHL Plus, Ovid
MEDLINE, PsycINFO and Social Care Online) were
accessed for the purpose of this study. All databases
provide abstracts of journal papers to professions including
midwifery/nursing and social work, academia and managers
and were deemed appropriate for use with this study
topic. CINAHL Plus, Ovid MEDLINE and PsycINFO use
individualised controlled vocabulary thesaurus for indexing
papers. CINAHL Plus (subject headings which are adapted
from Medical Subject Headings (MeSH), Ovid MEDLINE
(MeSH) and PsycINFO (American Psychological Association
(APA) thesaurus of Psychological Index Terms).
ASSIA and Social Care Online use phrase searching and
are aimed at those in social science. Nevertheless, using a
wide variety of databases ensures a comprehensive search
across both professions (Finfgeld-Connett and Johnson,
2013). To compete with health and social care (HSC)
professionals’ time demands, it is crucial that a search
undertaken in these databases produces relevant papers in
a replicable approach. Good sensitivity (retrieving a high
number of relevant papers from a database) and good
precision (low number of irrelevant papers retrieved) scores
depend upon the researcher’s ability to design an effective
search strategy, the effectiveness of the indexing against
the thesaurus, the number of journals abstracted and how
well the database supports the searchers in their searching
(Taylor et al, 2007). High sensitivity and precision scores are
indicative of an effective search strategy which emphasises
the importance of securing this from the outset (Lee et
al, 2012).
The majority of journal papers, PhD theses and research
reports rest on a foundation of a solid review undertaken
of previous literature to ascertain gaps in knowledge that
also informs evidence-based practice within the HSC
setting (Taylor et al, 2007). The Cochrane and Campbell
Collaboration reviews focus on questions of effectiveness
and mainly on research designs that are experimental in
nature. However, different types of research questions,
similar to this study on decision-making, require different
study designs. The methodology and systems for identifying
studies, appraising quality and synthesis are not as well
developed as they are for questions of effectiveness. This
paper hopes to complement existing knowledge by adding
an additional layer of scrutiny to the process, which includes
sensitivity and precision measurements of databases.
Search question
Prior to choosing appropriate databases, it is important to
have a clear review question using the PICO framework.
This framework is used to structure clinical questions
for systematic review and to increase the likelihood of
retrieving papers which are relevant to the question (Schardt
et al, 2007). There are two versions of PICO, depending
upon whether the search is for qualitative or quantitative
reviews. Searching for quantitative studies uses the Patient,
Intervention, Comparison and Outcome (PICO) version.
However, the qualitative version, Population, Interest,
Context and Outcome (PICO) was used to frame the search
question for this paper (Lewensen and Truglio-Londrigan,
2015). Consequently, the question was framed as ‘How
do HSC professionals (P) make decisions (I) in relation to
pregnant women (C) where there is a safeguarding concern
(O) regarding an unborn child?’
Inclusion criteria for search
This paper focuses on the rigour of the searching process
but does not include the synthesis of literature to create a
systematic narrative review on the search question posed.
Predetermined criteria were established for the purpose of
this. Papers retrieved from this search were screened for their
suitability for inclusion using a screening tool developed by
the research team. Papers were required to report empirical
research; to have been published in peer-reviewed journals as
an indicator of a measure of quality (Best et al, 2014); and
to be available in the English language. Full-text papers were
chosen if the data were gathered from or about decision-
making regarding safeguarding in pregnancy by midwives,
nurses, social workers and professional managers. Papers
focusing on the risk factors identified by professionals’ child
safeguarding in pregnancy were excluded. In addition, papers
© 2016 The Royal College of Midwives. Evidence Based Midwifery 14(1): 29-34 31
that focused on assessment tools used in practice to assess the
risk of harm to an unborn child were also excluded.
Selection of databases
In the process of systematically identifying and retrieving
literature, it is recommended that more than one database
should be used to ensure a comprehensive and rigorous
search process (Whiting et al, 2008). Five academic and
professional databases were chosen in consultation with
an experienced subject librarian for use within this review.
Applied Social Sciences and Abstracts (ASSIA), Cumulative
Index of Nursing and Allied Health Literature (CINAHL)
Plus, Ovid MEDLINE, PsycINFO and Social Care Online.
These databases were selected based on their availability at
the university and their suitability to capture the relevant
subject fields as indexing of papers varies between databases.
Papers retrieved from CINAHL Plus, PsycINFO and Ovid
MEDLINE are indexed using either Medical Subject Headings
(MeSH), an adaptation of MEDLINE (MeSH) or APA
Thesaurus of Psychological Index Terms. However, searches
within ASSIA and Social Care Online, which do not have an
indexing system, relied heavily upon retrieving papers through
the use of relevant phrase searching. All these databases are
large interdisciplinary international databases, available in
both the UK and the US. CINAHL Plus, Ovid MEDLINE and
PsycINFO include papers from the professions of psychology,
nursing and medicine and ASSIA and Social Care Online
(provided by the Social Care Institute for Excellence) include
papers from social care and social work. A piloting exercise
to test and refine the search formula was undertaken which
revealed sufficient numbers of papers were available.
Search formulae and filters
The use of Boolean operators within the search forms
relationships between concepts or words for the purpose of
establishing search parameters (Best et al, 2014). The most
frequently used Boolean operators are AND (used between
terms to capture papers containing both terms), OR (used
to retrieve papers using either term) and NOT (to narrow
or refine a search) (Houser, 2012). The search formula used
for CINAHL Plus, Ovid MEDLINE and PsycINFO is shown
in Figure 1. The use of truncation facilitated the retrieval
of papers using singular and plural words with different
endings (Reznowski, 2011).
For the purpose of this review, truncation was used on
several terms including midwi* which returned words such
as midwives, midwife and midwifery. Proximity operators,
which vary through the databases but are generally
represented using N for Near or adjn for adjacent were
used to search for terms within a specific number of words
from each other, for example, significant N1 harm and was
used in CINAHL Plus, Ovid MEDLINE and PsycINFO to
retrieve a paper which contains the term ‘significant’ within
one word of ‘harm’ (Dresch et al, 2015).
The search formula was adapted for use on the databases,
but notably on ASSIA and Social Care Online as searches
were undertaken using phrase searching such as ‘child
protection’ OR ‘child abuse’ OR ‘child neglect’ OR ‘child
welfare AND nurs* OR midwi*’ OR ‘health visitor*’ OR
‘social work*’ AND pregnan* OR perinat* OR matern*
OR fetus OR foetus OR ‘unborn child*’ AND measure*
OR assess* OR decision* OR decide OR judgment* OR
criter* OR regist* OR diagnos* OR threshold OR ‘harm
reduction’ OR ‘significant harm’ OR prevent. Search filters
were applied to narrow the number of papers retrieved to
include those papers available in the English language only
and exclude books to narrow the search strategy (Schneider
et al, 2013).
Sensitivity and precision
Determining the quality of a database can be measured by
its capacity to retrieve a satisfactory number of published
papers available on the study topic (McFadden et al, 2012).
The capacity of the database to do this is generally measured
in terms of sensitivity. Sensitivity is calculated by identifying
the number of relevant papers retrieved by a database,
which is then divided by the total number of relevant papers
identified by all searches (Watson and Richardson, 1999).
However, adding more terms to a particular search makes
it more sensitive, resulting in the retrieval of papers that
are less relevant to the study question (Taylor et al, 2007).
Consequently, a second measure of quality is necessary to
prevent retrieving too many irrelevant papers, as this would
involve a lengthy task of elimination.
Therefore, a calculation of precision was undertaken to
determine the number of relevant articles identified by a
search (Taylor et al, 2007) using the formulae of relevant
number of database hits divided by the total number of
database hits (Taylor et al, 2003). Number Needed to Read
(NNR) is a further measurement of precision of databases
(Best et al, 2014). This measurement indicates the number
CINAHL
Plus, Ovid
MEDLINE
and PsycINFO
child* protection
OR child* abuse OR
child* neglect OR
child* welfare
pregnan* OR
perinatal* OR
matern*
measure*
OR assess* OR
decision* OR decide
OR judgment* OR
criter* OR regist*
OR diagnos* OR
threshold OR harm
reduction OR
significant harm
OR prevent*
nurs* OR
midwi* OR
health visitor*
OR social work*
Figure 1. Search formula CINAHL Plus, Ovid MEDLINE and
PsycINFO (all circles are linked with the operator AND)
Mc Elhinney H, Taylor B, Sinclair M, Holman MR. (2016) sensitivity and specificity of electronic databases: the example
of searching for evidence on child protection issues related to pregnant women. Evidence Based Midwifery 14(1): **-**
32 © 2016 The Royal College of Midwives. Evidence Based Midwifery 14(1): 29-34
Mc Elhinney H, Taylor B, Sinclair M, Holman MR. (2016) Sensitivity and specificity of electronic databases: the example
of searching for evidence on child protection issues related to pregnant women. Evidence Based Midwifery 14(1): 29-34
of papers that must be read in order to find one paper for
inclusion (Terwee et al, 2009). Calculating NNR involved
dividing the total number of hits retrieved by the total
number of included studies on a database (Golder et al,
2008). Therefore, a low NNR score measured on a database
is an indication of high quality.
Identifying unique hits
Within the retrieved searches, unique hits were identified –
that is a relevant paper sourced from one database only. This
process was undertaken using a method of identifying the
database(s) in which each of the final nine papers for review
were located. The papers were then listed in chronological
order indicating the databases from which they were retrieved.
Results
A systematic search of the databases retrieved 866 papers.
Titles and abstracts were reviewed by the researcher using a
screening tool. A smaller number of papers were reviewed by
the research team and nine papers were identified for review.
Unique hits retrieved
Of the five databases, only two returned unique hits (Table
1). The search on Ovid MEDLINE returned the largest
number of unique hits retrieved (three papers) and CINAHL
Plus returned one unique paper. ASSIA, PsycINFO and Social
Care Online did not return any unique papers in this search.
Sensitivity and precision
The ability of each database to retrieve relevant items was
measured producing sensitivity scores. CINAHL Plus (36%)
recorded the highest sensitivity, followed by Ovid MEDLINE
(28%) and PsycINFO (14%). ASSIA and Social Care Online
both scored 0% indicating that they were ineffective for use
within this study and retrieved no relevant items. In general,
precision scores between all databases were extremely low.
CINAHL Plus had the highest precision score (4%) of all
the databases indicating that it was the most effective
database at avoiding retrieving irrelevant papers. However,
PsycINFO had a marginally lower precision score (3%) and
Ovid MEDLINE had a precision score of 2%. ASSIA, Social
Care Online and the hand search had poor precision scoring
between 0% and 1%. The NNR scores are a measure of how
many papers need to be read to retrieve one relevant hit on
each database. CINAHL Plus was found to be most effective
with a NNR score of 26%, followed by PsycINFO with a
NNR score of 36% and Ovid MEDLINE was the weakest
database with an NNR score of 45%. No relevant hits were
found in either ASSIA or Social Care Online.
Methodology of retrieved papers
The relevant papers retrieved comprised of qualitative studies
(using semi-structured interviews, 11%), surveys (22.4%),
mixed methods, including both qualitative and quantitative
methods (questionnaires, interviews and focus groups,
33.3%), and quantitative (surveys, 33.3%).
Discussion
Summary of approach
The systematic retrieval of papers from databases is an
important aspect of evidence-based practice (Taylor et
al, 2007). Consequently, it is essential that identification
of relevant databases and accurate search formulae and
filters are applied from inception. The development of
a sophisticated search formula was key to the retrieval
of relevant papers (Best et al, 2014). A search question
was established, a screening tool developed to determine
inclusion/exclusion of papers, the search strategy piloted to
determine the appropriateness and effectiveness of search
terms and modified when necessary. The database searches
were methodical and the initial search was repeated to ensure
it was up to date (Ramlaul, 2010). A preliminary search of
the databases provided a good indication of the relevant
information available and the correct search terms to be used.
Effectiveness of the databases
The study topic of child safeguarding in pregnancy from the
perspective of decisions made by social work and midwifery
staff indicated that databases had to be chosen which
encompassed research from both professional groups. In
general, the databases for social sciences were more difficult
to navigate than those aimed at professionals in healthcare
fields. This may be due to the variation in terminology
internationally and also due to the facilities on the databases
(McFadden et al, 2012). It could be assumed that the
databases predominately aimed at those in social sciences
– ASSIA and Social Care Online, in this instance – would
generate most of the relevant papers.
However, this study showed the contrary, as no relevant
hits were identified on either database. It could be argued
that social science databases, ASSIA and Social Care Online
are less effective than their counterparts – Ovid MEDLINE,
PsycINFO and CINAHL Plus – possibly due to inconsistency
in language, as identifying papers depends upon how well
they are indexed within databases. The latter three databases
are aimed at the nursing (including midwifery) and allied
health professionals and index their papers using MeSH
headings, which are believed to produce greater specificity
than phrase searching used in ASSIA and Social Care Online
(McIntosh, 2011).
Databases Total Hits
Retrieved
Relevant
Hits
Retrieved
NNR Unique
Hits
Sensitivity
%
Precision
%
ASSIA 45 0 – 0* 00
CINAHL
Plus
267 10 26 1* 36 4
Ovid
MEDLINE
361 845 3* 28 2
PsycINFO 144 4 36 0* 14 3
Social Care
Online
43 0 – 0* 0 0
Hand
Search
6 6
Total 866 28*
Number asterisked (*) include total number of hits after duplicates removed
Table 1. Number needed to read (NNR) and unique hits
© 2016 The Royal College of Midwives. Evidence Based Midwifery 14(1): 29-34 33
Mc Elhinney H, Taylor B, Sinclair M, Holman MR. (2016) Sensitivity and specificity of electronic databases: the example
of searching for evidence on child protection issues related to pregnant women. Evidence Based Midwifery 14(1): 29-34
Measures of sensitivity, precision and NNR
The measure of sensitivity of a database is significantly
important to ensure that the papers retrieved from the
search are relevant (Haynes et al, 2005). Aiming for a high
sensitivity score may reduce the chance of missing papers that
are relevant (Pack, 2014). In this study, the highest sensitivity
score was calculated for CINAHL Plus and Ovid MEDLINE
scored marginally lower. PsycINFO scored disappointedly
lower in sensitivity. CINAHL Plus, which indexes
considerably fewer papers than PsycINFO, had the highest
sensitivity score and included papers from the midwifery
profession, but not social work, unlike its counterpart Ovid
MEDLINE, which source papers from both. The final two
databases – ASSIA and Social Care Online – had a sensitivity
score of 0%, indicating that they were ineffective for use
within this study. However, they are predominately social
work and social science based databases and the previous
three databases weighed heavily towards the medical and
midwifery professions. Although ASSIA does include social
service topics, it does not include midwifery, therefore, papers
may be retrieved connected with child safeguarding, but not
necessarily in pregnancy. Additionally, Social Care Online is
predominately aimed at practitioners and policy-makers with
the core material sourced from the UK, therefore restricting
its scope. Similarly to ASSIA, Social Care Online covers
child safeguarding but, again, does not include pregnancy
or maternity research. However, it would be advisable to
include both those databases to ensure that a comprehensive
search is undertaken (Kemp and Brustman, 1997). Similar to
CINAHL Plus, Ovid MEDLINE and PsycINFO, ASSIA is an
international database that indexes fewer journals than the
other databases but may be aimed at those in academia rather
than social work professionals (McFadden et al, 2012).
An effective literature search is reflected through the
precision scores of a particular database and the number of
relevant hits retrieved (Schardt et al, 2007). Precision within
this study was quite low, identifying many papers that were
not relevant to the study question (Gough et al, 2012). The
highest precision score was recorded on CINAHL Plus and
the lowest on Ovid MEDLINE. These higher precision scores
could be attributed to the scope of the journal coverage on
this specific topic area (Best et al, 2014).
The retrieval of papers that are not found on other
databases (unique hits) can give an indication of the best
choice of databases to use in the search. Two of the five
databases searched within this study retrieved a small
number of unique hits. Ovid MEDLINE recovered the
highest number of unique hits (3%) followed by CINAHL
Plus (1%). ASSIA, PsycINFO and Social Care Online failed
to retrieve any unique hits. The use of these latter databases
within future searches around the topic of professional
decision-making around child safeguarding in pregnancy
may be unproductive. It could have been presumed that
ASSIA and Social Care Online, both social science databases,
would retrieve some unique hits considering the study topic
but, in this instance, proved fruitless. As both database
searches use phrase searching, developing a standard
vocabulary for searching literature, consistent throughout
all databases and across HSC professions may be beneficial
(Curran et al, 2007).
In an almost alternative measurement to precision,
NNR refers to the number of papers that must be read to
find one relevant paper from a database search (Hersh,
2009). A low NNR is an indication of a good and efficient
search string narrowing the search of the literature, ensuring
that the task it less time-consuming for a busy professional
(Pillastrini et al, 2015). However, this depends upon the
correct use of language and indexing terms within those
databases (Stewart et al, 2014). The relevant papers retrieved
for final review included a wide range of research methods
confirming the validity of the search strategy and appraisal
of papers (McFadden et al, 2012).
Limitations of the review
Every good literature search and retrieval has its limitations
that must be acknowledged to assist future research in this
study area. Two of the databases in this study, ASSIA and
Social Care Online, were less than optimal for this topic area.
This was partly due to the limited number of journals they
index in comparison with the more medically-based journal
databases CINAHL Plus, PsycINFO and Ovid MEDLINE.
On reflection, it may have been beneficial to add a further
social science database to the search to test its effectiveness,
but the results might still have been limited in comparison
with those found on more sophisticated databases with
advanced indexing facilities and superior user interface.
Implications for practice
Literature searching is a common core skill that HSC
professionals are expected to be able to conduct with
confidence and skill. This paper provides a new insight for
those in management, policy-making, midwifery, nursing and
social work with further methods for undertaking a robust
literature search, which can inform practice and policy to
improve services. Employers and professional bodies need to
ensure that employees have access to regulated training in
literature searching skills for staff undertaking research and
clinical projects designed to improve maternal and child care.
Conclusion
There are increasing demands on the interdisciplinary team
to remain updated with research developments in their fields
of practice. The task of locating relevant research now relies
substantially on the quality of bibliographic databases. This
study highlighted low precision in searching five databases
on this topic, despite a detailed search formula and the
expertise of a specialist librarian. The ‘information age’
requires investment in systems that are efficient as well as
effective if professionals are to make the most use of available
knowledge and increase their chances of retrieving relevant
literature in an efficient manner. Support from leaders in the
HSC organisations and professions to develop the quality
of databases is a priority. The development of expertise in
identifying relevant research and education on the most
robust methods of database searching is a priority if the high
ideals of evidence-based practice are to become a reality.
34 © 2016 The Royal College of Midwives. Evidence Based Midwifery 14(1): 29-34
Mc Elhinney H, Taylor B, Sinclair M, Holman MR. (2016) Sensitivity and specificity of electronic databases: the example
of searching for evidence on child protection issues related to pregnant women. Evidence Based Midwifery 14(1): 29-34
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