Original Articles
A Two-Term MEDLINE Search Strategy for Identifying Randomized Trials in Obstetrics and Gynecology

https://doi.org/10.1016/S0029-7844(97)00703-5Get rights and content

Abstract

Objective: To develop and test a simple MEDLINE search strategy for identification of randomized controlled trials (RCTs) in obstetrics and gynecology.

Methods: To develop our search strategy, we asked clinicians in our department to indicate, from a list of search terms, the terms they would use to identify RCTs in MEDLINE. The two most common terms, controlled-clinical-trial (publication type) and randomized-controlled-trial (publication type), were combined with the link word, OR, and then used to identify RCTs in four obstetrics and gynecology journals for the years 1975, 1980, 1985, 1990, and 1995. Concurrently, a handsearch of these same journals and years was performed to identify RCTs. The sensitivity and precision of MEDLINE and handsearch were calculated using the total number of RCTs identified by both methods as a reference standard. Sensitivity is the RCTs identified by search strategy as a percentage of all RCTs identified by reference standard. Precision is the RCTs identified by a search strategy as a percentage of all articles identified by it.

Results: The overall sensitivity of our MEDLINE search strategy was 72.5%, and the precision was 83.4%. Over 2 decades, sensitivity of our MEDLINE search increased from 0% to 94.9% (P < .001), while its precision dropped from 100% to 75.5% (P = .003). For 1990 and 1995 combined, sensitivity and precision of our MEDLINE search strategy were 90.3% and 79.6%, respectively. Overall sensitivity for handsearch was 96.5%; its precision was 5.0%. Over 2 decades, the sensitivity of handsearch dropped insignificantly from 100% to 92.3% (P = .05), while the precision increased from 2.6% to 6.3% (P < .001).

Conclusion: Our simple MEDLINE search strategy has a high sensitivity and precision, especially in more recent years. Obstetricians and gynecologists may use it to search quickly for RCTs to guide patient care.

Section snippets

Materials and Methods

The following steps were undertaken in performing this study: we developed a simple search strategy for MEDLINE identification of RCTs by a survey of practicing obstetricians and gynecologists, created a database (reference standard) of RCTs by MEDLINE and handsearch of four obstetrics and gynecology journals, and compared the yield of our MEDLINE and handsearches against this reference standard. In this study, we defined an RCT as a trial in which subjects are allocated randomly to two or more

Results

The questionnaires from which our search strategy was developed were returned by 14 of 17 clinicians in our department. Ten of these 14 clinicians indicated two search terms, two indicated one search term, and another two did not indicate any search terms. The two most common search terms, controlled-clinical-trial (publication type) and randomized-controlled-trial (publication type), accounted for 15 of 22 terms chosen in the survey of clinicians.

There were 403 RCTs of parallel design in the

Discussion

Clinicians spend limited time reading medical literature, with specialist registrars (resident doctors) and consultants (attending physicians) spending 10–90 minutes a week reading the literature.[4]To practice evidence-based medicine, this time should be spent generating clinical questions and seeking and appraising the best evidence for patient care before applying it to clinical practice.[4]With this time constraint on clinicians, methods for identifying published evidence should be simple

References (17)

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