MEDLINE

Appraisal of: Fangerau HC. Finding European bioethical literature: An evaluation of the leading abstracting and indexing services. J Med Ethics 2004; 30 (3): 299–303.

Short description: 

The aim of the article is to ascertain indexing of medical ethics publications in commonly used bibliographic databases. The purpose of the author is to introduce a set of databases which provides the highest possible quantity of bioethical journal publications to researchers as well as the added value of each database considered.

The article provides information on the methods of collecting the existing Medical Ethics journals, the searching for coverage of these by bibliographic abstract and indexing services, the evaluation results, and finally the conclusions for doing literature searches on medical ethics journal publications.

The search for Medical Ethics journals yielded in 290 periodicals. Thereof 173 journals (60%) were identified in at least one of the considered databases; the remaining journals were not indexed. The highest coverage rates were found in Current Contents (23%) and Medline (22%). A maximum quantity of Medical Ethics journals (45%) was obtained when combining the 10 databases with the highest coverage: Current Contents, MEDLINE, Research Alert, Social Sciences Citation Index, EMBASE, AgeLine, CINAHL, E-psyche, Sociological Abstracts, and Family Index.

A tendency to index more North American than European journals was observed (=bias). EMBASE seems to cover the highest number of European journals.

However, the author recommends that “a medical ethics literature search has to be carried out in several databases in order to reach an adequate collection of literature.”

Limitations stated by the author(s): 
  • The analyzed set of journals is a representative sample, not the whole range of journals possibly comprising articles on medical ethics.
  • Current Contents cites literature from the last five years.
Limitations stated by the reviewer(s): 
No national / supranational services (as European databases) were included in the study. Due to the high turnover in existing relevant journals as well as indexing services (e.g. Current Contents now is part of the ISI Web of Science) the presented results couldn’t be reproduced in detail today. Nevertheless the main results and the recommendations are still valid.
Study Type: 
Single study

Appraisal of: National Reference Center for Bioethics Literature, National Information Resource on Ethics and Human Genetics (Ed). Bioethics searcher’s guide to online information resources. Washington, DC: Kennedy Institute of Ethics, Georgetown Universi

Short description: 

The aim of the article is to present selected information resources available online and relevant to bioethics. The purpose of the authors is to give bioethics researchers an idea and guidance on the literature databases at 1) The Joseph and Rose Kennedy Institute of Ethics (KIE), Georgetown University, Washington, DC, 2) the National Library of Medicine (NLM), Washington, DC, as well as a short introduction to 3) BELIT (German Reference Centre for Ethics in the Life Sciences, DRZE) and 4) Global Ethics Observatory (UNESCO).

The article provides information on searching the KIE databases ETHXWeb and GenETHX, besides the Syllabus Exchange Database and the International Bioethics Organizations Database. In addition, some information on the National Reference Center for Bioethics Literature Classification Scheme is introduced as well as on some features to find bioethics information in the NLM Databases PubMed, NLM Catalog, and the Bioethics Portal. 

Limitations stated by the author(s): 

No limitations were stated.

Limitations stated by the reviewer(s): 
No limitations. As the features in the databases have been modified in the last years the screen shots are not always up-to-date.

Appraisal of: Droste S, Dintsios CM, Gerber A. Information on ethical issues in health technology assessment: How and where to find them. Int J Technol Assess Health Care 2010; 26(4): 441–449.

Short description: 

The aim of the article is to present a procedure to identify information on ethical implications of the use and value-related decision-making in the assessment of health technologies. The purpose of the project is to develop, propose and test a step-by step workflow adapted to the specific issues of information on ethical issues (searching for arguments and qualitative data).

The article provides information on the background of developing the methodological approach as well as on the 8 working steps - Step 1 “Translation of the search question using the PICO scheme and additional components” to Step 8 “Final quality check and calculation of precision and recall”. The article is supplemented by the application results of the example “Ethical issues of autologous stem cell transplantation in metastatic breast cancer”.

Limitations stated by the author(s): 
  • Not all ethical issues related to health technologies can be identified by means of the approach described.
  • Some ethical issues cannot be found with systematic approaches - additional non-systematic searching may be useful.
  • The ethical issues relevant to the health technology investigated should be known in more detail before starting the systematic information retrieval.
  • Alleged innovations cannot be identified as such by the methodological approach.
Limitations stated by the reviewer(s): 
- Reference(s) to the validation work could have been provided. - The authors claim in the objective that if choosing the proper methodological approach: the central ethical dimensions then should be answerable. This seems like a too strong claim, what the authors do is to provide a brilliant methodological approach to address central ethical dimensions, to the extent there is anything published concerning these. Whether that answers ethical concerns is to some extent another matter and might call for a separate ethics analysis. Both since the sources might give conflicting answers, or give no answers at all. - Lack references to the database Philosopher’s index which in some cases might provide sources for a more general but relevant ethical discussion.
Study Type: 
Single study

Appraisal of: Rauprich O, Nolte M, Vollmann J. Systematische Literaturrecherchen in den Datenbanken PubMed® und BELIT: Ein Werkstattbericht. Ethik Med 2010; 22(1): 59–67.

Short description: 

The aim of the article is to present the systematic searching for Medical Ethics literature in the bibliographic databases BELIT (German Reference Centre for Ethics in the Life Sciences, DRZE) and PubMed (National Library of Medicine, NLM) by means of two examples. The purpose of the project is to evaluate the feasibility and capacity of BELIT and PubMed as well as to design optimized search strategies for these two databases.

The article provides information on the selected databases, the search strategies designed for each source, and on the comparative analysis of the search results. Subjects of application are the examples “Concept of health and disease” and “Ethical, legal, social and economic issues of financing fertility treatments”.

In both examples the searches yielded in several hundred hits each with a small overlap of 3 and 4% between BELIT and PubMed. The best results are achieved by combining controlled terms and free-text queries. Using different query languages (German and English) in BELIT further improves the result. While in PubMed building of complex search strategies is possible, BELIT is restricted to process simple search queries.

Limitations stated by the author(s): 

Due to the high effort needed to investigate the study is restricted to PubMed and BELIT. Other databases with information on ethical issues are neglected – although important for systematic searches.

Limitations stated by the reviewer(s): 
This journal article represents a short report version of the study. To fully understand the methods used it is necessary to study the long report version.
Study Type: 
Single study

Appraisal of: Petrova M, Sutcliffe P, Fulford KW, Dale J. Search terms and a validated brief search filter to retrieve publications on health-related values in Medline: A word frequency analysis study. J Am Med Inform Assoc 2012; 19(3): 479–488.

Short description: 

The aim of the article is to present search terms (keywords) and a “brief” search filter to identify information on health-related values in Medline developed by using word frequency analysis. The purpose of the project is to support broad-scoping searches by “a brief search filter (≤20 lines) of high precision (≥67%) and acceptable sensitivity (≥67%) which can be used […] in generic medical and health databases (e.g., Medline, Embase, or Cinahl) and across a range of topics (e.g., health conditions, health settings, health interactions, etc.)”.

The article provides extensive information on the background as on health-related values defined by the authors and on word frequency analyses. The application of this analysis in the conditions diabetes, dementia, schizophrenia and obesity resulted in a small overlap of relevant MeSH and free-text search terms (9 of 124 different MeSH terms (7.3%) and 4 of 144 different words (2.8%) were identified in all 4 conditions among the 50 “best” MeSH respective words in each condition). Applying the developed search filter in hypersensitivity and dentistry resulted in (authors defined) sensitivity of 70.1% (hypersensitivity) and 47.1% (dentistry), and precision of 63.6% (hypersensitivity) and 82.6% (dentistry). 

Limitations stated by the author(s): 
  • A number of ‘subjective’ additions to the objectively derived filter improved sensitivity and precision.
  • The brief values filter can be applied productively to other topics in Medline, but there is instability in its performance.
  • The study covers a limited period, limited number of topics, a single database, and a single approach to compiling its corpus of citations.
  • The study lacked well-articulated criteria for distinguishing cases (of values publications) from non-cases. The criteria used may have been overly inclusive.
  • This study did not have the capacity for both theoretical and empirical work of adequate depth.
  • The reported frequencies for text words did not necessarily reflect the number of abstracts in which a word appears.
  • Data cleaning was performed on text words that had a 100% precision, but not for the remainder.
  • Limit to the very field of designing objective search strategies on the basis of word frequency analysis: The field may be lagging behind advances in medical informatics. Some of the methods applied in this study may need to be superseded, including methods that have improved on standard practices of objective search strategy design.

 

 

Limitations stated by the reviewer(s): 
The theoretical concept of values defined by the authors is not fully clear and different from those used in ethical analysis in HTA. Besides the many limitations already stated by the authors there are some significant methodological shortcomings, and the results don’t fulfill the needs of systematic reviews in HTA regarding sensitivity in a sufficient manner. The proposed search filter is clearly not this universal solution as claimed in the authors’ objectives. As well the results indicate that the method of word frequency analysis itself fails in the field of values. The shortcomings in detail: The glossary definitions are not always identical with the common ones in Information Retrieval. Authors’ objective: No reasoning for the line number (and no meaning on the length of each line) and sensitivity and precision. The validation, in particular the external validation, applied by the authors does not fulfill criteria of an evidence-based validation. Building-up the derivation dataset is not reported in a transparent and reproducible manner. As the conditions were just defined by one MeSH term each the sensitivity of the results may be low. Calculating sensitivity of the search filter by using these datasets seems to be questionable (and a self-fulfilling prophecy).
Study Type: 
Single study

Appraisal of: Coyle KB, Trochlil K, Iversen P. MEDLINE and EMBASE for health economic literature reviews [abstract]. Value Health 2012;15(4):A162.

Reviewer(s): 
Short description: 
The authors compared search results in MEDLINE and Embase for the indication chronic pulmonary obstructive disease (COPD) with regard to cost of illness (COI), burden of illness (BOI) and cost benefit analysis (CBA). MEDLINE retrieved a higher number of references for CBA, while Embase retrieved higher results in the areas of COI and BOI. Conference abstracts accounted for the higher Embase totals. The inclusion of conference abstracts in Embase support the practice of conducting economic literature reviews in both MEDLINE and Embase.
Limitations stated by the author(s): 
None stated - this is an abstract.
Limitations stated by the reviewer(s): 
Since the results were published only in abstract form, very limited information was presented on methods, results and conclusions. Specific search strategies were not provided, nor was it stated if the citations retrieved were evaluated for relevance. Only one subject area (COPD) was searched for citations published during 2010-11, resulting in low retrieval results. Differences in retrieval may therefore not have statistical significance or be generalizable to other topic areas.
Study Type: 
Single study
Related Chapters: 

Appraisal of: Golder S, Loke YK. Failure or success of electronic search strategies to identify adverse effects data. J Med Libr Assoc 2012;100(2):130-134.

Short description: 
The aim of this study was to assess the prevalence of adverse effects terms in the title, abstract, and / or indexing of adverse effects papers published from 2001 onwards and the implications of this on search strategy approaches. A cohort of 242 papers, indexed in MEDLINE, Embase and / or Science Citation Index (SCI), was identified to investigate this and compare the results with a similar study published in 2001 by Derry, Loke and Aronson. Of the 242 papers identified, 231 were indexed in MEDLINE, 222 were indexed in Embase and 238 were indexed in SCI. Searching with generic or specific named adverse effects terms in the title, abstract, or indexing identify 89% of the references indexed in Embase, 80% of the references indexed in Medline and 70% of the references indexed in SCI. Generic adverse effects terms in the title and abstract in any of the 3 databases, generic and specific indexing terms or adverse effects subheadings in Embase, and subheadings for adverse effects in Medline retrieved the highest proportion of references. Compared to previous research findings, adverse effects terms seemed to be increasingly prevalent in the title, abstract and indexing of adverse effects papers in both MEDLINE and Embase.
Limitations stated by the author(s): 
No limitations stated by the study authors
Limitations stated by the reviewer(s): 
No limitations detected by the reviewer
Study Type: 
Single study
Related Chapters: 

Appraisal of: Golder S, Loke YK. Sensitivity and precision of adverse effects search filters in MEDLINE and EMBASE: a case study of fractures with thiazolidinediones. Health Info Libr J 2012;29(1):28-38.

Short description: 
A systematic review of fracture-related adverse effects associated with the use of thiazolidinediones was used as a case study to calculate the sensitivity, precision and Number Needed to Read (NNR) of published adverse effects search filters in MEDLINE and Embase. 12 MEDLINE filters and 3 Embase filters were tested. The results showed that 4 search filters in MEDLINE achieved high levels of sensitivity (95 or 100%) with improved levels of precision compared with searches without any adverse effects filters. The highest level of precision in MEDLINE (55%) was achieved with search filters that relied only on subject headings (MeSH). No search filter in Embase achieved sensitivity higher than 83% and precision remained low using any of the filters (all under 5%).
Limitations stated by the author(s): 
The main limitation to this study is that because only one systematic review was used as a case study, the generalisability of the study results is limited. In addition, this case study is of a particular named adverse effect (fractures), while a case study of a safety profile systematic review, in which all adverse effects are searched for, might have given different results. Another limitation is the adaptations made to some of the tested search filters. These filters were originally created for use in searches where the adverse effects are not known in advance of searching, while in this case study, these filters were used in addition to search terms for a named adverse effect (fracture terms).
Limitations stated by the reviewer(s): 
In addition to the limitation noted above by the authors, it should be noted that the number of included studies on which the search filters were tested was relatively small (19 records in MEDLINE and 24 records in Embase). It should also be noted that the filters were tested as published. Testing of individual terms within the filters might have resulted in higher precision and better trade-off between sensitivity and precision than the full filters.
Study Type: 
Single study
Related Chapters: 

Comments from the authors:

Appraisal of: Golder S, Loke YK. Sources of information on adverse effects. Health Info Libr J 2010;27:176-190.

Short description: 
Research has shown that most systematic reviews of adverse effects rely solely on searches of MEDLINE, even though it is unlikely to be a comprehensive source on adverse effects information. The authors aimed to identify and summarize studies that had evaluated sources of information on adverse effects. No date or language restrictions were applied when searching for studies. The results indicated that Embase, Derwent Drug File, MEDLINE and industry submissions might be the sources of the largest number of relevant references for adverse effects information. In addition, they concluded that searching a wide range of sources might be a useful approach when conducting a thorough search.
Limitations stated by the author(s): 
Studies included in the review were inconsistent in their use of outcome measures. They used different information sources which made direct comparisons difficult. Recent research information was lacking and many of the studies were more than 10 years old. Many potentially useful information sources were not covered in the studies identified (e.g. search engines and industry clinical trial registers). Most studies reported only the number of relevant references retrieved for comparison which is not a sufficient criterion. Also, the cost of searching different sources had not been assessed.
Limitations stated by the reviewer(s): 
No additional limitations detected by the reviewer.
Study Type: 
Review
Related Chapters: 
Comments from the authors:
 
This publication is related to Su Golder’s PhD Thesis “Evaluating and Optimising the Retrieval of Research Evidence for Systematic Reviews of Adverse Drug Effects and Adverse Drug Reactions” from 2013. The thesis is available from http://etheses.whiterose.ac.uk/4749/

Appraisal of: Golder S, Loke Y. The performance of adverse effects search filters in MEDLINE and EMBASE. Health Info Libr J 2012;29(2):141-151.

Short description: 
The aim of the study was to measure the sensitivity of published adverse effects search filters in MEDLINE and Embase. The performance of all the individual search terms included in the filters was also measured. The results showed that 93% of the MEDLINE records and 97% of the Embase records could be retrieved by using adverse effects search filters. High sensitivity could also be achieved by using individual adverse effects ‘floating’ subheadings such as Adverse Drug Reaction (83%) or Side Effect (83%) in Embase. In MEDLINE the highest sensitivity using individual adverse effects ‘floating’ subheadings was achieved by using Adverse Effects (51%). Some free text terms for adverse effects in the title and / or abstract were also found to be useful, but the authors recommend applying these terms only concurrently with other search terms such as subheadings. The sensitivity of the few existing indexing terms (MeSH and Emtree) for adverse effects was shown to be low.
Limitations stated by the author(s): 
The main limitation of this study was that the precision of search terms and search filters was not measured. The most sensitive search filters or search terms might be those with the lowest precision and might therefore result in very low precision (that is, the retrieval of very large numbers of irrelevant records). Further research that measures the precision of these search terms and filters is required in order to determine the full value and effectiveness of using adverse effects terms in search strategies. Caution should be applied when using the results of this study, especially as some of the search terms with relatively high sensitivity appear to have only a vague connection to adverse effects (such as ‘Therapeutic Use’ and ‘Pharmacology’).
Limitations stated by the reviewer(s): 
No additional limitations detected by the reviewer
Study Type: 
Single study
Related Chapters: 

Comments from the authors:

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