Ethics

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: Dracos A. SIBIL: uno strumento italiano per il reperimento dell'informazione in bioetica. Ann Ist Super Sanita 2004; 40 (): 283–6.

Short description: 

The aim of the article is to present the development and structure of the project SIBIL (Sistema Informativo per la Bioetica In Linea) provided by the Istituto Superiore di Sanità (ISS), Rome, Italy. The purpose of the project is to collect, index and disseminate the Italian literature on bioethics since 1995.

The article provides information on the background of the database development, the development of the indexing system, the Italian Bioethics Thesaurus (TIB), and the presented publications. These are books, book contributions, journal articles, legal documents, ethical codes, statements, guidelines reports, grey literature, proceedings, electronic documents and resources. Further, information on conferences in bioethics is announced via the SIBIL web page (http://www.iss.it/sibi/index.php?lang=2).

This publication is in Italian. Abstract is provided in English.

 

Limitations stated by the author(s): 

No limitations were stated.

Limitations stated by the reviewer(s): 
No limitations detected by the reviewers. SIBIL is currently searchable via the portal ethicsweb, the European information and documentation system for ethics and science (http://ethicsweb.org/portal).
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
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