Optimal search strategies for retrieving scientifically strong studies of diagnosis from Medline: analytical survey

摘要

>Objective To develop optimal search strategies in Medline for retrieving sound clinical studies on the diagnosis of health disorders.>Design Analytical survey.>Setting Medline, 2000.>Participants 170 journals for 2000 of which 161 were indexed in Medline.>Main outcome measures The sensitivity, specificity, precision (“positive predictive value”), and accuracy of 4862 unique terms in 17 287 combinations were determined by comparison with a hand search of all articles (the “gold standard”) in 161 journals published during 2000 (49 028 articles).>Results Only 147 (18.9%) of 778 articles about diagnostic tests met basic criteria for scientific merit. Combinations of search terms reached peak sensitivities of 98.6% at a specificity of 74.3%. Compared with best single terms, best multiple terms increased sensitivity for sound studies by 6.8% (absolute increase), while also increasing specificity (absolute increase 6.0%) when sensitivity was maximised. When terms were combined to maximise specificity, the single term, specificity.tw. (98.4%), outperformed combinations of terms. The strategies newly reported in this paper outperformed other validated search strategies except for one strategy that had slightly higher sensitivity (99.3% v 98.6%) but lower specificity (54.7% v 74.3%).>Conclusion New empirical search strategies in Medline can optimise retrieval of articles reporting high quality clinical studies of diagnosis.