MEDLINE中临床内容实证检索策略的稳健性。
Robustness of empirical search strategies for clinical content in MEDLINE.
作者信息
Wilczynski Nancy L, Haynes R Brian
机构信息
Health Information Research Unit, McMaster University, Hamilton, Ontario, Canada.
出版信息
Proc AMIA Symp. 2002:904-8.
BACKGROUND
It is important for clinical end users of MEDLINE to be able to retrieve articles that are both scientifically sound and directly relevant to clinical practice. The use of methodologic search filters (such as "random allocation" for sound studies of medical interventions) has been advocated to improve the accuracy of searching for such studies. Methodologic search filters have been tested in previous MEDLINE files but indexing continues to evolve and the operating characteristics of these search filters in current MEDLINE files are unknown.
OBJECTIVE
To determine the robustness of empirical search strategies developed in 1991 for detecting clinical content in MEDLINE in the year 2000.
DESIGN
A survey based on a hand search of 171 core health care journals using predetermined quality indicators for scientific merit and clinical relevance.
METHODS
6 trained, experienced research assistants read all issues of 171 journals for the publishing year 2000. Each article was rated using purpose and quality indicators and categorized into clinically relevant original studies, review articles, general papers, or case reports. The original and review articles were then categorized as 'pass' or 'fail' for methodologic rigor in the areas of therapy/quality improvement, diagnosis, prognosis, causation, economics, clinical prediction, and qualitative and review articles. Search strategies developed in 1991 were tested in the 2000 database.
MAIN OUTCOME MEASURES
Sensitivity, specificity, precision, and accuracy of the search strategies.
RESULTS
Search strategies developed in 1991 generally performed at least as well in 2000 for both best single terms and combinations of terms for high-sensitivity MEDLINE searches for studies of treatment, prognosis, etiology and diagnosis. For example, the accuracy of "clinical trial (pt)" rose from 91.6% to 94.4% (P<0.05) for retrieving high-quality studies of treatments.
CONCLUSION
Most MEDLINE search strategies developed in 1991 are robust when searching in the publishing year 2000.
背景
对于医学文献数据库（MEDLINE）的临床终端用户而言，能够检索到科学合理且与临床实践直接相关的文章至关重要。有人主张使用方法学检索过滤器（如用于医学干预可靠研究的“随机分配”）来提高此类研究检索的准确性。方法学检索过滤器已在先前的MEDLINE文档中进行过测试，但索引仍在不断发展，这些检索过滤器在当前MEDLINE文档中的运行特征尚不清楚。
目的
确定1991年开发的用于检测2000年MEDLINE中临床内容的实证检索策略的稳健性。
设计
基于对171种核心医疗保健期刊进行手工检索的调查，使用预定的质量指标来评估科学价值和临床相关性。
方法
6名训练有素、经验丰富的研究助理阅读了2000年出版的171种期刊的所有期次。每篇文章根据目的和质量指标进行评分，并分类为临床相关的原始研究、综述文章、一般论文或病例报告。然后，将原始文章和综述文章在治疗/质量改进、诊断、预后、病因、经济学、临床预测以及定性和综述文章等领域的方法学严谨性分类为“通过”或“未通过”。1991年开发的检索策略在2000年的数据库中进行了测试。
主要观察指标
检索策略的敏感性、特异性、精确性和准确性。
结果
1991年开发的检索策略在2000年对于最佳单个术语以及用于MEDLINE高敏感性检索治疗、预后、病因和诊断研究的术语组合，总体表现至少同样出色。例如，检索高质量治疗研究时，“临床试验（pt）”的准确性从91.6%提高到了94.4%（P<0.05）。
结论
1991年开发的大多数MEDLINE检索策略在检索2000年出版的文献时是稳健的。
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