Wilczynski N L, Walker C J, McKibbon K A, Haynes R B
Dept. of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ont., Canada.
Proc Annu Symp Comput Appl Med Care. 1994:905-9.
To compare the retrieval characteristics of subheadings with methodologic textwords and MeSH terms in MEDLINE for identifying sound clinical studies on the etiology, prognosis, diagnosis, prevention and treatment of disorders in general adult medicine.
Analytic survey of the information retrieval properties of methodologic textwords, single methodologic MeSH terms, pre-explosions and subheadings selected to detect studies meeting basic methodologic criteria for direct clinical use in general adult medicine.
The sensitivity, specificity, and precision of search terms were determined by comparing the citations retrieved by the search strategies in MEDLINE with that of a manual review (the gold standard) of all articles in 10 internal and general medicine journals for 1986 and 1991.
For treatment and diagnosis in 1991, and treatment, diagnosis, and etiology in 1986, pre-explosions yielded the highest sensitivity, with typical absolute increases exceeding 15%. For etiology and prognosis in 1991, and prognosis in 1986, textwords or MeSH terms yielded the highest sensitivity. In all cases the increase in sensitivity was coupled with a loss in specificity and precision.
Compared with searching with single methodologic textwords and subject headings, the detection of sound clinical studies on the diagnosis and treatment of disorders in general adult medicine was consistently enhanced by searching with pre-explosions, but at a price of decreased specificity and precision.
比较医学主题词表（MEDLINE）中副标题与方法学文本词及医学主题词（MeSH）的检索特征，以识别关于普通成人医学中疾病病因、预后、诊断、预防和治疗的可靠临床研究。
对方法学文本词、单一方法学MeSH词、预扩展词和副标题的信息检索特性进行分析调查，以检测符合普通成人医学直接临床应用基本方法学标准的研究。
通过将MEDLINE检索策略检索到的文献引用与对1986年和1991年10种内科和普通医学期刊中所有文章的人工评审（金标准）进行比较，确定检索词的敏感性、特异性和精确性。
对于1991年的治疗和诊断，以及1986年的治疗、诊断和病因，预扩展词产生的敏感性最高，典型的绝对增幅超过15%。对于1991年的病因和预后，以及1986年的预后，文本词或MeSH词产生的敏感性最高。在所有情况下，敏感性的提高都伴随着特异性和精确性的降低。
与使用单一方法学文本词和主题词进行检索相比，使用预扩展词检索可持续提高对普通成人医学中疾病诊断和治疗的可靠临床研究的检测，但代价是特异性和精确性降低。
