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. 1995:436-40.
To determine the reasons for the loss of sensitivity and specificity of methodologic MeSH terms and textwords in MEDLINE for identifying sound clinical studies of the etiology, prognosis, diagnosis, prevention, or treatment of disorders in adult general medicine.
Analytic survey of the information retrieval properties of methodologic MeSH terms and textwords selected to detect studies meeting basic methodologic criteria for direct clinical use in general adult medicine.
Frequency of non-use and misuse of relevant methodologic MeSH terms and textwords among studies meeting and not meeting the basic criteria for clinical practice as determined by the manual review (the gold standard) of all articles in 10 internal and general medicine journals for 1986 and 1991.
Loss of sensitivity due to the non-use of relevant methodologic terms among articles meeting basic methodologic criteria was more pronounced in the areas of diagnosis, prognosis, and etiology than treatment in 1991 and 1986. The use of relevant methodologic terms has improved from 1986 to 1991 in all areas except prognosis. Loss of specificity due to the use of relevant methodologic terms among articles not meeting basic methodologic criteria occurred most frequently in the areas of treatment and etiology.
Although the appropriate use of methodologic MeSH and textwords has improved from 1986 to 1991 among studies meeting basic methodologic criteria for direct clinical use in general adult medicine much improvement is still needed in the areas of diagnosis, prognosis, and etiology. Improvement is needed in assigning the relevant methodologic index terms to studies that meet the methods criteria and in having the authors use the relevant methodologic textwords in the title or abstract. Some improvement is also needed in not using methodologic terms when the study clearly does not meet the methods criteria.
确定医学主题词表（MeSH）中的方法学主题词和文本词在MEDLINE中用于识别成人普通医学中疾病病因、预后、诊断、预防或治疗的可靠临床研究时，敏感性和特异性丧失的原因。
对为检测符合成人普通医学直接临床使用基本方法学标准的研究而选择的方法学MeSH主题词和文本词的信息检索特性进行分析性调查。
通过对1986年和1991年10种内科和普通医学期刊中所有文章进行人工审核（金标准），确定符合和不符合临床实践基本标准的研究中相关方法学MeSH主题词和文本词的未使用和误用频率。
在1991年和1986年，符合基本方法学标准的文章中，因未使用相关方法学术语导致的敏感性丧失在诊断、预后和病因学领域比治疗领域更为明显。除预后外，1986年至1991年所有领域中相关方法学术语的使用都有所改善。在不符合基本方法学标准的文章中，因使用相关方法学术语导致的特异性丧失最常发生在治疗和病因学领域。
尽管1986年至1991年期间，在符合成人普通医学直接临床使用基本方法学标准的研究中，方法学MeSH主题词和文本词的恰当使用有所改善，但在诊断、预后和病因学领域仍有很大改进空间。在为符合方法学标准的研究指定相关方法学索引词以及让作者在标题或摘要中使用相关方法学文本词方面需要改进。在研究明显不符合方法学标准时不使用方法学术语方面也需要一些改进。
