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Searching for Relevant Studies Interactive Quiz. Prepared for: The Agency for Healthcare Research and Quality (AHRQ) Training Modules for Systematic Reviews Methods Guide www.ahrq.gov. Overview.
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Searching for Relevant Studies Interactive Quiz Prepared for: The Agency for Healthcare Research and Quality (AHRQ) Training Modules for Systematic Reviews Methods Guide www.ahrq.gov
Overview You are interested in evaluating the benefits and harms associated with the use of thrombectomy devices in acute coronary syndromes. You need to determine what literature is available to conduct your review.
A Comprehensive Search A comprehensive search is required. When conducting this search, what do you need to assure? • You balance precision and recall. • You have gotten every possible relevant citation, regardless of the workload involved. • You limit the search so that only relevant citations are found.
The First Step Given the need to balance precision and recall, what should you do before initiating a search on the use of thrombectomy in patients with acute coronary syndromes? • Enter the search as “thrombectomy AND acute coronary syndromes.” • Enter the search as “thrombectomy OR acute coronary syndromes.” • Understand the topic, devise an analytic framework, pose clearly defined key questions, and understand the scope of the review before devising your strategy.
The Power of Due Diligence Your due diligence pays off. You now realize that your initial search “thrombectomy AND acute coronary syndrome” would compromise the recall. Using “((Thrombectomy OR MerciClot.mp OR “other devices names”) AND (acute coronary syndromes OR myocardial infarction OR angina, unstable))” would assure better recall without appreciably impacting precision.
More Than One Search May Be Needed You try to decide whether to perform one search or two searches (one for “benefits” and another for “harms”). Which of the following would cause you to perform two searches? • Performing two searches is redundant and should be avoided. • You decide a priori to allow only data from randomized controlled trials (RCTs) when evaluating benefits but allow RCTs and observational trials for harms. • The available literature base on the topic is small.
Database Selection You need to decide which databases to use. The minimum requirement for a thorough search of the literature would include which two databases? • MEDLINE + TOXNET • MEDLINE + CINAHL • MEDLINE + Cochrane Central
Hand Searching Why would you decide to use hand searching of references from identified systematic reviews, studies, and abstract booklets from prominent meetings within the field of interest? • Hand searching can capture citations that are not indexed or are improperly indexed. • Limiting hand searching to these sources can target this time-intensive activity to areas where the yield will be the greatest. • Both are correct.
Other Documents You decide to search the U.S. Food and Drug Administration Web site and ClinicalTrials.gov to identify studies that might be appropriate for your systematic review. These Web sites are sources of what kind of documents? • Black literature • Grey literature • SIPs
The Final Task You conduct a thorough search of MEDLINE and Cochrane Central, use two searches (one for “benefits” and another for “harms”), and employ targeted hand searching and grey literature evaluation. What is the last thing you need to remember to do that is germane to searching? • Choose only citations that agree with your preconceived notions. • Selectively report aspects of your search strategy. • Provide transparent reporting of search strategies and the citations you identified.
Summary • Literature searching can have many pitfalls. • Readers will have confidence in the results of your systematic review if you: • demonstrate a comprehensive understanding of the topic, • use multiple searches and databases, • use hedges, • use hand searching and grey literature, and • develop a transparent reporting structure.
Author • This quiz was prepared by C. Michael White, Pharm.D., FCP, FCCP, a member of the University of Connecticut/Hartford Hospital Evidence-based Practice Center. • This module is based on chapter 5 in version 1.0 of the Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews (available at: http://effectivehealthcare.ahrq.gov/repFiles/ 2007_10Draft MethodsGuide.pdf).