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PubMed1998

A two-term MEDLINE search strategy for identifying randomized trials in obstetrics and gynecology.

OBJECTIVE: To develop and test a simple MEDLINE search strategy for identification of randomized controlled trials (RCTs) in obstetrics and gynecology. METHODS: To develop our search strategy, we asked clinicians in our department to indicate, from a list of search terms, the terms they would use to identify RCTs in MEDLINE. The two most common terms, controlled-clinical-trial (publication type) and randomized-controlled-trial (publication type), were combined with the link word, OR, and then used to identify RCTs in four obstetrics and gynecology journals for the years 1975, 1980, 1985, 1990, and 1995. Concurrently, a handsearch of these same journals and years was performed to identify RCTs. The sensitivity and precision of MEDLINE and handsearch were calculated using the total number of RCTs identified by both methods as a reference standard. Sensitivity is the RCTs identified by search strategy as a percentage of all RCTs identified by reference standard. Precision is the RCTs identified by a search strategy as a percentage of all articles identified by it. RESULTS: The overall sensitivity of our MEDLINE search strategy was 72.5%, and the precision was 83.4%. Over 2 decades, sensitivity of our MEDLINE search increased from 0% to 94.9% (P < .001), while its precision dropped from 100% to 75.5% (P=.003). For 1990 and 1995 combined, sensitivity and precision of our MEDLINE search strategy were 90.3% and 79.6%, respectively. Overall sensitivity for handsearch was 96.5%; its precision was 5.0%. Over 2 decades, the sensitivity of handsearch dropped insignificantly from 100% to 92.3% (P=.05), while the precision increased from 2.6% to 6.3% (P < .001). CONCLUSION: Our simple MEDLINE search strategy has a high sensitivity and precision, especially in more recent years. Obstetricians and gynecologists may use it to search quickly for RCTs to guide patient care.

Gynecology↗

PubMed2000

Identifying clinical trials in the medical literature with electronic databases: MEDLINE alone is not enough.

The objective of this study was to compare the performance of MEDLINE and EMBASE for the identification of articles regarding controlled clinical trials (CCTs) published in English and related to selected topics: rheumatoid arthritis (RA), osteoporosis (OP), and low back pain (LBP). MEDLINE and EMBASE were searched for literature published in 1988 and 1994. The initial selection of papers was then reviewed to confirm that the articles were about CCTs and to assess the quality of the studies. Selected journals were also hand searched to identify CCTs not retrieved by either database. Overall, 4111 different references were retrieved (2253 for RA, 978 for OP, and 880 for LBP); 3418 (83%) of the papers were in English. EMBASE retrieved 78% more references than MEDLINE (2895 versus 1625). Overall, 1217 (30%) of the papers were retrieved by both databases. Two hundred forty-three papers were about CCTs. Two-thirds of these were retrieved by both databases, and one-third by only one. An additional 16 CCTs not retrieved by either database were identified through hand searching. Taking these into account, EMBASE retrieved 16% more CCTs than MEDLINE (220 versus 188); the EMBASE search identified 85% of the CCTs compared to 73% by MEDLINE. No significant differences were observed in the mean quality scores and sample size of the CCTs missed by MEDLINE compared to those missed by EMBASE. Our findings suggest that the use of MEDLINE alone to identify CCTs is inadequate. The use of two or more databases and hand searching of selected journals are needed to perform a comprehensive search.

Controlled Clinical Trials as Topic↗

PubMed1996

Selecting a database for literature searches in nursing: MEDLINE or CINAHL?

This study compares the usefulness of the MEDLINE and CINAHL databases for students on post-registration nursing courses. We searched for nine topics, using title words only. Identical searches of the two databases retrieved 1162 references, of which 88% were in MEDLINE, 33% in CINAHL and 20% in both sources. The relevance of the references was assessed by student reviewers. The positive predictive value of CINAHL (70%) was higher than that of MEDLINE (54%), but MEDLINE produced more than twice as many relevant references as CINAHL. The sensitivity of MEDLINE was 85% (95% CI 82-88%), and that of CINAHL was 41% (95% CI 37-45%). To assess the ease of obtaining the references, we developed an index of accessibility, based on the holdings of a number of Irish and British libraries. Overall, 47% of relevant references were available in the students' own library, and 64% could be obtained within 48 hours. There was no difference between the two databases overall, but when two topics relating specifically to the organization of nursing were excluded, references found in MEDLINE were significantly more accessible. We recommend that MEDLINE should be regarded as the first choice of bibliographic database for any subject other than one related strictly to the organization of nursing.

Choice Behavior↗

PubMed1992

The MEDLINE Retriever.

Baylor College of Medicine has developed the MEDLINE Retriever, a tool to query MEDLINE, the data-base of medical literature at the National Library of Medicine. The MEDLINE Retriever communicates via the Internet to achieve excellent response time for MEDLINE queries. It uses the X Window System and the Motif toolkit, and employs the Knowbot Operating Environment developed by the Corporation for National Research Initiatives. We discuss the architecture of the MEDLINE Retriever, focusing on the graphical user interface that we have developed, as well as our experiences in developing and deploying the MEDLINE Retriever at Baylor. The MEDLINE Retriever is an extension of Baylor's IAIMS design concept that brought forth the Virtual Notebook System, and fits well with Baylor's aims with regard to the High Performance Computing Initiative.

Computer Communication Networks↗

PubMed1991

Evaluating the impact of MEDLINE using the Critical Incident Technique.

An adaptation of the Critical Incident Technique for the evaluation of an online information system is described. 552 users of the National Library of Medicine's MEDLINE database, interviewed by telephone and responding to a highly structured set of open-ended questions, reported 1,158 incidents in which the results of a MEDLINE search was especially helpful (or not helpful) in carrying out professional activities. Systematic analysis of these "critical incidents" produced three comprehensive and detailed views of the purposes and outcomes of MEDLINE searches: (1) why information is sought from MEDLINE; (2) the impact of MEDLINE-derived information on medical decision-making; and (3) the ultimate outcome of having (or not having) the desired information on medical situations prompting a MEDLINE search. Results revealed that MEDLINE is used to satisfy a diversity of medical needs concerning patient care, the progress of biomedical research, the quality of education received by health professionals in training, the safety and effectiveness of health care institutions, the operation of the system of third-party reimbursement, for legal decisions, and for the knowledge of the public.

Consumer Behavior↗

PubMed1991

MELVYL MEDLINE: a library services perspective.

The MELVYL MEDLINE project resulted in the addition of a full five-year subset of MEDLINE to the University of California's (UC) MELVYL online union catalog. As one of the nation's largest MEDLINE end-user searching systems, MELVYL MEDLINE provides online bibliographic access to the biomedical journal literature for all UC personnel at over seventy library sites or by remote access. This paper summarizes the project's accomplishments, reports MELVYL MEDLINE use and its impact on library services, and provides insights for other end-user search systems. The project serves as a model for adding databases to the MELVYL catalog and demonstrates the potential for use by other disciplines of a specialized database when readily accessible. Evaluation results report high user satisfaction and high usage. However, many advanced searching features of the interface are little used by searchers. Effects on library services include marked increases in reference transactions and interlibrary loans, with significant declines in mediated search services. Future MELVYL MEDLINE enhancements include matching search retrievals to journal locations, linkage to an online document delivery system, and consideration of building a superset of databases by combining MELVYL MEDLINE with citations from another database in the MELVYL catalog.

California↗

PubMed1993

International access to the Chinese medical literature through MEDLINE.

This article reviews, for authors publishing in the Chinese literature, the characteristics of MEDLINE users, the format of MEDLINE citations and the main retrieval strategies used with the system. References were retrieved and data collected through MEDLINE searches of the database 1988-June 1992. Thirty-six indexed journals from the People's Republic of China (PRC) were analyzed. The items of a MEDLINE citation are described. Titles of Chinese journals are listed in English as well as Chinese in the annual "List of Serials Indexed" of Index Medicus. Articles from journals in the PRC are indexed at the China MEDLARS Center, Beijing, PRC. For the 36 journals analyzed, 12,530 citations appeared in MEDLINE during the search period. Basic search strategies are described. Users doing author searches may have difficulties with common Chinese surnames, especially if only one given name initial is used. Journal searches of specialty journals, as well as address field searches for publications from a particular institution, may be helpful to scientists planning a visit to China. Effective use of MEDLINE has become an opportunity and responsibility for scientists and physicians over the world. Suggestions for preparation of English titles and abstracts to assure optimal information transfer and retrieval efficiency are: think about your audience; do not waste words; include key features in the title; be consistent with names and affiliations; use MeSH terms; include important non-MeSH terms in text; use structured abstracts; and obtain MEDLINE printouts of your own citations.

Authorship↗

PubMed1983

MEDLINE at BRS, DIALOG, and NLM: is there a choice?

Since May 1981, MEDLINE has been offered by three vendors: Bibliographic Retrieval Services, DIALOG, and the National Library of Medicine. Although the contents of these MEDLINE files are basically the same, they have major differences: on-line versus off-line coverage, costs, hours, software capabilities, and bibliographic variations. MEDLINE searchers need to know about the important differences among these three files whether or not they have direct access to them. Ideally, a searcher should have access to all three MEDLINEs. However, staying up to date on the basics of comparative MEDLINE searching should be the responsibility of each MEDLINE searcher. A broad-based decision about a vendor must consider the characteristics of each MEDLINE file and of each search request.

Costs and Cost Analysis↗

PubMed1992

The comprehensiveness of Medline and Embase computer searches. Searches for controlled trials of homoeopathy, ascorbic acid for common cold and ginkgo biloba for cerebral insufficiency and intermittent claudication.

OBJECTIVE: To assess the comprehensiveness of Medline and Embase computer searches for controlled trials. DESIGN: Comparison of articles found after an exhaustive search of the literature with the yield of a Medline or Embase search. This was performed for controlled clinical trials on the efficacy of three interventions: homoeopathy, ascorbic acid for common cold, and ginkgo biloba for intermittent claudication and cerebral insufficiency. The number of controlled trials found by exhaustive search of the literature was 107, 61 and 45, respectively. RESULTS: For homoeopathy, ascorbic acid and ginkgo the proportion of all trials found by Medline was 17%, 36% and 31% respectively and for Embase 13%, 25% and 58% respectively. After checking of the references in the Medline articles 44%, 79% and 76% of all trials were identified. After checking of the references in the Embase articles 42%, 72% and 93% of all trials were identified. About 20% of the articles was not correctly indexed. Of the best trials 68%, 91% and 83% could be found with Medline and 55%, 82% and 92% of the best trials were identified through Embase. CONCLUSIONS: For the topics mentioned, Medline and Embase searches are sufficient to get an impression of the evidence from controlled trials, but only if references in the articles are followed for further evidence. If one wants to get a more complete picture, additional search strategies make sense. Of course, this picture may be different for other topics.

Abstracting and Indexing↗

PubMed1994

An investigation of the adequacy of MEDLINE searches for randomized controlled trials (RCTs) of the effects of mental health care.

Valid reviews of the effects of mental health care depend on identifying as high a proportion as possible of relevant randomized controlled trials (RCTs). To investigate the sensitivity and precision both of MEDLINE and of hand-searching for RCTs in mental health, 12 journals specializing in mental health and indexed by the National Library of Medicine (NLM) for MEDLINE were searched for the years 1971, 1976, 1981, 1986 and 1991. The sensitivity of the hand-search was 94% (95% Confidence Interval (CI) 93-95%), but it had a precision of only 7% (CI 6-8%). The optimal MEDLINE search had a sensitivity of only 52% (CI 48-56%) and a precision of 59% (CI 55-63%). Of the reports of RCTs identified by the hand-search, 9% (CI 7-11%) were not included in MEDLINE at all. Authors had included methodological descriptions in 84% (CI 80-88%) of RCTs found by the hand-search but missed by the MEDLINE search. Systematic reviews of mental health care which are based solely on MEDLINE searches of the literature will miss a large proportion of the relevant RCTs, and are thus liable to random error and bias. A register of mental health RCTs is urgently required.

Bias↗

PubMed1994

Effect of search experience on sustained MEDLINE usage by students.

PURPOSE: While educators agree that medical students should learn to use MEDLINE for clinical application, there is a lack of consensus on an optimal level of exposure to this resource during training that will result in sustained usage. This study sought to identify the level of search experience (1) to increase the odds that the student searcher will continue to search MEDLINE in the absence of search assignments, and (2) to make an appreciable difference in the odds of retrieving items of relevance from the MEDLINE database. METHOD: Search frequencies of MEDLINE via the PaperChase interface by 184 fourth-year students (class of 1992) at the University of Michigan Medical School were analyzed using the log cross-product technique. The students were required to take the Comprehensive Clinical Assessment, an examination that included a search assignment, as they entered their fourth year of medical school. Their levels of MEDLINE use and their retrieval performances before the examination were compared with those achieved during the subsequent five months as fourth-year medical students. RESULTS: For those who searched an average of at least once a month during their first three years of medical school, there was a 7.38:1 chance that they would conduct three searches per month in the fourth year, compared with those who searched less frequently. The odds of retrieving at least one item of definite relevance were 8.27:1 for those who had searched at least one and one-half times per month before the search assignment. CONCLUSION: Searching once a month through the first few years of medical school provided an experience level that improved the odds that a student would continue to search MEDLINE: Data indicated that a history of a minimum of 1.5 online sessions per month increased the odds of retrieving relevant items to 8.27:1. Implications for educational strategy are clear.

Education, Medical, Undergraduate↗

PubMedDate not supplied

Use of MEDLINE by rural physicians in Washington state.

Studies have suggested that rural physicians do not use MEDLINE to aid their clinical decision making, and yet rural physicians appear to be a group that would benefit greatly from the use of MEDLINE because of their isolation from libraries and colleagues. This study was undertaken to understand why a population so likely to benefit from the use of MEDLINE is not using it. The study confirmed that rural physicians regard colleagues, reference texts, and journal articles as the most important information sources. However, a surprising number of rural generalist physicians in Washington, 40 percent of respondents, use MEDLINE, and most possess the requisite awareness, resources, and ability to use MEDLINE. Of those who use MEDLINE, 70 percent consider it a valuable clinical tool.

Attitude to Computers↗

PubMed2000

A study comparing centralized CD-ROM and decentralized intranet access to MEDLINE.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of a decentralized intranet access in each medical department as opposed to centralized unique MEDLINE access in the medical library. DESIGN: A two-phase questionnaire to evaluate MEDLINE use was given to junior and senior physicians at Rouen University Hospital (RUH). Phase I (August-October 1996) corresponded to a time period when centralized access was the only means of access available and phase II (August-October 1997) to a time period following the introduction of decentralized intranet access. RESULTS: A total of 168 physicians filled out at least one phase of the questionnaire, among whom 123 (73%) filled out both phases. Use of MEDLINE significantly increased in 1997 (average of 10.2+/-1.1 searches in three months) versus 1996 (average of 4.9+/-0.7 searches in three months, P<0.0001). The aim of searches changed, becoming significantly more care oriented in phase II (P<0.0001). The number of searches performed by the physicians alone increased (P<0.0001) and searches performed by the librarian decreased (P<0.0001) in phase II. The method of searches also changed, as searches by author (P< 0.0001), by journal (P = 0.0042), and by free word (P = 0.0027) increased in phase II. Knowledge of the following concepts of MEDLINE significantly increased: explosion (P<0.0001), scope note (P<0.0001), Abridged Index Medicus (AIM) journals (P<0.0001), Medical Subject Headings (MeSH) qualifier (P<0.0001), and focus (P<0.0001). CONCLUSION: A decentralized intranet access to MEDLINE increased the number of searches and knowledge of this bibliographic database. MEDLINE intranet access modified the purpose and the methods of searching.

CD-ROM↗

PubMed2002

Robustness of empirical search strategies for clinical content in MEDLINE.

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.

Information Storage and Retrieval↗

PubMed2006

[A list and analysis of reproductive medicine periodicals indexed in MEDLINE in 2006].

MEDLINE established by National Library of Medicine (NLM), USA, is the most commonly used biomedical literature retrieval system, whose indexed literature generally represents the top of the medical world. Of the total number of 4959 journals listed in the Lists of Journals Indexed in MEDLINE (2006) published by NLM, 46 are periodicals of reproductive medicine, mainly including andrology, fertility, and sterility. Researchers of reproductive medicine should be familiar with the journals indexed in MEDLINE, closely follow their published frontier researches in this field, and consciously contribute to them in English. Editors of reproductive medicine journals should endeavour to have their journals included in such internationally authoritative systems as MEDLINE, SCI, etc by publishing them in English in compliance with international standards. This article presents a list of the reproductive medicine periodicals indexed in MEDLINE (2006) together with a brief analysis, which is meant to help researchers in reproductive medicine, andrology and other relevant fields with their contribution, subscription, reading and retrieving, as well as to share some more knowledge about MEDLINE and its indexed journals with Chinese editors of reproductive medicine journals.

Bibliometrics↗

PubMedDate not supplied

Use of MEDLINE by physicians for clinical problem solving.

OBJECTIVE: To understand the ways in which computer-mediated searching of the biomedical literature affects patient care and other professional activities. Undertaken to determine the ways in which on-line access to the biomedical literature via the National Library of Medicine's MEDLINE database "makes a difference" in what physicians do when confronted with a medical problem requiring new or additional information. DESIGN: An adaptation of the Critical Incident Technique used to gather detailed reports of MEDLINE search results that were especially helpful (or not helpful) in carrying out the individual's professional activities. The individual physician was the source of the patient care incident reports. One thousand one hundred fifty-eight reports were systematically analyzed from three different perspectives: (1) why the information was sought; (2) the effect of having (or not having) the needed information on professional decisions and actions; and (3) the outcome of the search. PARTICIPANTS AND SETTING: Telephone interviews were carried out with a purposive sample of 552 physicians, scientists, and other professionals working in a variety of clinical care and other settings. Of these, 65% were direct users of MEDLINE throughout the United States, and 35% had MEDLINE searches conducted for them either at a major health sciences center or in community hospitals. RESULTS: Three comprehensive and detailed inventories that describe the motivation for the searches, how search results affected the actions and decisions of the individual who initiated the search, and how they affected the outcome of the situation that motivated the search. CONCLUSIONS: MEDLINE searches are being carried out by and for physicians to meet a wide diversity of clinical information needs. Physicians report that in situations involving individual patients, rapid access to the biomedical literature via MEDLINE is at times critical to sound patient care and favorably influences patient outcomes.

Data Collection↗

PubMed1999

Accessing the literature on outcome studies in group psychotherapy: the sensitivity and precision of Medline and PsycINFO bibliographic database searching.

BACKGROUND: Bibliographic databases such as Medline and PsycINFO are major sources of initial information for systematic reviews. This study investigates the adequacy of Medline and PsycINFO in retrieving articles describing outcome studies of group-based psychological treatments. METHOD: Ten journals publishing a high number of group psychotherapy articles were hand searched for the publication years 1993 and 1994. They were then searched using narrow and broad strategies developed for each database. RESULTS: The sensitivities (number of relevant articles identified by each search divided by the total number of known relevant articles identified by all searches) of narrow and broad Medline searches were 28% and 67% respectively. Precision (the number of relevant articles identified by a search divided by the number of both relevant and irrelevant articles identified by the search) was 91% and 35% for narrow and broad searches respectively. The sensitivities of narrow and broad PsycINFO searches were 8% and 47% respectively. Precision was 30% for the narrow search and 36% for the broad search. The hand search identified 94% of all known articles. CONCLUSIONS: PsycINFO performed more poorly than Medline. Although it was possible to identify 67% of outcome studies using Medline, the low precision of the necessary search strategies would make it uneconomical in practice. Abstracts of papers not identified by either search strategy were examined for possible reasons for this failure. For Medline this was generally due to the terms used to identify group psychotherapy. For PsycINFO it appears that the indexing system does not allow the easy identification of outcome studies.

Databases, Bibliographic↗

PubMed1993

MEDLINE Search Strategies for Literature on Asian Americans/Pacific Islanders.

PURPOSE OF THE REVIEW: The purpose of this study is to examine the professional health literature on Asian American/Pacific Islanders in MEDLINE, review the guiding indexing principles used in MEDLINE, and present suggestions on how to most effectively search for material in the database. SEARCH METHODS USED: The authors conducted database searches in MEDLINE and examined the National Library of Medicine indexing principles related to Asian Americans/Pacific Islanders to develop database search strategies. SUMMARY OF IMPORTANT FINDINGS: Two factors which contribute to the difficulty in identifying health literature on Asian Americans/Pacific Islanders are the small amount of material published when compared to other ethnic groups and the complex nature of indexing in MEDLINE that may create problems for less experienced database searchers. MAJOR CONCLUSIONS: Additional journal publications concerning Asian Americans/Pacific Islanders, a more thorough understanding of how the literature on this group is best retrieved from MEDLINE, and the development of more userfriendly approaches to the National Library of Medicine databases will aid researchers interested in this ethnic group. KEY WORDS: Asian Americans, MEDLINE, periodicals, databases, bibliographic

Journal Article↗