Abstract
The research sought to determine the value of PubMed filters and combinations of filters in literature selected for systematic reviews on therapy-related clinical questions. References to 35,281 included and 48,514 excluded articles were extracted from 2,629 reviews published prior to January 2008 in the Cochrane Database of Systematic Reviews and sent to PubMed with and without filters. Sensitivity, specificity, and precision were calculated from the percentages of unfiltered and filtered references retrieved for each review and averaged over all reviews. Sensitivity of the Sensitive Clinical Queries filter was reasonable (92.7%, 92.1-93.3); specificity (16.1%, 15.1-17.1) and precision were low (49.5%, 48.5-50.5). The Specific Clinical Queries and the Single Term Medline Specific filters performed comparably (sensitivity, 78.2%, 77.2-79.2 vs. 78.0%; 77.0-79.0; specificity, 52.0%, 50.8-53.2 vs. 52.3%, 51.1-53.5; precision, 60.4%, 59.4-61.4 vs. 60.6%, 59.6-61.6). Combining the Abridged Index Medicus (AIM) and Single Term Medline Specific (65.2%, 63.8-66.6), Two Terms Medline Optimized (64.2%, 62.8-65.6), or Specific Clinical Queries filters (65.0%, 63.6-66.4) yielded the highest precision. Sensitive and Specific Clinical Queries filters used to answer questions about therapy will result in a list of clinical trials but cannot be expected to identify only methodologically sound trials. The Specific Clinical Queries filters are not suitable for questions regarding therapy that cannot be answered with randomized controlled trials. Combining AIM with specific PubMed filters yields the highest precision in the Cochrane dataset.
Highlights
PubMed [1] is one of the major sources of medical information
Clinical Queries filters have been designed to help physicians limit search results, achieving high sensitivity or specificity, depending on the filter, but limited precision. These filters have been previously validated by internal validation on a subset of clinical journals, not related to clinical questions, limiting the generalizability of the results
This study is the first to perform an external validation of the Clinical Queries filters for therapy using references in Cochrane reviews as a gold standard
Summary
PubMed [1] is one of the major sources of medical information. Information sources containing integrated data, like online textbooks and guidelines, are more practical for handling daily clinical questions, PubMed or comparable databases are indispensable for answering detailed questions, finding information on rare diseases, or uncovering the latest developments [2]. Physicians trying to answer patient-related questions using PubMed during daily medical care are confronted with the difficult task of retrieving only relevant information. Retrieving a limited set of articles that is likely to answer the question requires skill. After potentially relevant articles have been retrieved, a critical appraisal must follow to determine the methodological quality of each study. Tools that help in retrieving a small set of methodologically strong trials can help the physician find relevant answers to the question
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