Instant Electronic Access to Randomized Controlled Trials (RCT)

Abstract

As readers will know, since 2004, the Centre for Evidence in Transplantation has twice a year published a registry of all published randomized controlled trials (RCTs) in organ transplantation, together with an assessment of the methodological quality of each trial. This popular feature has been well received by our readers. However, it has become evident that although this resource is useful for the transplant community, it will be increasingly difficult to find the RCTs required for a particular intervention in organ transplantation. Furthermore, there can be a lapse of 1 year between the publication of a registry and its appearance in the journal. For this reason, the Centre for Evidence in Transplantation, in collaboration with Lippincott Williams & Wilkins, has developed an electronic transplant library that is easy to search, up-to-date, and particularly useful for a busy clinician looking quickly for level 1 evidence. The transplant library contains all randomized controlled trials in organ transplantation since 1970, and all trials from January 2004 will continue to be assessed for quality. The database for the library is comprehensive, covering both the English and the non-English literature, as well as conference proceedings. The library is updated every 2 weeks. In due course, we hope to add a library of systematic reviews in organ transplantation and also highlights from national and international registries in organ transplantation. We will also indicate articles or trials in transplantation that are in the “must read” category. A common question is why do we need this specialized library when one can use PubMed (MEDLINE) (currently used mostly by doctors), Google, Google Scholar, and the Cochrane Library of RCTs? In a recent editorial by Steinbrook in the New England Journal of Medicine, it was noted that searches on PubMed have risen from around 1 million per month in 1997 to 70 million in 2005 (1). The editorial also noted that Google is now the most commonly used search engine for examining the medical literature. The answer to the question posed above is that a true and accurate search of the literature using MEDLINE requires quite sophisticated search skills, and indeed use of the Cochrane Library also requires a certain amount of search skills. It is noteworthy that, in the same editorial, Steinbrook discussed the increasing difficulty of searching the literature and cites a comment from John Sack, director of HighWire Press, that “most human beings on the planet who are not librarians don’t know anything about how to search with MeSH.” We would add that most of those in the profession, even if they have the appropriate skills, do not have the time. Google and Google Scholar are not comprehensive, with many hits but also many misses. For these reasons, we have developed a library that can be quickly searched in a matter of minutes with minimal search skills (rather than in hours as might be the case when using PubMed or even the Cochrane Library) to retrieve all RCTs on any given topic. The last registry publication in Transplantation is in this issue of the journal, covering trials from June 30th until December 31st of 2006. The electronic library is up-to-date and even includes trials that have been published electronically in advance of their appearance in print. This library will become available to subscribers to Transplantation on January 1, 2008. Peter J. Morris European Special Features Editor Anthony P. Monaco North American Special Features Editor Jim Mulligan Publisher