Abstract
BackgroundEconomic evaluations in the medical literature compare competing diagnosis or treatment methods for their use of resources and their expected outcomes. The best evidence currently available from research regarding both cost and economic comparisons will continue to expand as this type of information becomes more important in today's clinical practice. Researchers and clinicians need quick, reliable ways to access this information. A key source of this type of information is large bibliographic databases such as EMBASE. The objective of this study was to develop search strategies that optimize the retrieval of health costs and economics studies from EMBASE.MethodsWe conducted an analytic survey, comparing hand searches of journals with retrievals from EMBASE for candidate search terms and combinations. 6 research assistants read all issues of 55 journals indexed by EMBASE for the publishing year 2000. We rated all articles using purpose and quality indicators and categorized them into clinically relevant original studies, review articles, general papers, or case reports. The original and review articles were then categorized for purpose (i.e., cost and economics and other clinical topics) and depending on the purpose as 'pass' or 'fail' for methodologic rigor. Candidate search strategies were developed for economic and cost studies, then run in the 55 EMBASE journals, the retrievals being compared with the hand search data. The sensitivity, specificity, precision, and accuracy of the search strategies were calculated.ResultsCombinations of search terms for detecting both cost and economic studies attained levels of 100% sensitivity with specificity levels of 92.9% and 92.3% respectively. When maximizing for both sensitivity and specificity, the combination of terms for detecting cost studies (sensitivity) increased 2.2% over the single term but at a slight decrease in specificity of 0.9%. The maximized combination of terms for economic studies saw no change in sensitivity from the single term and only a 0.1% increase in specificity.ConclusionSelected terms have excellent performance in the retrieval of studies of health costs and economics from EMBASE.
Highlights
Economic evaluations in the medical literature compare competing diagnosis or treatment methods for their use of resources and their expected outcomes
Sensitivity for a given topic is defined as the proportion of high quality articles for that topic that are retrieved; specificity is the proportion of low quality articles not retrieved; precision is the proportion of retrieved articles that are of high quality; and accuracy is the proportion of all articles that are correctly classified
Economics studies formed a subset of cost studies and were evaluated for methodologic rigor as follows: The study question is a comparison of alternatives; alternative services or activities are compared on outcomes produced and resources consumed; evidence of effectiveness must be from a study of real patients that meets the criteria for diagnosis, treatment, quality improvement, or a systematic review article; effectiveness and cost estimates are based on individual patient data; results are presented in terms of the incremental or additional costs and outcomes of one intervention over another; and sensitivity analysis is provided if there is uncertainty
Summary
The best evidence currently available from research regarding both cost and economic comparisons will continue to expand as this type of information becomes more important in today's clinical practice. Economic evaluations in the medical literature compare competing diagnosis or treatment methods for their use of resources and their expected outcomes. Several databases provide access to this literature; some are specialty databases such as the U.K. National Health Service Economic Evaluation Database while others are large general purpose biomedical databases. End-users frequently access the medical literature online via the huge biomedical databases such as MEDLINE and EMBASE. Gaining access to this economic and cost literature through these databases can be daunting. The retrieval of relevant information is difficult due to the millions of articles and thousands of journals indexed, the minuscule concentration of articles with economic content, and the inconsistency of indexing within the databases [3,4]
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