Abstract
<h3>To the Editor.</h3> —Lindberg et al<sup>1</sup>report that physicians find that searching the MEDLINE database "is at times critical to sound patient care and favorably influences patient outcomes." This conclusion is a welcome reflection on the wisdom of the National Library of Medicine (NLM) in establishing the database and in making it available so inexpensively to the clinical and academic communities worldwide. Unfortunately, clinicians may not be aware that MEDLINE is highly selective in its decision as to which sources of information to index, and indeed its choice of journals has been described as idiosyncratic by Wakeford and Roberts.<sup>2</sup>In recent clinical reviews or case presentations we frequently read that a MEDLINE search was done, leaving the reader to believe that the relevant world literature was assessed. Henshaw<sup>3</sup>reports that MEDLINE has a select coverage, mainly of US journals, and that it has only a 36% overlap
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