BMJ 2004;328:1040 (1 May), doi:10.1136/bmj.38068.557998.EE (published 8 April 2004)
Paper
Optimal search strategies for retrieving scientifically strong studies of diagnosis from Medline: analytical survey
R Brian Haynes, professor1,
Nancy L Wilczynski, research associate1, Hedges Team
1 Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
Correspondence to: R B Haynes bhaynes{at}mcmaster.ca
Objective To develop optimal search strategies in Medline for retrieving sound clinical studies on the diagnosis of health disorders.
Design Analytical survey.
Setting Medline, 2000.
Participants 170 journals for 2000 of which 161 were indexed in Medline.
Main outcome measures The sensitivity, specificity, precision ("positive predictive value"), and accuracy of 4862 unique terms in 17 287 combinations were determined by comparison with a hand search of all articles (the "gold standard") in 161 journals published during 2000 (49 028 articles).
Results Only 147 (18.9%) of 778 articles about diagnostic tests met basic criteria for scientific merit. Combinations of search terms reached peak sensitivities of 98.6% at a specificity of 74.3%. Compared with best single terms, best multiple terms increased sensitivity for sound studies by 6.8% (absolute increase), while also increasing specificity (absolute increase 6.0%) when sensitivity was maximised. When terms were combined to maximise specificity, the single term, specificity.tw. (98.4%), outperformed combinations of terms. The strategies newly reported in this paper outperformed other validated search strategies except for one strategy that had slightly higher sensitivity (99.3% v 98.6%) but lower specificity (54.7% v 74.3%).
Conclusion New empirical search strategies in Medline can optimise retrieval of articles reporting high quality clinical studies of diagnosis.

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Rapid Responses:
Read all Rapid Responses
- Does it help to use the best search strategy?
- Jos H Verbeek, et al.
bmj.com, 14 Apr 2004
[Full text]
- Network of expertise
- Sara J Stock
bmj.com, 30 Apr 2004
[Full text]
- New search filter for diagnostic studies: Ovid and PubMed versions not the same
- Yngve T Falck-Ytter, et al.
bmj.com, 28 May 2004
[Full text]
- Response to letter: New search filter for diagnostic studies: Ovid and PubMed versions not the same
- Nancy L Wilczynski, et al.
bmj.com, 25 Jan 2006
[Full text]
- Response to letter: Does it help to use the best search strategy?
- Nancy L. Wilczynski, et al.
bmj.com, 3 Feb 2006
[Full text]
- Response to letter: Network of expertise
- Nancy L. Wilczynski, et al.
bmj.com, 3 Feb 2006
[Full text]