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. 2015 Jul 31:15:57.
doi: 10.1186/s12874-015-0058-2.

Efficiency of pragmatic search strategies to update clinical guidelines recommendations

L Martínez García  1 , A J Sanabria  2 , I Araya  3 , J Lawson  4 , I Solà  5 , R W M Vernooij  6 , D López  7 , E García Álvarez  8 , M M Trujillo-Martín  9 , I Etxeandia-Ikobaltzeta  10 , A Kotzeva  11   12 , D Rigau  13 , A Louro-González  14 , L Barajas-Nava  15 , P Díaz del Campo  16 , M D Estrada  17   18 , J Gracia  19 , F Salcedo-Fernandez  20 , R B Haynes  21 , P Alonso-Coello  22   23 ; Updating Guidelines Working Group
Collaborators, Affiliations

Efficiency of pragmatic search strategies to update clinical guidelines recommendations

L Martínez García et al. BMC Med Res Methodol. .

Abstract

Background: A major challenge in updating clinical guidelines is to efficiently identify new, relevant evidence. We evaluated the efficiency and feasibility of two new approaches: the development of restrictive search strategies using PubMed Clinical Queries for MEDLINE and the use of the PLUS (McMaster Premium Literature Service) database.

Methods: We evaluated a random sample of recommendations from a national guideline development program and identified the references that would potentially trigger an update (key references) using an exhaustive approach. We designed restrictive search strategies using the minimum number of Medical Subject Headings (MeSH) terms and text words required from the original exhaustive search strategies and applying broad and narrow filters. We developed PLUS search strategies, matching Medical Subject Headings (MeSH) and Systematized Nomenclature of Medicine (SNOMED) terms with guideline topics. We compared the number of key references retrieved by these approaches with those retrieved by the exhaustive approach.

Results: The restrictive approach retrieved 68.1 % fewer references than the exhaustive approach (12,486 versus 39,136), and identified 89.9 % (62/69) of key references and 88 % (22/25) of recommendation updates. The use of PLUS retrieved 88.5 % fewer references than the exhaustive approach (4,486 versus 39,136) and identified substantially fewer key references (18/69, 26.1 %) and fewer recommendation updates (10/25, 40 %).

Conclusions: The proposed restrictive approach is a highly efficient and feasible method to identify new evidence that triggers a recommendation update. Searching only in the PLUS database proved to be a suboptimal approach and suggests the need for topic-specific tailoring.

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Figures

Fig. 1
Fig. 1
Restrictive approach algorithm. Figure01_RestrictiveApproachAlgorithm. Microsoft PowerPoint presentation
Fig. 2
Fig. 2
References analysis. Figure02_ReferencesAnalysis. Microsoft PowerPoint presentation
Fig. 3
Fig. 3
Key references not identified by restrictive approach. Figure03_RefNotIdentifiedRestrictive. Microsoft PowerPoint presentation
Fig. 4
Fig. 4
Key references not identified by PLUS approach. Figure04_RefNotIdentifiedPLUS. Microsoft PowerPoint presentation
See this image and copyright information in PMC

References

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