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An investigation of the adequacy of MEDLINE searches for randomized controlled trials (RCTs) of the effects of mental health care

Published online by Cambridge University Press:  09 July 2009

C. E. Adams ,
A. Power ,
K. Frederick  and
C. Lefebvre
C. E. Adams*
Affiliation:
Departments of Psychiatry and General Adult Psychiatry, Warneford Hospital, Oxford; UK Cochrane Centre, Oxford
A. Power
Affiliation:
Departments of Psychiatry and General Adult Psychiatry, Warneford Hospital, Oxford; UK Cochrane Centre, Oxford
K. Frederick
Affiliation:
Departments of Psychiatry and General Adult Psychiatry, Warneford Hospital, Oxford; UK Cochrane Centre, Oxford
C. Lefebvre
Affiliation:
Departments of Psychiatry and General Adult Psychiatry, Warneford Hospital, Oxford; UK Cochrane Centre, Oxford
*
1Address for correspondence: Dr Clive E. Adams, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX
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Synopsis

Valid reviews of the effects of mental health care depend on identifying as high a proportion as possible of relevant randomized controlled trials (RCTs). To investigate the sensitivity and precision both of MEDLINE and of hand-searching for RCTs in mental health, 12 journals specializing in mental health and indexed by the National Library of Medicine (NLM) for MEDLINE were searched for the years 1971, 1976, 1981, 1986 and 1991. The sensitivity of the hand-search was 94% (95% Confidence Interval (CI) 93–95%), but it had a precision of only 7% (CI 6–8%). The optimal MEDLINE search had a sensitivity of only 52% (CI 48–56%) and precision of 59% (CI 55–63%). Of the reports of RCTs identified by the hand-search, 9% (CI 7–11 %) were not included in MEDLINE at all. Authors had included methodological descriptions in 84% (CI 80–88%) of RCTs found by the hand-search but missed by the MEDLINE search. Systematic reviews of mental health care which are based solely on MEDLINE searches of the literature will miss a large proportion of the relevant RCTs, and are thus liable to random error and bias. A register of mental health RCTs is urgently required.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 3 , August 1994 , pp. 741 - 748
Copyright
Copyright © Cambridge University Press 1994

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