Search strategies to identify diagnostic accuracy studies in MEDLINE and EMBASE

A systematic and extensive search for as many eligible studies as possible is essential in any systematic review. When searching for diagnostic test accuracy (DTA) studies in bibliographic databases, it is range of specificities and precision were reported amongst the evaluation studies for MEDLINE filters without an original performance measure. Sensitivities ranged from 31 to 100 (median 71 ), specificity ranged from 13 to 90 (median 55.5 ) and precision from 1.0 to 11.0 (median 3.35 ).For the EMBASE filters, the original sensitivities reported in two development studies ranged from 74 to 100 (median 90 ) for three filters, and precision ranged from 1.2 to 17.6 (median 3.7 ). Evaluation studies of these filters had sensitivities from 72 to 97 (median 86 ) and precision from 1.2 to 9 (median 3.7 ). The performance of EMBASE search filters in development and evaluation studies were more alike than the performance of MEDLINE filters in development and evaluation studies. None of the EMBASE filters in either type of study had a sensitivity above 90 and precision above 10 . None of the current methodological filters designed to identify reports of primary DTA studies in MEDLINE or EMBASE combine sufficiently high sensitivity, required for systematic reviews, with a reasonable degree of precision. This finding supports the current recommendation in the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy that the combination of methodological filter search terms with terms for the index test and target condition should not be used as the only approach when conducting formal searches to inform systematic reviews of DTA.