Database searching in manual medicine

Article type
Authors
Aker PD
Abstract
Introduction: Use of computerized literature databases is expected when background literature searching is conducted. Accessibility, time, and costs make this form of literature retrieval preferable to manual methods. In the field of manual medicine, many relevant journals are not contained in the commonly used MEDLINE computerized database.

Objective: To determine whether searching computerized databases in addition to MEDLINE would yield further relevant literature, the efficiency of 4 different computerized databases was compared.

Methods: Using identical or similar search terms, searches for English literature on efficacy of manual therapy to the cervical spine were conducted in CHIROLARS (Chiropractic), CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE (Excerpta Medica) and MEDLINE (Index Medicus) databases from 1966 forward (or as early as possible). Relevant citations were classified by methodology to find RCTs. (a) The number of relevant RCTs divided by the total number of citations x 100%, and (b) the cost per RCT, were used as measures of database efficiency.

Results: Of 1457 total citations from the 4 databases, 767 were relevant. CHIROLARS found 376 relevant citations for a cost of $57.78; CINAHL found 8 for $14.54; EMBASE found 191 for $451.93; and MEDLINE found 192 for $25.39. Seventeen discrete RCTs were identified, 11 each by CHIROLARS, EMBASE and MEDLINE and 1 by CINAHL. Efficiency measures for each database were: CHIROLARS (a) 1.3%, (b) $5.25; CINAHL 8%, $14.54; EMBASE 3.6%, $41.08; and MEDLINE 3.5%, $2.31.

Discussion: Reviews of the literature in manual medicine require searching of at least 2 computerized databases. MEDLINE is the most efficient database to search, but alone will only retrieve approximately 65% of the accessible RCTs on the topic. EMBASE is the second most efficient in terms of RCT retrieval rate, but is expensive. CHIROLARS is inexpensive, but retrieves a large number of non-relevant citations along with the relevant citations. CINAHL does not contribute beyond what the other three databases offer.