Identifying diagnostic studies relevant for primary health care

Article type
Authors
van der Weijden T, Dinant G, van Duijn N, Jzermans J, Buntinx F
Abstract
Introduction: In the scope of reviewing diagnostic studies, the first important step is collecting data in a systematic and reproducible way.

Objective: To examine the sensitivity and precision of MESH searching in comparison with a combination of MESH and freetext searching for the identification of diagnostic studies in Medline.

Methods: Two medical tests were choosen to address the question; the ability of the erythrocyte sedimentation rate (ESR) to discriminate between 'pathology' and 'no pathology', and the diagnostic accuracy of the dipstick test for urinary tract infection. The results of each Medline search were compared with a gold standard set of studies: a literature database on ESR collected continuously during many years by one of the authors (GJD), and the result of all available search methods on dipstick. Outcome measures: Sensitivity (the proportion of the total number of known diagnostic studies identified by the search) and Precision (the proportion of publications retrieved by Medline that were actually diagnostic studies).

Results: With the combined search high sensitivity could be reached: 0.91 and 0.98 for ESR and dipstick respectively. The precision was 0.10 for ESR and 0.67 for dipstick. By restricting the search to the primary care setting sensitivity droppped to 0.10 (ESR) and 0.00 for (dipstick).

Discussion: Combining freetext and MESH searching, without restriction to the setting, is the most valuable strategy in systematic searching for diagnostic studies. The precision seems dependent on the extent of the indication area of the test.