Search strategies to identify reports on “off-label” drug use in EMBASE

Bita Mesgarpour · Markus Müller · Harald Herkner

12 citations0/0 files storedBMC Medical Research Methodology

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Meta-analysis and systematic reviews Information Retrieval and Search Behavior Pharmaceutical industry and healthcare

Abstract

BACKGROUND: Medications are frequently prescribed outside their regulatory approval (off-label) by physicians particularly where appropriate therapies are not available. However, the risk/benefit ratio of drugs in off-label use needs to be critically appraised because it may differ from approved on-label usage. Therefore, an extensive exploration of current evidence on clinical data is well-advised. The objective of this study was to develop a search strategy that facilitates detection of the off-label drug use documents in EMBASE via OvidSP. METHODS: We constructed two sets of gold standards from relevant records to off-label drug use by a sensitive search of MEDLINE and EMBASE. Search queries, including search words and strings, were conceived based on definition of off-label use of medications as well as text analysis of 500 randomly selected relevant documents. The selected terms were searched in EMBASE (from 1988 to 2011) and their retrieval performance was compared with the gold standards. We developed a sensitivity-maximizing, and a sensitivity- and precision-maximizing search strategy. RESULTS: From 4067 records relevant to off-label drug use in our full gold standard set, 3846 records were retrievable from EMBASE. "off label*.af." was the most sensitive single term (overall sensitivity 77.5%, sensitivity within EMBASE 81.9%, precision 88.1%). The highest sensitive search strategy was achieved by combining 36 search queries with overall sensitivity of 94.0% and precision of 69.5%. An optimal sensitive and precise search strategy was yielded precision 87.4% at the expense of decreasing overall sensitivity to 89.4%. CONCLUSION: We developed highly sensitive search strategies to enhance the retrieval of studies on off-label drug use in OvidSP EMBASE.

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2003Should meta-analysts search Embase in addition to Medline?2004Comparison of Medical Subject Headings and text-word searches in MEDLINE to retrieve studies on sleep in healthy individuals.2006Comparison of top-performing search strategies for detecting clinically sound treatment studies and systematic reviews in MEDLINE and EMBASE.2005EMBASE versus MEDLINE for family medicine searches: can MEDLINE searches find the forest or a tree?2009How well do search filters perform in identifying economic evaluations in MEDLINE and EMBASE 2010MEDLINE Versus EMBASE and CINAHL for Telemedicine Searches 2008So many databases, such little clarity: Searching the literature for the topic aboriginal.2011Search filter precision can be improved by NOTing out irrelevant content.

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