Of studies, syntheses, synopses, summaries, and systems: the "5S" evolution of information services for evidence-based healthcare decisions.
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Biomedical subjects
Publications and source records attributed to Brian Haynes.
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BACKGROUND: Many clinicians and researchers are interested in patients of a specific age (childhood, geriatrics, and so on). Searching for age-specific publications in large bibliographic databases such as Medline is problematic because of inconsistencies in indexing, overlapping age categories, and the spread of the relevant literature over many journals. To our knowledge, no empirically tested age-specific search strategies exist for Medline. OBJECTIVE: We sought to determine the retrieval characteristics of age-specific terms in Medline for identifying studies relevant for five clinical specialties: adult medicine, geriatric medicine, pediatric medicine, neonatal medicine, and obstetrics. METHODS: We compared age-specific search terms and phrases for the retrieval of citations in Medline with a manual hand search of the literature for 161 core health care journals. Six experienced research assistants who were trained and intensively calibrated read all issues of 161 journals for the publishing year 2000. In addition to classifying all articles for purpose and quality, study participants' ages were also recorded. Outcome measures were sensitivity, specificity, precision, and accuracy of single and combination search terms. RESULTS: When maximizing sensitivity, the best sensitivity and specificity achieved with combination terms were 98% and 81.2%, respectively, for pediatric medicine, 96.4% and 55.9% for geriatric medicine, 95.3% and 83.6% for neonatal medicine, 94.9% and 64.5% for adult medicine, and 82% and 97.1% for obstetrics. When specificity was maximized, all disciplines had an expected decrease in sensitivity and an increase in precision. Highest values for optimizing best sensitivity and specificity were achieved in neonatal medicine, 92.5% and 92.6%, respectively. CONCLUSION: Selected single terms and combinations of MeSH terms and textwords can reliably retrieve age-specific studies cited in Medline.
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Explore the source record for details and available documents.
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BACKGROUND: Following bacterial contamination of a municipal water system in the rural town of Walkerton, Ontario, over 2,300 cases of acute gastroenteritis were documented. The Walkerton Health Study is currently underway to assess for long-term health sequelae among consenting inhabitants of Walkerton, related to the original outbreak. We explored whether the association between the acute exposure and preliminary long-term health outcomes may have been biased through differences between early- and late-recruited study participants. METHODS: Using multiple data sources, including the 1996 and 2001 Canadian Census, and records from the Regional Health Unit, hospital and Walkerton Health Study, we determined both sample representativeness and the anticipated effects of intensifying study participant recruitment. Selection bias was assessed by examining for differences between initial and late participants, and their subsequent risk of having hypertension, proteinuria and reduced renal clearance. RESULTS: Of the 4,315 participants, 2,756 were permanent residents of Walkerton, representing 55% of the town's total population. The sample was demographically similar to the population of interest, although statistically women were more likely to participate than men (55% of sample were women compared to 52% of population, p<0.01), and the proportion of both young and very elderly adults was smaller than expected (13% of sample were > or = 65 years of age compared to 18% of population, p<0.01). Comparing the initial 3,959 participants to the 356 persons additionally recruited with substantial effort, the latter were more likely to be free of symptoms during the outbreak (21% vs. 7%, p<0.001), but were otherwise similar in terms of age, sex, the use of medical care resources and underlying health state predating the outbreak. The risk of long-term hypertension or renal sequelae did not significantly differ between initial and late study recruits. CONCLUSIONS: Participants in the Walkerton Health Study represent the population of interest, and comprise those who were acutely ill during the infected water outbreak. The available study sample should provide reasonably unbiased estimates of the associated risk between acute bacterial gastroenteritis and long-term health sequelae.
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