循证医学系统综述来源文献与检索策略的分析研究
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摘要
背景：循证医学模式的出现使系统综述成为一种新型的文献形式在医疗实践过程中传播、交流、利用和更新。但是系统综述由于其制作过程的特殊性和制作人员较少等原因，导致目前系统综述的数量较少且不能满足循证医学实践的需求；另外，目前已有的系统综述已分布在著名的循证医学数据库和书目数据库之中，但是由于医学实践工作者没有广泛、全面的利用现有的系统综述资源，有碍于循证医学实践的顺利开展。因此在保证系统综述质量的基础上大量提高其数量的研究以及系统综述检索策略的研究成为了循证医学发展过程中的一项重大研究课题。
目的：本文是从系统综述的产生和利用两个角度来分析研究它的文献来源和检索策略，为系统综述的制作者和利用者提供一些定性和定量的参考信息，从而促进循证医学实践模式的顺利发展。
方法：首先，采用网上跟踪调查法，统计分析了Cochrane Library系统综述文摘来源文献的检索方法和信息资源；其次，通过转换英国York大学制定的OVID数据库检索系统综述的检索策略至PubMed／Medline数据库，并进行试验性检索对比分析几种检索策略的差异。
结果：1、2002年度Cochrane Library系统综述文摘共增加了282篇；2、Cochrane系统综述者使用了以下几种检索方法：机检电子信息资源(100％)、浏览参考文献或参考书目(56.89％)、联系作者、研究者、试验者、专家等(43.73％)、联系厂家、企业等机构组织(22.10％)、手检会议文献(17.85％)、手检期刊(16.89％)、手检图书、教材、出版物等(2.76％)、手检印刷版检索工具书(1.57％)、浏览灰色文献(1.06％)，其中手检方式占总检索方法的25.73％；3、Cochrane系统综述者于2002年度共利用了286种信息资源；4、Cochrane专业组数据库之间的交叉利用；5、四种检索系统综述的检索策略存在较大的差异。
结论：1、鼓励全体医疗工作者积极参与系统综述的制作过程以提高系统综述的数量；2、广泛、全面地利用优质的信息资源，确保来源文献的真实性和可靠性，从而提高系统综述的质量；3、使用系统的、
无偏倚的检索方法和检索途径保证原始文献的检全率；4、根据医学专
业的内在联系注意利用相关专业的数据库；5、根据检索目的的不同，
应选择不同的检索策略检索系统综述文献。
根据统计分析的结果，创建一个循证医学信息资源集成检索系统
模型，可为系统综述的制作者和利用者直接获取循证医学信息资源提
供极大的方便。
Background: Systematic Reviews (SRs), as a new type of literature, are spread, communicated, utilized and updated in medical practice while the Evidence Based Medicine (EBM) is emerging. Because of the particularity of the SR's producing process and a little of systematic reviewers, the quantities of current SRs are less and can not meet the need of EBM practitioners. On the other hand, although SRs have distributed in EBM databases and bibliographic databases, the medical practitioners don't utilize them sufficiently and this will hold back the development of EBM practices. Therefore, the study on how to increase the quantities of the SRs at the same time to improve its quality and the search strategies for the SRs have become more and more important in the development of EBM.
Objective: The materials and the search strategies for the SRs are analyzed in this paper. The results of this study will provide many useful references to the systematic reviewers and the users of the SRs.
Methods: Firstly, calculated and analyzed the search methods and the information resources of material for SRs in Cochrane Library using network survey; Secondly, converted the search strategies for SRs which are established by the UK York University in OVID database to *
PubMed/Medline database, and do a experimental search to find differences between the four search strategies.
Results: 1. SR Abstracts of Cochrane Library increased 282 records in 2002; 2. Cochrane systematic reviewers used many search methods, such as searching the electronic information resources by computer (100%), browsing bibliographies and the reference lists of identified studies and review articles (56.89%), contacting author, investigator, trialist, experts and so on (43.73%), contacting manufacturer, industry and relevant organization (22.10%), hand-searching conference proceedings(17.85%), hand-searching relevant journals(16.89%), hand-searching books, textbooks and relevant publications(2.76%), hand-searching printed retrieval books(1.57%), browsing the grey literature(1.06%). The percent of hand-searching is
25.73% in the total searching approaches; 3. Cochrane systematic reviewer utilized 286 information resources in 2002; 4. Cochrane Collaborative Review Groups are cross-referenced; 5. There are significant differences between the four search strategies to SRs.
Conclusion: 1. Encourage all of the medical practitioners to participate actively in the process of producing SRs to increase the quantity of SRs; 2. To ensure the authenticity and dependability of the material of SRs and improve the quality of the SRs, we should utilize the high-quality information resources widely and completely; 3. Using systematic, no-biased search methods can ensure the sensitivity of the search results; 4. Pay attention to utilize relevant databases; 5. Select appropriate search strategies to search SRs according to the searching purpose.
According to the results of this study, we established a model of integrated search system about EBM information resources. It will provide conveniences to get EBM information for the systematic reviewers and the users of the SRs.
目的：本文是从系统综述的产生和利用两个角度来分析研究它的文献来源和检索策略，为系统综述的制作者和利用者提供一些定性和定量的参考信息，从而促进循证医学实践模式的顺利发展。
方法：首先，采用网上跟踪调查法，统计分析了Cochrane Library系统综述文摘来源文献的检索方法和信息资源；其次，通过转换英国York大学制定的OVID数据库检索系统综述的检索策略至PubMed／Medline数据库，并进行试验性检索对比分析几种检索策略的差异。
结果：1、2002年度Cochrane Library系统综述文摘共增加了282篇；2、Cochrane系统综述者使用了以下几种检索方法：机检电子信息资源(100％)、浏览参考文献或参考书目(56.89％)、联系作者、研究者、试验者、专家等(43.73％)、联系厂家、企业等机构组织(22.10％)、手检会议文献(17.85％)、手检期刊(16.89％)、手检图书、教材、出版物等(2.76％)、手检印刷版检索工具书(1.57％)、浏览灰色文献(1.06％)，其中手检方式占总检索方法的25.73％；3、Cochrane系统综述者于2002年度共利用了286种信息资源；4、Cochrane专业组数据库之间的交叉利用；5、四种检索系统综述的检索策略存在较大的差异。
结论：1、鼓励全体医疗工作者积极参与系统综述的制作过程以提高系统综述的数量；2、广泛、全面地利用优质的信息资源，确保来源文献的真实性和可靠性，从而提高系统综述的质量；3、使用系统的、
无偏倚的检索方法和检索途径保证原始文献的检全率；4、根据医学专
业的内在联系注意利用相关专业的数据库；5、根据检索目的的不同，
应选择不同的检索策略检索系统综述文献。
根据统计分析的结果，创建一个循证医学信息资源集成检索系统
模型，可为系统综述的制作者和利用者直接获取循证医学信息资源提
供极大的方便。
Background: Systematic Reviews (SRs), as a new type of literature, are spread, communicated, utilized and updated in medical practice while the Evidence Based Medicine (EBM) is emerging. Because of the particularity of the SR's producing process and a little of systematic reviewers, the quantities of current SRs are less and can not meet the need of EBM practitioners. On the other hand, although SRs have distributed in EBM databases and bibliographic databases, the medical practitioners don't utilize them sufficiently and this will hold back the development of EBM practices. Therefore, the study on how to increase the quantities of the SRs at the same time to improve its quality and the search strategies for the SRs have become more and more important in the development of EBM.
Objective: The materials and the search strategies for the SRs are analyzed in this paper. The results of this study will provide many useful references to the systematic reviewers and the users of the SRs.
Methods: Firstly, calculated and analyzed the search methods and the information resources of material for SRs in Cochrane Library using network survey; Secondly, converted the search strategies for SRs which are established by the UK York University in OVID database to *
PubMed/Medline database, and do a experimental search to find differences between the four search strategies.
Results: 1. SR Abstracts of Cochrane Library increased 282 records in 2002; 2. Cochrane systematic reviewers used many search methods, such as searching the electronic information resources by computer (100%), browsing bibliographies and the reference lists of identified studies and review articles (56.89%), contacting author, investigator, trialist, experts and so on (43.73%), contacting manufacturer, industry and relevant organization (22.10%), hand-searching conference proceedings(17.85%), hand-searching relevant journals(16.89%), hand-searching books, textbooks and relevant publications(2.76%), hand-searching printed retrieval books(1.57%), browsing the grey literature(1.06%). The percent of hand-searching is
25.73% in the total searching approaches; 3. Cochrane systematic reviewer utilized 286 information resources in 2002; 4. Cochrane Collaborative Review Groups are cross-referenced; 5. There are significant differences between the four search strategies to SRs.
Conclusion: 1. Encourage all of the medical practitioners to participate actively in the process of producing SRs to increase the quantity of SRs; 2. To ensure the authenticity and dependability of the material of SRs and improve the quality of the SRs, we should utilize the high-quality information resources widely and completely; 3. Using systematic, no-biased search methods can ensure the sensitivity of the search results; 4. Pay attention to utilize relevant databases; 5. Select appropriate search strategies to search SRs according to the searching purpose.
According to the results of this study, we established a model of integrated search system about EBM information resources. It will provide conveniences to get EBM information for the systematic reviewers and the users of the SRs.
引文
[1] 王吉耀．循证医学与临床实践．北京：科学出版社，2002．1
[2] Sackett DL, et al: Evidence based medicine: what it is and what it isn't? BMJ 1996 Jan 13;312(7023):71-2
[3] Sackett DL, et al: Evidence-based medicine. Now to practice and teach EBM(2nd edition). Edinburgh: Churchill Livingstone, 2000.1-240
[4] Cook DJ, et al: Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med 1997 Mar 1;126(5):376-80
[5] 王家良．循证医学．北京：人民卫生出版社，2001．6
[6] Cook DJ, Guyatt GH, Laupacis A, Sackett DL, Goldberg RJ. Clinical recommendations using levels of evidence for antithrombotic agents. Chest 1995 108(4) Supp: 227S-230S
[7] Cochrane Collaboration. Cochrane Reviewers' Handbook 4.1.5. 2002
[8] Siwek J, et al: How to write an evidence-based clinical review article.Am Fam Physician 2002 Jan 15;65(2):251-8
[9] 李静，等：系统综述的基本方法．中国循证医学 2001 1(1)：34-38
[10] 屈会起，等：浅谈系统综述的文献偏倚问题．中国循证医学 2001；1(2)：114-116
[11] Diane Helmer, et al. Evidence-based practice: extending the search to find material for the systematic review. BMA 2001;89(4):346-352
[12] Dickersin K, et al. Identifying relevant studies for systematic reviews. BMJ 1994 Nov 12;309(6964):1286-91
[13] McDonald S, et al: The contribution of handsearching European general health care journals to the Cochrane Controlled Trials Register. Eval Health Prof 2002 Mar;25(1):65-75
[14] Adams CE, Power A, Frederick K, Lefebvre C. An investigation of the adequacy of MEDLINE searches for randomized controlled trials (RCTs) of the effects of mental health care. Psychol Med 1994 Aug; 24(3):741-8
[15] Juni P, et al:Direction and Impact of language bias inmeta-analysis of controlled trials: empirical study. Iht J Epidemiol 2002 31(1): 115-23
[16] Clark M. Commnetary: Searching for trials for systematic reviews: what difference dose it make? Int J Epidemiol 2002 Feb;31(1):123-4
[17] Easterbrook PJ, et al. Publication bias in clinical research. Lancet
1991 Apr 13;337(8746):867-72
[18] Shed B, et al: A comparison of the quality of Cochrane reviews and systematic reviews published in paper-based journals. Eval HeaIth Prof 2002 Mar;25(1):116-2
[19] 刘雪梅，等译：提高随机对照试验Meta-分析的质量：QUOROM报告项目列表．中国循证医学 2002 2(1)：65-66
[20] McCray AT. Better access to information about clinical trials. Ann Intern Med 2000 Oct; 133(8):609-14
[21] Shojania KG, Bero LA. Taking advantage of the explosion of systematic reviews: an efficient MEDLINE search strategy. Eff Clin Pract. 2001 Jul-Aug;4(4):157-62
[22] Boynton J, Glanville J, McDaid D, Lefebvre C. Identifying systematic reviews in MEDLINE: developing an objective approach to search strategy design. J Inf Sci. 1998;24:137-157
[23] Haynes RB, Wilczynski N, McKibbon KA, Walker CJ, Sinclair JC. Developing optimal search strategies for detecting clinically sound studies in MEDLINE. J Am Med Inform Assoc. 1994 Nov-Dec;1(6):447-58
[24] Ovid Medline Search Strategies for Systematic Reviews. Evidence Based Medicine Working Group. December 11, 2000. http://www.med.ualberta.ca/ebm/hedgesys.htm
[25] Search Strategies to Identify Reviews and Meta-analyses in MEDLINE and CINAHL [Internet]. NHS Centre for Reviews and Dissemination University of York, York, Y010 5DD.http://www.york.ac.uk/inst/crd/search.htm
[26] White VJ, Glanville JM, Lefebvre C, Sheldon TA. A statistical approach to designing search filters to find systematic reviews: objectivity enhances accuracy. Journal of Information Science 2001;27(6):357-370
[27] 方平．医学科技信息检索．长沙：湖南人民出版社，1999．6
[28] 莫梅琦，王吉耀：循证医学资源分布及其检索特点．中华医学杂志 2001(20)：1275-1277
[29] 中国循证医学中心．http://www.chinacochrane.org/cochrane chinese/z2.htm
[30] Locating And Selecting Studies. Cochrane Reviewers' Handbook 4.1.5.2002
[2] Sackett DL, et al: Evidence based medicine: what it is and what it isn't? BMJ 1996 Jan 13;312(7023):71-2
[3] Sackett DL, et al: Evidence-based medicine. Now to practice and teach EBM(2nd edition). Edinburgh: Churchill Livingstone, 2000.1-240
[4] Cook DJ, et al: Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med 1997 Mar 1;126(5):376-80
[5] 王家良．循证医学．北京：人民卫生出版社，2001．6
[6] Cook DJ, Guyatt GH, Laupacis A, Sackett DL, Goldberg RJ. Clinical recommendations using levels of evidence for antithrombotic agents. Chest 1995 108(4) Supp: 227S-230S
[7] Cochrane Collaboration. Cochrane Reviewers' Handbook 4.1.5. 2002
[8] Siwek J, et al: How to write an evidence-based clinical review article.Am Fam Physician 2002 Jan 15;65(2):251-8
[9] 李静，等：系统综述的基本方法．中国循证医学 2001 1(1)：34-38
[10] 屈会起，等：浅谈系统综述的文献偏倚问题．中国循证医学 2001；1(2)：114-116
[11] Diane Helmer, et al. Evidence-based practice: extending the search to find material for the systematic review. BMA 2001;89(4):346-352
[12] Dickersin K, et al. Identifying relevant studies for systematic reviews. BMJ 1994 Nov 12;309(6964):1286-91
[13] McDonald S, et al: The contribution of handsearching European general health care journals to the Cochrane Controlled Trials Register. Eval Health Prof 2002 Mar;25(1):65-75
[14] Adams CE, Power A, Frederick K, Lefebvre C. An investigation of the adequacy of MEDLINE searches for randomized controlled trials (RCTs) of the effects of mental health care. Psychol Med 1994 Aug; 24(3):741-8
[15] Juni P, et al:Direction and Impact of language bias inmeta-analysis of controlled trials: empirical study. Iht J Epidemiol 2002 31(1): 115-23
[16] Clark M. Commnetary: Searching for trials for systematic reviews: what difference dose it make? Int J Epidemiol 2002 Feb;31(1):123-4
[17] Easterbrook PJ, et al. Publication bias in clinical research. Lancet
1991 Apr 13;337(8746):867-72
[18] Shed B, et al: A comparison of the quality of Cochrane reviews and systematic reviews published in paper-based journals. Eval HeaIth Prof 2002 Mar;25(1):116-2
[19] 刘雪梅，等译：提高随机对照试验Meta-分析的质量：QUOROM报告项目列表．中国循证医学 2002 2(1)：65-66
[20] McCray AT. Better access to information about clinical trials. Ann Intern Med 2000 Oct; 133(8):609-14
[21] Shojania KG, Bero LA. Taking advantage of the explosion of systematic reviews: an efficient MEDLINE search strategy. Eff Clin Pract. 2001 Jul-Aug;4(4):157-62
[22] Boynton J, Glanville J, McDaid D, Lefebvre C. Identifying systematic reviews in MEDLINE: developing an objective approach to search strategy design. J Inf Sci. 1998;24:137-157
[23] Haynes RB, Wilczynski N, McKibbon KA, Walker CJ, Sinclair JC. Developing optimal search strategies for detecting clinically sound studies in MEDLINE. J Am Med Inform Assoc. 1994 Nov-Dec;1(6):447-58
[24] Ovid Medline Search Strategies for Systematic Reviews. Evidence Based Medicine Working Group. December 11, 2000. http://www.med.ualberta.ca/ebm/hedgesys.htm
[25] Search Strategies to Identify Reviews and Meta-analyses in MEDLINE and CINAHL [Internet]. NHS Centre for Reviews and Dissemination University of York, York, Y010 5DD.http://www.york.ac.uk/inst/crd/search.htm
[26] White VJ, Glanville JM, Lefebvre C, Sheldon TA. A statistical approach to designing search filters to find systematic reviews: objectivity enhances accuracy. Journal of Information Science 2001;27(6):357-370
[27] 方平．医学科技信息检索．长沙：湖南人民出版社，1999．6
[28] 莫梅琦，王吉耀：循证医学资源分布及其检索特点．中华医学杂志 2001(20)：1275-1277
[29] 中国循证医学中心．http://www.chinacochrane.org/cochrane chinese/z2.htm
[30] Locating And Selecting Studies. Cochrane Reviewers' Handbook 4.1.5.2002