A database of randomised clinical trials (RCTs) in pain research publi
shed from 1950 to 1990 was created following an extensive literature s
earch. By applying a refined MEDLINE search strategy from 1966 to 1990
and by hand-searching more than 1 000 000 pages of a total of 40 biom
edical journals published during the period 1950-1990, more than 8000
RCTs were identified. The RCTs were published in more than 800 journal
s and over 85% appeared between 1976 and 1990. If the trend of the las
t 15 years persists, a total of more than 15 000 RCTs will be publishe
d in pain relief by the year 2000. A detailed description of methods t
o ensure efficient use of resources during the identification, retriev
al and management of the information in pain relief and other fields i
s given. Emphasis is made on the importance of refining MEDLINE search
strategies, on the use of volunteers to hand-search journals and on c
areful monitoring of each of the steps of the process. The potential u
ses of the database to guide clinical and research decisions are discu
ssed.