Ce. Adams et al., AN INVESTIGATION OF THE ADEQUACY OF MEDLINE SEARCHES FOR RANDOMIZED CONTROLLED TRIALS (RCTS) OF THE EFFECTS OF MENTAL-HEALTH-CARE, Psychological medicine, 24(3), 1994, pp. 741-748
Valid reviews of the effects of mental health care depend on identifyi
ng as high a proportion as possible of relevant randomized controlled
trials (RCTs). To investigate the sensitivity and precision both of ME
DLINE and of hand-searching for RCTs in mental health, 12 journals spe
cializing in mental health and indexed by the National Library of Medi
cine (NLM) for MEDLINE were searched for the years 1971, 1976, 1981, 1
986 and 1991. The sensitivity of the hand-search was 94% (95% Confiden
ce Interval (CI) 93-95%), but it had a precision of only 7% (CI 6-8%).
The optimal MEDLINE search had a sensitivity of only 52% (CI 48-56%)
and a precision of 59% (CI 55-63%). Of the reports of RCTs identified
by the hand-search, 9% (CI 7-11%) were not included in MEDLINE at all.
Authors had included methodological descriptions in 84% (CI 80-88%) o
f RCTs found by the hand-search but missed by the MEDLINE search. Syst
ematic reviews of mental health care which are based solely on MEDLINE
searches of the literature will miss a large proportion of the releva
nt RCTs, and are thus liable to random error and bias. A register of m
ental health RCTs is urgently required.