Use of methodological search filters to identify diagnostic accuracy studies can lead to the omission of relevant studies

J Clin Epidemiol. 2006 Mar;59(3):234-40. doi: 10.1016/j.jclinepi.2005.07.014.


Objective: To determine the usefulness of methodological filters in search strategies for diagnostic studies in systematic reviews.

Study design and setting: We made an inventory of existing methodological search filters for diagnostic accuracy studies and applied them in PubMed to a reference set derived from 27 published systematic reviews in a broad range of clinical fields. Outcome measures were the fraction of not identified relevant studies and the reduction in the number of studies to read.

Results: We tested 12 search filters. Of the studies included in the systematic reviews, 2%-28% did not pass the sensitive search filters, 4%-24% did not pass the accurate filters, and 39%-42% did not pass the specific filters. Decrease in number-needed-to-read when a search filter was used in a search strategy for a diagnostic systematic review varied from 0% to 77%.

Conclusion: The use of methodological filters to identify diagnostic accuracy studies can lead to omission of a considerable number of relevant studies that would otherwise be included. When preparing a systematic review, it may be preferable to avoid using methodological filters.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Biomedical Research*
  • Databases, Bibliographic*
  • Diagnosis*
  • Diagnostic Errors
  • Evidence-Based Medicine / methods*
  • Humans
  • Information Storage and Retrieval / methods
  • Information Storage and Retrieval / standards*
  • Meta-Analysis as Topic
  • Sensitivity and Specificity
  • Subject Headings