Appraisal of: Are MEDLINE searches sufficient for systematic reviews and meta-analysis of the diagnostic accuracy of depression screening tools? A review of meta-analyses.


Caroline Higgins

Julie Glanville

Full reference:

Rice DB, Kloda LA, Levis B, Qi B, Kingsland E, Thombs BD. Are MEDLINE searches sufficient for systematic reviews and meta-analyses of the diagnostic accuracy of depression screening tools? A review of meta-analyses. J Psychosom Res. 2016 Aug;87:7-13.

Short description:

This study builds on the findings of Enst, et al (2014), testing to see if limiting literature searches to only MEDLINE is sufficient when conducting a systematic search for diagnostic accuracy studies of depression screening tools.

Authors used a peer-reviewed strategy to search MEDLINE and PsycINFO for meta-analyses of diagnostic accuracy of depression screening tools, screened titles and abstracts for inclusion, which resulted in the identification of 16 meta-analyses to inform this review. Authors then conducted a known item search in MEDLINE to determine if primary studies used in the meta-analyses were indexed in that database. For those studies not found in MEDLINE, authors searched a core set of databases and Google Scholar to identify where studies were indexed.

94% (375/398) (range: 83-100%) of the primary studies included in the 16 meta-analyses were indexed in MEDLINE. Of the 23 primary studies not indexed in MEDLINE, 71% were located in Scopus, 64% in PsycINFO, and/or 50% in Embase.

Limitations stated by the study author(s):

- Authors did not re-analyze meta-analyses to determine if results changed when non-MEDLINE indexed studies were removed from the analyses;

- The search used to identify sample was not updated from the original 2014 search date, therefore there is the potential for missed studies in sample;

- Study design retrospectively reviewed existing meta-analyses, which authors acknowledge is not equivalent as conducting a ‘live’ systematic review and meta-analysis;

- Unable to confirm whether the search strategies used in each meta-analysis did identify the articles indexed in MEDLINE as most included meta-analyses did not provide reproducible search strategies. Known-item search may have resulted in an overestimation of studies found in MEDLINE.

Limitations stated by the reviewer(s):

- Authors did not provide a rationale for limiting their search to MEDLINE and PsycINFO;

- It is unclear why the authors decided to exclude systematic reviews that did not meta-analyze since excluding these studies likely resulted in a small sample and authors did not re-analyze the meta-analyses with non-MEDLINE studies removed;

- The authors raise the concern of MEDLINE not being updated as frequently having implications if groups were to adopt this approach for conducting systematic reviews and meta-analyses of diagnostic test accuracy studies, but did not highlight the importance of updating searches or setting up database search alerts.


Diagnostic accuracy

Study type:

Single study

Supplemental publications to the study: