Nancy L. Wilczynski

Doubling the impact: publication of systematic review articles in orthopaedic journals.

BACKGROUNDnInvestigators aim to publish their research papers in top journals to disseminate their findings to the widest possible audience. Systematic reviews of the literature occupy the highest position in currently proposed hierarchies of evidence. We hypothesized that the number of citations (a measure of scholarly interest) for systematic reviews (or meta-analyses) published in leading orthopaedic journals would be greater than the number of citations for narrative reviews published in the same journals.nnnMETHODSnWe identified fifteen journals that had high Science Citation Index impact factors for the orthopaedic subspecialty and were believed to have a higher yield of studies and reviews of scientific merit and clinical relevance. For the year 2000, six research associates applied methodological criteria to each article in each issue of the fifteen journals to determine whether the article was scientifically sound (rigorous versus nonrigorous). Of the 3916 articles identified, 2331 were original or review articles. We queried the ISI (Institute for Scientific Information) Web of Science database to ascertain, as of March 2003, the number of subsequent citations to each one of the reviews after its original publication in all journals that published both narrative and systematic reviews.nnnRESULTSnOf the 2331 articles published across the fifteen journals in the year 2000, 110 were review articles. Only seventeen (15%) of the 110 reviews met our criteria for systematic reviews with rigor. Rigorous systematic reviews received more than twice the mean number of citations compared with other systematic or narrative reviews (13.8 compared with 6.0, p = 0.008). The rigor of a review was a significant predictor of the number of citations in other orthopaedic journals (p = 0.01). In addition, rigor was significantly associated with the number of citations in nonorthopaedic journals (p = 0.03).nnnCONCLUSIONSnOur findings suggest that journal editors and authors can improve the relevance and scholarly interest in their reviews (as shown by the number of citations) by meeting standard guidelines for methodological rigor.

Optimal search strategies for detecting cost and economic studies in EMBASE

BackgroundEconomic evaluations in the medical literature compare competing diagnosis or treatment methods for their use of resources and their expected outcomes. The best evidence currently available from research regarding both cost and economic comparisons will continue to expand as this type of information becomes more important in todays clinical practice. Researchers and clinicians need quick, reliable ways to access this information. A key source of this type of information is large bibliographic databases such as EMBASE. The objective of this study was to develop search strategies that optimize the retrieval of health costs and economics studies from EMBASE.MethodsWe conducted an analytic survey, comparing hand searches of journals with retrievals from EMBASE for candidate search terms and combinations. 6 research assistants read all issues of 55 journals indexed by EMBASE for the publishing year 2000. We rated all articles using purpose and quality indicators and categorized them into clinically relevant original studies, review articles, general papers, or case reports. The original and review articles were then categorized for purpose (i.e., cost and economics and other clinical topics) and depending on the purpose as pass or fail for methodologic rigor. Candidate search strategies were developed for economic and cost studies, then run in the 55 EMBASE journals, the retrievals being compared with the hand search data. The sensitivity, specificity, precision, and accuracy of the search strategies were calculated.ResultsCombinations of search terms for detecting both cost and economic studies attained levels of 100% sensitivity with specificity levels of 92.9% and 92.3% respectively. When maximizing for both sensitivity and specificity, the combination of terms for detecting cost studies (sensitivity) increased 2.2% over the single term but at a slight decrease in specificity of 0.9%. The maximized combination of terms for economic studies saw no change in sensitivity from the single term and only a 0.1% increase in specificity.ConclusionSelected terms have excellent performance in the retrieval of studies of health costs and economics from EMBASE.