Complementary approaches to searching MEDLINE may be sufficient for updating systematic reviews

Objectives
To maximize the proportion of relevant studies identified for inclusion in systematic reviews (recall), complex time-consuming Boolean searches across multiple databases are common. Although MEDLINE provides excellent coverage of health science evidence, it has proved challenging to achieve high levels of recall through Boolean searches alone.

Study Design and Setting
Recall of one Boolean search method, the clinical query (CQ), combined with a ranking method, support vector machine (SVM), or PubMed-related articles, was tested against a gold standard of studies added to 6 updated Cochrane reviews and 10 Agency for Healthcare Research and Quality (AHRQ) evidence reviews. For the AHRQ sample, precision and temporal stability were examined for each method.

Results
Recall of new studies was 0.69 for the CQ, 0.66 for related articles, 0.50 for SVM, 0.91 for the combination of CQ and related articles, and 0.89 for the combination of CQ and SVM. Precision was 0.11 for CQ and related articles combined, and 0.11 for CQ and SVM combined. Related articles showed least stability over time.

Conclusions
The complementary combination of a Boolean search strategy and a ranking strategy appears to provide a robust method for identifying relevant studies in MEDLINE.