title: Inclusion of methodological filters in searches for diagnostic test accuracy studies misses relevant studies.
abstract: OBJECTIVE
  To compare the performance of MEDLINE searches using index test(s) and target condition (subject searches) with the same searches combined with methodological filters for test accuracy studies.
  
  
  METHODS
  We derived a reference set of 506 test accuracy studies indexed on MEDLINE from seven systematic reviews that conducted extensive searches. We compared the performance of "subject" with "filtered" searches (same searches combined with each of 22 filters). Outcome measures were number of reference set records missed, sensitivity, number needed to read (NNR), and precision (Number of reference set studies identified for every 100 records screened).
  
  
  RESULTS
  Subject searches missed 47 of the 506 reference studies; filtered searches missed an additional 21 to 241 studies. Sensitivity was 91% for subject searches and ranged from 43% to 87% for filtered searches. The NNR was 56 (precision 2%) for subject searches and ranged from 7 to 51 (precision 2-15%) for filtered searches.
  
  
  CONCLUSIONS
  Filtered searches miss additional studies compared with searches based on index test and target condition. None of the existing filters provided reductions in the NNR for acceptable sensitivity; currently available methodological filters should not be used to identify studies for inclusion in test accuracy reviews.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PR, UK. penny.whiting@bristol.ac.uk
authors.forename: Penny
authors.initials: P
authors.lastname: Whiting
authors.forename: Marie
authors.initials: M
authors.lastname: Westwood
authors.forename: Rebecca
authors.initials: R
authors.lastname: Beynon
authors.forename: Margaret
authors.initials: M
authors.lastname: Burke
authors.forename: Jonathan Ac
authors.initials: JA
authors.lastname: Sterne
authors.forename: Julie
authors.initials: J
authors.lastname: Glanville
mesh_terms: D003955:Diagnostic Tests, Routine / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D016247:Information Storage and Retrieval / Q000592:standards*; D016239:MEDLINE / Q000592:standards*; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012107:Research Design; D014481:United States