hrb centre for primary care research department of general practice rcsi medical school developing...
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HRB Centre for Primary Care ResearchDepartment of General PracticeRCSI Medical School
Developing an International Register of CPRs for Primary Care: Identifying an Optimal Strategy to Search the Literature Claire Keogh
Quality Assessment of CPR studiesEmma Wallace
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1) Developing an international register of CPRs for primary care
2) Search strategies to identify CPRs relevant to primary care
3) Quality assessment of CPR studies
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The International Register of CPRs for Primary Care
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The International Register of CPRs for Primary Care
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• Develop a register of CPRs for use in primary care
• Developed as part of the Cochrane Primary Health Care Field (http://www.cochraneprimarycare.org/en/index.html)
• Currently 239 relevant articles on the register
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The International Register of CPRs for Primary Care
• Problems associated with developing and maintaining the register– No internationally agreed term for CPRs– No internationally agreed term for primary care– No Medical Subject Heading (MeSH) term for CPRs – Over two million articles are published every year
• Haynes and the Hedges Team have developed search tools to identify CPRs. These are not specific to primary care
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Developing an electronic search strategy for MEDLINE
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Electronic Search Filters: Method
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Database Filter type Filter search string
PubMed Haynes Broad Filter (predict*[tiab] OR predictive value of tests[mh] OR scor*[tiab] OR observ*[tiab] OR observer variation[mh])
PubMed Haynes Narrow Filter (validation[tiab] OR validate[tiab])
EBSCO host McGrath/Murphy Broad Filter ((predict* N3 rule* OR predict* N3 model OR predict* N3 models) OR (decision* N3 rule*) OR (TX validat*))
EBSCO host McGrath/Murphy Narrow Filter
((predict* N3 rule* OR predict* N3 model OR predict* N3 models) OR (decision* N3 rule*))
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Electronic Search Filters: Results
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Total number of articles CPRs for primary care
Manual ‘Gold Standard’ 6344 44
N articles retrieved by each filter
Haynes Broad Filter 1241 34
Haynes Narrow Filter 88 13
McGrath/Murphy Broad Filter
258 24
McGrath/Murphy Broad Filter
62 16
Combination of filters
HBF and MMBF 1391 35
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Electronic Search Filters: Results
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Register
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The International Register of CPRs for Primary Care
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Quality assessment of CPR studies
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• CPRs are utilised in decisions regarding patient care
• Quality of CPR studies of key importance• Clinicians need to be able to evaluate
research • Need for clarity and accuracy in research
reporting
Clinical prediction rules (CPRs)
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Health research reporting
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Health research reporting
• International initiative ‘Equator’ set up in 2008
• Aim to provide resources and education enabling improvement of reporting and monitor progress and improvements
• Develop network of reporting guidelines e.g. CONSORT, STARD, STROBE, PRISMA
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Quality assessment of CPRs
• Wasson et al, 1985, Laupacis et al, 1997, McGinn et al, 2000
• Specifically review methodological standards for CPR studies
• Different quality markers for derivation and validation CPR studies
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Quality assessment of CPRs
• Currently piloting quality checklists for CPR studies on register
• Combination of quality markers from available resources to develop CPR quality checklist e.g. QUADAS, McGinn
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Discussion
• Addition of new search terms?
• Acceptable level missing articles?
• Other available resources for literature?
• Decide on quality guidelines
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HRB Centre for Primary Care ResearchDepartment of General PracticeRCSI Medical School
Developing an International Register of CPRs for Primary Care: Identifying an Optimal Strategy to Search the Literature Claire Keogh
Quality Assessment of CPR studiesEmma Wallace