Academic journal article Journal of the Medical Library Association

Comparison of Medical Subject Headings and Text-Word Searches in MEDLINE to Retrieve Studies on Sleep in Healthy Individuals*

Academic journal article Journal of the Medical Library Association

Comparison of Medical Subject Headings and Text-Word Searches in MEDLINE to Retrieve Studies on Sleep in Healthy Individuals*

Article excerpt

Objective: The objective was to investigate the performance of two search strategies in the retrieval of primary research papers containing descriptive information on the sleep of healthy people from MEDLINE.

Methodology: Two search strategies-one based on the use of only Medical Subject Headings (MeSH), the second based on text-word searching-were evaluated as to their specificity and sensitivity in retrieving a set of relevant research papers published in the journal Sleep from 1996 to 2001 that were preselected by a hand search.

Results: The subject search provided higher specificity than the text-word search (66% and 47%, respectively) but lower sensitivity (78% for the subject search versus 88% for the text-word search). Each search strategy gave some unique relevant hits.

Conclusions: The two search strategies complemented each other and should be used together for maximal retrieval. No combination of MeSH terms could provide comprehensive yet reasonably precise retrieval of relevant articles. The text-word searching had sensitivity and specificity comparable to the subject search. In addition, use of text words "normal," "healthy," and "control" in the title or abstract fields to limit the final sets provided an efficient way to increase the specificity of both search strategies.


Recent years have seen a proliferation in the use of research synthesis methodologies such as meta-analyses and systematic reviews in the health care fields. Driven by the increased emphasis on evidence-based health care practices, practitioners need more works that summarize the current state of research in their areas of interest or that integrate the research findings.

The first important step of any systematic review or meta-analysis is identification and retrieval of relevant publications in a systematic, comprehensive, and reproducible way. This is usually achieved by searching bibliographic databases. Of biomedical bibliographic databases, MEDLINE is the largest and most widely used in the world. A number of researchers have developed general strategies for MEDLINE searches of randomized controlled trials [1-3]; diagnostic studies [4, 5]; etiological, therapeutic, or prognosis studies [6]; and systematic reviews [7]. These strategies rely on the use of subject headings or text words that define the methodologies, clinical applications, and publication types in addition to the specific subject terms to achieve comprehensive yet accurate retrieval.

In some cases, however, relevant research papers may not be limited to a particular study type or methodology. This happens when the goal of a meta-analysis is to synthesize research findings on a particular phenomenon or activity. The meta-analysis of descriptive data on sleep of healthy humans conducted by our research group is an example of this kind of study. It involves research synthesis of descriptive information on the sleep of healthy people of different ages to see whether and how these sleep characteristics change over time. The research synthesis methods used to combine findings reported in primary research papers are described elsewhere [8].

The sleep characteristics of interest (Table 1) encompass a very broad area of sleep research. The reports containing relevant information include studies of normal sleep physiology and the effects of various conditions and/or substances on normal sleep, studies comparing the sleep of subject populations with various physical or psychological conditions to groups of healthy subjects, and large population surveys of sleep-related behaviors. They belong to various classes of studies, including diagnostic, therapeutic, and etiological studies. As a result, the approaches typically used to limit the retrieval of irrelevant studies from MEDLINE cannot be used in this case. On the other hand, selection of studies based on an important criterion relevant for our meta-analysis-whether or not they provide data for healthy subjects-is not readily supported by MEDLINE. …

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