Recording Database Searches for Systematic Reviews - What is the Value of Adding a Narrative to Peer-Review Checklists? A Case Study of NICE Interventional Procedures Guidance

This paper discusses the value of open and transparent methods for recording systematic database search strategies, showing how they have been applied at the National Institute for Health and Clinical Excellence (NICE, see Appendix C for definitions) in the United Kingdom (UK). Objective - The objectives are to: 1) Discuss the value of search strategy recording methods. 2) Assess any limitations to the practical application of a checklist approach. 3) Make recommendations for recording systematic database searches. Methods - The procedures for recording searches for Interventional Procedures Guidance at NICE were examined. A sample of current methods for recording systematic searches identified in the literature was compared to the NICE processes. The case study analyses the search conducted for evidence about an interventional procedure and shows the practical issues involved in recording the database strategies. The case study explores why relevant papers were not retrieved by a search strategy meeting all of the criteria on the checklist used to peer review it. The evidence was required for guidance on non-rigid stabilisation techniques for the treatment of low back pain. Results - The analysis shows that amending the MEDLINE strategy to make it more sensitive would have increased its yield by 6614 articles. Examination of the search records together with correspondence between the analyst and the searcher reveals the peer reviewer had approved the search because its sensitivity was appropriate for the purpose of producing Interventional Procedures Guidance. The case study demonstrates the limitations of relying on a checklist to ensure the quality of a database search without having any contextual information. Conclusion - It is difficult for the peer reviewer to assess the subjective elements of a search without knowing why it has a particular structure or what the searcher intended. There is a risk that the peer reviewer will concentrate on the technical details, such as spelling mistakes, without having the contextual information. It is beneficial if the searcher records correspondence on key decisions and reports a summary alongside the search strategy. The narrative describes the major decisions that shaped the strategy and gives the peer reviewer an insight into the rationale for the search approach.