hrb centre for primary care research department of general practice rcsi medical school developing...

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

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

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*))

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

Electronic Search Filters: Results

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Register

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)

Health research reporting

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

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

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

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