Clinical Evidence diagnosis: developing a sensitive search strategy to retrieve diagnostic studies on deep vein thrombosis: a pragmatic approach

OBJECTIVES: To devise and evaluate a sensitive search strategy to retrieve diagnostic studies on specific diagnostic tests for deep vein thrombosis (DVT). METHODS: Systematic reviews on diagnostic tests for DVT were identified and the studies cited by them used to produce a reference set of search results (to be used to evaluate different search strategies). Five existing diagnosis search filters were combined to produce a sensitive search. This combined search was then refined to produce a more specific strategy, which was run on medline and the results were checked against the reference set. This search was too specific and was modified to produce a more balanced final strategy, which was again tested and the results compared with the reference set. The sensitivity of this newly created strategy was compared with the existing diagnosis searches already found. Finally, studies identified by the final search strategy were critically appraised for validity and relevance and the selected articles were compared with those found in the reference set. RESULTS: The final filter retrieved 124 out of 126 references from the reference set. From the search result, 227 cohort studies were selected and 147 of these were not cited in any of the systematic reviews on diagnostic tests for DVT. CONCLUSIONS: The search strategy had 98.8% sensitivity. The precision of 8.8%, although low, compares well with other strategies with high sensitivity. Most of the systematic reviews on diagnosing a DVT have omitted a number of high quality articles.