1. HRB Centre for Primary Care Research Department of General Practice RCSI 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 studies Emma Wallace

2. 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 2

3. The International Register of CPRs for Primary Care 3

4. 4 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

5. 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 5

6. Developing an electronic search strategy for MEDLINE 6

7. Electronic Search Filters: Method 7 DatabaseFilter typeFilter search string PubMedHaynes Broad Filter (predict*[tiab] OR predictive value of tests[mh] OR scor*[tiab] OR observ*[tiab] OR observer variation[mh]) PubMedHaynes Narrow Filter (validation[tiab] OR validate[tiab]) EBSCO hostMcGrath/Murphy Broad Filter ((predict* N3 rule* OR predict* N3 model OR predict* N3 models) OR (decision* N3 rule*) OR (TX validat*)) EBSCO hostMcGrath/Murphy Narrow Filter ((predict* N3 rule* OR predict* N3 model OR predict* N3 models) OR (decision* N3 rule*))

8. Electronic Search Filters: Results 8 Total number of articlesCPRs for primary care Manual ‘Gold Standard’ 634444 N articles retrieved by each filter Haynes Broad Filter124134 Haynes Narrow Filter8813 McGrath/Murphy Broad Filter 25824 McGrath/Murphy Broad Filter 6216 Combination of filters HBF and MMBF139135

9. Electronic Search Filters: Results N = 9 Articles not retrieved by any filter N = 4 Articles that did not have abstracts or key words in title N = 5 Outstanding articles 9

10. 10 Agreed Search Strategy Haynes Broad Filter Combination Main Databases Embase MEDLINE Include other journals Expert Contact Author’s database Published Unpublished Other databases Medion Cochrane LILACS Secondary Sources EBM Rational Clinical Examination Register

11. The International Register of CPRs for Primary Care 11

12. Quality assessment of CPR studies 12

13. 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)

14. Health research reporting

15. 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

16. 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

17. 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

18. Discussion Addition of new search terms? Acceptable level missing articles? Other available resources for literature? Decide on quality guidelines 18

19. HRB Centre for Primary Care Research Department of General Practice RCSI 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 studies Emma Wallace