Abstract
Background:We have developed a method to identify, filter, review, and distribute the published level I evidence for solid tumor oncology.
Methods:A standardized MEDLINE search identified prospective randomized controlled trials (PRCTs) in solid tumor oncology. Only PRCTs with therapeutic end points were included. All references were reviewed by a surgical oncology fellow in consultation with experts in the field. The full citations were imported into a comprehensive database. Data on statistical methods according to the Consolidated Standard of Reporting Trials statement were tabulated along with reviewer’s comments. A designation of Ia was given to articles that were well designed and significant contributions to their field. The database powers a dynamic, easily searchable Web site on our intranet and is available in personal digital assistant (PDA) format.
Results:By using standard search criteria, only .03% of the 11 million articles listed in MEDLINE are PRCTs concerning therapy for solid organ malignancies. Approximately 14% of reviewed articles were given a designation of Ia. Having comprehensive data readily available with intranet access or PDAs during conferences enhances their educational value and specificity.
Conclusions:We have developed an exciting tool that uses a highly trained filter to screen and record the medical data available to the clinician. This information has been made available and portable by using the Internet and PDAs.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Gotzsche PC, Lange B. Comparison of search strategies for recalling double-blind trials from MEDLINE. Dan Med Bull 1991;38:476–478.
Jadad AR, McQuay HJ. A high-yield strategy to identify randomized controlled trials for systematic reviews. Online J Curr Clin Trials 1993;Doc No. 33 p.
Silagy C. Developing a register of randomised controlled trials in primary care. BMJ 1993;306:897–900.
Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. BMJ 1994;309:1286–1291.
Adams CE, Power A, Frederick K, Lefebvre C. An investigation of the adequacy of MEDLINE searches for randomized controlled trials (RCTs) of the effects of mental health care. Psychol Med 1994;24:741–748.
Solomon MJ, Laxamana A, Devore L, McLeod RS. Randomized controlled trials in surgery. Surgery 1994;115:707–712.
Marson AG, Chadwick DW. How easy are randomized controlled trials in epilepsy to find on Medline? The sensitivity and precision of two Medline searches. Epilepsia 1996;37:377–380.
Balas EA, Stockham MG, Mitchell JA, Sievert ME, Ewigman BG, Boren SA. In search of controlled evidence for health care quality improvement. J Med Syst 1997;21:21–32.
Bender JS, Halpern SH, Thangaroopan M, Jadad AR, Ohlsson A. Quality and retrieval of obstetrical anaesthesia randomized controlled trials. Can J Anaesth 1997;44:14–18.
Nwosu CR, Khan KS, Chien PF. A two-term MEDLINE search strategy for identifying randomized trials in obstetrics and gynecology. Obstet Gynecol 1998;91:618–622.
Croft AM, Vassallo DJ, Rowe M. Handsearching the Journal of the Royal Army Medical Corps for trials. J R Army Med Corps 1999;145:86–88.
Langham J, Thompson E, Rowan K. Identification of randomized controlled trials from the emergency medicine literature: comparison of hand searching versus MEDLINE searching. Ann Emerg Med 1999;34:25–34.
Suarez-Almazor ME, Belseck E, Homik J, Dorgan M, Ramos-Remus C. Identifying clinical trials in the medical literature with electronic databases: MEDLINE alone is not enough. Control Clin Trials 2000;21:476–487.
Jadad AR, Haynes RB. The Cochrane Collaboration—advances and challenges in improving evidence-based decision making. Med Decis Making 1998;18:2–9.
Etzioni A. The need for quality filters in information systems. Science 1971;171:133.
Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 1996;276:637–639.
Cook DJ, Guyatt GH, Laupacis A, Sackett DL. Rules of evidence and clinical recommendations on the use of antithrombotic agents [published erratum appears in Chest 1994; 105:647]. Chest 1992;102(Suppl 4):S305–S311.
Search MEDLINE. PubMed and Internet Grateful Med, www.nlm.nih.gov/pubs/factsheets/medline.html. National Library of Medicine, 2000.
Wilczynski NL, Walker CJ, McKibbon KA, Haynes RB. Assessment of methodologic search filters in MEDLINE. Proc Annu Symp Comput Appl Med Care 1993;601–5.
Cochrane AL. Effectiveness and Efficiency. Random Reflections on Health Services. London: Nuffield Provincial Hospitals Trust, 1999
Moher D, Jadad AR, Nichol G, Penman M, Tugwell P, Walsh S. Assessing the quality of randomized controlled trials: an annotated bibliography of scales and checklists. Control Clin Trials 1995;16:62–73.
Adetugbo K, Williams H. How well are randomized controlled trials reported in the dermatology literature?. Arch Dermatol 2000;136:381–385.
Ah-See KW, Molony NC. A qualitative assessment of randomized controlled trials in otolaryngology. J Laryngol Otol 1998;112:460–463.
Bath FJ, Owen VE, Bath PM. Quality of full and final publications reporting acute stroke trials: a systematic review. Stroke 1998;29:2203–2210.
Moher D, Pham B, Jones A, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses?. Lancet 1998;352:609–613.
Clinical Evidence. London: BMJ Publishing Group, 2000.
Pisters P, Edge S. Surgical Oncology. Yesterday, Today and Tomorrow. Society for Surgical Oncology, 2000.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Brooks, A.D., Karpoff, H.M., Sulimanoff, I. et al. The Search for Level I Evidence in Solid-Tumor Oncology. Ann Surg Oncol 8, 638–643 (2001). https://doi.org/10.1007/s10434-001-0638-8
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10434-001-0638-8