Search strategies-identified reports on "off-label" drug use in MEDLINE.

OBJECTIVE We developed search strategies that facilitate the identification of studies on "off-label" drug use in the bibliographic database OvidSP MEDLINE. STUDY DESIGN AND SETTING We compiled a gold standard reference set of reports classified as relevant or not relevant to off-label drug use. We conceived search queries, including search words and word strings. We searched MEDLINE via OvidSP from 1948 to 2011. In comparison with the gold standard, we determined sensitivity and precision of search queries and their combinations. We attempted to achieve the highest possible sensitive search strategy and an optimal balance of sensitivity and precision. RESULTS Our gold standard set contained 4,067 relevant documents overall of 6,785 records, among those 2,177 could be retrieved from MEDLINE. The most sensitive single term was "off label∗.af." (overall sensitivity 40.9%, sensitivity within MEDLINE 76.4%, and precision 84.4%). A combination of 31 search queries had the maximum overall sensitivity of 53.3% (sensitivity within MEDLINE 99.5%) at a precision of 60.3%. A search strategy with the maximum precision (84.0%) yielded a sensitivity of 49.0% (sensitivity within MEDLINE 91.5%). CONCLUSION We empirically developed two versions of optimized sensitive search strategies, which can achieve reasonable performance for retrieving off-label drug use documents in OvidSP MEDLINE.

[1]  Kay Dickersin,et al.  Selective exposure reporting and Medline indexing limited the search sensitivity for observational studies of the adverse effects of oral contraceptives. , 2005, Journal of clinical epidemiology.

[2]  Amy P Abernethy,et al.  Development of a subject search filter to find information relevant to palliative care in the general medical literature. , 2006, Journal of the Medical Library Association : JMLA.

[3]  J. Collier.  Paediatric prescribing: using unlicensed drugs and medicines outside their licensed indications. , 1999, British journal of clinical pharmacology.

[4]  S. Micek,et al.  Off-label medication use in adult critical care patients. , 2011, Journal of critical care.

[5]  R Brian Haynes,et al.  Optimal search strategies for identifying mental health content in MEDLINE: an analytic survey , 2006, Annals of general psychiatry.

[6]  A. Torres.  The use of Food and Drug Administration--approved medications for unlabeled (off-label) uses. The legal and ethical implications. , 1994, Archives of dermatology.

[7]  D. Cherkin,et al.  The use of drugs for unlabeled indications. , 1980, JAMA.

[8]  A. Mcmanus,et al.  Off‐label prescribing during pregnancy in the UK: an analysis of 18 000 prescriptions in Liverpool Women's Hospital , 2010, The International journal of pharmacy practice.

[9]  F. Burzotta,et al.  A simple hint to improve Robinson and Dickersin's highly sensitive PubMed search strategy for controlled clinical trials. , 2004, International journal of epidemiology.

[10]  Carol Lefebvre,et al.  The effect of postings information on searching behaviour A statistical approach to designing search filters to find systematic reviews : objectivity enhances accuracy , 2001 .

[11]  A. Fugh-Berman,et al.  Off-Label Promotion, On-Target Sales , 2008, PLoS medicine.

[12]  R. Ward,et al.  Off‐label use of medicines: consensus recommendations for evaluating appropriateness , 2006, The Medical journal of Australia.

[13]  H. Kokki,et al.  Off‐label and unlicensed drug prescribing in three paediatric wards in Finland and review of the international literature , 2009, Journal of clinical pharmacy and therapeutics.

[14]  Lucas M. Bachmann,et al.  Research Paper: Identifying Diagnostic Studies in MEDLINE: Reducing the Number Needed to Read , 2002, J. Am. Medical Informatics Assoc..

[15]  S. Golder,et al.  Developing efficient search strategies to identify reports of adverse effects in MEDLINE and EMBASE. , 2006, Health information and libraries journal.

[16]  Marie FitzSimmons,et al.  A Review of the OvidSP Platform , 2008, Medical reference services quarterly.

[17]  R. Stafford,et al.  Increasing off‐label use of antipsychotic medications in the United States, 1995–2008 , 2011, Pharmacoepidemiology and drug safety.

[18]  Christopher J Noto,et al.  Current and emerging pharmacologic therapies for pain and challenges which still lay ahead. , 2010, Methods in molecular biology.

[19]  T. Wilkins,et al.  EMBASE versus MEDLINE for family medicine searches: can MEDLINE searches find the forest or a tree? , 2005, Canadian family physician Medecin de famille canadien.

[20]  Michelle Jenkins,et al.  Evaluation of methodological search filters--a review. , 2004, Health information and libraries journal.

[21]  Henrik S. Thomsen,et al.  Contrast media : safety issues and ESUR guidelines , 2009 .

[22]  Judith A Floyd,et al.  Comparison of Medical Subject Headings and text-word searches in MEDLINE to retrieve studies on sleep in healthy individuals. , 2004, Journal of the Medical Library Association : JMLA.

[23]  F. van Dijk,et al.  UvA-DARE ( Digital Academic Repository ) A search strategy for occupational health intervention studies , 2005 .

[24]  Sandy L. De Groote,et al.  PubMed, internet grateful med, and Ovid: A comparison of three MEDLINE internet interfaces , 2000 .

[25]  R Brian Haynes,et al.  Search filter precision can be improved by NOTing out irrelevant content. , 2011, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[26]  L. Rollin,et al.  Precision and Recall of Search Strategies for Identifying Studies on Return-To-Work in Medline , 2009, Journal of Occupational Rehabilitation.