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Objective: This article describes the evolution of academic public health library services from standalone academic public health libraries in 2004 to centralized services by 2021. Methods: Five public health libraries serving public health graduate programs (SPH) at public and private institutions were visited in 2006-07. Visits comprised tours, semi-structured interviews with librarians and local health department staff, and collecting of contemporary print documents. We compiled and compared visit notes across libraries. In 2022, we reviewed online materials announcing library closure or transition for timing and how services were to be subsequently provided. Results: Libraries and SPH were co-located and most librarians maintained public health expertise though they did not have faculty appointments in their SPHs. Specialized statistical and geographic information systems (GIS) software and data were provided in partnership, often with other system libraries. Only two libraries had strong connections to health departments-one with direct service agreements and another engaged in public health training. Conclusion: Academic public health libraries' relationships with SPHs and health departments did not ensure their existence as standalone entities. Following a national trend for branch libraries, public health information services were centralized into larger health or science libraries. The scope and specialization of librarian expertise continues to be valued with several institutions having librarians dedicated to public health.
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Bibliotecólogos , Bibliotecas Médicas , Salud Pública , Bibliotecólogos/estadística & datos numéricos , Bibliotecas Médicas/organización & administración , Humanos , Servicios de Biblioteca/organización & administración , Estados UnidosRESUMEN
OBJECTIVES: To find what proportion of a broad set of health journals have published on climate change and health, how many articles they have published, and when they first published on the subject. DESIGN: Bibliometric study. SETTING AND PARTICIPANTS: We conducted electronic searches in Ovid MEDLINE ALL for articles about climate change and human health published from 1860 to 31 December 2022 in 330 health journals. There were no limits by language or publication type. Results were independently screened by two raters for article eligibility. RESULTS: After screening there were 2932 eligible articles published across 253 of the 330 journals between 1947 and 2022; most (2795/2932; 95%) were published in English. A few journals published articles in the early 90s, but there has been a rapid increase since about 2006. We were unable to categorise the types of publication but estimate that fewer than half are research papers. While articles were published in journals in 39 countries, two-thirds (1929/2932; 66%) were published in a journal published in the UK or the USA. Almost a quarter (77/330; 23%) of the journals published no eligible articles, and almost three-quarters (241/330; 73%) published five articles or fewer. The publication of joint editorials in over 200 journals in 2021 and 2022 boosted the number of journals publishing something on climate change and health. A third of the (112/330; 34%) journals in our sample published at least one of the joint editorials, and almost a third of those (32/112; 29%) were publishing on climate change and health for the first time. CONCLUSIONS: Health journals are rapidly increasing the amount they publish on climate change and health, but despite climate change being the major threat to global health many journals had until recently published little or nothing. A joint editorial published in multiple journals increased coverage, and for many journals it was the first thing they published on climate change and health.
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Bibliometría , Cambio Climático , Publicaciones Periódicas como Asunto , Humanos , Publicaciones Periódicas como Asunto/estadística & datos numéricosRESUMEN
OBJECTIVES: To determine the reproducibility of biomedical systematic review search strategies. STUDY DESIGN AND SETTING: A cross-sectional reproducibility study was conducted on a random sample of 100 systematic reviews indexed in MEDLINE in November 2021. The primary outcome measure is the percentage of systematic reviews for which all database searches can be reproduced, operationalized as fulfilling six key Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S) reporting guideline items and having all database searches reproduced within 10% of the number of original results. Key reporting guideline items included database name, multi-database searching, full search strategies, limits and restrictions, date(s) of searches, and total records. RESULTS: The 100 systematic review articles contained 453 database searches. Only 22 (4.9%) database searches reported all six PRISMA-S items. Forty-seven (10.4%) database searches could be reproduced within 10% of the number of results from the original search; six searches differed by more than 1,000% between the originally reported number of results and the reproduction. Only one systematic review article provided the necessary search details to be fully reproducible. CONCLUSION: Systematic review search reporting is poor. To correct this will require a multifaceted response from authors, peer reviewers, journal editors, and database providers.
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Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Estudios Transversales , Bases de Datos Factuales , MEDLINE , Reproducibilidad de los ResultadosRESUMEN
Background: In 2020 the Health Science Center Libraries (HSCL) at the University of Florida collaborated with the Okeechobee County Public library (OCPL) on their plan to install Little Free Libraries (LFLs) within their community. It was agreed that the HSCL would provide consumer health-related materials for the Little Free Libraries and training with the goal of improving health literacy, precision medicine, and increasing rural access to consumer health materials and services. Case Presentation: Using census data, the County Health Improvement Plan, and OCPL circulation data the team identified minority population groups, potential accessibility issues, and local consumer health information needs and barriers to select appropriate resources. Additionally, partnerships were created with the local Health Department, Parks and Recreation services, the Rotary Club, and other local organizations to make the project a success. A total of 424 books were selected for the LFLs and 40 unique online resources were selected, printed, and shipped to OCPL to be used during LFL reference sessions. Technology was purchased to assist OCPL with their planned community health reference outreach sessions. HSCL created and provided online training on facilitating consumer health outreach, conducting health information reference services, and promoting community engagement for OCPL. Discussion: LFLs have become an important resource for lower-income rural families in Okeechobee. There are 7 LFLs in Okeechobee County, with a goal of eventually establishing 15 total to provide vital health resources and books. Over 2,456 items have been circulated among the 7 LFLs since May 2020. Overall, the project has been successful with positive feedback received from the community and with OCPL planning to continue to expand the project.
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Información de Salud al Consumidor , Alfabetización en Salud , Bibliotecas Médicas , Bibliotecas , Humanos , FloridaRESUMEN
Objective: We sought to identify trends and themes in how academic health sciences libraries in the United States, Canada, and Mexico have supported engagement and outreach with Native Americans, Alaska Natives, First Nations, and Indigenous peoples, in or from those same countries. We also sought to learn and share effective practices for libraries engaging with these communities. Methods: We conducted a scoping review utilizing Arksey and O'Malley's framework for scoping reviews and followed principles from JBI Manual for Evidence Synthesis. We searched seven bibliographic databases, E-LIS (Eprints in Library and Information Science repository), and multiple sources of grey literature. Results were screened using Covidence and Google Sheets. We reported our review according to the PRISMA and PRISMA-S guidelines. We determined types of interventions used by academic health sciences libraries in engagement with our included populations, the level of public participation reached by these interventions, what partnerships were established, and what practices emerged. Results: Database searching returned 2,020 unique results. Additional searching resulted in 211 further unique results. Full text screening of relevant articles found 65 reports meeting criteria for inclusion. Data extraction was conducted on these programs to identify partners, intervention type, and evaluation method. The programs were categorized using the IAP2 Spectrum of Public Participation. Conclusion: Our scoping review found that many programs were health information trainings and did not move beyond informing the public with little further involvement. The need for sustained funding, greater community participation and more publishing on engagement and outreach are discussed.
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Participación de la Comunidad , Humanos , América del Norte , CanadáRESUMEN
The Health Science Center Libraries at the University of Florida formalized, focused, and expanded their diversity, equity, and inclusion-related activities by creating a Diversity, Equity, and Inclusion Team. This paper describes the activities of the Team from 2018 to 2020, including efforts related to assessment, programming, promotion, and space. Future plans are also discussed. The Team activities described here can serve as models for other health science libraries with a commitment to diversity, equity, and inclusion.
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Bibliotecas MédicasRESUMEN
The PRISMA 2020 and PRISMA-S guidelines help systematic review teams report their reviews clearly, transparently, and with sufficient detail to enable reproducibility. PRISMA 2020, an updated version of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement, is complemented by PRISMA-S, an extension to PRISMA focusing on reporting the search components of systematic reviews. Several significant changes were implemented in PRISMA 2020 and PRISMA-S when compared with the original version of PRISMA in 2009, including the recommendation to report search strategies for all databases, registries, and websites that were searched. PRISMA-S also recommends reporting the number of records identified from each information source. One of the most challenging aspects of the new guidance from both documents has been changes to the flow diagram. In this article, we review some of the common questions about using the PRISMA 2020 flow diagram and tracking records through the systematic review process.
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Informe de Investigación , Bases de Datos Factuales , Metaanálisis como Asunto , Reproducibilidad de los Resultados , Revisiones Sistemáticas como AsuntoRESUMEN
Health science libraries are ideally suited for proactive Diversity, Equity, and Inclusion (DEI) efforts, as their work and spaces transcend disciplinary boundaries. In 2018, a DEI Team was created by the Health Science Center Libraries at the University of Florida, with the purpose of improving the library's climate for its diverse patrons and employees. This article provides an overview of the Team's formation and development, including its charge, culture, structure, teamwork, leadership, and reporting processes. Recommendations are offered for other libraries seeking to establish similar committees.
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Bibliotecas MédicasRESUMEN
Academic searching is integral to research activities: (1) searching to retrieve specific information, (2) to expand our knowledge iteratively, (3) and to collate a representative and unbiased selection of the literature. Rigorous searching methods are vital for reliable, repeatable and unbiased searches needed for these second and third forms of searches (exploratory and systematic searching, respectively) that form a core part of evidence syntheses. Despite the broad awareness of the importance of transparency in reporting search activities in evidence syntheses, the importance of searching has been highlighted only recently and has been the explicit focus of reporting guidance (PRISMA-S). Ensuring bibliographic searches are reported in a way that is transparent enough to allow for full repeatability or evaluation is challenging for a number of reasons. Here, we detail these reasons and provide for the first time a standardised data structure for transparent and comprehensive reporting of search histories. This data structure was produced by a group of international experts in informatics and library sciences. We explain how the data structure was produced and describe its components in detail. We also demonstrate its practical applicability in tools designed to support literature review authors and explain how it can help to improve interoperability across tools used to manage literature reviews. We call on the research community and developers of reference and review management tools to embrace the data structure to facilitate adequate reporting of academic searching in an effort to raise the standard of evidence syntheses globally.
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Objective: To understand the experience of academic health sciences libraries during the pandemic using a phenomenological approach. Methods: This study used a multisite, mixed-method approach to capture the direct experience of academic health sciences libraries as they evolved during the COVID-19 pandemic. Phase one of the study involved administering a qualitative survey to capture to capture current evolutions of programs and services. The survey for phases two (August 2020) and three (February 2021) contained eight questions asking participants to share updates on their evolution and experiences. Results: Qualitative data were analyzed using open coding techniques to ensure emergent themes were allowed to surface. Additional post-hoc sentiment analysis ascertained the frequency of positive and negative words in each data set. Of the 193 possible AAHSL libraries, 45 (23.3%) responded to the April 2020 survey, 26 to the August 2020 survey, and 16 to the February 2021 survey. Libraries represented 23 states and the District of Columbia. The majority of libraries closed in March 2020. The ease of transferring library services to a remote environment varied by type of service. For the quantitative analysis, ten distinct areas were analyzed using text coded as "Staff" as a lens for understanding the connection between codes. Conclusion: Innovations by libraries during the early stages of the pandemic are having a long-term impact on library culture and the delivery of services. Even as libraries returned to in-person services, elements of telecommuting, using online conferencing software, safety precautions, and monitoring of staff well-being persisted.
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COVID-19 , Bibliotecas Médicas , Servicios de Biblioteca , Humanos , Pandemias , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To identify the engagement of health sciences librarians (HSLs) in open science (OS) through the delivery of library services, support, and programs for researchers. METHODS: We performed a scoping review guided by Arksey and O'Malley's framework and Joanna Briggs' Manual for Scoping Reviews. Our search methods consisted of searching five bibliographic databases (MEDLINE, Embase, CINAHL, LISTA, and Web of Science Core Collection), reference harvesting, and targeted website and journal searching. To determine study eligibility, we applied predetermined inclusion and exclusion criteria and reached consensus when there was disagreement. We extracted data in duplicate and performed qualitative analysis to map key themes. RESULTS: We included fifty-four studies. Research methods included descriptive or narrative approaches (76%); surveys, questionnaires, and interviews (15%); or mixed methods (9%). We labeled studies with one or more of FOSTER's six OS themes: open access (54%), open data (43%), open science (24%), open education (6%), open source (6%), and citizen science (6%). Key drivers in OS were scientific integrity and transparency, openness as a guiding principle in research, and funder mandates making research publicly accessible. CONCLUSIONS: HSLs play key roles in advancing OS worldwide. Formal studies are needed to assess the impact of HSLs' engagement in OS. HSLs should promote adoption of OS within their research communities and develop strategic plans aligned with institutional partners. HSLs can promote OS by adopting more rigorous and transparent research practices of their own. Future research should examine HSLs' engagement in OS through social justice and equity perspectives.
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Bibliotecólogos , Medicina , Bases de Datos Bibliográficas , Humanos , MEDLINE , Proyectos de InvestigaciónRESUMEN
BACKGROUND: Problems continue to exist with the reporting quality and risk of bias in search methods and strategies in systematic reviews and related review types. Peer reviewers who are not familiar with what is required to transparently and fully report a search may not be prepared to review the search components of systematic reviews, nor may they know what is likely to introduce bias into a search. Librarians and information specialists, who have expertise in searching, may offer specialized knowledge that would help improve systematic review search reporting and lessen risk of bias, but they are underutilized as methodological peer reviewers. METHODS: This study will evaluate the effect of adding librarians and information specialists as methodological peer reviewers on the quality of search reporting and risk of bias in systematic review searches. The study will be a pragmatic randomized controlled trial using 150 systematic review manuscripts submitted to BMJ and BMJ Open as the unit of randomization. Manuscripts that report on completed systematic reviews and related review types and have been sent for peer review are eligible. For each manuscript randomized to the intervention, a librarian/information specialist will be invited as an additional peer reviewer using standard practices for each journal. First revision manuscripts will be assessed in duplicate for reporting quality and risk of bias, using adherence to 4 items from PRISMA-S and assessors' judgements on 4 signaling questions from ROBIS Domain 2, respectively. Identifying information from the manuscripts will be removed prior to assessment. DISCUSSION: The primary outcomes for this study are quality of reporting as indicated by differences in the proportion of adequately reported searches in first revision manuscripts between intervention and control groups and risk of bias as indicated by differences in the proportions of first revision manuscripts with high, low, and unclear bias. If the intervention demonstrates an effect on search reporting or bias, this may indicate a need for journal editors to work with librarians and information specialists as methodological peer reviewers. TRIAL REGISTRATION: Open Science Framework. Registered on June 17, 2021, at https://doi.org/10.17605/OSF.IO/W4CK2 .
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Bibliotecólogos , Humanos , Servicios de Información , Revisión por Pares , Ensayos Clínicos Controlados Aleatorios como Asunto , Informe de InvestigaciónRESUMEN
BACKGROUND: Literature searches underlie the foundations of systematic reviews and related review types. Yet, the literature searching component of systematic reviews and related review types is often poorly reported. Guidance for literature search reporting has been diverse and, in many cases, does not offer enough detail to authors who need more specific information about reporting search methods and information sources in a clear, reproducible way. This document presents the PRISMA-S (Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension) checklist, and explanation and elaboration. METHODS: The checklist was developed using a three-stage Delphi survey process, followed by a consensus conference and public review process. RESULTS: The final checklist includes sixteen reporting items, each of which is detailed with exemplar reporting and rationale. CONCLUSIONS: The intent of PRISMA-S is to complement the PRISMA Statement and its extensions by providing a checklist that could be used by interdisciplinary authors, editors, and peer reviewers to verify that each component of a search is completely reported and, therefore, reproducible.
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Publicaciones , Informe de Investigación , Lista de VerificaciónRESUMEN
BACKGROUND: Literature searches underlie the foundations of systematic reviews and related review types. Yet, the literature searching component of systematic reviews and related review types is often poorly reported. Guidance for literature search reporting has been diverse, and, in many cases, does not offer enough detail to authors who need more specific information about reporting search methods and information sources in a clear, reproducible way. This document presents the PRISMA-S (Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension) checklist, and explanation and elaboration. METHODS: The checklist was developed using a 3-stage Delphi survey process, followed by a consensus conference and public review process. RESULTS: The final checklist includes 16 reporting items, each of which is detailed with exemplar reporting and rationale. CONCLUSIONS: The intent of PRISMA-S is to complement the PRISMA Statement and its extensions by providing a checklist that could be used by interdisciplinary authors, editors, and peer reviewers to verify that each component of a search is completely reported and therefore reproducible.
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Lista de Verificación , Informe de Investigación , Consenso , Publicaciones , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND: The authors present efforts to build capacity at our institution for conducting systematic reviews and other forms of evidence synthesis through partnerships and a recharge model. This report describes how we successfully created and launched a for-fee systematic review core at our library. CASE PRESENTATION: Throughout 2014 and 2015, library leadership proposed different models for getting institutional and financial support for librarians and staff to better support university researchers conducting systematic reviews. Though well received, initial requests for financial support were not funded. The executive director of the Health Sciences Library released two years' worth of salary and benefits to fund an evidence synthesis and retrieval librarian position. With this new position, the team formed a charge-back core facility in partnership with our university's Clinical Translation and Science Award hub. A series of procedural decisions and operational changes helped the group achieve success. Within eighteen months after launching the Systematic Review Core, we reached maximum capacity with more than twenty ongoing reviews. DISCUSSION: Assigning a dollar value to our expertise put us on par with other subject matter experts on campus and actually drove demand. We could act as paid consultants in research projects and shifted the perception of librarians from service providers to research partners. Affiliating with our partners was key to our success and boosted our ability to strengthen our campus' research infrastructure.
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Bases de Datos Bibliográficas , Revisiones Sistemáticas como Asunto , Humanos , Consultores , Bases de Datos Bibliográficas/economía , Bases de Datos Bibliográficas/normas , Bibliotecólogos , Bibliotecas Médicas/economía , Bibliotecas Médicas/organización & administración , Estudios de Casos OrganizacionalesRESUMEN
Creating search strategies for systematic reviews, finding the best balance between sensitivity and specificity, and translating search strategies between databases is challenging. Several methods describe standards for systematic search strategies, but a consistent approach for creating an exhaustive search strategy has not yet been fully described in enough detail to be fully replicable. The authors have established a method that describes step by step the process of developing a systematic search strategy as needed in the systematic review. This method describes how single-line search strategies can be prepared in a text document by typing search syntax (such as field codes, parentheses, and Boolean operators) before copying and pasting search terms (keywords and free-text synonyms) that are found in the thesaurus. To help ensure term completeness, we developed a novel optimization technique that is mainly based on comparing the results retrieved by thesaurus terms with those retrieved by the free-text search words to identify potentially relevant candidate search terms. Macros in Microsoft Word have been developed to convert syntaxes between databases and interfaces almost automatically. This method helps information specialists in developing librarian-mediated searches for systematic reviews as well as medical and health care practitioners who are searching for evidence to answer clinical questions. The described method can be used to create complex and comprehensive search strategies for different databases and interfaces, such as those that are needed when searching for relevant references for systematic reviews, and will assist both information specialists and practitioners when they are searching the biomedical literature.
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Indización y Redacción de Resúmenes/normas , Bases de Datos Factuales/normas , Almacenamiento y Recuperación de la Información/métodos , Literatura de Revisión como Asunto , Humanos , Medical Subject Headings , Vocabulario ControladoRESUMEN
BACKGROUND: Research into study replication and reporting has led to wide concern about a reproducibility crisis. Reproducibility is coming to the attention of major grant funders, including the National Institutes of Health, which launched new grant application instructions regarding rigor and reproducibility in 2015. STUDY PURPOSE: In this case study, the authors present one library's work to help increase awareness of reproducibility and to build capacity for our institution to improve reproducibility of ongoing and future research. CASE PRESENTATION: Library faculty partnered with campus research leaders to create a daylong conference on research reproducibility, followed by a post-conference day with workshops and an additional seminar. Attendees came from nearly all schools and colleges on campus, as well as from other institutions, nationally and internationally. Feedback on the conference was positive, leading to efforts to sustain the momentum achieved at the conference. New networking and educational opportunities are in development. DISCUSSION: Libraries are uniquely positioned to lead educational and capacity-building efforts on campus around research reproducibility. Costs are high and partnerships are required, but such efforts can lead to positive change institution-wide.
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Creación de Capacidad/organización & administración , Difusión de la Información/métodos , Servicios de Biblioteca/organización & administración , Reproducibilidad de los Resultados , Investigación sobre Servicios de Salud/organización & administración , Humanos , Bibliotecas MédicasRESUMEN
To evaluate and validate the time of completion and results of a new method of searching for systematic reviews, the exhaustive search method (ESM), using a pragmatic comparison. METHODS: Single-line search strategies were prepared in a text document. Term completeness was ensured with a novel optimization technique. Macros in MS Word converted the syntaxes between databases and interfaces almost automatically. We compared search characteristics, such as number of search terms and databases, and outcomes, such as number of included and retrieved references and precision, from ESM searches and other Dutch academic hospitals identified by searching PubMed for systematic reviews published between 2014 and 2016. We compared time to perform the ESM with a secondary comparator of recorded search times from published literature and contact with authors to acquire unpublished data. RESULTS: We identified 73 published Erasmus MC systematic reviews and 258 published by other Dutch academic hospitals meeting our criteria. We pooled search time data from 204 other systematic reviews. The ESM searches differed by using 2 times more databases, retrieving 44% more references, including 20% more studies in the final systematic review, but the time needed for the search was 8% of that of the control group. Similarities between methods include precision and the number of search terms. CONCLUSIONS: The evaluated similarities and differences suggest that the ESM is a highly efficient way to locate more references meeting the specified selection criteria in systematic reviews than traditional search methods. Further prospective research is required.
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Informática Médica/métodos , Revisiones Sistemáticas como Asunto , Centros Médicos Académicos , Bibliometría , Bases de Datos Bibliográficas , Humanos , Almacenamiento y Recuperación de la Información/métodos , Almacenamiento y Recuperación de la Información/normas , Bibliotecas Médicas , Países Bajos , PubMed , Motor de Búsqueda , Programas Informáticos , UniversidadesRESUMEN
PURPOSE: To characterize reporting of P values, confidence intervals (CIs), and statistical power in health professions education research (HPER) through manual and computerized analysis of published research reports. METHOD: The authors searched PubMed, Embase, and CINAHL in May 2016, for comparative research studies. For manual analysis of abstracts and main texts, they randomly sampled 250 HPER reports published in 1985, 1995, 2005, and 2015, and 100 biomedical research reports published in 1985 and 2015. Automated computerized analysis of abstracts included all HPER reports published 1970-2015. RESULTS: In the 2015 HPER sample, P values were reported in 69/100 abstracts and 94 main texts. CIs were reported in 6 abstracts and 22 main texts. Most P values (≥77%) were ≤.05. Across all years, 60/164 two-group HPER studies had ≥80% power to detect a between-group difference of 0.5 standard deviations. From 1985 to 2015, the proportion of HPER abstracts reporting a CI did not change significantly (odds ratio [OR] 2.87; 95% CI 1.04, 7.88) whereas that of main texts reporting a CI increased (OR 1.96; 95% CI 1.39, 2.78). Comparison with biomedical studies revealed similar reporting of P values, but more frequent use of CIs in biomedicine. Automated analysis of 56,440 HPER abstracts found 14,867 (26.3%) reporting a P value, 3,024 (5.4%) reporting a CI, and increased reporting of P values and CIs from 1970 to 2015. CONCLUSIONS: P values are ubiquitous in HPER, CIs are rarely reported, and most studies are underpowered. Most reported P values would be considered statistically significant.
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Educación Profesional , Empleos en Salud/educación , Informe de Investigación , Estadística como Asunto , Intervalos de Confianza , HumanosRESUMEN
BACKGROUND: Within systematic reviews, when searching for relevant references, it is advisable to use multiple databases. However, searching databases is laborious and time-consuming, as syntax of search strategies are database specific. We aimed to determine the optimal combination of databases needed to conduct efficient searches in systematic reviews and whether the current practice in published reviews is appropriate. While previous studies determined the coverage of databases, we analyzed the actual retrieval from the original searches for systematic reviews. METHODS: Since May 2013, the first author prospectively recorded results from systematic review searches that he performed at his institution. PubMed was used to identify systematic reviews published using our search strategy results. For each published systematic review, we extracted the references of the included studies. Using the prospectively recorded results and the studies included in the publications, we calculated recall, precision, and number needed to read for single databases and databases in combination. We assessed the frequency at which databases and combinations would achieve varying levels of recall (i.e., 95%). For a sample of 200 recently published systematic reviews, we calculated how many had used enough databases to ensure 95% recall. RESULTS: A total of 58 published systematic reviews were included, totaling 1746 relevant references identified by our database searches, while 84 included references had been retrieved by other search methods. Sixteen percent of the included references (291 articles) were only found in a single database; Embase produced the most unique references (n = 132). The combination of Embase, MEDLINE, Web of Science Core Collection, and Google Scholar performed best, achieving an overall recall of 98.3 and 100% recall in 72% of systematic reviews. We estimate that 60% of published systematic reviews do not retrieve 95% of all available relevant references as many fail to search important databases. Other specialized databases, such as CINAHL or PsycINFO, add unique references to some reviews where the topic of the review is related to the focus of the database. CONCLUSIONS: Optimal searches in systematic reviews should search at least Embase, MEDLINE, Web of Science, and Google Scholar as a minimum requirement to guarantee adequate and efficient coverage.