Defining the process to literature searching in systematic reviews: a literature review of guidance and supporting studies.

BACKGROUND: Systematic literature searching is recognised as a critical component of the systematic review process. It involves a systematic search for studies and aims for a transparent report of study identification, leaving readers clear about what was done to identify studies, and how the findings of the review are situated in the relevant evidence. Information specialists and review teams appear to work from a shared and tacit model of the literature search process. How this tacit model has developed and evolved is unclear, and it has not been explicitly examined before. The purpose of this review is to determine if a shared model of the literature searching process can be detected across systematic review guidance documents and, if so, how this process is reported in the guidance and supported by published studies. METHOD: A literature review. Two types of literature were reviewed: guidance and published studies. Nine guidance documents were identified, including: The Cochrane and Campbell Handbooks. Published studies were identified through 'pearl growing', citation chasing, a search of PubMed using the systematic review methods filter, and the authors' topic knowledge. The relevant sections within each guidance document were then read and re-read, with the aim of determining key methodological stages. Methodological stages were identified and defined. This data was reviewed to identify agreements and areas of unique guidance between guidance documents. Consensus across multiple guidance documents was used to inform selection of 'key stages' in the process of literature searching. RESULTS: Eight key stages were determined relating specifically to literature searching in systematic reviews. They were: who should literature search, aims and purpose of literature searching, preparation, the search strategy, searching databases, supplementary searching, managing references and reporting the search process. CONCLUSIONS: Eight key stages to the process of literature searching in systematic reviews were identified. These key stages are consistently reported in the nine guidance documents, suggesting consensus on the key stages of literature searching, and therefore the process of literature searching as a whole, in systematic reviews. Further research to determine the suitability of using the same process of literature searching for all types of systematic review is indicated.

Métricas alternativas: más allá del factor de impacto / Altmetrics: Beyond the Impact Factor

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Stereotactic body radiotherapy (SBRT) for the treatment of inoperable stage I non-small cell lung cancer patients

Introduction: Lung cancer is the most frequent neoplasm in humans. Surgery is considered the best therapeutic approach for stage I non-small lung cell cancer (NSCLC). However, a remarkable amount of patients are considered as inoperable. Stereotactic body radiotherapy (SBRT) has risen as an option for those patients, rendering excellent results in quality of life and survival. Materials and methods: We analyzed clinical studies published between 2002 and 2015 which included SBRT as a treatment modality. Our own clinical series was analyzed as well. The patterns of failure following SBRT were investigated, together with the outcomes and the toxicity observed. Results: SBRT has proven to maintain an excellent local control. The analysis showed the tumor size and the histology as determinant factors for the response to treatment. Conclusion: According to the published evidence as well as our own experience, SBRT is a safe and feasible approach for early NSCLC. Its results may be comparable with surgery treatment (AU)

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Ejercicio terapéutico para epicondilalgia lateral: revisión sistemática / Exercise therapy for lateral epicondylalgia: systematic review

La epicondilalgia lateral es una de las lesiones más comunes del brazo, siendo el músculo extensor radial corto del carpo (ERCB) la estructura más afectada, por movimientos repetitivos, rápidos y monótonos, principalmente afecta entre 1-3% de la población general, siendo más común en mujeres. El ejercicio terapéutico, es uno de los elementos claves en los programas diseñados para el manejo de esta condición. Se realizará una búsqueda de la evidencia a través de una revisión sistemática de ensayos clínicos aleatorizados que hayan determinado la efectividad del ejercicio terapéutico para el manejo de estos pacientes. El objetivo de esta Revisión es determinar si existe evidencia científica que avale la efectividad clínica del ejercicio terapéutico sólo o dentro de un programa de tratamiento en pacientes adultos con epicondilalgia lateral. La estrategia de búsqueda incluyó ensayos clínicos aleatorizados (ECA) y ensayos clínicos controlados (ECC); las bases de datos usadas fueron: Medline, Cinahl, PEDro, Central, Lilacs. Los resultados obtenidos fueron de treinta y seis artículos que cumplían con nuestros criterios de elegibilidad. Se concluye que existe evidencia moderada que el ejercicio terapéutico comparado con una intervención única, disminuye el dolor, mejora la funcionalidad y aumenta la fuerza libre de dolor en corto, medio y largo plazo. Existe evidencia de que el ejercicio terapéutico disminuye el dolor, y aumenta la fuerza sin dolor a corto plazo. Existe evidencia fuerte de que el ejercicio terapéutico disminuye el dolor, aumenta la fuerza y mejora la funcionalidad a corto, medio y largo plazo (AU)

The lateral epicondylalgia is one of the most common injuries of the arm; with the muscle extensor carpi radialis brevis (ERCB) affected the structure, repetitive motion, rapids and monotonous, mainly affects between 1-3% of the general population, being more common in women. Therapeutic exercise is one of the key elements in programs designed for the management of this condition. There will be a synthesis of evidence through a systematic review of randomized clinical trials that established the effectiveness of exercise therapy in the management of these patients. The aim of this review is to determine whether there is scientific evidence to support the clinical effectiveness of exercise therapy alone or in a treatment program for adult patients with LE. The search strategy included randomized clinical trials (RCTs) and controlled clinical trials (CCTs) databases were used: Medline, CINAHL, PEDro, Central, Lilacs. The results obtained were thirty-six articles that met our eligibility criteria. We conclude that there is moderate evidence shows that therapeutic exercise alone compared with a single intervention, decreases pain, improves function and increases strength pain free in short, medium and long term. There is strong evidence that exercise therapy reduces pain, increases strength and free from short-term pain. There is strong evidence that exercise therapy reduces pain, increases strength and improves functionality in the short, medium and long term (AU)

A Metadata based Knowledge Discovery Methodology for Seeding Translational Research.

In this paper, we present a semantic, metadata based knowledge discovery methodology for identifying teams of researchers from diverse backgrounds who can collaborate on interdisciplinary research projects: projects in areas that have been identified as high-impact areas at The Ohio State University. This methodology involves the semantic annotation of keywords and the postulation of semantic metrics to improve the efficiency of the path exploration algorithm as well as to rank the results. Results indicate that our methodology can discover groups of experts from diverse areas who can collaborate on translational research projects.

Prescripción electrónica asistida (PEA) y su influencia en la comunicación verbal entre Médicos y Enfermeras en una planta de Medicina Interna, Neumología y Cardiología / Assisted Electronic Prescribing (EPA) and its influence on verbal communication between doctors and nurses in a plant of Internal Medicine, Pneumology and Cardiology

Introducción. Con el advenimiento de la informatización de la documentación médica, incluida la Prescripción Electrónica Asistida, la comunicación entre Médicos y Enfermeras es cada vez más electrónica y menos 'cara a cara' produciéndose efectos no deseados como cambios en los patrones de comunicación entre profesionales. Objetivos. Definir cuáll es el grado de comunicación verbal existente entre Médicos y personal de Enfermería en la unidad de Medicina Interna y establecer propuestas de mejora. Material y método: Revisión bibliográfica en bases de datos Pubmed, Medline, CINAHL, Scielo España y en base de datos de editorial Elseiver utilizando los descriptores DeCS o palabras clave (Relaciones Médico-Enfermero, Comunicación, Prescripción Electrónica, Pase de Guardia, Grupo de Atención al Paciente). Estudio observacional descriptivo, con una muestra de 19 Médicos y 19 Enfermeros, mediante cuestionario con 10 preguntas cerradas y varias opciones de respuesta. Resultados. Los resultados de la encuesta muestran que ambos colectivos consideran de gran importancia la necesidad de comunicación entre ambos tanto a nivel global como individual así como de trabajo en equipo. Conclusiones. Entre los aspectos más relevantes y que apoyan nuestro planteamiento inicial es que 78% (IC 95%; 85,6%-70,39%) de los encuestados piensa que tras la implantación del programa de PEA ha cambiado el patrón de comunicación entre ambos colectivos disminuyendo considerablemente la comunicación verbal directa (AU)

Introduction: With the advent of computerization of medical records, including electronic prescribing, communication between doctors and nurses is becoming more electronic and less 'face to face', thus producing unwished effects such as changes in the communication patterns. Objectives: Establishing the level of verbal communication between physicians and nurses in an internal medicine unit and suggesting improvement proposals. Material and method: Literature review in databases Pubmed, Medline, CINAHL, SciELO Spain and publishing database Elseiver using MeSH descriptors or keywords (Physician-Nurse Relations, Communication, Electronic Prescribing, Patient Handoff, Patient Care Team). Descriptive observational study with a sample of 19 physicians and 19 nurses, using a questionnaire with 10 closed questions with several answer options. Results: Both groups considered of great importance the need for communication, globally and individually, as well as teamwork. Conclusions: Among the most relevant aspects supporting our initial approach we have to point out that 78% (CI 95%; 85,6%-70,39%) of people being interviewed thought that after the implementation of computerized physician medication order entry the communication behaviour between both groups has changed significantly by reducing direct verbal communication (AU)

El enfermero de unidades hospitalarias oncológicas: perfil y capacitación profesional / O enfermeiro que atua em unidades hospitalares oncológicas: perfil e capacitação profissional / The nurse that operates in oncology unit hospital: profile and vocational training

Este es un estudio que tuvo como objetivo identificar el perfil de la enfermera que trabaja en las unidades hospitalarias de oncología. Se trata de una revisión integradora y la recolección de datos se llevó a cabo en cuatro bases de datos electrónicas en el período de marzo a mayo de 2013. Se seleccionaron 15 artículos publicados en el período 2004-2013. Los resultados se describen en dos categorías: 1. El perfil social y profesional de las enfermeras que trabajan en unidades hospitalarias de oncología y 2. Formación y preparación de la enfermera para actuar en unidades hospitalarias de oncología. Las enfermeras son mujeres, con edades comprendidas entre 23 y 57 años de experiencia en el campo, con la preparación académica suficiente para la graduación. Identifica la necesidad de un desarrollo científico y técnico profesional a través de la especialización, de postgrado, residencias, capacitación, cursos de actualización y la participación en conferencias. El estudio deberá aumentar la conciencia de las enfermeras y administradores de servicios de salud como el perfil y la preparación adecuada de los que trabajan en las unidades de oncología hospitalaria (AU)

Trata-se de um estudo que teve como objetivo identificar o perfil do enfermeiro que atua em unidades hospitalares oncológicas. É uma revisão integrativa e a coleta de dados foi realizada em quatro bases eletrônicas no período de março a maio de 2013. Foram selecionados 15 artigos, publicados no período de 2004 a 2013. Os resultados foram descritos em duas categorias: 1. O perfil social e profissional do enfermeiro que atua unidades hospitalares oncológicas e 2. Capacitação e preparo do Enfermeiro para atuar em unidades hospitalares oncológicas. Os enfermeiros são do sexo feminino, faixa etária entre 23 e 57 anos e experiência na área, com preparo acadêmico insuficiente durante a graduação. Identificam-se a necessidade de desenvolvimento profissional técnico-científico por meio de especializações, pós-graduação, residências, treinamentos, cursos de atualização e participação em congressos. O estudo deve provocar reflexão dos enfermeiros e gestores dos serviços de saúde quanto ao perfil e preparo adequado para a atuação em unidades hospitalares de oncologia

This is a study that aimed to identify the profile of the nurse working in oncology hospital units. It is an integrative review and data collection was conducted in four electronic databases in the period March-May 2013. 15 articles published in the period 2004-2013 were selected. The results were described in two categories: 1. The social and professional profile of nurses who work oncological hospitals and 2. Training and preparation of the nurse to act in oncological hospitals. The nurses are female, aged between 23 and 57 years, experience in the field, with insufficient academic preparation for graduation. Identifies the need for professional technical and scientific development through specialization, graduate, homes, training, refresher courses and participation in conferences. The study should increase awareness of nurses and managers of health services as the profile and adequate preparation of working in hospital oncology units (AU)

Lesiones por humedad. Revisión de conocimientos / Moisture lesions. A review

La dermatitis asociada a la incontinencia, una manifestación clínica de lesiones de la piel asociadas a la humedad, es un estado caracterizado por irritación e inflamación, y es una consideración común en pacientes con incontinencia urinaria y/o fecal. Debido a la localización y apariencia de estas 'lesiones por humedad', a menudo se confunden con las úlceras por presión. Objetivo: Llevar a cabo una revisión bibliográfica acerca del término 'lesiones por humedad'. Método: Se realizó una búsqueda de datos mediante el metabuscador Gerion del Sistema Sanitario Público de Andalucía. El término empleado para la búsqueda fue el concepto 'lesiones por humedad' en inglés ('moisture lesions'). La recolección de datos fue realizada por una sola persona. Se identificaron y analizaron 18 artículos en los que se trata el concepto 'lesiones por humedad'. Resultados y conclusiones: El diagnóstico diferencial, usualmente basado en el examen visual, puede ayudar a determinar si está presente una úlcera por presión o una lesión por humedad. Los objetivos del tratamiento incluyen proteger la piel de un daño adicional por la exposición a irritantes y establecer un ambiente orientado a la curación. Esta revisión de la literatura subraya la escasa cantidad de información basada en la evidencia disponible y destaca la necesidad de realizar más estudios. Esto debería alentar a las enfermeras a prestar más atención a las lesiones por humedad y a su evaluación y tratamiento (AU)

Incontinence-associated dermatitis, a clinical manifestation of moisture-associated skin damage, is a condition characterized by irritation and inflammation, and is a common consideration in patients with fecal and/or urinary incontinence. Due to the location and appearance of 'moisture lesions', they are often mistaken for pressure ulcers. Objective: To perform a literature review about the term 'moisture lesions'. Methods: We conducted a search of data through the metasearch Gerion Andalusian Public Health System. The term used for search centered on the concept: 'moisture lesions'. Data extraction was performed by a single person. We identified and analyzed 18 articles in which the term 'moisture lesions' is treated. Results and conclusions: Differential diagnosis, usually based on visual examination, can help determine whether incontinence-associated dermatitis or a pressure ulcer is present.Treatment goals include protection of the skin from further exposure to irritants and establishment of a healing environment. This review of literature underscores the scant amount of evidence-based information available and highlights the need for further studies. This should encourage nurses to pay closer attention to moisture lesions and its assessment and treatment (AU)

El Reiki como forma terapéutica en el cuidado de la salud: una revisión narrativa de la literatura / O Reiki como forma terapêutica no cuidado à saúde: uma revisão narrativa da literatura / The Reiki as therapeutic form in health care: a narrative literature review

Reiki es una terapia complementaria, caracterizada por la imposición de manos en el ser humano como un objetivo para restablecer el equilibrio físico, mental y espiritual. Este trabajo tiene como objetivo identificar la producción científica en terapia complementaria reiki, mediante una revisión narrativa de la literatura, realizada a través de una búsqueda de la salud Biblioteca Virtual (BVS), entre los años 2007 y 2012. Se detectó un total de 398 artículos, indexados en MEDLINE, LILACS y BDENF, utilizando los descriptores reiki and enfermería y reiki and cuidado. S incluyeron en este estudio 6 artículos, 1 publicado en periódico brasileño y 5 en periódicos extranjeros, disponible solamente el resumen en inglés. Se constató que, de los artículos analizados, se puede afirmar que el reiki, en cuanto que dispositivo de cuidado, provoca cambios significativos en el individuo, especialmente en lo referente a la ansiedad, dolor, estrés, aumento de células de defensa y disminución de la presión arterial. Pocos estudios han sido publicados para demostrar la eficacia del reiki, fundamental en la práctica de enfermería, y por lo tanto de suma importancia disponer de esta herramienta de cuidado, pudiendo asi publicar sus experiencias y estudios, pues cuantos más estudios se publiquen más motivación hay para poner en práctica este dispositivo tan importante para el equilibrio del ser humano (AU)

Reiki é uma terapia complementar, caracterizado pela imposição das mãos no ser humano com objetivo de reestabelecer o equilíbrio, físico, mental e espiritual. Este trabalho visa identificar a produção científica sobre a terapia complementar reiki, a partir de uma revisão narrativa da literatura, realizada através de uma busca na Biblioteca Virtual da Saúde, entre os anos de 2007 a 2012. Foram encontrados um total de 398 artigos, indexados no MEDLINE, LILACS e BDENF, usando os descritores reiki and enfermagem e reiki and cuidado. Foram incluídos no estudo 6 artigos, sendo 1 publicado em periódico brasileiro e 5 em periódicos estrangeiros, disponibilizado apenas o resumo em inglês. Constata-se que, dos artigos analisados, podemos afirmar que o reiki, enquanto dispositivo de cuidado, provoca mudanças significativas no indivíduo, principalmente em relação a ansiedade, dores, estresse, aumento das células de defesa e diminuição dos níveis pressóricos. Poucos estudos têm sido publicados para demonstrar a eficácia do reiki é fundamental na prática da enfermagem e assim de suma importância que este tenha em mãos esta ferramenta do cuidado, podendo assim publicar suas experiências e estudos, pois quanto mais estudos publicados mais motivação se tem para colocar em prática este dispositivo tão importante para o equilíbrio do ser humano

Reiki is a complementary therapy, characterized by the laying on of hands in the human being with the aim of re-establish the physical, mental and spiritual balance. This work involves identifying the scientific production on complementary therapy; reiki from a narrative review of literature, research conducted through a search of the Virtual Health Library (BVS), between the years 2007 to 2012. It was found a total of 398 articles, indexed in MEDLINE, LILACS and BDENF, using the descriptors reiki and nursing and reiki and care. It was included 6 articles in this study, 1 published in Brazilian periodical and 5 in foreign ones. It is available only the abstract in English. It is find that, of the articles analyzed, we can affirm that the reiki, while care device, causes significant changes in the individual, especially in relation to anxiety, pain, stress, increase defense cells and decreased blood pressure. Few studies have been published to demonstrate the effectiveness of reiki, is fundamental in the practice of nursing and thus of the most importance that the professional take into account this care tool and then can publish their experiences and studies, because the more published studies more motivation will be created to put into practice this device so important for the balance of the human being (AU)

Reducing systematic review workload through certainty-based screening.

In systematic reviews, the growing number of published studies imposes a significant screening workload on reviewers. Active learning is a promising approach to reduce the workload by automating some of the screening decisions, but it has been evaluated for a limited number of disciplines. The suitability of applying active learning to complex topics in disciplines such as social science has not been studied, and the selection of useful criteria and enhancements to address the data imbalance problem in systematic reviews remains an open problem. We applied active learning with two criteria (certainty and uncertainty) and several enhancements in both clinical medicine and social science (specifically, public health) areas, and compared the results in both. The results show that the certainty criterion is useful for finding relevant documents, and weighting positive instances is promising to overcome the data imbalance problem in both data sets. Latent dirichlet allocation (LDA) is also shown to be promising when little manually-assigned information is available. Active learning is effective in complex topics, although its efficiency is limited due to the difficulties in text classification. The most promising criterion and weighting method are the same regardless of the review topic, and unsupervised techniques like LDA have a possibility to boost the performance of active learning without manual annotation.

Associação entre doença periodontal e aterosclerose subclínica: uma revisão sistemática / Association betwenn periodontal disease and subclinic atherosclerosis: a sistematic review

A associação entre doença periodontal e o desenvolvimento de aterosclerose tem sido pesquisada. Esta revisão sistemática da literatura se propõe a verificar a associação entre a doença periodontal e a aterosclerose subclínica. A pesquisa utilizou as bases de dados: PubMed, Scopus, LILACS, BBO, Biblioteca Cochrane e Scielo com os termos: "doença periodontal", "periodontite", "carótida" e "aterosclerose". Foram excluídos artigos: que apresentaram resumos escritos em idiomas diferentes do português, inglês e espanhol; com abordagem laboratorial em modelos experimentais; sem descrição ou referência a estimadores de associação entre doença periodontal e aterosclerose subclínica; pesquisas que realizaram a medida da doença periodontal por parâmetros diferentes de exames clínicos; pesquisas que não analisaram a espessura da íntima média da artéria carótida através de exame de ultrassom; e que abordassem grupos específicos. Foram comparados os desenhos de estudo, protocolos de medida e os dados relatados. De um total de 63 referências, apenas 10 artigos contemplavam todos os critérios de inclusão, distribuídos em: 1 estudo longitudinal, 6 transversais e 3 casos controles. Observou-se uma heterogeneidade entre os estudos em relação ao método de mensuração da doença periodontal e os desfechos da aterosclerose. Concluiu-se que infecções periodontais são fortemente associadas ao desenvolvimento da aterosclerose subclínica, entretanto os mecanismos envolvidos no processo patogênico ainda permanecem desconhecidos.

The association between periodontal disease and the development of atherosclerosis has been studied. The systematic review of literature aims to evaluate the association between periodontal disease and subclinical atherosclerosis. A literature search of the PubMed, Scopus, LILACS, BBO, Cochrane Library and Scielo bibliographic databases was conducted using the following descriptors: "periodontal disease", "periodontitis", "carotid", and "therosclerosis". Articles were excluded if they: presented abstracts written in languages other than Portuguese, English and Spanish; experimental studies; did not contain data testing the degree of association between periodontal disease and subclinical atherosclerosis; did measure the extent of periodontal disease by parameters other than the clinical examination; did not measure the carotid artery intima-media wall thickness by ultrasonography; and covered specific population groups. The studies design, measurement protocols and reported data were compared. A total of 63 papers identified only 10 studies that met the inclusion criteria: 1 longitudinal study, 6 cross-sectional, and 3 case control studies. There was a wide heterogeneity between the studies regarding the methods of measuring periodontal disease and atherosclerosis outcomes. The conclusion is that periodontal infections are strongly associated with the development of subclinical atherosclerosis, however the mechanisms involved on the pathogenic process remain unknown.

Fuentes de información bibliográfica (II). Bases de datos bibliográficas españolas en ciencias de la salud de interés en pediatría: IME, IBECS y MEDES / Sources of bibliographic information (II). Spanish bibliographic database in Health Sciences of interest in pediatrics. Databases of IME, IBECS and MEDES

En este trabajo se describen las bases de datos españolas en ciencias de la salud más relevantes, tanto las de carácter general, Índice Médico Español (IME), Índice Bibliográfico Español en Ciencias de la Salud (IBECS) y Medicina en Español (MEDES), como las específicas, CUIDEN (Enfermería), ENFISPO (Enfermería, Fisioterapia y Podología) y Compludoc (con referencias de artículos publicados en más de 4.000 revistas científicas españolas y extranjeras recibidas en la biblioteca de la Universidad Complutense de Madrid). Se detallan sus principales características, como la entidad que las elabora, el año de inicio, su tamaño o número de registros que contienen, el número de revistas biomédicas, la lista de revistas pediátricas y el número de registros incluidos en ellas. También se comentan otras características, como las diversas posibilidades de buscarla información (búsqueda simple, avanzada por campos y por índices), el uso de operadores booleanos o sus equivalentes, el truncamiento de términos y la existencia o no de control de la terminología empleada. El IME es la base de datos con una mayor cobertura en pediatría y la revista Acta Pediátrica Española está incluida en las tres bases de datos de carácter general (AU)

This paper describes the most relevant Spanish health bibliographic databases, those of general subjects such as the Índice Médico Español (IME), Índice Bibliográfico Español en Ciencias de la Salud (IBECS) and Medicina en Español (MEDES), as well as those of specific subject as CUIDEN (specialized in Nursing), ENFISPO (Nursing, Physiotherapy and Podiatry) and Compludoc (with references from articles published in more than 4.000 Spanish and foreign journals received in the library of the Complutense University of Madrid). Main features are detailed such as the producing entity, the starting year, size or number of records contained, the number of biomedical journals, the list of pediatric journals and the number of records included in them, are detailed. Some other features, such as the various possibilities of finding information (simple, advanced by fields or by indexes), the use of Boolean operators or their equivalent, truncation of terms and the existence of control of the terminology, are also discussed. IME is the database with greater coverage in pediatrics, and the Spanish journal Acta Pediátrica Española is included in the three general databases (AU)

Bases de datos médicas / Medical databases

Listado de las principales bases de datos que incluyen resúmenes de artículos biomédicos.

Bases de datos médicas / Medical databases

Listado de las principales bases de datos que incluyen resúmenes de artículos biomédicos.

When is a search not a search? A comparison of searching the AMED complementary health database via EBSCOhost, OVID and DIALOG.

BACKGROUND: The researchers involved in this study work at Exeter Health library and at the Complementary Medicine Unit, Peninsula School of Medicine and Dentistry (PCMD). Within this collaborative environment it is possible to access the electronic resources of three institutions. This includes access to AMED and other databases using different interfaces. OBJECTIVES: The aim of this study was to investigate whether searching different interfaces to the AMED allied health and complementary medicine database produced the same results when using identical search terms. METHODS: The following Internet-based AMED interfaces were searched: DIALOG DataStar; EBSCOhost and OVID SP_UI01.00.02. Search results from all three databases were saved in an endnote database to facilitate analysis. A checklist was also compiled comparing interface features. RESULTS: In our initial search, DIALOG returned 29 hits, OVID 14 and Ebsco 8. If we assume that DIALOG returned 100% of potential hits, OVID initially returned only 48% of hits and EBSCOhost only 28%. In our search, a researcher using the Ebsco interface to carry out a simple search on AMED would miss over 70% of possible search hits. Subsequent EBSCOhost searches on different subjects failed to find between 21 and 86% of the hits retrieved using the same keywords via DIALOG DataStar. In two cases, the simple EBSCOhost search failed to find any of the results found via DIALOG DataStar. CONCLUSIONS: Depending on the interface, the number of hits retrieved from the same database with the same simple search can vary dramatically. Some simple searches fail to retrieve a substantial percentage of citations. This may result in an uninformed literature review, research funding application or treatment intervention. In addition to ensuring that keywords, spelling and medical subject headings (MeSH) accurately reflect the nature of the search, database users should include wildcards and truncation and adapt their search strategy substantially to retrieve the maximum number of appropriate citations possible. Librarians should be aware of these differences when making purchasing decisions, carrying out literature searches and planning user education.