TY  - JOUR
AU  - Khan, Danyal Zaman
AU  - Khan, Muhammad Shuaib
AU  - Kotter, Mark RN
AU  - Davies, Benjamin Marshall
PY  - 2020
DA  - 2020/6/11
TI  - Tackling Research Inefficiency in Degenerative Cervical Myelopathy: Illustrative Review
JO  - JMIR Res Protoc
SP  - e15922
VL  - 9
IS  - 6
KW  - cervical
KW  - myelopathy
KW  - spondylosis
KW  - spondylotic
KW  - stenosis
KW  - disc herniation
KW  - ossification posterior longitudinal ligament
KW  - systematic review
KW  - research inefficiency
KW  - imprecision
AB  - Background: Degenerative cervical myelopathy (DCM) is widely accepted as the most common cause of adult myelopathy worldwide. Despite this, there is no specific term or diagnostic criteria in the International Classification of Diseases 11th Revision and no Medical Subject Headings (MeSH) or an equivalent in common literature databases. This makes searching the literature and thus conducting systematic reviews or meta-analyses imprecise and inefficient. Efficient research synthesis is integral to delivering evidence-based medicine and improving research efficiency. Objective: This study aimed to illustrate the difficulties encountered when attempting to carry out a comprehensive and accurate evidence search in the field of DCM by identifying the key sources of imprecision and quantifying their impact. Methods: To identify the key sources of imprecision and quantify their impact, an illustrative search strategy was developed using a validated DCM hedge combined with contemporary strategies used by authors in previous systematic reviews and meta-analyses. This strategy was applied to Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica dataBASE (EMBASE) databases looking for relevant DCM systematic reviews and meta-analyses published within the last 5 years. Results: The MEDLINE via PubMed search strategy returned 24,166 results, refined to 534 papers after the application of inclusion and exclusion criteria. Of these, 32.96% (176/534) results were about DCM, and 18.16% (97/534) of these were DCM systematic reviews or meta-analyses. Non-DCM results were organized into imprecision categories (spinal: 268/534, 50.2%; nonspinal: 84/534, 15.5%; and nonhuman: 8/534, 1.5%). The largest categories were spinal cord injury (75/534, 13.67%), spinal neoplasms (44/534, 8.24%), infectious diseases of the spine and central nervous system (18/534, 3.37%), and other spinal levels (ie, thoracic, lumbar, and sacral; 18/534, 3.37%). Counterintuitively, the use of human and adult PubMed filters was found to exclude a large number of relevant articles. Searching a second database (EMBASE) added an extra 12 DCM systematic reviews or meta-analyses. Conclusions: DCM search strategies face significant imprecision, principally because of overlapping and heterogenous search terms, and inaccurate article indexing. Notably, commonly employed MEDLINE filters, human and adult, reduced search sensitivity, whereas the related articles function and the use of a second database (EMBASE) improved it. Development of a MeSH labeling and a standardized DCM definition would allow comprehensive and specific indexing of DCM literature. This is required to support a more efficient research synthesis. 
SN  - 1929-0748
UR  - https://www.researchprotocols.org/2020/6/e15922
UR  - https://doi.org/10.2196/15922
UR  - http://www.ncbi.nlm.nih.gov/pubmed/32525490
DO  - 10.2196/15922
ID  - info:doi/10.2196/15922
ER  -