Trustworthy Clinical Practice Guidelines Begin with Medical Research Librarians

Guideline developers and medical specialty societies encounter significant challenges when performing systematic literature searches, which are crucial for developing trustworthy clinical practice guidelines. Factors such as insufficient funding, limited staff capacity, inadequate access to medical databases, and a lack of specialized search expertise often leave medical societies with significant gaps in their guideline development process. Problems that societies routinely encounter when developing clinical practice guidelines include:

• Access to subscription-based interfaces for biomedical literature searching (e.g., Embase.com, OVID, AccessMedicine) and subject-specific databases (e.g., APA PsycINFO, CINAHL Plus, LILACS, EconLit)
• Limited knowledge and experience in searching for relevant grey literature
• Funding to purchase database access (e.g., up to $60,000/year for enterprise access to Embase.com alone)
• Access to Master’s-level medical librarians with expertise in formulating complex search strategies using controlled vocabulary and database-specific syntax
• Ability to perform periodic search updates to ensure timeliness and relevancy of research materials
• Use of a systematic process to peer review search strategies using the industry standard PRESS guideline
• Documenting search strategies using PRISMA-S guidance to ensure clarity and reproducibility of search results
• Lack knowledge of how to obtain free full texts of published clinical studies
• Trouble developing search strategies that are based on PICOs (patients, interventions, comparators, outcomes) and key questions

How We Can Assist

With more than 25 years of guideline development, evidence synthesis, and systematic review experience, ECRI is uniquely qualified to provide organizations with the most current and high-quality evidence available. ECRI’s team of Master’s-level medical research librarians excel in formulating comprehensive search strategies across multiple medical databases, adeptly navigating various interfaces, and collaborating with a diverse range of stakeholders, including guideline panels.

Use Case 1

ECRI has assisted numerous organizations in addressing these issues. For example, one medical society wanted to conduct its own literature searches to update several outdated clinical practice guidelines. However, the society was limited to freely accessible medical databases, restricting its ability to perform comprehensive searches.

The society did not have funds to purchase essential database subscriptions, and its librarian, while experienced with free databases like PubMed, was unfamiliar with the search syntax required for proprietary databases like Embase.

ECRI’s librarians collaborated with the society to create systematic search strategies to address the PICO framework and key questions for each updated clinical practice guideline. ECRI also searched proprietary databases and provided citations to the society in EndNote and DistillerSR, saving on database fees and expediting the guideline update process.

Use Case 2

In another case, ECRI helped a medical society having concerns about the quality of the existing literature search techniques used to inform its clinical practice guideline development. ECRI’s expertise with reviewing and enhancing literature search techniques ensured that critical studies were not missed.

ECRI identified several weaknesses in the society's current approach, including searches that were not conducted in more than one database to ensure comprehensive coverage. ECRI offered recommendations to improve the society’s search strategies, providing a more transparent, rigorous, and comprehensive process in the future.

ECRI librarians reviewed the society’s search strategies and provided guidance on improving these strategies using Ovid MEDLINE. ECRI librarians used industry standard peer-review methods to review the society’s strategies and provide feedback. Additionally, ECRI created a model to help distribute the effort of guideline updates more efficiently throughout the year.

Explore how ECRI can assist your organization by reviewing our 2024 webinar on Developing Trustworthy Evidence-Based Guidelines, visiting our Evidence-based Practice Center website, or contacting us at ECC@ecri.org to discuss your literature search needs.