The practice of evidence‐based health care requires that information on methodology be identified from databases such as MEDLINE. Up until this year there have been no designated medical subject headings (MeSH) for evidence‐based health care. ‘EVIDENCE‐BASED MEDICINE’ appears as a MeSH term from 1997. The absence of designated MeSH for this concept prior to 1997 provides a challenge to the searcher. This paper describes the creation of a MEDLINE search strategy to retrieve articles on the methods of evidence‐based health care published prior to the introduction of the new term, where an optimal combination of free‐text and MeSH terms is required to identify relevant material. The study examines both free‐text and subject heading searching and attempts an optimal balance of sensitivity and specificity. It begins by examining separate free‐text and subject heading searches. Sensitivity of the subject heading search was 33% and specificity 80%, while the free‐text search produced a sensitivity of 50% and a specificity of 67%. The final strategy, combining both approaches, was more successful with sensitivity reaching between 82 and 90% and specificity 83%.
It is therefore possible to devise a search strategy to retrieve articles on the methods of evidence‐based health care with relatively successful rates ofsensitivity and specificity. The limitations of MEDLINE, however, necessitate the use of additional approaches in identifying articles on the methods of evidence‐based health care.