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Guideline 61: Investigation of post-menopausal bleeding - Supporting material
Search narrative
The search strategies used were based on key questions drawn up by the guideline development group in conjunction with the information officer. The initial search strategies were subject to review by an external information officer. The strategy listed below has taken account of comments made during that review.
Summary
The initial search for systematic reviews and randomised controlled trials covered the Cochrane Library, Embase (1985 - May 1999), Healthstar (1975 - May 1999), and Medline (1966 - May 1999). A supplementary search for the risk factors subgroup covered Healthstar and Medline from 1991 to 1999. A further search on economic issues was conducted on the NEED database, as well as Embase, Healthstar, Medline, and Pascal databases from 1991 - 1999. This search did not cover the economics of individual diagnostic tools or techniques.
Internet search.
Ask Jeeves
http://www.ask.com/
CMA Infobase
http://mdm.ca/cpgsnew/cpgs/index.asp
NHS
HTA Programme
http://www.ncchta.org/
National Institutes
of Health
http://www.nih.gov/
National
Guideline Clearinghouse
http://www.guideline.gov/index.asp
Northern Light
http://www.northernlight.com/
OMNI
http://omni.ac.uk/
These searches were carried out using the Ovid implementation of Medline. A * before a search term indicates that term was focused - i.e. limited to records where the term was a major MeSH term. "exp" before a term indicates that the term was exploded. A / after a term indicates that all subheadings were selected. A $ at the end of a term indicates that this term has been truncated. Basic search.
| 1 |
Postmenopause |
This first section aims to identify the patient group. |
| 2 |
Menopause, premature/ |
|
| 3 |
Metrorrhagia/ |
|
| 4 |
Uterine hemorrhage/ |
|
| 5 |
Postmenopaus$.tw. |
|
| 6 |
Post-menopaus$.tw. |
|
| 7 |
Vaginal adj (hemorrhag$ or haemorrhag$).tw. |
|
| 8 |
Vaginal bleeding.tw. |
|
| 9 |
Uterine bleeding.tw. |
|
| 10 |
(bleeding adj3 (uter$ or vagin$)).tw. |
|
| 11 |
Or/3-10 |
|
| 12 |
{Limit set 11 to individuals aged 45 or over} |
|
| 13 |
Exp uterine neoplasms/di,pa,pc,pp |
|
| 14 |
11 and 13 |
|
| 15 |
Postmenopausal bleed$.tw. |
|
| 16 |
(1 or 2) and 11 |
|
| 17 |
Or/12, 14-16 |
|
| 18 |
Exp hormone replacement therapy |
|
| 19 |
Hormone replacement.tw. |
|
| 20 |
HRT.tw. |
|
| 21 |
Estrogen therapy.tw. |
|
| 22 |
Oestrogen therapy.tw. |
|
| 23 |
Or/18-22 |
|
| 24 |
Or/2, 12 |
|
| 25 |
23 and 24 |
|
| 26 |
17 or 25 |
|
| 27 |
Exp tamoxifen |
Identify patients that have been taking tamoxifen |
| 28 |
26 and 27 |
|
| 29 |
Exp risk/ |
Identify material on risk assessment |
| 30 |
Risk factor$.tw. |
|
| 31 |
(level adj2 risk) |
|
| 32 |
Incidence.ti. |
|
| 33 |
Prevalence.ti. |
|
| 34 |
Or/29-33 |
|
| 35 |
17 and 34 |
|
| 36 |
Uterine hemorrhage/ep |
|
| 37 |
35 or 36 |
|
| 38 |
Hysteroscopy/ |
Identify material on diagnosis |
| 39 |
Hysteroscop$.tw. |
|
| 40 |
Magnetic resonance imaging/ |
|
| 41 |
MRI.tw. |
|
| 42 |
Magnetic resonance.tw. |
|
| 43 |
Ultrasonography/ |
|
| 44 |
Ultrsonograph$.tw. |
|
| 45 |
Sonograph$.tw. |
|
| 46 |
Ultrasound.tw. |
|
| 47 |
Hysterosonograph$.tw. |
|
| 48 |
Ultrasonography, interventional/ |
|
| 49 |
Endosonography/ |
|
| 50 |
Explode curettage/ |
|
| 51 |
Vaginal smears/ |
|
| 52 |
smear$1.tw. |
|
| 53 |
cytol$.tw. |
|
| 54 |
Smear test$.tw. |
|
| 55 |
Biopsy, needle/ |
|
| 56 |
Biopsy.tw. |
|
| 57 |
Pipelle.tw. |
|
| 58 |
Tao brush.tw. |
|
| 59 |
Vabra.tw. |
|
| 60 |
Wallach endocell$.tw. |
|
| 61 |
Diagnosis, differential/ |
|
| 62 |
Diagnos$.tw. |
|
| 63 |
Investigat$.tw. |
|
| 64 |
Or/38-63 |
|
| 65 |
26 and 64 |
|
| 66 |
Cost benefit analysis/ |
Identify material on cost effectiveness |
| 67 |
Health care costs/ |
|
| 68 |
Quality of life/ |
|
| 69 |
Cost of illness/ |
|
| 70 |
Cost effect$.tw. |
|
| 71 |
Cost utility.tw. |
|
| 72 |
QALY.tw. |
|
| 73 |
Or/66-72 |
|
| 74 |
and 73 |
|
Search filters to identify systematic reviews, randomised controlled trials, and observational studies were added at this point. Strategies for other databases followed the same general structure as that listed above, but were amended to take account of differences in indexing languages. Following revision of their questions, a revised strategy was developed for the risk management subgroup. The Medline version of this was as follows:
| 1 |
Postmenopause/ |
|
| 2 |
Menopause, premature/ |
|
| 3 |
Metrorrhagia/ |
|
| 4 |
Postmenopaus$.tw. |
|
| 5 |
Metrorrhagia.tw. |
|
| 6 |
Or/1-5 |
|
| 7 |
Exp uterine neoplasms/ |
|
| 8 |
Endometrial carcinoma.tw. |
|
| 9 |
Endometrial cancer$.tw. |
|
| 10 |
(Cancer adj2 endometrium).tw. |
|
| 11 |
Cervical carcinoma.tw. |
|
| 12 |
Cervical cancer$.tw. |
|
| 13 |
(Cancer adj2 cervix).tw. |
|
| 14 |
Uterine carcinoma.tw. |
|
| 15 |
Uterine cancer$.tw. |
|
| 16 |
(Cancer adj2 uterus).tw. |
|
| 17 |
Or/7-16 |
|
| 18 |
Bleeding.tw. |
|
| 19 |
Uterine hemorrhage/ |
|
| 20 |
Hemorrhag$.tw. |
|
| 21 |
Haemorrhag$.tw. |
|
| 22 |
Or/18-21 |
|
| 23 |
6 and 17 |
|
| 24 |
22 and 23 |
|
| 25 |
23 not 24 |
|
| 26 |
Exp tamoxifen/ |
|
| 27 |
Tamoxifen.tw. |
|
| 28 |
26 or 27 |
|
| 29 |
24 not 28 |
|
| 30 |
25 not 28 |
Search filters to identify systematic reviews, randomised controlled trials, and observational studies were added at this point. A similar strategy was used on Embase.