Sensitivity and specificity of electronic databases: The example of searching for evidence on child protection issues related to pregnant women

H Mc Elhinney, Brian J Taylor, Marlene . Sinclair, Mary Rose Holman

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)
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Background. There are increasing demands on health and social care (HSC) professionals to make decisions based on bestevidence to inform their practice. To do this, they must be skilled in searching the literature. A robust approach to literaturereviewing that results in optimal outcomes is highly desirable in a climate where time and resources are limited.Aim. This paper explores the processes of undertaking a structured literature search and measuring the effectiveness of fivecommonly used health and social care databases.Method. A review question was posed using the qualitative version of PICO (Population, Interest, Context and Outcome): ‘Howdo HSC professionals (P) make decisions (I) in relation to pregnant women (C) where there is a safeguarding concern (O) regardingan unborn child?’ Databases selected for review were: ASSIA, CINAHL Plus, Ovid MEDLINE, PsycINFO and Social Care Online.Searches were undertaken from October 2014 to April 2015. A rapid update was undertaken in March 2016 prior to publication.Papers were screened for their suitability for inclusion using a screening tool developed by the research team. Papers were requiredto report empirical research; to have been published in peer-reviewed journals, as an indicator of a measure of quality; and to beavailable in the English language. Full-text papers were chosen if the data were gathered from or about decision-making regardingsafeguarding in pregnancy by midwives, nurses, social workers and professional managers. The quality of the chosen databaseswas determined by sensitivity (capacity to retrieve a satisfactory number of papers), precision (to prevent the retrieval of too manyirrelevant papers) and Numbers Needed to Read (NNR) – number of papers needed to read to find one paper to include.Results. A total of 866 papers were identified, titles and abstracts were reviewed by the researcher and full-text papers werefurther reviewed by the research team, both using a screening tool. These results were discussed and nine papers were identifiedfor review. Sensitivity was greatest on CINAHL Plus and Ovid MEDLINE. Precision scores were generally low; CINAHL Plusscored the highest at 4%. CINAHL Plus was found to be most effective with an NNR score of 26%, followed by PsycINFO withan NNR score of 36% and Ovid MEDLINE was the lowest precision with an NNR score of 45%.Implications. The challenges of robust searching for literature indicate that if evidence-based practice is to become a reality,regular training for midwives, social workers and other healthcare professionals in database searching is essential
Original languageEnglish
Pages (from-to)29-34
JournalEvidence Based Midwifery
Issue number1
Publication statusPublished (in print/issue) - 30 Apr 2016


  • Search methodology
  • systematic literature searching
  • sensitivity and precision
  • decision-making
  • child safeguarding
  • pregnancy
  • evidence-based midwifery


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