Spinal palpation: The challenges of information retrieval using available databases

This study addressed 2 questions: first, what is the yield of PubMed MEDLINE for complementary and alternative medicine (CAM) studies compared to other databases; second, what is an effective search strategy to answer a sample research question on spinal palpation?

We formulated the following research question: "What is the reliability of spinal palpation procedures?" We identified specific Medical Subject Headings (MeSH) and key terms as used in osteopathic medicine, allopathic medicine, chiropractic, and physical therapy. Using PubMed, we formulated an initial search template and applied it to 12 additional selected databases. Subsequently, we applied the inclusion criteria and evaluated the yield in terms of precision and sensitivity in identifying relevant studies.

The online search result of the 13 databases identified 1189 citations potentially addressing the research question. After excluding overlapping and nonpertinent citations and those not meeting the inclusion criteria, 49 citations remained. PubMed yielded 19, while MANTIS (Manual Alternative and Natural Therapy Index System), a manual therapy database, yielded 35 citations. Twenty-six of the 49 online citations were repeatedly indexed in 3 or more databases. Content experts and selective manual searches identified 11 additional studies. In all, we identified 60 studies that addressed the research question. The cost of the databases used for conducting this search ranged from free-of-charge to $43,000 per year for a single network subscription.

Commonly used databases often do not provide accurate indexing or coverage of CAM publications. Subject-specific specialized databases are recommended. Access, cost, and ease of using specialized databases are limiting factors.