Appendix A. Protocol for NASS Literature Searches

One of the most crucial elements of evidence analysis, to support the development of recommendations for appropriate clinical care or use of new technologies, is the comprehensive literature search. Thorough assessment of the literature is the basis for the review of existing evidence, which will be instrumental to these activities.

Background

Since the quality of a literature search directly affects the quality of recommendations made NASS adheres to a protocol to ensure that all NASS searches are conducted consistently to yield the most comprehensive results

Protocol for NASS Literature Searches

When it is determined that a literature search is needed, NASS research staff will work with the requesting parties and our contracted medical librarian to run a comprehensive search employing at a minimum the following search techniques:

1. A preliminary search of the evidence will be conducted using the following clearly defined search parameters (as determined by the content experts). In addition to the project goal and clinical question(s) of interest, the following parameters are to be provided to research staff to facilitate this systematic literature search:
2. Time frames for search;
3. Foreign and/or English language;
4. Order of results (chronological, by journal, etc.);
5. Key search terms and connectors, with or without MeSH terms to be employed;
6. Age range;

Must answer the following questions:

• Should duplicates be eliminated between searches?
• Should searches be separated by term or as one large package?
• Should human studies, animal studies or cadaver studies be included?

This preliminary search should encompass a search of the Cochrane database when access is available.

1. Search results with abstracts will be compiled by the medical librarian in both Endnote software and a PubMed account, whenever possible. The medical librarian typically responds to requests and completes the searches within 2-5 business days. Results will be forwarded to the Research staff, who will share it with the appropriate NASS staff member or requesting party(ies). (Research staff has access to Endnote software and will maintain a database of search results for future use/documentation.)
2. NASS staff shares the search results with an appropriate content expert (NASS Committee member or other) to assess relevance of articles and identify appropriate articles to review and on which to run a “related articles” search.
3. Based on content expert’s review, NASS Research staff will then coordinate with the medical librarian the second level searching to identify relevant “related articles.”
4. The medical librarian will forward results to Research staff to again share with appropriate NASS staff member.
5. NASS staff shares related articles search results with an appropriate content expert (NASS Committee member or other) to assess relevance of this second set of articles, and identify appropriate articles to review and on which to run a second “related articles” search.
6. NASS Research staff will work with the medical librarian to obtain the 2nd related articles search results and any necessary full-text articles for review.
7. NASS members reviewing full-text articles should also review the references at the end of each article to identify additional articles which should be reviewed, but may have been missed in the search.

Protocol for Expedited Searches

Numbers 1, 2 and 3 should minimally be followed for any necessary expedited search. Following #3, depending on the time frame allowed, deeper searching may be conducted as described by the full protocol or request of full-text articles may occur. If full-text articles are requested, #8 should also be included. Use of the expedited protocol or any deviation from the full protocol should be documented with explanation.

Following these protocols will help ensure that NASS recommendations are (1) based on a thorough review of relevant literature; (2) are truly based on a uniform, comprehensive search strategy; and (3) represent the current best research evidence available. Research staff will maintain a search history in Endnote, for future use or reference.