Increasingly, clinicians are doing their own searches using large biomedical literature databases . Choice of database can influence the success of a search . MEDLINE is often searched first due to its free access through the PubMed interface and its broad coverage of the biomedical literature, including nursing, dentistry, paramedic professions, reproductive biology, and clinical and experimental medicine. EMBASE searching is not free but has greater coverage of European and non-English language publications and topics such as pharmaceuticals, psychiatry, toxicology, and alternative medicine. The overlap of EMBASE and MEDLINE is estimated to be 10% to 87%, depending on the topic .
To date, search strategy development has focused more on MEDLINE [4–9] than on EMBASE. Search strategies developed for MEDLINE cannot be directly translated for use in other databases because indexing practices vary and thesaurus terms are not equivalent across databases.
In the 1990s, the Hedges Team developed MEDLINE search strategies for a small subset of 10 journals [10, 11]. This work has been expanded using data from 161 journals indexed in MEDLINE in 2000 and a 55-journal subset for EMBASE. The MEDLINE strategies [12–18] and some EMBASE strategies [19–22] have previously been published. This report compares the sensitivity and specificity of top-performing search strategies for detecting treatment and review articles in MEDLINE and EMBASE.
The methods used in this study have been detailed elsewhere . Briefly, the operating characteristics of search strategies were compared with a manual review of 161 health care journals in 2000 for MEDLINE  and a 55-journal subset for EMBASE . Six research assistants manually assessed all articles for studies meeting methodologic criteria in 7 purpose categories (treatment, causation, prognosis, diagnosis, economics, clinical prediction, and reviews). The authors reported purpose category definitions and methodologic criteria in an earlier paper . To evaluate search strategies designed to retrieve studies meeting basic methodologic criteria, index terms and text-words related to research design features were run as search strategies. Search strategies were treated as “diagnostic tests” for sound studies, and the manual review (hand search) was treated as the “gold standard.” Operating characteristics of the search strategies were determined. Top-performing strategies for detecting sound treatment and systematic review articles in MEDLINE [17, 18] and EMBASE [26, 27] were compared.