Ten years have passed, but the quality of search strategies in Indian systematic reviews tells the same story — one of missed opportunities for true rigor.…
Looking Back: The 2015 WAME Poster
In 2015, I participated in a conference organized by the World Association of Medical Editors, in New Delhi, India. I had presented a poster titled “Systematic reviews in Indian publications. How many are really systematic reviews?”
At that time, my co-authors and I analyzed about 147 results retrieved from PubMed — articles with the words “Systematic review” in the title, appearing in Indian journals only. With not very stringent criteria, we found that only about half of them could actually be called systematic reviews.
A Decade Later: What’s Changed? (Sadly, Not Much)
Fast forward to 2025. We have observed that things do not seem to have changed much.
I am specifically referring to the search strategies that we often check out in systematic reviews — both those I come across randomly and those that reach us at QMed, when authors ask for help reviewing their search strategies.
Where Do Systematic Review Searches Go Wrong?
Here are some of the most common shortcomings we still see in 2025:
1. Number of databases searched:
Many authors lack access to paid databases like EMBASE or SCOPUS — understandable. But there are still several free resources available. At QMed, we often search around ten databases, depending on the topic.
2. Wrong MeSH terms used:
In one review, authors had used the MeSH term Nutritional Support where Dietary Supplements would have been correct. Every MeSH term has a defined scope, which may not match the common understanding of the word.
(The MeSH term Nutritional support refers to artificial feeding. In this review the “support” was about supplements, so the Mesh term – Dietary supplements should have been used)
3. Inadequate use of search term alternatives:
In a review on hypertension, authors had used only:
Hypertension OR Hypertension[MeSH]
There was no tag for the text word “hypertension” and no inclusion of synonyms like hypertensive, blood pressure, systolic pressure, diastolic pressure, or abbreviations like BP. There was also no use of truncation.
The key point: authors use multiple variations of a word — and every possible variation must be searched.
4. Wrong Boolean operators:
Many strategies contain incorrect use of AND / OR operators, leading to incomplete or skewed results.
5. No proximity operators:
Searching for words that appear near each other is vital — yet this feature is rarely used.
6. No peer review of search strategies:
International standards now mandate peer review of search strategies before they are run. The peer review process is done by information specialists ONLY for searches created by trained specialists. In India, we lack trained information specialists for these roles. This gap must be filled.
The Way Forward: Building Better Reviews
With these inadequacies, many of our “systematic” reviews are, unfortunately, not truly systematic.
The solution lies in immediate and structured training in literature searching — at multiple levels.
- Most researchers need beginner-to-mid-level search training.
- Those authoring systematic reviews must learn advanced skills — enough to collaborate effectively with trained information specialists.
From Talk to Action: Our Solutions
At QMed Knowledge Foundation, we already offer structured training and support at very moderate costs.
We urge:
- Institutions in India to make search training mandatory.
- The National Medical Commission and other Councils to embed it in the curriculum.
Journal editors to insist on documented evidence of proper search strategies and, ideally, peer review.
Final Word: Peer Review Is Not Optional
I have personally completed the training for peer reviewing of search strategies — a six-hour, deeply intensive program. The process is rigorous and humbling, and it makes one realize how critical this step is for a true systematic review.
It’s time India makes this level of diligence standard practice.
#SystematicReviews #EvidenceBasedMedicine #MedicalResearch #ResearchQuality #LiteratureSearching #InformationLiteracy #ResearchTraining
