Search strategy for chronic kidney disease

Chronic kidney disease?  Chronic kidney failure?   Chronic renal failure?

There are many ways to describe this (1).  After a few searches on the topic, I tried to come up with a Medline strategy.  I think it may include some conditions that Hsu and Chertow would not, but I have this:

1.            ((endstage or “end stage” or established or chronic or progressive) adj1 (renal or kidney) adj1 (failure or disease* or insufficienc*)).ti,ab

2.            (Chronic adj1 nephropath*).ti,ab

3.            (“Chronic uremia” or “chronic uraemia”).ti,ab

4.            (CKD or CKF or CKI or CRD or CRF or CRI).ti,ab

5.            (ESKD or ESRD or ESRF).ti,ab

6.            kidney diseases/ and chronic.ti,ab

7.            exp Renal insufficiency, chronic/ 

8.            Renal insufficiency/ AND chronic.ti,ab

9.            1 or 2 or 3 or 4 or 5 or 6 or 7 or 8

This is for Medline via HDAS.   

I started with terms I had used previously, and added terms used by colleagues at UHL, MeSH Used For, and terms used in strategies in First Consult, SIGN guideline 103 and NICE CG182.  I then asked people on lis-medical, and also had some further suggestions when I circulated the strategy there.

This, for the record, is the version dated 22^nd June 2016 with tiny minor amendments made in April 2017 to remove some unnecessary full stops! 

(1) Hsu CY, Chertow GM. Chronic renal confusion: insufficiency, failure, dysfunction, or disease. Am J Kidney Dis. 2000 Aug;36(2):415-8.

What's in a name?

You have waited a long time for this post, I notice!   I am sure you have had plenty to do while waiting.

In their article Chronic renal confusion, Chi-yuan Hsu and Glenn Chertow looked at the wide variety of terms used to describe the same level of kidney function, and the wide range of renal function described by the use of a term like "chronic renal failure".   They examined a sample of literature to reach their conclusions (1).

They argue that some terms should be dropped - a term like "chronic renal failure" has negative connotations for patients, and a term like "pre-dialysis" might discourage practitioners from attempting other sorts of treatment.   They argue for the use of "chronic renal insufficiency" instead. 

I am not sure people have been listening in the intervening 15 years!    Maybe it is too big an "ask".  There are still lots of terms for the same thing, and people do use terms interchangeably (their example is "chronic renal failure" and "end stage renal disease").

Their article shows two things:

1.  The wide variety of terms used to describe the same thing demonstrates why you need to include synonyms in a search.  This is particularly important if you are doing a systematic review, or other sort of systematic search.  You must try to use all the terms that authors might have used, however odd that usage might be.

2. It is important to review your search results, to remove those where the authors' definition of that condition does not match yours.   There is not a lot you can do in the search strategy to deal with this.

I think point 2 is the responsibility of the requestor of the search, or the reviewer of the results, and not the information specialist/librarian.

Point 1 is definitely the responsibility of the searcher, so often, the librarian, with help from the requestor or reviewers.

As an example, I devised a search strategy for chronic kidney disease, which is on the UHL Clinical Librarian Blog.

(1) Hsu CY, Chertow GM. Chronic renal confusion: insufficiency, failure, dysfunction, or disease. Am J Kidney Dis. 2000;36(2):415-8