Conference or Event

Medical Library Association 2026 Annual Meeting

Document Type

Poster

Date

2026

Abstract

This project compared MEDLINE and Embase indexers' use of therapy subheadings and discusses the implications for literature searching. Objectives Our long experience with MEDLINE searching and attendance at NNLM-sponsored PubMed training sessions taught us to depend on specific patterns of subheading use by MEDLINE’s indexers. For instance, we learned to expect that drug trials would be indexed with a drug heading combined with a therapeutic use subheading. Our library licensed EMBASE in 2012. We soon began to suspect that subheading application was not as predictable in EMBASE as it was in MEDLINE. We wanted the recommendations we provide novice EMBASE searchers to be based on evidence, so we decided to compare use of subheadings in EMBASE and MEDLINE. Methods On December 5, 2024, we searched MEDLINE (via EBSCOhost) and EMBASE (via embase.com) for articles with 1) either a “trial” title word or indexed “trial” publication type/heading plus 2) a “chronic-myelogenous leukemia” title phrase or a “chronic myelogenous leukemia” (CML) heading that 3) did not have a “CML” heading combined with a “therapeutic use/therapy”-related subheading and that 4) were within the MEDLINE-subset. No language or publication type filters were applied. Both authors independently reviewed all records retrieved. Articles were included in our analysis if they met the NIH’s definition of a clinical trial, reported tests of a therapeutic intervention aimed at CML treatment, and focused on that intervention and its outcomes. Any disagreements concerning article inclusion were settled by discussion. The authors then looked at both the MEDLINE and EMBASE records (M-record and E-record) for each included article to document any issues in the areas of CML-related heading and subheading use and clinical trial indexing. Results 307 records for 271 articles were retrieved. Records corresponding to 90 articles met our study’s inclusion criteria. 7 of the E-records and two of the M-records used an incorrect heading for CML, and one M-record included no disease heading. Of those with a “CML” heading, 69 E-records and 7 M-records failed to combine the “CML” heading with one of the “therapy” subheadings. All of the 22 E-records lacking clinical trial indexing post-dated the introduction of clinical trial indexing in EMBASE (1974). 4 of the 18 M-records lacking clinical trial indexing post-dated the introduction of clinical trial indexing in MEDLINE (1991). Conclusions Our study provides evidence that EMBASE searches depending on subheadings will miss more relevant articles than similar searches in MEDLINE. It’s important to consider this inconsistent use of subheadings when developing routine mediated literature searches, creating searches for evidence synthesis projects, or testing or developing search hedges/filters. An approach to EMBASE search training that advises against routine subheading use seems justified.

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