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6.4.4  Sensitivity versus precision 

Searches for systematic reviews aim to be as extensive as possible in order to ensure that as many as possible of the necessary and relevant studies are included in the review. It is, however, necessary to strike a balance between striving for comprehensiveness and maintaining relevance when developing a search strategy. Increasing the comprehensiveness (or sensitivity) of a search will reduce its precision and will retrieve more non-relevant articles.


Sensitivity is defined as the number of relevant reports identified divided by the total number of relevant reports in existence. Precision is defined as the number of relevant reports identified divided by the total number of reports identified.


Developing a search strategy is an iterative process in which the terms that are used are modified, based on what has already been retrieved. There are diminishing returns for search efforts; after a certain stage, each additional unit of time invested in searching returns fewer references that are relevant to the review. Consequently there comes a point where the rewards of further searching may not be worth the effort required to identify the additional references. The decision as to how much to invest in the search process depends on the question a review addresses, the extent to which the CRG's Specialized Register is developed, and the resources that are available. It should be noted, however, that article abstracts identified through a literature search can be ‘scan-read’ very quickly to ascertain potential relevance. At a conservatively-estimated reading rate of two abstracts per minute, the results of a database search can be ‘scan-read’ at the rate of 120 per hour (or approximately 1000 over an 8-hour period), so the high yield and low precision associated with systematic review searching is not as daunting as it might at first appear in comparison with the total time to be invested in the review.