Detailed Methods

Jillian T Henderson; Elizabeth M Webber; George F Sawaya

Literature Search Strategies for Primary Literature

Key:

/ = MeSH subject heading

$ = truncation

* = truncation

? = wildcard

ab = word in abstract

adj# = adjacent within x number of words

ae = adverse effects

hw = subject heading word

id = identifier

kw = keyword

md = methodology

near/# = adjacent within x number of words

ti = word in title

Cochrane Central Register of Controlled Trials (CENTRAL)

#1	(ovar* or (fallopian next tub) or adenx):ti,ab,kw near/4 (cancer* or neoplas* or tumo* or malignan* or carcinoma* or adenocarcinoma* or mass*):ti,ab,kw
#2	screen*:ti,ab,kw
#3	detect*:ti
#4	(sonog* or ultraso*):ti,ab,kw
#5	(tumo* next marker*):ti,ab,kw
#6	(serum next cancer next antigen*):ti,ab,kw
#7	“CA 125”:ti,ab,kw
#8	^101-#7
#9	#1 and #8 Publication Year from 2003 to 2016, in Trials

MEDLINE

1	Ovarian Neoplasms/
2	Fallopian Tube Neoplasms/
3	((ovar$ or fallopian tub$ or adenx$) adj4 (cancer$ or neoplas$ or tumo$ or malignan$ or carcinoma$ or adenocarcinoma$ or mass$)).ti,ab.
4	or/1-3
5	Mass screening/
6	“Early detection of cancer”/
7	(screen$ adj5 (ovar$ or fallopian tub$ or adnex$)).ti,ab.
8	detect$.ti.
9	Ultrasonography/
10	(sonog$ or ultraso$).ti,ab.
11	Tumor Markers, Biological/
12	tumo?r marker$.ti,ab.
13	serum cancer antigen$.ti,ab.
14	CA 125.ti,ab.
15	algorithm$.ti,ab.
16	ROCA.ti,ab.
17	or/5-16
18	4 and 17
19	Ovarian Neoplasms/us [Ultrasonography]
20	Fallopian Tube Neoplasms/us [Ultrasonography]
21	18 or 19 or 20
22	clinical trials as topic/ or controlled clinical trials as topic/ or randomized controlled trials as topic/ or meta-analysis as topic/
23	(clinical trial or controlled clinical trial or meta analysis or randomized controlled trial).pt.
24	Random$.ti,ab.
25	control groups/ or double-blind method/ or single-blind method/
26	clinical trial$.ti,ab.
27	controlled trial$.ti,ab.
28	meta analy$.ti,ab.
29	or/22-28
30	21 and 29
31	Animals/ not (Humans/ and Animals/)
32	30 not 31
33	limit 32 to (english language and yr=“2003 -Current”)
34	remove duplicates from 33

PUBMED, publisher-supplied records

#14	Search (((#13) AND publisher[sb]) AND (“2003/01/01”[Date - Publication] : “3000”[Date - Publication])) AND English[Language]
#13	Search #8 AND #12
#12	Search #9 OR #10 OR #11
#11	Search (control[tiab] OR controls[tiab] OR controlled[tiab] OR controled[tiab]) AND (trial[tiab] OR trials[tiab])
#10	Search “clinical trial”[tiab] OR “clinical trials”[tiab] OR random*[tiab]
#9	Search systematic review[sb] OR metaanaly*[tiab] OR meta analysis[tiab]
#8	Search #1 AND #7
#7	Search #2 OR #3 OR #4 OR #5 OR #6
#6	Search CA 125[tiab]
#5	Search serum cancer antigen*[tiab]
#4	Search tumo* marker*[tiab]
#3	Search sonog[tiab] or ultraso[tiab]
#2	Search screen[tiab] OR detect[tiab]
#1	Search (ovar[tiab] or fallopian tub[tiab] or adenx[tiab]) AND (cancer[tiab] or neoplas[tiab] or tumor[tiab] OR tumour[tiab] or malignan[tiab] or carcinoma[tiab] or adenocarcinoma[tiab] or mass*[tiab])

This figure is a flow chart that summarizes the search and selection of articles in the review. There were 1337 citations identified through literature databases. An additional 17 citations were identified from outside sources such as reference lists and suggestions from peer reviewers, 27 citations were from the previous reviews for the USPSTF on screening for ovarian cancer. After duplicates were removed, 1381 unique citations were screened at the title/abstract stage. The full text of 74 citations were examined for inclusion for one or more of the Key Questions. There were 3 studies (in 14 articles) included for Key Question 1, and 4 studies (in 15 articles) included for Key Question 2. Reasons for excluding the other articles are available in Appendix C.

Appendix A Figure 1Literature Flow Diagram

Appendix A Table 1Inclusion and Exclusion Criteria

Category	Included	Excluded
Aim	Screening for ovarian cancer in a primary care setting (alone or as part of a clinical examination)	Screening for ovarian cancer in selected high-risk populations, such as women who are BRCA mutation carriers or patients of a specialty practice, such as oncology
Populations	Asymptomatic, average risk women, ages 45 years and older	Trials enrolling only women who are selected based on an increased risk for ovarian cancer (e.g. known predisposing genetic syndromes, strong family history)
Screening tests	Screening tests and approaches evaluated in clinical trials such as, but not limited to: testing for serum cancer antigen (CA–125), transvaginal ultrasonography, and combined screening approaches or algorithms	Screening tests not evaluated in clinical trials
Comparisons	Comparison of screening with usual care or no screening; comparison of different included screening methods or programs
Outcomes	KQ 1: Ovarian cancer–specific mortality (including primary peritoneal and fallopian tube cancer), all-cause mortality, cancer-related morbidity, and quality of life. KQ 2: Surgery rate, rates of false-positive screening results, complications of diagnostic surgical procedures, and health and psychological effects of screening tests
Settings	Primary care settings, including obstetrics/gynecology practices	Specialty practice settings, such as oncology
Study designs	Randomized, controlled trials	Cohort studies, case-controls, case reports, case series, and decision analyses
Study quality	Good and fair quality according to USPSTF criteria and supplemented quality measures	Poor quality according to USPSTF criteria and supplemental quality measures
Language	English	Non–English language studies

: Abbreviations: KQ = key question; USPSTF = United States Preventive Services Task Force

Appendix A Table 2Quality Assessment Criteria of Randomized Controlled Trials

USPSTF quality rating criteria¹²⁰

Initial assembly of comparable groups employs adequate randomization, including first concealment and whether potential confounders were distributed equally among groups
Maintenance of comparable groups (includes attrition, crossovers, adherence, contamination)
Important differential loss to followup or overall high loss to followup
Measurements: equal, reliable, and valid (includes masking of outcome assessment)
Clear definition of the interventions
All important outcomes considered
Intention-to-treat analysis

: Abbreviations: KQ = key question; USPSTF = United States Preventive Services Task Force

Bookshelf ID: NBK493403

Contents

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Bookshelf

Screening for Ovarian Cancer: An Updated Evidence Review for the U.S. Preventive Services Task Force [Internet].

Appendix ADetailed Methods