Search strategy and evidence selection

Search strategy and evidence selection

Search strategy

The search strategy was designed to identify evidence on the use of Episcissors‑60 in women undergoing episiotomy.

The strategy was developed for MEDLINE (Ovid interface). The strategy was devised using a combination of subject indexing terms and free text search terms in the title, abstract and keyword heading word fields. The search terms were identified through discussion within the research team, scanning background literature, and browsing database thesauri. The strategy reflected the nature of the MIB assessments as rapid evidence reviews.

The search comprised two concepts:

  • Episcissors‑60 or any scissors used in episiotomy.

  • Similar instruments used in episiotomy, sought through searching for literature on episiotomy technique characteristics (such as angle of incision).

The search concepts were combined as follows: scissors OR techniques.

Additional search lines focusing on other possible product names combined with episiotomy terms, and 'Medinvent', the UK supplier, were also used. These lines were designed to capture any records that may have been missed by the rest of the search.

The strategy excluded non‑English language publications. Animal studies were also excluded using a standard algorithm. No additional filters for study design were applied. Results were limited to studies published from 2000 due to the novelty of the instrument.

The final MEDLINE strategy was peer‑reviewed by an independent information specialist. The MEDLINE strategy was translated appropriately for the other databases searched. The PubMed search was limited to records which were not fully indexed on MEDLINE.

The following databases were searched:

  • Cochrane Database of Systematic Reviews (Cochrane Library, Wiley);

  • Database of Abstracts of Reviews of Effects (Cochrane Library, Wiley);

  • Cochrane Central Register of Controlled Trials (Cochrane Library, Wiley);

  • Health Technology Assessment Database (Cochrane Library, Wiley);

  • NHS Economic Evaluation Database (Cochrane Library, Wiley);

  • Embase (Ovid SP)

  • MEDLINE and MEDLINE in Process (Ovid SP);

  • PubMed (

  • Conference Proceedings Citation Index- Science (CPCI‑S) (Web of Science)

The search strategies used for each of the databases are presented below (A1 to A6).

Specific conferences

Conference abstracts were sought online for:

  • Royal College of Obstetricians and Gynaecologists (RCOG) meetings from 2013 to date.

Searches were made of the Abstracts of the RCOG World Congress 2014, 28–30 March 2014, Hyderabad, India. No results were found for episcissor* or epima* or episa*. Searches of BJOG which holds some of the meetings of RCOG were also made. No results were found.

  • British Society of Urogynaecology (BSUG) meetings from 2013 to date.

No results were found for episcissor* or epima* or episa* in International Urogynaecology Journal which publishes abstracts from BSUG research meetings (the 2014 abstracts are as yet unpublished). 

Evidence selection

A total of 643 records were retrieved from the literature search. After de‑duplication, 413 records remained and were sifted against the inclusion criteria at title and abstract level.

Records were sifted independently by 2 researchers. Any disagreements were discussed and agreement was reached in all cases, so a third independent arbiter was not required. The first sift removed 411 records based on the following exclusion criteria:

  • articles of poor relevance against search terms

  • publication types that were out of scope

  • non‑English language studies

  • conference abstracts

  • review articles.

The search strategy was designed to identify evidence for the use of Episcissors‑60 in women undergoing episiotomy. This search found the number of database records which explicitly included the brand name or reference to scissors was very low. Therefore a selective search of episiotomy techniques was also performed.

Full articles were retrieved for the 2 remaining studies and a full text assessment was done independently by 2 researchers to identify relevant primary research addressing the key outcomes of interest. Both studies explicitly investigated Episcissors‑60 and were included for full review.

One additional article was highlighted by the UK supplier following recent publication and was therefore also included in this MIB.

A further 16 articles were selected and retrieved to guide the background and technical aspects of this briefing.