The most striking finding when comparing the two reviews is the large number of studies published in the Chinese language identified by Gao et al. had no geographical or language restrictions. only searched for studies reported in English or Chinese, whereas the review from Whiting et al. The rationale for restricting the review to the Chinese population was a presumed variability in anti-CCP accuracy, related to the genetic or ethnic background. specifically aimed to evaluate the accuracy of anti-CCP antibodies in the Chinese population. In contrast with the review of Whiting et al., the review from Gao et al. We also evaluate to what extent Cochrane reviewers have included these Chinese databases in their search strategy. We describe five major Chinese electronic biomedical literature databases, with regard to content, search features, and accessibility. We here report on a case of two recently published independent systematic reviews on the same topic: one for which the authors did not search in Chinese databases and the other for which the authors did. Available studies are limited to the field of traditional Chinese medicine, and the results of such investigations have been conflicting. There is limited evidence that searching Chinese databases when performing systematic reviews leads to the identification of additional relevant studies and influences the outcome of meta-analysis. China’s share in the world’s total published scientific papers increased from less than 1% in 1980 to about 12% in 2011, currently ranking second behind the US. The Chinese biomedical literature has been continuously growing over the past decades. A similar evaluation in the field of complementary and alternative medicine found that English-language studies tend to report smaller effects than those published in other languages. A systematic review of those studies found no evidence of bias when restricting to English language literature in reviews of conventional medical interventions. Several empirical studies have evaluated the influence of English language restrictions in systematic reviews and meta-analyses of treatment effects. Including studies published in languages other than English not only prevents from language bias but also increases precision of meta-analysis estimates and statistical power to explore sources of heterogeneity. Since it was shown that trials with significant results are more likely to be published in English-language journals, standards from the Cochrane Collaboration recommend that ‘whenever possible review authors should attempt to identify and assess for eligibility all possibly relevant reports of trials irrespective of language of publication’. Developing a comprehensive literature search is a key element in retrieving all relevant evidence available to answer a specific clinical question. Systematic reviews are a cornerstone of evidence-based medicine.

We encourage future initiatives to evaluate more systematically the relevance of searching Chinese databases, as well as collaborative efforts to allow better incorporation of Chinese resources in systematic reviews. Discussion and conclusionsĪlthough searching Chinese databases may lead to the identification of a large amount of additional clinical evidence, Cochrane reviewers have rarely included them in their search strategy. All 243 Cochrane reviews evaluated an intervention, 179 (74%) had at least one author with a Chinese affiliation 118 (49%) addressed a topic in complementary or alternative medicine. These Chinese databases index about 2,500 journals, of which less than 6% are also indexed in MEDLINE. Only 243 of the published 8,680 Cochrane reviews (less than 3%) searched one or more of the five major Chinese databases. The summary accuracy estimates from the two reviews were comparable. The first review included five studies published in the Chinese language (out of 151) while the second included 114 (out of 118). The two diagnostic reviews included a total of 269 unique studies, but only 4 studies were included in both reviews. We additionally assessed the extent to which Cochrane reviewers have searched Chinese databases in a systematic overview of the Cochrane Library (inception to 2014). In one of these, the authors did not search Chinese databases in the other, they did. We report a case of two systematic reviews on the accuracy of anti-cyclic citrullinated peptide for diagnosing rheumatoid arthritis. Chinese biomedical databases contain a large number of publications available to systematic reviewers, but it is unclear whether they are used for synthesizing the available evidence.

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