Wednesday, 14 June 2017

Bicuspid aortic valve - Medline search strategy

The aortic valve should have three "leaflets", so is "tricuspid".    Sometimes it has only two, because two are fused together, and then it is "bicuspid".

Bicuspid aortic valve (BAV) is a congenital condition.  It is linked to aortic aneurysms.

How to find literature about BAV?

There is no MeSH term for bicuspid aortic valve, although there is a "supplementary concept" Bicuspid aortic valve.  This is searchable in PubMed as [Supplementary Concept], but as far as I can work out, is not searched or searchable in HDAS.

In PubMed, the freetext term "bicuspid aortic valve" maps to the supplementary concept.

So is it enough to rely just on the phrase "bicuspid aortic valve(s)"?   I think not, because: 

a) I have seen phrases like "bicuspid and tricuspid aortic valve" and "bicuspid aortopathy".  The latter, I think, relates to the aorta, not the valve, but the aorta as it is affected by the valve.  

b) Perhaps there is literature where BAV is indexed under Heart Defects, Congenital/ and a MeSH term relating to the aortic valve but where phrases describing BAV itself are not used.

I was working on a search about fusion patterns in BAV, that is, which leaflet is joined to which, and that gave me some more terms.

So, taking all that into account, here is my draft of a search strategy for Medline via HDAS:

1. ("bicuspid aort*").ti,ab
2. (BAV).ti,ab
3. "AORTIC VALVE"/
4. "AORTIC VALVE INSUFFICIENCY"/
5. exp "AORTIC VALVE STENOSIS"/         
6. "HEART DEFECTS, CONGENITAL"/
7. "HEART VALVE DISEASES"/
8. (fusion OR fused OR fusing OR morphol* OR morphotyp* OR phenotyp* OR habitus OR raphe).ti,ab
9. ("right noncoronary" OR "left noncoronary" OR "right left" OR "left right").ti,ab
10. ((left OR right) ADJ2 "non coronary").ti,ab
11. (classif* OR pattern* OR commissur*).ti,ab
12. 1 OR 2
13. (3 OR 4 OR 5) AND 6
14. 3 AND 7
15. (8 OR 9 OR 10 OR 11)
16. ("aortic valve*").ti,ab
17. (3 AND 15)
18. (15 AND 16)

19. (12 OR 13 OR 14 OR 17 OR 18)

Lines 3 - 7 are an attempt to capture the way BAV is indexed in the absence of a single MeSH heading.

Lines 8 - 11 describe the fusion patterns and other features of a BAV, although some words are possibly too general ("pattern" for example could be referring to something else, not the valve).

On 14th June 2017, line 1 found 2454, line 19 found 12693.    How many of these extra ones are relevant, but not found in set 1 or 2, is not clear.

Maybe:

12 or 13 or 14 

would be enough (this finds 9939).

All of this, of course needs, testing.  

Perhaps which strategy you use (assuming you think it worth using!) would depend why you are searching, and if there were other aspects to the search, it may matter less.

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