Appendix: Search strategy and evidence selection

Appendix: Search strategy and evidence selection

Search strategy

General background, guidelines and technology assessments:

MEDLINE (via Ovid)

Database: Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) <1946 to Present>

Search Strategy:

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  1. (Rectiv or Rectogesic or Glyceryl trinitrate or glyceryltrinitrate).tw. (2121)

  2. (Topical adj3 nitroglycerin).tw. (144)

  3. (topical adj3 nitric oxide).tw. (31)

  4. Nitroglycerin/ (11424)

  5. 1 or 2 or 3 or 4 (12141)

  6. Fissure in Ano/ (1839)

  7. (anal adj3 fissure?).tw. (1224)

  8. (ano adj3 fissure?).tw. (163)

  9. 6 or 7 or 8 (2183)

  10. 5 and 9 (215)

  11. limit 10 to english language (193)

  12. exp review/ (1773989)

  13. (scisearch or psychinfo or psycinfo or medlars or embase or psychlit or psyclit or cinahl or pubmed or medline).ti,ab,sh. (71599)

  14. ((hand adj2 search$) or (manual$ adj2 search$)).ti,ab,sh. (6273)

  15. ((electronic or bibliographic or computeri?ed or online) adj4 database$).ti,ab. (14011)

  16. (pooling or pooled or mantel haenszel).ti,ab,sh. (46325)

  17. (peto or dersimonian or der simonian or fixed effect).ti,ab,sh. (2738)

  18. or/13-17 (122776)

  19. 12 and 18 (55479)

  20. Meta Analysis/ (38678)

  21. (meta-analys$ or meta analys$ or metaanalys$).ti,ab,sh. (67568)

  22. ((systematic$ or quantitativ$ or methodologic$) adj5 (review$ or overview$ or synthesis$)).ti,ab,sh. (53736)

  23. (integrative research review$ or research integration).ti,ab,sh. (83)

  24. or/20-23 (104679)

  25. 19 or 24 (132915)

  26. clinical trials, phase iv/ or clinical trials, phase iii/ or randomized controlled trials/ or multicenter studies/ (242591)

  27. (random$ or placebo$ or ((singl$ or double$ or triple$ or treble$) and (blind$ or mask$))).ti,ab,sh. (879710)

  28. 26 or 27 (977688)

  29. (animal$ not human$).sh. (3735670)

  30. 28 not 29 (872591)

  31. 25 or 30 (955847)

  32. 11 and 31 (90)

  33. 11 and (cost$ or economic$).tw.

Embase (via Ovid)

Database: Embase <1988 to 2012 December 14>

Search Strategy:

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  1. (Rectiv or Rectogesic or Glyceryl trinitrate or glyceryltrinitrate).tw. (2144)

  2. (Topical adj3 nitroglycerin).tw. (144)

  3. (topical adj3 nitric oxide).tw. (37)

  4. glyceryl trinitrate/ (23129)

  5. 1 or 2 or 3 or 4 (23459)

  6. Fissure in Ano/ (1971)

  7. (anal adj3 fissure?).tw. (1407)

  8. (ano adj3 fissure?).tw. (121)

  9. 6 or 7 or 8 (2145)

  10. 5 and 9 (467)

  11. limit 10 to english language (401)

  12. exp review/ (1727013)

  13. (scisearch or psychinfo or psycinfo or medlars or embase or psychlit or psyclit or cinahl or pubmed or medline).ti,ab,sh. (87309)

  14. ((hand adj2 search$) or (manual$ adj2 search$)).ti,ab,sh. (7260)

  15. ((electronic or bibliographic or computeri?ed or online) adj4 database$).ti,ab. (17583)

  16. (pooling or pooled or mantel haenszel).ti,ab,sh. (51618)

  17. (peto or dersimonian or der simonian or fixed effect).ti,ab,sh. (3311)

  18. or/13-17 (145092)

  19. 12 and 18 (56326)

  20. Meta Analysis/ (67804)

  21. (meta-analys$ or meta analys$ or metaanalys$).ti,ab,sh. (96320)

  22. ((systematic$ or quantitativ$ or methodologic$) adj5 (review$ or overview$ or synthesis$)).ti,ab,sh. (90383)

  23. (integrative research review$ or research integration).ti,ab,sh. (88)

  24. or/20-23 (159220)

  25. 19 or 24 (186718)

  26. clinical trials, phase iv/ or clinical trials, phase iii/ or randomized controlled trials/ or multicenter studies/ (27736)

  27. (random$ or placebo$ or ((singl$ or double$ or triple$ or treble$) and (blind$ or mask$))).ti,ab,sh. (978983)

  28. 26 or 27 (981997)

  29. (animal$ not human$).sh. (2454674)

  30. 28 not 29 (886030)

  31. 25 or 30 (1004543)

  32. 11 and 31 (161)

  33. limit 32 to exclude medline journals (14)

  34. 11 and (cost$ or economic$).tw.

Cochrane Central Register of Controlled Trials (CENTRAL)

glyceryl trinitrate and anal fissure*

CRD HTA, DARE and EED database

(anal fissure) AND (glyceryl trinitrate)

Grey literature and ongoing trials

Manufacturer's website

ProStrakan

Evidence selection

The rationale for this evidence summary was that 0.2% glyceryl trinitrate rectal ointment is sometimes prescribed in an effort to reduce the frequency or severity of headaches associated with using the 0.4% glyceryl trinitrate licensed option. Therefore, the evidence selection focused on studies containing a potential comparison of 0.2% and 0.4% glyceryl trinitrate strengths in relation to effectiveness and headache outcomes.

Both the literature search and a 2012 Cochrane systematic review of non-surgical therapy for anal fissure identified 4 RCTs that form the main body of evidence for this review.

Other possible comparators including 0.2% glyceryl trinitrate ointment against placebo, botulinum injection or surgery were not reviewed.