Development and validation of search hedges for Transgender and Gender Diverse (TGD) populations in Ovid MEDLINE and Ovid APA PsycInfo
Clinical Snapshot
PICO Framework
| P — Population | Literature search systems (MEDLINE and PsycInfo databases) |
| I — Intervention | Newly developed search hedges for transgender and gender diverse populations |
| C — Comparator | Gold standard set of 144 articles from Knowsy portal |
| O — Outcomes | Sensitivity and precision of search hedges in identifying TGD literature |
Bottom Line
This validation study demonstrates that newly developed search hedges achieve perfect sensitivity (100%) for identifying transgender and gender diverse literature in MEDLINE and PsycInfo databases, with reasonable precision (67-71%). While the methodology lacks some detail and confidence intervals, these tools address a critical gap in evidence synthesis methodology for TGD populations. The high sensitivity ensures comprehensive literature capture, essential for systematic reviews and evidence-based practice development. For Australian healthcare professionals and researchers, these hedges offer valuable support for identifying relevant evidence to inform inclusive care practices and address health disparities in TGD communities. The tools are immediately applicable in research settings, though users should be prepared for moderate precision requiring additional screening of results.
Key Findings
P Value: Not reported
Effect Size: Sensitivity: 100% (both databases); Precision: 71% (MEDLINE), 67% (PsycInfo)
Primary Outcome: Search hedge sensitivity and precision
Nnt Or Sensitivity: Sensitivity 100% (144/144 articles identified)
Confidence Interval: Not reported
Clinical Application
High feasibility - search hedges can be readily implemented in standard database searches using Ovid platforms Highly relevant for Australian researchers given growing focus on LGBTIQ+ health equity, aligns with RACGP position on inclusive healthcare and supports evidence synthesis for TGD health guidelines Researchers, librarians, and clinicians conducting literature searches on transgender and gender diverse populations
Abstract
INTRODUCTION: This paper describes the development and validation of highly sensitive search hedges for Ovid MEDLINE and Ovid APA PsycInfo that effectively identify literature on transgender and gender diverse (TGD) populations. METHODS: Two librarians developed the search hedges using relevant keywords and controlled vocabulary terms, building on previous work on identifying transgender populations in evidence synthesis. The hedges were tested and refined to capture diverse and expansive gender identities across cultures and disciplines. The hedges were validated for sensitivity using a gold standard set of 144 articles from the Knowsy portal of evidence syntheses tagged as Two-Spirit, transgender, or gender non-binary. To assess precision an international research team of subject experts independently screened a randomized sample of search results in a two-stage screening process with an additional screener resolving disputes. RESULTS: The final search hedges demonstrated 100% sensitivity in both MEDLINE and APA PsycInfo, identifying all 144 relevant articles from the Knowsy gold standard set. The MEDLINE search hedge achieved a 71% precision, and the APA PsycInfo hedge achieved a 67% precision. These results balance comprehensive retrieval while minimizing non-relevant articles for an efficient screening process. CONCLUSIONS: These search hedges in MEDLINE and APA PsycInfo are valuable tools for researchers and librarians to more effectively identify literature on TGD populations. These tools will be crucial for ongoing work in addressing gaps in research and health disparities faced by TGD populations and will be particularly valuable for researchers conducting evidence synthesis projects related to this population.
References
- 1.Gagen, R., Marsalis, S., Dinh, C., Applejohn, M., Shah, R., Tong, O. X., Marshall, Z., & Everhart, A. (2026). Development and validation of search hedges for Transgender and Gender Diverse (TGD) populations in Ovid MEDLINE and Ovid APA PsycInfo. PLoS One. https://doi.org/10.1371/journal.pone.0351303
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