The Cochrane Handbook of Systematic Reviews contains two search filters to find randomized controlled trials (RCT) in Ovid MEDLINE: a sensitivity maximizing RCT filter and a sensitivity and precision maximizing RCT filter. The RCT search strategies were originally published in 1994 have been adapted and updated, most recently in 2008. To determine whether the Cochrane filters are still performing adequately to inform Cochrane reviews, we tested the performance of the Cochrane filters and 36 other MEDLINE filters in a large new gold standard set of relevant records.

We identified a gold standard set of RCT reports published in 2016 from the Cochrane CENTRAL database of controlled clinical trials. We retrieved the records in Ovid MEDLINE using their PubMed identifiers. Each RCT filter was run in MEDLINE and combined with the gold standard set of records, to determine their sensitivity, precision and f-scores.

The gold standard comprised 27,617 records and the searches were run on 16 July 2019. The most sensitive RCT filter was Duggan (sensitivity 0.99). The Cochrane sensitivity maximizing RCT filter had a sensitivity of 0.96, but was more precise than Duggan (0.14 compared to 0.04 for Duggan). The most precise RCT filter was Chow, Glanville/Lefebvre, Royle/Waugh, Dumbrique (precision 0.97, sensitivity 0.83). The best precision Cochrane filter was the sensitivity and precision maximising RCT filter.

The Cochrane MEDLINE sensitivity maximizing RCT filter can continue to be used by Cochrane reviewers and CENTRAL compilers as it has very high sensitivity but a more acceptable precision than many higher sensitivity filters. Slightly more sensitive filters are available, but with lower precision than the Cochrane sensitivity maximizing RCT filter. These other filters may be preferred when combining with a subject search when record numbers may be more manageable than searching the whole of MEDLINE.