ArticleBMC medical research methodology2018
Bubble effect: including internet search engines in systematic reviews introduces selection bias and impedes scientific reproducibility.
Article in BMC medical research methodology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Primary healthcare models for refugees involving nurses: a systematic review and narrative synthesis.BMJ global health · 2025Pooled it
- Tools used to assess the quality of peer review reports: a methodological systematic review.BMC medical research methodology · 2019Pooled it
- Scoping review of patient and family engagement interventions in diagnosis: a paradox of too much, yet so little.BMJ quality & safety · 2026Article
- Assessing and measuring community health system resilience - an updated scoping review of approaches.BMC health services research · 2025Article
- Readability analysis of breast cancer resources shared on X-implications for patient education and the potential of AI.Breast cancer research and treatment · 2025Article
- Protocol for an undergraduate student-led scoping review of methods used to conduct inclusive focus groups with autistic adolescents.PloS one · 2025Article
- Methodological and Systematic Errors in Systematic Reviews in Health Domain: A Systematic Review.Medical journal of the Islamic Republic of Iran · 2025Review
- Patient Education Materials for Immobilisation Masks in Radiation Therapy for Adult Head and Neck Cancer Patients: A Scoping Review.Journal of cancer education : the official journal of the American Association for Cancer Education · 2024Article
- Smart Buildings: A Comprehensive Systematic Literature Review on Data-Driven Building Management Systems.Sensors (Basel, Switzerland) · 2024Review
- Finding a needle in a haystack: The identification of clinical practice guidelines for psychosocial oncology through an environmental scan of the academic and gray literature.Cancer medicine · 2024Review
- Open reproducible scientometric research with Alexandria3k.PloS one · 2023Article
- Scoping review and characteristics of publicly available checklists for assessing clinical trial feasibility.BMC medical research methodology · 2022Article
- Literature searching methods or guidance and their application to public health topics: A narrative review.Health information and libraries journal · 2022Review
- Protocol for a scoping review on the development of policy, guidelines and protocols within emergency medical services.British paramedic journal · 2022Article
- Article
- Comprehension Profile of Patient Education Materials in Endocrine Care.Kansas journal of medicine · 2022Article
- Wikipedia, Google Trends and Diet: Assessment of Temporal Trends in the Internet Users' Searches in Italy before and during COVID-19 Pandemic.Nutrients · 2021Article
- Dynamic methods for ongoing assessment of site-level risk in risk-based monitoring of clinical trials: A scoping review.Clinical trials (London, England) · 2021Article
- Fine silt and clay content is the main factor defining maximal C and N accumulations in soils: a meta-analysis.Scientific reports · 2021Article
- Searching for Programme theories for a realist evaluation: a case study comparing an academic database search and a simple Google search.BMC medical research methodology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUsing internet search engines (such as Google search) in systematic literature reviews is increasingly becoming a ubiquitous part of search methodology. In order to integrate the vast quantity of available knowledge, literature mostly focuses on systematic reviews, considered to be principal sources of scientific evidence at all practical levels. Any possible individual methodological flaws present in these systematic reviews have the potential to become systemic. MAIN TEXT: This particular bias, that could be referred to as (re)search bubble effect, is introduced because of inherent, personalized nature of internet search engines that tailors results according to derived user preferences based on unreproducible criteria. In other words, internet search engines adjust their user's beliefs and attitudes, leading to the creation of a personalized (re)search bubble, including entries that have not been subjected to rigorous peer review process. The internet search engine algorithms are in a state of constant flux, producing differing results at any given moment, even if the query remains identical. There are many more subtle ways of introducing unwanted variations and synonyms of search queries that are used autonomously, detached from user insight and intent. Even the most well-known and respected systematic literature reviews do not seem immune to the negative implications of the search bubble effect, affecting reproducibility.
conclusionAlthough immensely useful and justified by the need for encompassing the entirety of knowledge, the practice of including internet search engines in systematic literature reviews is fundamentally irreconcilable with recent emphasis on scientific reproducibility and rigor, having a profound impact on the discussion of the limits of scientific epistemology. Scientific research that is not reproducible, may still be called science, but represents one that should be avoided. Our recommendation is to use internet search engines as an additional literature source, primarily in order to validate initial search strategies centered on bibliographic databases.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.