1. New articles harvested from >120 leading clinical journals from PubMed daily

Clinical journals have been added based on suggestions and requests by clinicians, clients, McMaster PLuS Editors, and other users of our services. Individual journal yield of articles meeting specific methodologic criteria is assessed annually, and journals may be dropped from the list as a result of this assessment.

2. Validated Boolean search filters and Machine Learning Algorithms

We have developed and validated Boolean search filters that retrieve over 99% of high-quality articles from our clinical journals, followed by machine learning algorithms to improve the specificity and precision of these searches that identifies the articles that are most likely to meet our methodologic criteria. This approach greatly reduces the number of articles that must be appraised by trained research associates (see 3. Critical appraisal process). To know more about machine learning algorithms, please visit this site to log in or register as a new user.

3. Critical appraisal process

Experts in research methods appraise each article that makes it through our Boolean search filters to determine whether they PASS our methodologic criteria within the categories of original studies, systematic reviews, and evidence-based guidelines while addressing clinical questions related to diagnosis, prognosis, prediction, primary prevention, therapeutics, quality improvement, treatment harm, and economics.

4. Articles meeting criteria (PASS)

Articles meeting our methodologic criteria are tagged for clinical areas of interest and indexed by content according to client need. Articles that FAIL our criteria are retained in a separate database and are not distributed further (unless requested by clients).

5. Review by clinicians

Articles that PASS are reviewed by one or more clinician editors to check accuracy and clinical relevance. Articles FAILED by the editor are retained in separate database and are not distributed further (unless requested by clients). Articles that PASS are sent to MORE raters.


The McMaster Online Rating of Evidence (MORE) system consists of a database of > 4000 physician raters. Physician raters are MDs or equivalent are in independent clinical practice at least part-time. There are more than 60 physician disciplines in MORE. The MORE EBN (Evidence-Based Nursing) system has >2000 nurse raters who are in independent clinical practice at least part-time (or supervise or manage others with direct patient contact) in >30 specialties.

MORE Rehab raters are currently practicing as occupational or physical therapists in a clinical setting, or as a clinical practice leader or manager directly supervising clinical care.

MORE raters complete a profile page indicating their Patient Populations, Discipline/Specialty selections, and the number of articles they would like to rate each month. When they are assigned an article, they rate it based on two 7-point scales (highest score, 7). The first scale, for Relevance, is for the extent to which the article was pertinent to practice in the rater’s clinical discipline/specialty. The second scale is newsworthiness in the same discipline.

We continue to recruit raters for all disciplines/specialties for all the MORE systems. If you would like to join us as a MORE rater, please contact us at more@mcmaster.ca (physicians), moreebn@mcmasterhkr.com (nurses), or rehab@mcmasterhkr.com (rehab specialists).


Articles that receive an average total MORE score of ≥ 4 of 7 for both Relevance and Newsworthiness for at least one discipline/specialty are transferred to a permanent database, Premium LiteratUre Service (PLUS). Articles not scoring at least 4 of 7 for any discipline/specialty are transferred to a quarantine database.