Survey of instructions for authors on how to report an update of a systematic review: guidance is needed
Systematic reviews have become the cornerstone of evidence-based healthcare. Approximately half of the systematic reviews are out of date after 5.5 years, and keeping them up to date remains a huge challenge. Despite new guidance on when and how to update systematic reviews, there seems to be a lack of guidance on how to report updates of systematic reviews. Therefore, we decided to systematically analyse instruction for authors in biomedical journals regarding guidance on reporting updates of systematic reviews. We conducted a survey investigating 250 journals. The journal list was derived by a twofold strategy. Firs...
Source: Evidence-Based Medicine - March 23, 2017 Category: Internal Medicine Authors: Pieper, D., Mathes, T. Tags: Original EBM Research Source Type: research
Practising evidence-based medicine (EBM): a descriptive analysis of medical students whole-task EBM assignments
This article describes medical students' execution of a whole-task EBM assignment and characterises themes emerging from assignment submissions. Between 2013 and 2015, Stanford University's paediatric clerkship students completed a whole-task EBM assignment based on a patient encounter. The assignment captured students' efforts to perform all EBM steps and describe their patient scenario and future knowledge needs strategies. Assignments were analysed using descriptive statistics and qualitative description. 123 students completed the assignment. Students formulated therapy (n=76), prognosis (n=18), diagnosis (n=15), harm ...
Source: Evidence-Based Medicine - March 23, 2017 Category: Internal Medicine Authors: Maggio, L. A., Capdarest-Arest, N. Tags: Original EBM Research Source Type: research
Whether neonatal phototherapy increases the risk of cancer in children is a disturbing unresolved issue
Commentary on: Wickremasinghe AC, Kuzniewicz MW, Grimes BA, et al.. Neonatal phototherapy and infantile cancer. Pediatrics 2016;137:pii:e20151353 ; Newman TB, Wickremasinghe AC, Walsh EM, et al.. Retrospective cohort study of phototherapy and childhood cancer in Northern California. Pediatrics 2016;137:pii:e20151354 . Context Phototherapy (PT) has been widely used for decades to reduce the total serum bilirubin of neonates, and the belief that the benefits far outweigh the hazards may warrant reconsideration not only for preterm infants but also near term and term infants.1 Although not generally appreciated by paediatrici...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Tyson, J. E., Miller, C. C. Tags: Rehabilitation medicine, Journalology, Epidemiologic studies, Cerebral palsy, Genetics, Drugs: CNS (not psychiatric), Drugs: musculoskeletal and joint diseases, Sports and exercise medicine, Ethics Aetiology/Harm Source Type: research
Consuming meals prepared at home more frequently appears to reduce the risk of type 2 diabetes, weight gain and obesity
Commentary on: Zong G, Eisenberg DM, Hu FB, et al.. Consumption of meals prepared at home and risk of type 2 diabetes: an analysis of two prospective cohort studies. PLoS Med 2016;13:e1002052 . Context Many public health strategies include promotion of cooking at home as a method to improve diet, and reduce obesity and diseases related to diet and obesity. However, a recent systematic review found that the majority of existing studies on the relationships between home food preparation and diet and health outcomes are cross-sectional, raising the possibility of reverse causation.1 The literature is also confused by poor con...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Adams, J., Mills, S. D. H. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Diet, Obesity (nutrition), Diabetes, Health education Aetiology/Harm Source Type: research
Cone depth increases risk of adverse obstetric outcomes following treatment for cervical preinvasive disease
Commentary on: Kyrgiou M, Athanasious A, Paraskevaidi M, et al.. Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis. BMJ 2016;354:i3633 . Context A strong and consistent association between treatment for cervical disease and subsequent preterm birth has been established.1 The association with preterm birth is stronger when more aggressive forms of treatment (eg, knife cones) are considered.1 Several studies have shown a biological gradient, with a greater risk of preterm delivery with increasing amount of tissue r...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Castanon, A. Tags: Epidemiologic studies, Pregnancy, Vulvovaginal disorders, Surgical diagnostic tests Aetiology/Harm Source Type: research
Height of head centre of gravity predicts paediatric head injury severity in short-distance falls
This study investigated the relationship between fall height and head injury severity using witnessed fall cases. Methods In this study, data from witnessed falls <3 m (10 feet)... (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Hu, J. Tags: EBM Prognosis, Injury Source Type: research
Pitfalls of administrative database analysis are evident when assessing the 'weekend effect in stroke
Commentary on: Li L, Rothwell PM. Biases in detection of apparent "weekend effect" on outcome with administrative coding data: population based study of stroke. BMJ 2016;353:i2648 . Context Multiple studies attempt to clarify the role of weekend admissions in stroke.1 2 Recent studies have leveraged large populations in administrative databases to retrospectively evaluate hypotheses. While these studies disagree as to whether weekend admissions are associated with increased stroke mortality, concern exists regarding inherent limitations of administrative coding databases, including accuracy of patient and disease variables...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Attenello, F. J., Mack, W. J. Tags: EBM Prognosis, Journalology, Epidemiologic studies, Stroke Source Type: research
Weekly adalimumab significantly reduces the number of abscesses and inflammatory nodules in patients with moderate to severe hidradenitis suppurativa
Commentary on: Kimball AB, Okun MM, Williams DA, et al.. Two phase 3 trials of adalimumab for hidradenitis suppurativa. N Engl J Med 2016;375:422–34 . Context Hidradenitis suppurativa (HS) is a painful, chronic inflammatory skin disease, characterised by the presence of inflamed nodules, abscesses, pustules, fistulas and scar tissue, usually located in the axillary and inguinal area. Treatment is difficult; most patients require a combination of surgical treatment and medical treatment. The clinical symptoms can be reduced considerably by using anti-inflammatory medication. Since 2001, several monoclonal antibodies h...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Mekkes, J. Tags: Therapeutics/Prevention Source Type: research
Caloric restriction improves health-related quality of life in healthy normal weight and overweight individuals
This study aimed to examine the sustained effects of a 25% CR on... (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Butsch, W. S., Stanford, F. C. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Diet, Obesity (nutrition), Health education Therapeutics/Prevention Source Type: research
Coronary-artery bypass surgery plus medical therapy is associated with longer survival over 10 years than medical therapy alone in patients with ischaemic cardiomyopathy
Commentary on: Velazquez EJ, Lee KL, Jones RH, et al.., STICHES Investigators. Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy. N Engl J Med 2016;374:1511–20 . Context The efficacy of coronary artery bypass grafting (CABG) in patients with ischaemic cardiomyopathy with low ejection fraction has long been controversial. However, few studies were available that compared the outcomes after CABG with medical therapy in those patients. These studies demonstrated long-term survival benefit of CABG compared with medical therapy alone. However, most of them were performed more than 40 years ago w...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Marui, A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Interventional cardiology, Ischaemic heart disease Therapeutics/Prevention Source Type: research
In critically ill patients with acute kidney injury stage 2, early initiation of renal replacement therapy is associated with reduced 90-day mortality compared to delayed initiation
Commentary on: Zarbock A, Kellum JA, Schmidt C, et al.. Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical trial. JAMA 2016;315(20):2190–9 . Context Clinical practice of acute renal replacement therapy (RRT) is variable. In particular, the optimal threshold for starting RRT remains uncertain. Early initiation may lead to more rapid correction of electrolyte and metabolic derangements, mitigate fluid overload and prevent serious complications but has to be balanced against potential harm from vascular access...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Ostermann, M. Tags: Therapeutics/Prevention Source Type: research
Intensive treatment of hypertension to a SBP
Commentary on: Williamson JD, Supiano MA, Applegate WB, et al.. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years. A randomized clinical trial. JAMA 2016;315:2673–82 . Context There is uncertainty regarding optimal blood pressure (BP) targets in treating hypertension. Most recent guidelines have recommended a systolic target of <140 mm Hg. The Systolic Blood Pressure Intervention Trial (SPRINT) compared cardiovascular (CV) outcomes in non-diabetic hypertensive patients randomised to standard (systolic blood pressure (SBP) <140 mm&nbs...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Weber, M. A. Tags: Palliative care, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Renal medicine, Ethics Therapeutics/Prevention Source Type: research
Early initiation of antiretroviral therapy prevents HIV transmission to seronegative sexual partners
Commentary on: Cohen MS, Chen YQ, McCauley M, et al.. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med 2016;375:830–9 . Context In 2011, interim results from the HIV Prevention Trials Network (HPTN) 052 trial confirmed that early antiretroviral therapy (ART) markedly reduces HIV transmission in serodiscordant couples.1 This, along with evidence that therapeutic benefits accrue from starting ART earlier,1–3 led the WHO to recommend that all patients with HIV infection start ART as soon as possible after diagnosis.4 Cohen et al have now published a final analysis from their original H...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Rutherford, G. W., Anglemyer, A. Tags: Sexual transmitted infections (viral), Immunology (including allergy), HIV/AIDS Therapeutics/Prevention Source Type: research
Liraglutide, a GLP-1 receptor agonist, prevents cardiovascular outcomes in patients with type 2 diabetes
Commentary on: Marso SP, Daniels GH, Brown-Frandsen K, et al.. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016;375:311–22 . Context Despite the treatments available for type 2 diabetes, about two-thirds of these patients die from associated heart disease or stroke.1 Approval of the first glucagon-like peptide-1 agonist (GLP-1), exenatide, by the FDA in 2005 generated an expectation that the clinical outcomes in type 2 diabetes would be improved. However, we still do not have definitive evidence that exenatide does this, although a clinical trial to determine this, the Exenatide Study of ...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Doggrell, S. A. Tags: Pancreas and biliary tract, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Diabetes Therapeutics/Prevention Source Type: research
Intraoperative on-table endoscopic retrograde cholangiopancreatography (ERCP) is better than laparoscopic bile duct exploration for concomitant bile duct stones during emergency laparoscopic cholecystectomy
Commentary on: Poh BR, Ho SP, Sritharan M, et al.. Randomized clinical trial of intraoperative endoscopic retrograde cholangiopancreatography versus laparoscopic bile duct exploration in patients with choledocholithiasis. Br J Surg 2016;103:1117–24 . Context Some 15% of patients with gallbladder (GB) stones have concomitant stones in the bile duct (BD) believed to have migrated out from the GB. While asymptomatic GB stones may be managed expectantly, BD stones, if detected, require removal even if asymptomatic because of their potential to cause two major complications: acute cholangitis and acute pancreatitis. In pa...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Garg, P. K., Bansal, V. K. Tags: Pancreas and biliary tract, Clinical trials (epidemiology), Pancreatitis, Epidemiologic studies, Radiology, Surgical diagnostic tests, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research
