Informed by research, transformed by research
At university, I volunteered for a charity that raised awareness of the symptoms of cancers in young people. One afternoon, I had been asked to visit a school to talk about my experience of having been diagnosed with melanoma in situ as a teenager. My survival represented a success story, highlighting the importance of early detection. ‘Had my melanoma not been caught early, I might not be stood here to tell the tale’, I announced to the class of wide-eyed 16 year olds. Although my treatment was deemed to be curative, the diagnosis had defined the previous few years of my life. I had been warned that I was at r...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Davies, E. Tags: Open access Patient voices Source Type: research
Rapid Reviews Methods Series: Involving patient and public partners, healthcare providers and policymakers as knowledge users
Rapid reviews (RRs) are a helpful evidence synthesis tool to support urgent and emergent decision-making in healthcare. RRs involve abbreviating systematic review methods and are conducted in a condensed timeline to meet the decision-making needs of organisations or groups that commission them. Knowledge users (KUs) are those individuals, typically patient and public partners, healthcare providers, and policy-makers, who are likely to use evidence from research, including RRs, to make informed decisions about health policies, programmes or practices. However, research suggests that KU involvement in RRs is often limited or...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Garritty, C., Tricco, A. C., Smith, M., Pollock, D., Kamel, C., King, V. J., On behalf of the Cochrane Rapid Reviews Methods Group Tags: Open access Research methods and reporting Source Type: research
Rapid reviews methods series: Guidance on assessing the certainty of evidence
This paper is part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group. Rapid reviews (RRs) use modified systematic review methods to accelerate the review process while maintaining systematic, transparent and reproducible methods. This paper addresses considerations for rating the certainty of evidence (COE) in RRs. We recommend the full implementation of GRADE (Grading of Recommendations, Assessment, Development and Evaluation) for Cochrane RRs if time and resources allow.
If time or other resources do not permit the full implementation of GRADE, the following recommendations can be consi...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Gartlehner, G., Nussbaumer-Streit, B., Devane, D., Kahwati, L., Viswanathan, M., King, V. J., Qaseem, A., Akl, E., Schuenemann, H. J., on behalf of the Cochrane Rapid Reviews Methods Group Tags: Open access Research methods and reporting Source Type: research
Deceptive shifts in cancer stage distribution
A change in cancer stage distribution, also known as a ‘stage shift’, is a common outcome measure in cancer epidemiology. A favourable stage shift—an increased proportion of early-stage cancer—is often the goal of early cancer detection efforts. An unfavourable stage shift—an increased proportion of late-stage cancer—is typically seen as evidence of the harm of diminished screening. Shifting cancer stage distributions, however, can be deceptive. The problem Consider the aspirational goal of the UK’s National Health Service (NHS): to increase the proportion of all cancers diagnosed ...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Oke, J. L., Welch, H. G. Tags: EBM learning Source Type: research
Setting new research in the context of previous research: some options
Discussion sets the results in the context of the results from available similar research.1 2 Indeed, the CONSORT statement3 (item 22) suggests including ‘a formal systematic review in the results or discussion section of the report’. However, CONSORT observes that ‘Such synthesis may be judged impractical for trial authors, but it is often possible to quote a systematic review of similar trials.’ For practical reasons, most authors are likely to choose the latter... (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Glasziou, P., Jones, M., Clarke, M. Tags: Open access EBM learning Source Type: research
Exploring the diverse definitions of 'evidence: a scoping review
Conclusions
The definition of ‘evidence’ has gradually attracted the attention of many scholars and decision-makers in health and social sciences. Nevertheless, there is no widely recognised and accepted definition in scientific research. Given the wide use of the term, we need to think about whether, or under what circumstances, a standardised, clear, meaningful and widely applicable definition of ‘evidence’ might be helpful. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Yu, X., Wu, S., Sun, Y., Wang, P., Wang, L., Su, R., Zhao, J., Fadlallah, R., Boeira, L., Oliver, S., Abraha, Y. G., Sewankambo, N. K., El-Jardali, F., Norris, S. L., Chen, Y. Tags: Open access Original research Source Type: research
Interpretation and use of a decision support tool for multiple treatment options: a combined randomised controlled trial and survey of medical students
Conclusion
Medical students with no prior training in EBM can interpret and use the MATCH-IT tool. Certain design alternatives were preferred but had no bearing on interpretation of evidence or understandability of the tool. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Stokke Hunskaar, B., Lovsletten, P. O., Muller, A., Vandvik, P. O. Tags: Open access Original research Source Type: research
Overdiagnosis in malignant melanoma: a scoping review
Conclusions
Epidemiological data suggest a high degree of overdiagnosis in malignant melanoma. Studies that examined the association between skin screening and malignant melanoma all found increased detection of melanomas, mostly thin and in situ melanomas, which raises concern about overdiagnosis. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Bjorch, M. F., Gram, E. G., Brodersen, J. B. Tags: Original research Source Type: research
The paradox of using SDM for de-implementation of low-value care in the clinical encounter
Introduction In the last decades, researchers, governments and public campaigns have increased awareness about healthcare overuse.1 Low-value care is described as care unlikely to benefit the patient given the harms, costs or available alternatives.2 Clinical practice guidelines with ‘do-not-do’ recommendations and other de-implementation strategies were promoted to reduce it.1 One of these strategies is shared decision making (SDM).3 SDM was traditionally described as an approach to enhance patient involvement in healthcare decisions by communicating evidence-based information about options, their pros and con...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Riganti, P., Kopitowski, K. S., McCaffery, K., van Bodegom-Vos, L. Tags: EBM opinion and debate Source Type: research
Choosing wisely 10 years later: reflection and looking ahead
Ellen and colleagues argue that expanding the geographical and professional reach and thematic scope of choosing wisely could help achieve greater impact Choosing wisely (CW) is a campaign for healthcare professionals and patients to engage in conversations about unnecessary tests, treatments and procedures, and to help them make smart and effective choices to ensure high-quality care.1 Through this partnership, national organisations representing medical specialists identify tests or procedures commonly used in their field whose necessity should be questioned and discussed. A successful decade has passed since CW recommen...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Ellen, M., Correia, L., Levinson, W. Tags: Analysis Source Type: research
Inverse publication reporting bias favouring null, negative results
WHAT IS ALREADY KNOWN ON THIS TOPIC Publication reporting bias is known to be a major threat for evidence-based medicine, but it is less appreciated that an inverse bias may operate sometimes, favouring the publication and dissemination of non-significant, null results. WHAT THIS STUDY ADDS Inverse publication reporting bias may operate in diverse settings including non-inferiority studies, adverse events literature, other reassurance-oriented narratives, the Proteus phenomenon and reproducibility checks. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY More transparency in protocols, statistical analysis plans and...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Ioannidis, J. P. A. Tags: Analysis Source Type: research
Rapid access to innovative medicinal products while ensuring relevant health technology assessment. Position of the French National Authority for Health
The challenge of accelerated clinical developments In France, decisions for reimbursement taken by the Ministry of Health are based on appraisal by an independent Health Technology Assessment body (HTAb): the ‘Haute Autorité de santé’ (HAS). HAS grades the clinical added value of any medicinal product for which a manufacturer seeks reimbursement. This appraisal considers different types of clinical and patient-centred outcomes, including patient-reported ones. Under certain conditions, a concomitant economic assessment which accounts for patients’ preferences in the form of utility values is...
Source: Evidence-Based Medicine - January 19, 2024 Category: Internal Medicine Authors: Vanier, A., Fernandez, J., Kelley, S., Alter, L., Semenzato, P., Alberti, C., Chevret, S., Costagliola, D., Cucherat, M., Falissard, B., Gueyffier, F., Lambert, J., Lengline, E., Locher, C., Naudet, F., Porcher, R., Thiebaut, R., Vray, M., Zohar, S., Coch Tags: Open access EBM analysis Source Type: research
Relationship between the conflicts of interest and the results of meta-analyses of homoeopathy trials
The objective of this study was, therefore, to assess whether COI was associated with the results of meta-analyses of homoeopathy trials. We conducted a literature search until July 2022 on PubMed and Embase to identify meta-analyses of randomised controlled trials assessing the efficacy of homoeopathy. There was no restriction on the investigational product or its comparator. The study population thus included patients with various... (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - November 22, 2023 Category: Internal Medicine Authors: Perrier, Q., Coste, A., Diallo, A., Guigui, A., Khouri, C., Roustit, M. Tags: Letters Source Type: research
How caring for my child with cancer changed my approach to clinical care and research
I am a clinical psychologist who specialises in helping children with medical illnesses and their families. I am also a mother of twin girls. And in April 2020 my 3-year-old daughter was diagnosed with two different types of cancer. In less than 24 hours I went from being Dr McCarthy, providing psychological services to children in our paediatric hospital, to the mom of a patient with very complex cancer. If you had asked me 3 years ago and if I had a good understanding of what paediatric oncology families go through during treatment, I probably would have answered yes. After living through cancer with my daughter, I now k...
Source: Evidence-Based Medicine - November 22, 2023 Category: Internal Medicine Authors: McCarthy, S. Tags: Patient voices Source Type: research
Rapid reviews methods series: Guidance on team considerations, study selection, data extraction and risk of bias assessment
This paper is part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group (RRMG). Rapid reviews (RRs) use modified systematic review (SR) methods to accelerate the review process while maintaining systematic, transparent and reproducible methods to ensure integrity. This paper addresses considerations around the acceleration of study selection, data extraction and risk of bias (RoB) assessment in RRs. If a RR is being undertaken, review teams should consider using one or more of the following methodological shortcuts: screen a proportion (eg, 20%) of records dually at the title/abstract level ...
Source: Evidence-Based Medicine - November 22, 2023 Category: Internal Medicine Authors: Nussbaumer-Streit, B., Sommer, I., Hamel, C., Devane, D., Noel-Storr, A., Puljak, L., Trivella, M., Gartlehner, G., On behalf of the Cochrane Rapid Reviews Methods Group Tags: Open access Research methods and reporting Source Type: research
