Teaching evidence-based medicine in Mexico: a systematic review of medical doctor curriculums at a national level
Conclusion
In Mexico, EBM teaching is limited to only one of five curriculums with minimal curricular value. A comprehensive curricular review is necessary across programmes to incorporate EBM as a first step to improve medical education and, consequently, public health. We call to action through an online, collaborative platform with several applications to optimise teaching of EBM.
Review protocol registration
The systematic review protocol is excluded from the International Prospective Register of Systematic Reviews since this platform only accepts systematic reviews with health-related outcomes. Review protocol regist...
Source: Evidence-Based Medicine - January 19, 2023 Category: Internal Medicine Authors: Rodriguez, D., Martinez-Alvarado, J. D., Garcia-Toto, R., Genel-Rey, T. I. Tags: General Medicine Original research Source Type: research
Reporting of patient-reported outcomes in trials on alcohol use disorder: a meta-epidemiological study
Conclusions
We found that the completeness of PRO reporting in RCTs involving AUD was deficient. Complete reporting of PROs is instrumental in understanding the effects of interventions, encourages patient participation in their treatment and may increase clinician confidence in the value of PROs. High quality treatment strategies for AUD require properly reported PROs. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 19, 2023 Category: Internal Medicine Authors: Douglas, A., Garrett, E., Staggs, J., Williams, C., Shepard, S., Wise, A., Hillman, C., Ottwell, R., Hartwell, M., Vassar, M. Tags: Mental Health Original research Source Type: research
Investigation into financial conflicts of interest and screening for atrial fibrillation in the UK: a cross-sectional study
Conclusions
The vast majority of UK media promotes screening for AF, in contrast to the position of the independent UK National Screening Committee, which recommends against screening. Most commentators, internal NHS organisations and UK charities promoting screening had a direct or indirect financial conflict of interest. Independent information was rare. The reasons for this are unknown. Readers should consider the potential for the impact of financial conflicts on recommendations to screen. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 19, 2023 Category: Internal Medicine Authors: McCartney, M., McCutcheon, C., Cooke, M., MacDonald, R., Mekwi, L., Noruddin, U. H., O'Keeffe, M. Tags: Original research Source Type: research
Risperidone and aripiprazole for autism spectrum disorder in children: an overview of systematic reviews
Conclusions
We found that aripiprazole and risperidone probably reduce symptom severity at short-term follow-up but may also cause adverse events. High-quality and updated SRs and larger randomised controlled trials with longer term follow-up are needed on this topic.
Overview protocol
PROSPERO CRD42020206535. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - January 19, 2023 Category: Internal Medicine Authors: Fieiras, C., Chen, M. H., Escobar Liquitay, C. M., Meza, N., Rojas, V., Franco, J. V. A., Madrid, E. Tags: Mental Health Evidence synthesis Source Type: research
Making care fit manifesto
For too many people, their care plans are designed without fully accounting for who they are, the lives they live, what matters to them or what they aspire to achieve. In other words, these care plans are designed for ‘patients like this’ rather than for ‘this patient’. To improve this situation, investigators often propose interventions, such as patient decision aids or patient-reported experience measures, which may disrupt clinical practice and increase the work patients must do. These interventions ‘target’ patients, or rather the images, biomarkers, or numbers that represent their d...
Source: Evidence-Based Medicine - January 19, 2023 Category: Internal Medicine Authors: Kunneman, M., Griffioen, I. P. M., Labrie, N. H. M., Kristiansen, M., Montori, V. M., van Beusekom, M. M., the Making Care Fit Working Group, Allwood, Bauer, Beusekom, Buckley, Dinneen, Edgar, Grande, Gravholt, Griffioen, Haddow, Hargraves, Hillen, Kelleh Tags: Open access EBM opinion and debate Source Type: research
Guest authorship as research misconduct: definitions and possible solutions
To advance healthcare and promote public trust, the integrity of medical research must be a high priority.1 Guest authorship (here encompassing gift, honorary, courtesy and coercive authorship) lists as ‘authors’ people who have not made substantial contributions to the work. It can occur: as fealty to supervisors, such as department chairs, laboratory directors or grant coordinators, who become authors on articles without making substantive contributions; as a means to enhance the esteem a paper receives by adding a preeminent name to the author list; or as a means to hide the publication’s origin in ind...
Source: Evidence-Based Medicine - January 19, 2023 Category: Internal Medicine Authors: Morreim, E. H., Winer, J. C. Tags: EBM analysis Source Type: research
Innovating in healthcare: perspective from a dual role
Yesterday I walked across the grounds of my local hospital twice. The first time was my regular route to the radiotherapy department. I've been coming here every working day for a few weeks now. I have to, because the triple-negative breast cancer that I was diagnosed with 8 months ago is aggressive and needs to be treated. After two courses of chemotherapy and a breast amputation, I hope that these radiation treatments will also stop the remaining cancer cells. Over my left shoulder I carried a bag with a water bottle and a shawl, items that prove useful when undergoing radiotherapy. My second walk was from the radiothera...
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Griffioen, I. P. M. Tags: General Medicine Patient voices Source Type: research
Density strips: visualisation of uncertainty in clinical data summaries and research findings
The disproportionate focus on statistical significance in reporting and interpreting clinical research studies contributes to publication bias and encourages selective reporting. This highlights a need for alternative approaches that clearly communicate the uncertainty in the data, enabling researchers to provide a more nuanced interpretation of clinical research findings.
Our purpose in this article is to introduce the density strip method as one potential approach that might act as a bridge between data visualisation for descriptive purposes and formal statistical inference. We build on existing theory, translating it to...
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Weir, C. J., Bowman, A. W. Tags: Research methods and reporting Source Type: research
Catalogue of bias: selective outcome reporting bias
Background Clinical trials reduce uncertainties about the benefits and harms of an intervention. Outcomes of interest should be specified before the trial starts (a priori), and clinically relevant to patient care. Selective reporting of prespecified outcomes based on the nature and direction of the analysed results occurs among a large proportion of published clinical trials. Selective outcome reporting bias can potentially compromise the validity of a trial and any subsequent meta-analyses.1 Selective outcome reporting can occur in different ways: Omitting outcomes which are deemed to be unfavourable or not statistically...
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Thomas, E. T., Heneghan, C. Tags: General Medicine EBM learning Source Type: research
Which actionable statements qualify as good practice statements In Covid-19 guidelines? A systematic appraisal
Conclusions
Statements that qualify as GPS are common in COVID-19 guidelines but are characterised by unclear designation and development processes, and methodological weaknesses. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Dewidar, O., Lotfi, T., Langendam, M., Parmelli, E., Saz Parkinson, Z., Solo, K., Chu, D. K., Mathew, J. L., Akl, E. A., Brignardello-Petersen, R., Mustafa, R. A., Moja, L., Iorio, A., Chi, Y., Canelo-Aybar, C., Kredo, T., Karpusheff, J., Turgeon, A. F., Tags: Open access, General Medicine, COVID-19 Original research Source Type: research
Quality of reporting among systematic reviews underpinning the ESC/ACC guidelines on ventricular arrhythmias and sudden cardiac death
Conclusion
Our study suggests the methodological and reporting quality of SRs used within ESC and ACC CPGs is insufficient, as demonstrated by the lack of adherence to both AMSTAR-2 and PRISMA checklists. Given the importance of CPGs on clinical decision making, and ultimately patient care, the methodological rigour and quality reporting within SRs used in CPGs should be held to the highest standard within the field of cardiology. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Garrett, E. P., Hightower, B., Walters, C., Srouji, D., Chronister, J., Torgerson, T., Hartwell, M., McIntire, R., Love, M., Vassar, M. Tags: Original research Source Type: research
Assessing the magnitude of reporting bias in trials of homeopathy: a cross-sectional study and meta-analysis
Conclusions
Registration of published trials was infrequent, many registered trials were not published and primary outcomes were often altered or changed. This likely affects the validity of the body of evidence of homeopathic literature and may overestimate the true treatment effect of homeopathic remedies. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Gartlehner, G., Emprechtinger, R., Hackl, M., Jutz, F. L., Gartlehner, J. E., Nonninger, J. N., Klerings, I., Dobrescu, A. I. Tags: Open access, Press releases Original research Source Type: research
Randomized trials on non-pharmaceutical interventions for COVID-19: a scoping review
Conclusions
Worldwide, 41 randomised trials assessing NPIs have been initiated with published results available to inform policy decisions for only 9 of them. A long-term research agenda including behavioural, environmental, social and systems level interventions is urgently needed to guide policies and practices in the current and future public health emergencies. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Hirt, J., Janiaud, P., Hemkens, L. G. Tags: Open access, COVID-19 Original research Source Type: research
Using absolute risk reduction to guide the equitable distribution of COVID-19 vaccines
Introduction Massive economic inequality, poverty and structural racism, in addition to intellectual property laws and regulations, are creating the conditions for gaping inequities in COVID-19 vaccine distribution. Journalists, activists and public health practitioners have characterised the largely preventable public health crisis as vaccine apartheid. At the time of this writing (January 2022), just 9.7% of people in lower-income countries had received at least one shot of the COVID-19 vaccine, compared with 60.6% globally.1 Vaccine inequities have also been observed within multiple countries such as India and South Afr...
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Fassler, E., Larkin, A., Rajasekharan Nayar, K., Waitzkin, H. Tags: Open access, COVID-19 EBM opinion and debate Source Type: research
Factors influencing estimated effectiveness of COVID-19 vaccines in non-randomised studies
Non-randomised studies assessing COVID-19 vaccine effectiveness need to consider multiple factors that may generate spurious estimates due to bias or genuinely modify effectiveness. These include pre-existing immunity, vaccination misclassification, exposure differences, testing, disease risk factor confounding, hospital admission decision, treatment use differences, and death attribution. It is useful to separate whether the impact of each factor admission decision, treatment use differences, and death attribution. Steps and measures to consider for improving vaccine effectiveness estimation include registration of studie...
Source: Evidence-Based Medicine - November 22, 2022 Category: Internal Medicine Authors: Ioannidis, J. P. A. Tags: Open access, COVID-19 EBM analysis Source Type: research
