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Evidence-based Medicine
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#1Tom JeffersonH-Index: 40
#2Peter DoshiH-Index: 18
Last.Lesley StewartH-Index: 45
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Reporting bias is a major threat to the validity and credibility of systematic reviews. This article outlines the rationale for accessing clinical study reports and other regulatory documents (regulatory data) as a means of addressing reporting bias and identifies factors that may help decide whether (or not) to include regulatory data in systematic reviews. The article also describes the origins and current state of regulatory data access and summarises a survey of current systematic reviewers'...
#1Ronald L. Koretz (UCLA Medical Center)H-Index: 16
#2Janus Christian Jakobsen (Cochrane Collaboration)H-Index: 17
Last.Christian Gluud (Cochrane Collaboration)H-Index: 10
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After describing the formal methodology for validating surrogate outcomes, Dobler and colleagues conditionally recommend that since there is convincing evidence that direct-acting agents do produce sustained viral responses (SVRs) in patients treated for chronic hepatitis C, such treatment ‘may be appropriate’.1 They did recognise that the SVR, a surrogate outcome, has never been formally validated, but they came to their recommendation anyway based on a strong association between SVRs and impor...
#1Rani Lill Anjum (NMBU: Norwegian University of Life Sciences)H-Index: 8
#2Samantha Marie Copeland (TU Delft: Delft University of Technology)H-Index: 1
Last.Elena Rocca (NMBU: Norwegian University of Life Sciences)H-Index: 4
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The rapid dominance of evidence-based medicine has sparked a philosophical debate concerning the concept of evidence. We urge that evidence-based medicine, if it is to be practised in accordance with its own mandate, should also acknowledge the importance of understanding causal mechanisms.1–7 The undersigned include 42 clinicians and philosophers from interdisciplinary research networks working specifically on questions related to causation in medicine worldwide. Our research has developed out ...
#1Dexter Canoy (University of Oxford)H-Index: 23
#2Kazem Rahimi (University of Oxford)H-Index: 31
Commentary on: Brunstrom M, Carlberg B. Association of blood pressure lowering with mortality and cardiovascular disease across blood pressure levels: a systematic review and meta-analysis. JAMA Intern Med 2018;178:28–36. Favourable vascular health outcomes associated with blood pressure (BP)-lowering treatment are well-established. Using evidence from randomised controlled trials (RCTs), clinical guidelines support initiating treatment in patients with elevated BP usually set at systolic/diasto...
#1Eelco DraaismaH-Index: 2
#2Jolita BekhofH-Index: 11
Last.Paul L. P. BrandH-Index: 39
view all 4 authors...
Implementing evidence-based medicine (EBM) in a busy hospital department is challenging, but when successful, may contribute to quality of care. This paper is a narrative review of the successes and challenges of deliberate implementation of EBM in a paediatric department in a general teaching hospital in Zwolle, the Netherlands. Key elements in this project were providing basic EBM education to the entire team of consultants and nurse practitioners, structurally embedding EBM activities into ou...
#1Kamal R Mahtani (University of Oxford)H-Index: 17
#2Tom Jefferson (University of Oxford)H-Index: 40
Last.Jeffrey Aronson (University of Oxford)H-Index: 42
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Systematic reviews involve systematically searching for all available evidence, appraising the quality of the included studies, and synthesising the evidence into a usable form. They contribute to the pool of best available evidence, translating research into practice, and are powerful tools for clinicians, policymakers, and patients.1 To be useful for decision making, systematic reviews need to include high-quality evidence. However, there are systemic failings with the publishing, reporting, a...
Background Cardiovascular risk assessment and stratification of stable coronary artery disease represents a pivotal component of coronary artery disease management. The introduction of risk stratification tools has advanced the detection of patients with intermediate to high risk for coronary artery events. These patients will ultimately undergo non-invasive and invasive cardiovascular testing. Objective To synthesise evidence illustrating risk stratification tools and non-invasive testing for p...
#1Sally K. Abell (Monash University)H-Index: 7
#2Sally K. Abell (Monash University)
Last.Sophia Zoungas (Monash University)H-Index: 43
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Commentary on: Feig DS, Donovan LE, Corcoy R, et al. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet 2017;390(10110):2347-59. Risk of adverse obstetric and neonatal outcomes in pregnant women with type 1 diabetes can be reduced with more intense glycaemic control,1 but achieving targets is challenging. Indeed, with specialist input, only 40% of women achieve optimal glycaemic control during pregnancy...
#1Mike Clarke (Queen's University)H-Index: 87
#2Iain Chalmers DScH-Index: 56
One of the key elements in evidence-based medicine (EBM) is reliable information from research on the benefits and harms of specific interventions, actions or strategies. This is true for resolving uncertainties about interventions that might be used to treat illnesses or improve well-being and also for choosing screening or diagnostic tests, understanding risk factors and estimating the current and future burden of disease. As the principles and practice of EBM have become more accepted and wid...
#1Sten Anttila (Lund University)H-Index: 1
#2Johannes Persson (Lund University)H-Index: 10
Last.Nils-Eric Sahlin (Lund University)H-Index: 15
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One of the most widely used tools for assessing and communicating scientific uncertainty is Grading of Recommendations Assessment, Development, and Evaluation (GRADE), a system for rating the quality of evidence and grading strength of recommendations in healthcare. More than 100 organisations around the world—WHO included1—are using GRADE or have endorsed it. In GRADE, a quantitative assessment of uncertainty is qualitatively communicated, so that a result obtained as a CI relative to a thresho...
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