Level of Evidence as a Future Gold Standard for the Content Quality of Health Resources on the Internet

2003 ◽  
Vol 42 (03) ◽  
pp. 220-225 ◽  
Author(s):  
E. Amsallem ◽  
M. Haugh ◽  
B. Lukacs ◽  
V. Leroux ◽  
B. Thirion ◽  
...  
Keyword(s):  
Health Resources ◽  
French Language ◽  
Medical Decision ◽  
The Internet ◽  
Sensitive Information ◽  
Level Of Evidence ◽  
Content Quality ◽  
Internet Resources ◽  
Significant Difference

Summary Objective: An assessment of the quality of health information on the Internet is an absolute necessity. In this study ‘sensitive’ information was defined as information found in documents published on the Internet, which could be used in a medical decision. For sensitive information, the main criterion chosen for the quality of the information was an indication of the level of evidence. A survey was conducted using the CISMeF health catalogue to assess how often a score of the level of evidence is mentioned in the information accessible on the Internet in French-language health resources. Methods: Since 1999, members of the CISMeF team have systematically been searching for all documents containing ‘sensitive’ information and verifying whether the level of evidence was explicitly indicated as a score at least once in the document. Results: As of June 2001, 10,190 resources were included in CISMeF; including 2964 textual ‘sensitive’ resources (29.1%). Out of all these resources, only 4.7% (95% confidence interval: 4.0 - 5.5%) indicated the level of evidence. A statistically significant difference in the prevalence of indicating the level of evidence according to resource types (e.g., 18.1% for guidelines compared to 0.0% for teaching material), year of publication (almost three times greater in 1997-2001 compared with 1990-1996) and publishers was observed. Conclusion: As the number of people accessing the growing amount of information on the Internet is increasing daily, publishers have an ethical obligation to inform their readers about the validity of ‘sensitive’ information their sites contain. However, the vast majority of the French language Internet resources that were surveyed do not mention a score of the level of evidence for their sensitive information.

scholarly journals Evaluation of French-language internet sites dealing with multiple sclerosis

2016 ◽  
Vol 2 ◽  
pp. 205521731665241 ◽  
Author(s):  
Antoine Guéguen ◽  
Elisabeth Maillart ◽  
Thibault Gallice ◽  
Bashar Allaf
Keyword(s):  
Multiple Sclerosis ◽  
Search Engines ◽  
French Language ◽  
The Internet ◽  
Content Quality ◽  
The Mean ◽  
Internet Searches ◽  
Ranking Index

Background Information available on the internet has changed patient–neurologist relationships. Its evaluation for multiple sclerosis is only partial, regardless of the language used. Objective We aim to evaluate the content quality and ranking indexes of French-language sites dealing with multiple sclerosis. Methods Two French terms and three search engines were used to identify the sites whose ranking indexes were calculated according to their positions on each page designated by the search engines. Three evaluators used the DISCERN questionnaire to assess the content quality of the 25 selected sites. The sites were classified according to the mean of the evaluators’ grades. Grading agreement between evaluators was calculated. Ranking indexes were computed as a rank/100. Results Content level was deemed mediocre, with poor referencing of the information provided. The naïve and two expert evaluators’ grades differed. Content quality disparity was found within the different website categories, except for institutional sites. No correlation was found between content quality and ranking index. Conclusion The information available was heterogeneous. Physicians should guide patients in their internet searches for information so that they can benefit from good-quality input which is potentially able to improve their management.

A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques

2019 ◽  
Vol 39 (9) ◽  
pp. 927-942 ◽  
Author(s):  
Andrew A Jacono ◽  
A Sean Alemi ◽  
Joseph L Russell
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Meta Analysis ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Facial Nerve Injury ◽  
Significant Difference ◽  
Meta Analyses ◽  
Smas Flap

AbstractBackgroundSub-superficial musculo-aponeurotic system (SMAS) rhytidectomy techniques are considered to have a higher complication profile, especially for facial nerve injury, compared with less invasive SMAS techniques. This results in surgeons avoiding sub-SMAS dissection.ObjectivesThe authors sought to aggregate and summarize data on complications among different SMAS facelift techniques.MethodsA broad systematic search was performed. All included studies: (1) described a SMAS facelifting technique categorized as SMAS plication, SMASectomy/imbrication, SMAS flap, high lateral SMAS flap, deep plane, and composite; and (2) reported the number of postoperative complications in participants. Meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total 183 studies were included. High lateral SMAS (1.85%) and composite rhytidectomy (1.52%) had the highest rates of temporary nerve injury and were the only techniques to show a statistically significant difference compared with SMAS plication (odds ratio [OR] = 2.71 and 2.22, respectively, P < 0.05). Risk of permanent injury did not differ among techniques. An increase in major hematoma was found for the deep plane (1.22%, OR = 1.67, P < 0.05) and SMAS imbrication (1.92%, OR = 2.65, P < 0.01). Skin necrosis was higher with the SMAS flap (1.57%, OR = 2.29, P < 0.01).ConclusionsThere are statistically significant differences in complication rates between SMAS facelifting techniques for temporary facial nerve injury, hematoma, seroma, necrosis, and infection. Technique should be selected based on quality of results and not the complication profile.Level of Evidence: 2

scholarly journals Knowledgebases in postgenomic molecular biology

2010 ◽  
Vol 56 (1) ◽  
pp. 82-89
Author(s):  
A.V. Lisitsa ◽  
B.V. Shilov ◽  
P.A. Evdokimov ◽  
S.A. Gusev
Keyword(s):  
Molecular Biology ◽  
Paradigm Shift ◽  
Life Science ◽  
The Internet ◽  
Research Groups ◽  
Quality Of Information ◽  
New Methods ◽  
Knowledge Based ◽  
Internet Resources

Knowledgebases can become an effective tool essentially raising quality of information retrieval in molecular biology, promoting the development of new methods of education and forecasting of the biomedical R&D. Knowledge-based technologies should induce "paradigm shift" in the life science due to integrative focusing of research groups towards the challenges of postgenomic era. This paper debates concept of the knowledgebase, which exploits web usage mining to personalize the access of molecular biologist to the Internet resources.

scholarly journals Scientific quality of COVID-19 and SARS CoV-2 publications in the highest impact medical journals during the early phase of the pandemic: A case control study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241826 ◽  
Author(s):  
Marko Zdravkovic ◽  
Joana Berger-Estilita ◽  
Bogdan Zdravkovic ◽  
David Berger
Keyword(s):  
New England ◽  
Citation Rate ◽  
Strong Association ◽  
Hierarchical Level ◽  
Scientific Quality ◽  
Level Of Evidence ◽  
Medical Journals ◽  
Pubmed Database ◽  
Significant Difference

Background A debate about the scientific quality of COVID-19 themed research has emerged. We explored whether the quality of evidence of COVID-19 publications is lower when compared to nonCOVID-19 publications in the three highest ranked scientific medical journals. Methods We searched the PubMed Database from March 12 to April 12, 2020 and identified 559 publications in the New England Journal of Medicine, the Journal of the American Medical Association, and The Lancet which were divided into COVID-19 (cases, n = 204) and nonCOVID-19 (controls, n = 355) associated content. After exclusion of secondary, unauthored, response letters and non-matching article types, 155 COVID-19 publications (including 13 original articles) and 130 nonCOVID-19 publications (including 52 original articles) were included in the comparative analysis. The hierarchical level of evidence was determined for each publication included and compared between cases and controls as the main outcome. A quantitative scoring of quality was carried out for the subgroup of original articles. The numbers of authors and citation rates were also compared between groups. Results The 130 nonCOVID-19 publications were associated with higher levels of evidence on the level of evidence pyramid, with a strong association measure (Cramer’s V: 0.452, P <0.001). The 155 COVID-19 publications were 186-fold more likely to be of lower evidence (95% confidence interval [CI] for odds ratio, 7.0–47; P <0.001). The quantitative quality score (maximum possible score, 28) was significantly different in favor of nonCOVID-19 (mean difference, 11.1; 95% CI, 8.5–13.7; P <0.001). There was a significant difference in the early citation rate of the original articles that favored the COVID-19 original articles (median [interquartile range], 45 [30–244] vs. 2 [1–4] citations; P <0.001). Conclusions We conclude that the quality of COVID-19 publications in the three highest ranked scientific medical journals is below the quality average of these journals. These findings need to be verified at a later stage of the pandemic.

Female-to-Male Gender-Confirming Drainless Mastectomy May Be Safe in Obese Males

2019 ◽  
Vol 40 (3) ◽  
pp. NP85-NP93
Author(s):  
Eric M Pittelkow ◽  
Stephen P Duquette ◽  
Farrah Rhamani ◽  
Corianne Rogers ◽  
Sidhbh Gallagher
Keyword(s):  
Gender Dysphoria ◽  
Medical Condition ◽  
Perioperative Outcomes ◽  
Morbidly Obese ◽  
Level Of Evidence ◽  
Transgender People ◽  
Super Obese ◽  
Significant Difference ◽  
Transgender Men

Abstract Background Gender dysphoria is a medical condition associated with suicidality. Transgender men who have undergone female-to-male (FTM) chest reconstruction report higher quality of life and reduced gender dysphoria. It has been reported that transgender men are at higher risk of obesity. Objectives The objective of this study was to compare perioperative outcomes and complications between different classes of obesity in FTM transgender patients who underwent chest masculoplasty. Methods A retrospective review of 145 consecutive patients who underwent mastectomy with free nipple graft was conducted. Postoperative outcomes and complications were collected. Patients were divided into nonobese (body mass index [BMI] &lt;30 kg/m2), obese (BMI 30-39.9 kg/m2), morbidly obese (BMI 40-49.9 kg/m2), and super obese (BMI &gt;50 kg/m2) groups. Results Sixty-six of the 145 patients were not obese, 52 were obese, 22 were morbidly obese, and 5 were super obese. There was a statistically significant increase in amount of breast tissue resected between each of the 4 groups (866.8 g vs 1672.4 g vs 3157.1 g vs 4827.6 g; P ≤ 0.0005) as BMI increased, respectively. There was a significant difference in operative time between the nonobese and obese groups (128.7 vs 134.6 vs 150.5 vs 171 minutes; P = 0.026). A significant increase in postoperative infections was observed between the morbidly obese, super obese, and the nonobese group (P = 0.048). Conclusions Chest wall reconstruction in FTM and nonbinary transgender people is important in relieving gender dysphoria. Postoperative complications were not significantly increased in obese patients (30-39.9 kg/m2). Delaying surgery for weight loss may not be necessary unless patients are morbidly obese. Level of Evidence: 4

scholarly journals Incidence of and Functional Significance of Floating Toe After Weil Osteotomy

2019 ◽  
Vol 4 (4) ◽  
pp. 247301141989195
Author(s):  
Emilio Wagner ◽  
Luis A. O’Connell ◽  
Ruben Radkievich ◽  
Nathaly Caicedo ◽  
Pablo Mococain ◽  
...  
Keyword(s):  
Clear Correlation ◽  
Functional Scale ◽  
Level Of Evidence ◽  
Patient’S Satisfaction ◽  
Significant Difference ◽  
The Mean ◽  
American Orthopaedic ◽  
Toe Deformity

Background: The most frequent complication after Weil osteotomies is a floating toe deformity, but there are no reports about its effect on the patient. In this study, we analyzed the consequences of floating toe deformities after the performance of a modified Weil osteotomy (MWO) or a modified Weil osteotomy with interphalangeal fixation (MWOIF). Methods: We performed a retrospective review with a prospective follow-up of 50 patients (98% women, 120 rays) who underwent MWO (65 rays) or MWOIF (55 rays), with a mean age of 54 ± 12 years and a minimum follow-up of 4 years (mean of 6 years). We analyzed the presence of floating toe deformity in MWO and MWOIF and the outcomes measured by the subjective satisfaction, Lower Extremity Functional Scale (LEFS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and quality of prehension force between patients with or without floating toe deformity. Results: The mean floating toe incidence was of 57%, with no significant difference between operative techniques (48% MWO, 67% MWOIF; P = .053). Our analysis did not show differences in satisfaction, LEFS and AOFAS scores, or grip strength between the group of patients with or without floating toes. Conclusion: The presence of a floating toe deformity was more frequent than generally believed but did not have a meaningful impact on the patient’s satisfaction or functional outcomes measured by the AOFAS and LEFS scales. There was no clear correlation between operative technique, floating toe, and quality of prehension force. Level of Evidence: Level III, retrospective comparative series.

A cross-sectional study on quality of diabetes information identified from the Internet (Preprint)

2019 ◽  
Author(s):  
Jingchun Fan ◽  
Jean Craig ◽  
Na Zhao ◽  
Fujian Song
Keyword(s):  
Health Information ◽  
Search Engine ◽  
Search Engines ◽  
The Internet ◽  
Online Health Information ◽  
Online Information ◽  
Significant Difference ◽  
Content Coverage ◽  
Google Search

BACKGROUND Increasingly people seek health information from the Internet, in particular, health information on diseases that require intensive self-management, such as diabetes. However, the Internet is largely unregulated and the quality of online health information may not be credible. OBJECTIVE To assess the quality of online information on diabetes identified from the Internet. METHODS We used the single term “diabetes” or equivalent Chinese characters to search Google and Baidu respectively. The first 50 websites retrieved from each of the two search engines were screened for eligibility using pre-determined inclusion and exclusion criteria. Included websites were assessed on four domains: accessibility, content coverage, validity and readability. RESULTS We included 26 websites from Google search engine and 34 from Baidu search engine. There were significant differences in website provider (P<0.0001), but not in targeted population (P=0.832) and publication types (P=0.378), between the two search engines. The website accessibility was not statistically significantly different between the two search engines, although there were significant differences in items regarding website content coverage. There was no statistically significant difference in website validity between the Google and Baidu search engines (mean Discern score 3.3 vs 2.9, p=0.156). The results to appraise readability for English website showed that that Flesch Reading Ease scores ranged from 23.1 to 73.0 and the mean score of Flesch-Kincaid Grade Level ranged range from 5.7 to 19.6. CONCLUSIONS The content coverage of the health information for patients with diabetes in English search engine tended to be more comprehensive than that from Chinese search engine. There was a lack of websites provided by health organisations in China. The quality of online health information for people with diabetes needs to be improved to bridge the knowledge gap between website service and public demand.

scholarly journals Love and Marital Quality in Romantic Relationships Mediated and Non-Mediated by Internet

2014 ◽  
Vol 24 (57) ◽  
pp. 105-113 ◽  
Author(s):  
Karla Rafaela Haack ◽  
Denise Falcke
Keyword(s):  
Romantic Relationships ◽  
Marital Quality ◽  
The Internet ◽  
Human Beings ◽  
Physical Relationship ◽  
Face To Face ◽  
Internet Users ◽  
Significant Difference ◽  
The Relationship

Love is one of the most desired feelings by human beings. According to the triangular theory of love, it is composed of three elements: intimacy, passion and decision/commitment, which constitutes a dimension related to the quality of love the partners perceive in their relationship. This study aims to compare the three elements of love and marital quality of 86 Internet users (43 in a relationship mediated by the Internet and 43 with a physical relationship). The results indicate that there is a significant difference in the intimacy, the decision/commitment and the whole dimension of love, as well as in the marital quality between partners who have a relationship mediated by Internet and the ones in a physical relationship. We can conclude that the Internet is a great tool for people to meet, but that it is important for the relationship to develop in a face-to-face context.

scholarly journals SURGICAL CORRECTION OF POST-TRAUMATIC KYPHOSIS WITH OSTEOTOMIES IN THE SPINE

2019 ◽  
Vol 18 (1) ◽  
pp. 60-63 ◽  
Author(s):  
José María Jiménez Avila ◽  
Omar Sánchez García ◽  
Paula Aranguren Vergara ◽  
Arelhi Catalina González Cisneros
Keyword(s):  
Sagittal Balance ◽  
The Body ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Before And After ◽  
Spinopelvic Balance ◽  
Post Traumatic ◽  
L1 And L2 ◽  
Indications And Complications

ABSTRACT Objective: To analyze the clinical and radiological evolution, indications and complications of the types of osteotomies in patients with disturbed sagittal balance (SB) resulting from post-traumatic kyphosis. The SB can be measured with a plumb line from the center of the body of C7 to S1, which allows recognizing the misalignment. The imbalance can be corrected by osteotomy. Methods: Thirty patients with SB loss due to post-traumatic kyphosis were studied from January 2014 to December 2017. SPO, PSO and VCR were performed to evaluate the degree of kyphosis before and after surgery, the Oswestry questionnaire was applied and the degree of correction, the days of hospital stay and transoperative bleeding were assessed. Results: Age, 50 years, SD = 14, follow-up time: 2-3 years. We performed 11 (36.7%) osteotomies of S-P, 17 (56.7%) pedicle subtractions and 2 (6.6%) vertebrectomies. Most of the lesions were found between levels L1 and L2; the complications were dehiscence of the surgical wound in 4 patients (13.3%) and infection in 2 (6.6%). The minimum surgical time was 3 hours; the Oswestry questionnaire did not showed statistically significant difference during the preoperative period, however, considerable improvement was observed 2 years after surgery. Conclusions: The use of corrective vertebral osteotomies significantly re-establishes the spinopelvic balance altered by different pathologies. It allows correcting in a single surgery the sagittal balance, achieving corrections from 10° to 40°, depending on the type of osteotomy performed, being a safe and effective procedure, which allows to restore the spinopelvic balance, improving the quality of life of the patients. Level of Evidence IIb; Prospective cohort study.

The Evidence Base of Neuropsychological Rehabilitation in Acquired Brain Impairment (ABI): How Good is the Research?

2006 ◽  
Vol 7 (2) ◽  
pp. 119-132 ◽  
Author(s):  
Michael Perdices ◽  
Regina Schultz ◽  
Robyn Tate ◽  
Skye McDonald ◽  
Leanne Togher ◽  
...  
Keyword(s):  
Research Design ◽  
Methodological Quality ◽  
Case Series ◽  
Evidence Base ◽  
Speech Disorders ◽  
Single Subject ◽  
Target Area ◽  
Level Of Evidence ◽  
Significant Difference

AbstractIn the context of evidence-based clinical practice (EBCP), the reliability of empirical data is largely determined by the methodological quality of research design. PsycBITE™ (Psychological Database of Brain Impairment Treatment Efficacy) is a web-based database listing all published, empirical reports on the effectiveness of nonpharmacological interventions for the psychological consequences of acquired brain impairment (ABI). The aim of this study was to survey the listings of PsycBITE™ and examine the methodological quality of the reports it contains. Reports listed in PsycBITE™ include systematic reviews (SRs), randomised controlled trials (RCTs), non-RCTs, case series (CSs) and single-subject designs (SSDs). They are indexed according to research design, neurological group, patient age group, target area and intervention type. The PEDro Scale is used to rate the methodological quality of RCTs, nonRCTs and CSs, with maximum obtainable methodological quality rating (MQR) of 10/10, 8/10 and 2/10 respectively. A search identified 1298 reports indexed in PsycBITE™. The largest proportion was SSDs (39%), followed by CSs (22%), RCTs (21%), non-RCTs (11%) and SRs (7%). The majority of reports was concerned with stroke (41%), traumatic brain injury (29%) and Alzheimer's and related dementias (22%). The most frequently investigated deficits were communication/language/speech disorders (24%); independent/self-care activities (19%); behaviour problems (17%); memory impairments (17%); anxiety, depression, stress, adjustment (15%). Approximately half of the RCTs, non-RCTs and CSs were rated for methodological quality. Mean MQR scores for RCTs, non-RCTs and CSs were 4.49, 2.85 and 1.15 respectively. While some PEDro criteria were met by a high proportion of RCTs and non-RCTs (≥ 70%), other criteria were only met by a small proportion of reports (as low as 1.6%). There was no significant difference in MQR scores between RCTs focusing on different neurological groups or target areas. Furthermore, there was no discernible improvement in MQR score for RCTs published over the last three decades. The methodological quality of studies investigating the efficacy of rehabilitation interventions in ABI has been consistently modest over several decades. This is largely attributable to poor adherence to fundamental tenets of research design, and requires urgent remediation. RCTs (and to a lesser extent, non-RCTs) are research methodologies which can potentially yield a high level of evidence, but only if they are adequately designed. PsycBITE™ has the facility to raise awareness of these issues and be instrumental in promoting EBCP in the field of ABI.

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