Communicating with consumers: The development of an evidence-based research agenda in chronic illness research

2003 ◽  
Vol 9 (3) ◽  
pp. 218 ◽  
Author(s):  
Sophie Hill ◽  
Judith Stoelwinder
Keyword(s):  
Large Scale ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Social Programs ◽  
Evidence Based ◽  
Clinical Interventions ◽  
Social Interventions ◽  
The Usa ◽  
History Of ◽  
The Cochrane Collaboration

It is probably not surprising, but when most people talk about the ?getting and using? of evidence in health care, they are usually referring to evidence about treatments - things like pills and procedures. Despite this contemporary focus on health treatments, there is a long history of evaluating social, as well as clinical, interventions. Methods developed to answer evaluation questions of social interventions arose early in the twentieth century, and were applied, for example, to evaluate large-scale social programs in the USA (Oakley, 2001, pp.17-19). The study design of meta-analysis, used to synthesise the evidence from a number of studies of similar interventions, has been picked up and developed within medicine as well (Daly, Kellehear, & Gliksman, 1997, pp.139-53). This has led to the establishment of large-scale enterprises such as the Cochrane Collaboration, an example of an international organisation that is assembling and reviewing the effectiveness of many clinical interventions (Chalmers, 1993; Cochrane Collaboration, 2003).

Evidence-Based Medicine and Anaesthesia: Uneasy Bedfellows?

1997 ◽  
Vol 25 (6) ◽  
pp. 679-685 ◽  
Author(s):  
B. F. Horan
Keyword(s):  
Evidence Based Medicine ◽  
Medical Literature ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Cochrane Collaboration ◽  
Evidence Based ◽  
Intermediate Outcomes ◽  
Multicentre Trials ◽  
The Cochrane Collaboration ◽  
Based Medicine

The term “evidence-based medicine” first appeared in the medical literature in 1992 and is in widespread use today. It is timely to examine the concept's relevance to anaesthetic practice as well as the validity of the premises on which it rests. An important difference between anaesthesia and the specialties which treat disease is that in anaesthesia there is very little research done with real outcomes as its end-point. Surrogate or intermediate outcomes predominate as the end-points of anaesthetic research, which is a weakness when the results serve as the evidence on which to base clinical decisions. Furthermore, in interventions which require personal skill, dexterity or decision-making, caution must be exercised in assuming that equally good outcomes are achievable by all. Key members of the Cochrane Collaboration, among the most prominent advocates of evidence-based medicine, promote the belief that much valid scientific evidence is to be found in sources outside the peer-reviewed published literature. This assertion must be treated with caution. Furthermore, some techniques central to the search for the evidence on which to base practice, including meta-analysis and multicentre trials, are prone to errors through incorrect application. Evidence-based medicine appears to have less to offer anaesthesia than it does to the “treating” specialties.

scholarly journals Effect of Composite Core Materials on Fracture Resistance of Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2251
Author(s):  
Maciej Zarow ◽  
Marzena Dominiak ◽  
Katarzyna Szczeklik ◽  
Louis Hardan ◽  
Rim Bourgi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fracture Resistance ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Composite Resins ◽  
In Vitro Studies ◽  
Endodontically Treated Teeth ◽  
The Cochrane Collaboration ◽  
Core Materials

Various material properties are involved in the success of endodontically treated restorations. At present, restorative composites are commonly employed as core build-up materials. This study aimed to systematically review the literature to assess the effect of using composite core materials on the in vitro fracture of endodontically treated teeth. Two different reviewers screened the literature, up to June 2021, in five distinct electronic databases: PubMed (MedLine), Scopus, Scielo, ISI Web of Science, and EMBASE. Only in vitro studies reporting the effect of the use of composite core materials on the fracture resistance of endodontically treated teeth were included. A meta-analysis was carried out using a software program (Review Manager v5.4.1; The Cochrane Collaboration, Copenhagen, Denmark). The risk of bias in each study was assessed following the parameters of another systematic review. A total of 5016 relevant papers were retrieved from all databases. After assessing the title and abstract, five publications remained for qualitative analysis. From these, only three studies remained for meta-analysis. The fracture strength of endodontically treated teeth where a core build-up composite was used was statistically significantly higher than the control (p = 0.04). Most of the analyses showed a high heterogenicity. The in vitro evidence suggests that the composite core build-up with higher filler content tended to improve the fracture resistance of the endodontically treated teeth, in comparison with conventional composite resins. This research received no external funding. Considering that this systematic review was only carried out on in vitro papers, registration was not performed. Furthermore, there were no identified clinical studies assessing core build-up materials; therefore, more well-designed research on these materials is needed.

scholarly journals Efficacy and safety of Si-Jun-Zi-Tang-based therapies for functional (non-ulcer) dyspepsia: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yaping Wang ◽  
Bin Liu ◽  
Xiuqiong Fu ◽  
Tiejun Tong ◽  
Zhiling Yu
Keyword(s):  
Relapse Rate ◽  
Large Scale ◽  
Primary Outcome ◽  
Response Rate ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Efficacy And Safety ◽  
History Of ◽  
Non Ulcer Dyspepsia

Abstract Background The traditional Chinese medicine formula Si-Jun-Zi-Tang (SJZT) has a long history of application in the treatment of functional dyspepsia (non-ulcer dyspepsia, FD)-like symptoms. SJZT-based therapies have been claimed to be beneficial in managing FD. This study aimed to assess the efficacy and safety of SJZT-based therapies in treating FD by meta-analysis. Methods Systematic searches for RCTs were conducted in seven databases (up to February 2019) without language restrictions. Data were analyzed using Cochrane RevMan software version 5.3.0 and Stata software version 13.1, and reported as relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CIs). The primary outcome was response rate and the secondary outcomes were gastric emptying, quality of life, adverse effects and relapse rate. The quality of evidence was evaluated according to criteria from the Cochrane risk of bias. Results A total of 341 potentially relevant publications were identified, and 12 RCTs were eligible for inclusion. For the response rate, there was a statically significant benefit in favor of SJZT-based therapies (RR = 1.23; 95% CI 1.17 to 1.30). However, the benefit was limited to modified SJZT (MSJZT). The relapse rate of FD patients received SJZT-based therapies was lower than that of patients who received conventional medicines (OR = 0.23; 95% CI 0.10 to 0.51). No SJZT-based therapies-related adverse effect was reported. Conclusion SJZT-based prescriptions may be effective in treating FD and no serious side-effects were identified, but the effect on response rate appeared to be limited to MSJZT. The results should be interpreted with caution as all the included studies were considered at a high risk of bias. Standardized, large-scale and strictly designed RCTs are needed to further validate the benefits of SJZT-based therapies for FD management. Trial registration Systematic review registration: [PROSPERO registration: CRD42019139136].

Evidence-Based Practice: The Cochrane Collaboration, and Occupational Therapy

1998 ◽  
Vol 65 (3) ◽  
pp. 144-151 ◽  
Author(s):  
Robyn L. Hayes ◽  
John J. McGrath
Keyword(s):  
Systematic Reviews ◽  
Randomised Controlled Trials ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Cochrane Collaboration ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomised Controlled ◽  
The Cochrane Collaboration

This paper describes how occupational therapists can become involved in the Cochrane Collaboration — a well-developed tool for facilitating the involvement of health professionals and lay people in evidence-based practice. The Cochrane Collaboration is a growing international project intended to systematically locate, conduct systematic reviews (including metaanalyses) of, and disseminate information on all available randomised controlled trials of interventions in any area of health. In particular, occupational therapists can use the Cochrane Collaboration to become better informed about best practice and evaluate research in their areas of interest, and learn skills related to conducting randomised controlled trials, systematic reviews, and meta-analyses.

scholarly journals Psychiatry in the future

2004 ◽  
Vol 28 (8) ◽  
pp. 277-278
Author(s):  
Frank Holloway
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Cochrane Collaboration ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
Policy Makers ◽  
The Future ◽  
The Cochrane Collaboration ◽  
Based Medicine

In an era of evidence-based medicine, policy-makers and researchers are preoccupied by the task of ensuring that advances in research are implemented in routine clinical practice. This preoccupation has spawned a small but growing research industry of its own, with the development of resources such as the Cochrane Collaboration database and journals such as Evidence-Based Mental Health. In this paper, I adopt a philosophically quite unfashionable methodology – introspection – to address the question: how has research affected my practice?

scholarly journals Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis

2018 ◽  
Vol 40 (11) ◽  
pp. 713-721 ◽  
Author(s):  
Iramar Nascimento ◽  
Guilherme Dienstmann ◽  
Matheus de Souza ◽  
Raquel Fleig ◽  
Carla Hoffmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Time ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Eligibility Criteria ◽  
Time Segment ◽  
Meta Analyses ◽  
The Cochrane Collaboration ◽  
Lower Correlation

Objective Does the use of metformin have an influence on the outcomes of preeclampsia (PE)? Sources of Data The descriptors pregnancy, metformin, treatment, and preeclampsia associated with the Boolean operators AND and OR were found in the MEDLINE, LILACS, Embase and Cochrane databases. A flowchart with exclusion criteria and inclusion strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and eligibility criteria was used. Data were extracted regarding the type of study, the applied dosage, treatment time, segment, bias risks, and the Patient, Intervention, Comparison and Outcome (PICO) strategy to identify the quality of the study. Selection of Studies Total number of journals in the initial search (n = 824); exclusions from repeated articles on different search engines (n = 253); exclusions after reading the titles, when the title had no correlations with the proposed theme (n = 164); exclusions due to incompatibility with the criteria established in the methodological analysis (n = 185), exclusion of articles with lower correlation with the objective of the present study (n = 187); and final bibliographic selection (n = 35). Data Collection At first, a systematic review of the literature was performed. Subsequently, from the main selection, randomized and non-randomized trials with metformin that presented their results in absolute and relative numbers of PE outcomes were selected. The variables were treated statistically in the meta-analysis with the Review Manager software (RevMan), version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration. Denmark in the Hovedistaden region. Synthesis of Data The study showed that metmorfin presented greater preventive effects for pregnancy-induced hypertension and was less effective for PE. Conclusion Metformin may gain place in preventive treatments for PE, once the dosages, the gestational age, and treatment time are particularly evaluated. A methodological strategy with an improved perspective of innovative and/or carefully progressive dosages during pregnancy to avoid side effects and the possibility of maternal-fetal risks is suggested.

scholarly journals Determinants of an evidence-based practice environment: an interpretive description

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Jed Duff ◽  
Laura Cullen ◽  
Kirsten Hanrahan ◽  
Victoria Steelman
Keyword(s):  
Nurse Managers ◽  
Evidence Based Practice ◽  
Direct Care ◽  
Evidence Based ◽  
Academic Medical Centre ◽  
Academic Medical ◽  
Iowa Model ◽  
The Usa ◽  
History Of ◽  
Evidence Based Care

Abstract Background Despite the available research to inform nursing practice, many patients still fail to receive evidence-based care. Several evidence-based practice (EBP) models have been developed to guide nurses through the steps in the process, yet these models have not been uniformly adopted or consistently used. The original purpose of this research was to gather perspectives and experiences of nurses using the Iowa Model of EBP to help inform its introduction into other practice settings. As a more in-depth understanding was gained, the emphasis of the study shifted towards understanding the determinants of the EBP environment. Method The study was conducted in an 800-bed comprehensive academic medical centre in the USA with a 25-year history of using the Iowa Model of EBP. Semi-structured in-depth interviews were conducted with twelve nurses from various roles to ascertain their perspectives and experiences using the model. The interview transcripts were reviewed alongside relevant published literature and internal documents in a process of synthesising, theorising, and conceptualising. Data were collected during the first half of 2019. Results Four determinants of the local EBP environment were identified from the perspectives and experiences of participants: (1) the importance of a shared model to guide staff through the EBP process; (2) support for EBP in the form of education, hands-on training, and knowledge infrastructure; (3) active team facilitation by direct care nurses, nurse managers, nurse specialists, and nurse scientists; and (4) a culture and leadership that encourages EBP. Conclusion Introducing an EBP model is an essential first step for an organisation to improve consistent and reliable evidence-based care; to be most effective, this should be done in conjunction with efforts to optimise the EBP environment.

P1011ATHE SGTL-2 INHIBITORS DECREASE THE MORTALITY AND PROGRESSION OF CHRONIC KIDNEY DISEASE (CKD) IN TYPE 2 DIABETES PATIENTES. SYSTEMATIC REVIEW AND META-ANALYSIS OF THE LITERATURE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sebastian Cabrera ◽  
Ruben Torres ◽  
Leticia Elgueta ◽  
Erico Segovia ◽  
Maria Eugenia Sanhueza ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Renal Outcome ◽  
Diabetic Patients ◽  
Renal Outcomes ◽  
The Cochrane Collaboration ◽  
Age Range

Abstract Background and Aims Diabetic nephropathy is one of the main causes of chronic kidney disease (CKD) in the world. In the past years new studies using SGLT-2 inhibitors in diabetic patients have shown benefit in both mortality and progression of CKD. However, these works show heterogeneity between studies regarding the severity of CKD of patients included. All above complicates the interpretation of the benefits of SGLT-2 inhibitors. Method We did a systematic search of the literature in PUBMED, EMBASE, Cochrane CENTRAL trials database and in references of the selected studies. Terms used for the search were Canaglifozin, Dapaglifozin, Ertuglifozin, Empaglifozin, diabetes, mortality and CKD. Search included studies in all languages. We selected only randomized and controlled studies that reported mortality and relevant renal outcomes (doubling serum creatinine or decrease in eGFR> 40%, need for renal replacement or renal death). We included studies until September 30, 2019. For the meta-analysis, a Mantel-Haenszel model of random effects was used. The software Review Manager, Version 5.3 The Cochrane Collaboration, 2014 was used. Results We obtained results from 142 studies, fifteen studies met the selected criteria, but only four reported mortality and renal outcomes (EMPA-REG, CANVAS, CREDENCE AND DECLARE-TIMI 58). A total of 38,721 patients (SGTL2 inhibitors n = 21,264 and control n = 17,457) were included for the analysis. The EMPA-REG study used Empaglifozin, the CANVAS and CREDENCE studies used Canaglifozin and the DECLARE-TIMI 58 used Dapaglifozin. All studies were funded by pharmaceutical laboratories.The average age range of the studies was between 62 to 67 years. The percentage of patients with eGFR <60ml/min were 26%, 20%, 60% and 7% for the EMPA-REG, CANVAS, CREDENCE and DECLARE-TIMI 58 studies respectively.Mortality was lower in patients who used SGTL2 inhibitors OR 0.86 (CI 0.80-0.94) Figure 1. Renal outcomes were also lower in patients who used SGTL-2 inhibitors OR 0.69 (CI 0.60-0.78) Figure 2. We assessed whether the effect was related to the severity of the CKD taking out the work with patients with more severe CKD (CREDENCE study), the effect on mortality did not change OR 0.87 (CI 0.80-0.95) as well as renal outcome OR 0.66 (CI 0.52- 0.83). Conclusion The SGTL-2 inhibitors decrease mortality and improve renal outcomes in patients with diabetic nephropathy. These benefits remain in patients with less severe CKD.

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