Stump management after trans-tibial amputation: A systematic review

2005 ◽  
Vol 29 (1) ◽  
pp. 13-26 ◽  
Author(s):  
S. E. Nawijn ◽  
H. van der Linde ◽  
C. H. Emmelot ◽  
C. J. Hofstad
Keyword(s):  
Functional Outcome ◽  
Methodological Quality ◽  
Literature Search ◽  
Weight Bearing ◽  
Relevant Literature ◽  
Evidence Based ◽  
Systematic Literature Search ◽  
Large Variability ◽  
Early Weight Bearing

In order to achieve stump healing after trans-tibial amputation, various methods are applied, such as soft dressings followed by elastic wrapping of the stump, rigid dressings, semi-rigid dressings, and more recently the application of silicon or gel-liners. A systematic literature search was performed to identify the optimal post-amputation management. The methodological quality of the studies was systematically evaluated by using a predefined list of criteria. Only 11 controlled studies were identified and evaluated for their methodological quality. From these studies, no studies were classified as A-level studies, whereas three were classified as B-level, and 8 were classified as C-level studies. Relevant literature appears heterogeneous with respect to patient selection, intervention and outcome measures. Despite the large variability of included studies, this review reveals a trend in favour of rigid and semi-rigid dressings for achieving stump healing and reduction of stump volume. No conclusions can be drawn with regard to the effect on functional outcome. The literature is not conclusive on the effects of early weight bearing on stump healing, volume reduction, and functional outcome. More research is needed for the development of evidence-based clinical practice guidelines concerning management after trans-tibial amputation.

scholarly journals Toward the Development of a Comprehensive Clinically Oriented Patient Profile: A Systematic Review of the Purpose, Characteristic, and Methodological Quality of Classification Systems of Adult Spinal Deformity

Neurosurgery ◽  
2021 ◽  
Author(s):  
Kenny Yat Hong Kwan ◽  
J Naresh-Babu ◽  
Wilco Jacobs ◽  
Marinus de Kleuver ◽  
David W Polly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Classification System ◽  
Methodological Quality ◽  
Literature Search ◽  
Adult Spinal Deformity ◽  
Classification Systems ◽  
Systematic Literature Search ◽  
Patient Profile

Abstract BACKGROUND Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. OBJECTIVE To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. METHODS A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science for literature published between January 2000 and October 2018. From the included studies, list of classification systems, their methodological measurement properties, and correlation with treatment outcomes were analyzed. RESULTS Out of 4470 screened references, 163 were included, and 54 different classification systems for ASD were identified. The most commonly used was the Scoliosis Research Society-Schwab classification system. A total of 35 classifications were based on radiological parameters, and no correlation was found between any classification system levels with patient-related outcomes. Limited evidence of limited quality was available on methodological quality of the classification systems. For studies that reported the data, intraobserver and interobserver reliability were good (kappa = 0.8). CONCLUSION This systematic literature search revealed that current classification systems in clinical use neither include a comprehensive set of dimensions relevant to decision-making nor did they correlate with outcomes. A classification system comprising a core set of patient-related, radiological, and etiological characteristics relevant to the management of ASD is needed.

The methodological quality of systematic reviews indexed in the MEDLINE database

2018 ◽  
Vol 36 (1) ◽  
pp. 146-158 ◽  
Author(s):  
Helena Martín-Rodero ◽  
Javier Sanz-Valero ◽  
Purificación Galindo-Villardón
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Literature Search ◽  
Metabolic Diseases ◽  
Medical Documentation ◽  
Large Variability ◽  
Content Type ◽  
Medline Database ◽  
Nutritional And Metabolic Diseases

Purpose The purpose of this paper is to describe and analyse the methodology quality of the literature search protocols of systematic reviews and to assess the relevance of the search filter that applies PubMed for retrieving this type of publication of the MEDLINE database. Design/methodology/approach For the selection of the document type, a literature search about nutritional and metabolic diseases was carried out in MEDLINE and the PubMed filter was used for retrieving “Systematic Reviews”, selecting “Nutritional and Metabolic Diseases” from the Medical Subject Headings (MeSH) database as Major Topic to determine the area of knowledge. Data analysis was carried out using “External Logistic Biplot”, a novel multivariate statistical technique in the field of medical documentation. Findings The results highlight the large variability of the methodology used in the literature search protocols of the systematic reviews analysed and confirm the low precision of the filter used by PubMed for the recovery of systematic reviews. Originality/value The Logistic Biplot used in this research allows an optimal categorization of the different documentary typologies and classifies the documents by their methodological quality, demonstrating its usefulness for the future development of the bibliometric analysis.

scholarly journals Do Guidelines for the Diagnosis and Monitoring of Diabetes Mellitus Fulfill the Criteria of Evidence-Based Guideline Development?

2008 ◽  
Vol 54 (11) ◽  
pp. 1872-1882 ◽  
Author(s):  
Eva Nagy ◽  
Joseph Watine ◽  
Peter S Bunting ◽  
Rita Onody ◽  
Wytze P Oosterhuis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Methodological Quality ◽  
Guideline Development ◽  
Evidence Based ◽  
Test Results ◽  
Time Period ◽  
Therapeutic Guidelines ◽  
Therapeutic Recommendations ◽  
Evidence Based Guideline

Abstract Background: Although the methodological quality of therapeutic guidelines (GLs) has been criticized, little is known regarding the quality of GLs that make diagnostic recommendations. Therefore, we assessed the methodological quality of GLs providing diagnostic recommendations for managing diabetes mellitus (DM) and explored several reasons for differences in quality across these GLs. Methods: After systematic searches of published and electronic resources dated between 1999 and 2007, 26 DM GLs, published in English, were selected and scored for methodological quality using the AGREE Instrument. Subgroup analyses were performed based on the source, scope, length, origin, and date and type of publication of GLs. Using a checklist, we collected laboratory-specific items within GLs thought to be important for interpretation of test results. Results: The 26 diagnostic GLs had significant shortcomings in methodological quality according to the AGREE criteria. GLs from agencies that had clear procedures for GL development, were longer than 50 pages, or were published in electronic databases were of higher quality. Diagnostic GLs contained more preanalytical or analytical information than combined (i.e., diagnostic and therapeutic) recommendations, but the overall quality was not significantly different. The quality of GLs did not show much improvement over the time period investigated. Conclusions: The methodological shortcomings of diagnostic GLs in DM raise questions regarding the validity of recommendations in these documents that may affect their implementation in practice. Our results suggest the need for standardization of GL terminology and for higher-quality, systematically developed recommendations based on explicit guideline development and reporting standards in laboratory medicine.

scholarly journals Journal Club is a way forward to adopt Evidence Based Practice among dental House Officers

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Kiran Fatima Fatima Mehboob Ali BANA
Keyword(s):  
Critical Thinking ◽  
Knowledge Acquisition ◽  
Literature Search ◽  
Job Training ◽  
Evidence Based Practice ◽  
Journal Club ◽  
Relevant Literature ◽  
P Value ◽  
Evidence Based ◽  
Total N

Objectives: To identify the improvement in knowledge, presentation skills, critical skills and self-directed learning process during Journal Club platform amidst dental house officers of 2018, 2019 and 2020 after completing one year house job training at Bahria dental College Karachi. Methods: This cross-sectional study was conducted from Dec- 2018 till Dec-2020. The six items were asked about perception of change for evidence-based process of (knowledge, cognitive, affective and participant domains) after completion of house job training by each cohort. The responses were noted on three point likert scale as agree, neutral and disagree. Total 150 questionnaires were distributed in three cohorts. The SPSS version 23 was used. P-value <0.05 was considered as statistically significant. Results: Total n=145 house officers had completed the proforma with response rate of 96.65%. The mean age was 24.45 ± SD 0.63 among three groups. There were n=20(14%) males and n=125(86%) females. There was improvement found for knowledge acquisition about relevant literature search among all three groups. Regarding knowledge acquisition of bio-statistics; majority of subjects n=26 (52%) in 2020 group had reported no change and in 2019 cohort n=23(48%) were agreed. Majority n=21(44%) of house officers had reported no change when asked as JC helped in critical thinking in year 2019. Conclusion: Knowledge acquisition about relevant literature search, presentation and confidence skills were improved but no significant changes were found in knowledge of biostatistics and critical thinking skills. JC is a convincing platform to learn evidence-based process amid dental house officers. doi: https://doi.org/10.12669/pjms.38.1.4562 How to cite this:Bana KFMA. Journal Club is a way forward to adopt Evidence Based Practice among dental House Officers. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4562 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Incentives and Support Programs to Improve Adherence to Tuberculosis Treatment

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Charlotte Wells ◽  
Melissa Severn
Keyword(s):  
High Risk ◽  
Methodological Quality ◽  
Clinical Effectiveness ◽  
Conclusive Evidence ◽  
Active Tuberculosis ◽  
Tuberculosis Treatment ◽  
Support Programs ◽  
Evidence Based ◽  
Evidence Based Guidelines

Three overviews of reviews and 11 systematic reviews were identified regarding the clinical effectiveness of adherence incentives in those who require assistance to complete their tuberculosis treatment. Four evidence-based guidelines were identified that provided recommendations regarding the use of adherence incentives in those who require assistance completing their tuberculosis treatment. The reported clinical effectiveness of adherence incentives for patients with tuberculosis was mixed. There were no detrimental effects of providing incentives, but there was also no conclusive evidence pointing to a clinical benefit. The overall quality of the included reviews was moderate to high. The included guidelines recommended that incentives and enablers be included as a part of a patient-centred strategy for treatment and for patients with active tuberculosis or patients at high risk; however, the evidence formulating these recommendations was of low certainty or quality. Two of the included guidelines were of high methodological quality, and 2 were of lower methodological quality.

How to Search and Critique Scientific Evidence for Decision-Making

2017 ◽  
pp. 100-123
Author(s):  
Mayuree Tangkiatkumjai ◽  
Win Winit-Watjana ◽  
Li-Chia Chen
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Literature Search ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Evidence Based ◽  
Search Terms ◽  
Based Medicine ◽  
Complementary And Alternative

A clinical decision on the use of complementary and alternative medicine (CAM) should be made based on evidence-based medicine (EBM) together with practitioner's knowledge and experiences. This chapter describes the process of EBM, including how to address a clinical question, do a systematic search for appropriate evidence with key search terms, appraise the evidence and make a clinical decision on CAM applications. An effective literature search should be performed by using a structured search strategy in searching biomedical and CAM databases, such as the National Center for Complementary and Alternative Medicine (CAM Citation Index). Few standard tools are recommended to evaluate the quality of CAM studies, i.e. the CONSORT extension for herbal interventions and STRICTA for RCTs of acupuncture. Additionally, some guidelines for designing RCTs in Chinese herbal medicine (CHM) can also be adopted to critique CAM literature. A clinical decision on choosing optimal CAM for patient care should be based on the current best evidence emerged from the EBM process.

Systematic Reviews and Meta-analyses

2018 ◽  
Vol 157 (04) ◽  
pp. 392-399
Author(s):  
Sebastian Scheidt ◽  
Patrick Vavken ◽  
Cornelius Jacobs ◽  
Sebastian Koob ◽  
Davide Cucchi ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Scientific Knowledge ◽  
Literature Search ◽  
Meta Analysis ◽  
Review Article ◽  
Systematic Literature Search ◽  
Meta Analyses

AbstractThe rising number of medical publications makes it difficult to keep up-to-date on scientific knowledge. In recent years, reviews in the form of narrative or systematic publications and meta-analyses have increased. These can only be interpreted and evaluated if the reader understands the techniques used. This review article describes the differences between narrative and systematic reviews, together with the characteristics of meta-analysis, and discusses their interpretation. The concept of systematic reviews and meta-analysis includes a systematic literature search and summary, together with an appraisal of the quality of the publications. Systematic reviews are often considered to be original studies due to their structure and ability to reduce bias.

The Absence of Evidence-Based Practices (EBPs) in the Treatment of Sexual Abusers: Recommendations for Moving Toward the Use of a True EBP Model

Sexual Abuse ◽  
2019 ◽  
Vol 32 (6) ◽  
pp. 679-705
Author(s):  
Adam Deming ◽  
Jerry L. Jennings
Keyword(s):  
Mental Health ◽  
Methodological Quality ◽  
Treatment Effectiveness ◽  
Current Status ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Treatment Approaches ◽  
Professional Discipline ◽  
History Of

Despite a continued evolution of the field of sexual abuser treatment toward a distinct professional discipline with clinicians using an increasing variety of treatment approaches, there is no consensus regarding the strength of our various clinical interventions as evidence-based practices (EBPs). This article provides a brief history of the development and goals of EBPs in medicine and mental health, and a review of the earnest efforts of researchers within the field to establish treatment approaches with sexual abusers as evidence-based. An appraisal of the current status of EBP’s with sexual abusers is provided. Although there have been improvements in the methodological quality of treatment outcome research with sexual abusers, divergent opinions about treatment effectiveness remain, and the field has not yet agreed on a system or set of criteria for what constitutes “evidence.” We contend that clinical practice has been influenced as much, or more, by new paradigms that are intuitively meaningful and perceived as needed than it has by what has been determined to be scientifically efficacious. This trend and other processes in our field that seem to be slowing the development of EBPs with sexual abusers are discussed. Recommendations for conducting evidence-based reviews and moving the field of sexual abuser treatment toward the use of a true EBP model are provided.

scholarly journals Scoping review: occupational therapy interventions in primary care

2019 ◽  
Vol 20 ◽  
Author(s):  
Marije Bolt ◽  
Tiska Ikking ◽  
Rosa Baaijen ◽  
Stephanie Saenger
Keyword(s):  
Primary Care ◽  
Occupational Therapy ◽  
Randomized Control Trial ◽  
Literature Search ◽  
Relevant Literature ◽  
Case Series ◽  
Evidence Based ◽  
Randomized Control ◽  
Therapy Interventions ◽  
Occupational Therapy Interventions

AbstractThis is the second article in a series of two about occupational therapy and primary care. The first article (see PH&RD….) described the position of the profession in primary care across Europe and the scope of the profession. In this article the broad scope of the profession is illustrated with various examples of occupational therapy interventions. The interventions are identified by means of a literature search. A questionnaire (the questionnaire is available by mailing the author) was sent out to experts across Europe which resulted in both relevant literature and evidence-based examples. The evidence level of these examples differs from expert opinion (5), case series (4), case–controlled studies (3), cohort studies (2) and randomized-control trial (1). The article ends with recommendations in four areas how to develop, establish or strengthen the profession in primary care.

Sign in / Sign up

Export Citation Format

Share Document