Evidence-based Medicine and Clinical Study Designs: Examples of Applications for Allergy Research

Evidence of the effect of clinical interventions in allergology, and in medicine as a whole, can be hierarchically grouped based on the research design producing the evidence. The most weight is given to systematic reviews and metaanalyses, and to randomised controlled trials. These trial designs are superior to non-randomised controlled trials and cohort studies, which in turn are superior to case-control studies. The least weight is given to case-studies and anecdotal evidence. Herein, the principles of evidence-based medicine and clinical study designs are reviewed in the context of examples from the allergology literature.

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Evidence biased psychiatry?

Psychiatric Bulletin ◽

10.1192/pb.25.8.290 ◽

2001 ◽

Vol 25 (8) ◽

pp. 290-291 ◽

Cited By ~ 5

Author(s):

David Healy

Keyword(s):

Evidence Based Medicine ◽

Randomised Controlled Trials ◽

Controlled Trials ◽

Evidence Based ◽

Bradford Hill ◽

The 1960S ◽

Randomised Controlled ◽

Based Medicine

For a variety of reasons evidence-based medicine is currently in vogue. The evidence most commonly appealed to comes from randomised controlled trials (RCTs), even though the creator of the RCT, Austin Bradford Hill, argued in the 1960s that while it was good to see some swing toward using RCTs, if we ever ended up thinking that RCTs were the only method to evaluate a treatment the pendulum would not only have swung too far, it would have come off its hook (Hill, 1966).

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Sollen wir Wasser trinken?

Nervenheilkunde ◽

10.1055/s-0038-1626403 ◽

2004 ◽

Vol 23 (08) ◽

pp. 435-437 ◽

Cited By ~ 3

Author(s):

Manfred Spitzer

Keyword(s):

Drinking Water ◽

Evidence Based Medicine ◽

Randomised Controlled Trials ◽

Large Scale ◽

Cochrane Library ◽

Controlled Trials ◽

Evidence Based ◽

Human Beings ◽

Randomised Controlled ◽

Based Medicine

Summary Aim: To decide whether drinking water is either effective in providing health benefits to human beings or increases the likelihood of injury and death among consumers. Design: A systematic review of randomised controlled trials was conducted according to standard ised criteria. Data sources: Medline, Embase, and the Cochrane Library Database. Study selection: Studies containing “water” and “health” in the abstract, thereby indicating their dealings with health associated benefits and risks of water consumption. Main outcome measure: Major changes in the status of health, as measured with various scores available on the internet (pick any of interest). Results: Studies on the effects of drinking water on health that meet the generally accepted criteria of evidence based medicine could not be identified. Conclusions: As with many interventions intended to prevent ill health, the effectiveness of drinking water has not been subjected to rigorous evaluation by using randomised controlled trials. This matter of fact is discussed using concepts from such diverse backgrounds as epidemiology (cohort effect), public health (need for large scale studies), medical economics (need to save money), medical ethics (bias effects) and social science (the dangers of medicalisation of drinking water). Within this complex framework it turns out that evidence based medicine is not without risks and sideeffects. It should therefore always be applied with reason.

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New Evidence is Required

The British Journal of Psychiatry ◽

10.1192/s0007125000147701 ◽

1997 ◽

Vol 171 (3) ◽

pp. 227-227 ◽

Cited By ~ 4

Author(s):

Glyn Lewis

Keyword(s):

Medical Practice ◽

Randomised Controlled Trials ◽

Scientific Evidence ◽

Controlled Trials ◽

Evidence Based ◽

Widespread Acceptance ◽

Standards Of Evidence ◽

Randomised Controlled ◽

Based Medicine ◽

New Evidence

What's new about evidence-based medicine? Medical practice has been based upon scientific evidence for some time, although the standards of evidence we require before using a treatment are becoming more stringent. EBM places more emphasis on evidence from randomised controlled trials (RCTs) than on clinical anecdote, but the notion that RCTs are the best evidence on the effectiveness of interventions has been around for nearly SO years. There is more emphasis now on systematic reviews and although they are not a new idea, their widespread acceptance has been a relatively recent phenomenon within medicine.

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Research made Easy: Answering Important Questions with Valid Designs

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1003 ◽

2012 ◽

Vol 46 (1) ◽

pp. 8-11

Author(s):

Harman Chaudhry ◽

Mohit Bhandari

Keyword(s):

Clinical Study ◽

Cohort Studies ◽

Case Reports ◽

Research Question ◽

Case Control ◽

Controlled Trials ◽

Case Control Studies ◽

Randomized Controlled ◽

Observational Cohort ◽

Study Designs

ABSTRACT Clinical research fundamentally involves finding answers to questions. Next to asking important questions, determining what type of study design to use is arguably the most pivotal step for a researcher. In this article, we provide an overview of various clinical study designs, including case reports and series, case-control studies, observational cohort studies, randomized controlled trials and systematic reviews. We aim to elucidate the utility, advantages and drawbacks of these study designs in order to assist researchers in selecting the most valid design for their research question. How to cite this article Chaudhry H, Bhandari M. Research made Easy: Answering Important Questions with Valid Designs. J Postgrad Med Edu Res 2012;46(1):8-11

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Evidence-based psychiatry

Oxford Handbook of Psychiatry ◽

10.1093/med/9780199693887.003.0004 ◽

2013 ◽

pp. 107-128

Keyword(s):

Cohort Studies ◽

Research Evidence ◽

Evidence Based Practice ◽

Treatment Decisions ◽

Case Control ◽

Controlled Trials ◽

Evidence Based ◽

Case Control Studies ◽

Based Medicine ◽

Economic Studies

Introduction Finding and appraising the evidence Systematic reviews (SRs) of RCTs Randomized controlled trials (RCTs) Case–control studies Cohort studies Diagnostic studies Qualitative studies Economic studies Applying the evidence to patients Measuring performance and implementing evidence-based practice Evidence-based medicine (EBM) is the application of research evidence to medical treatment decisions. Evidence-based practice aims to integrate the best available research evidence with individual clinical experience....

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

Canadian Journal of Occupational Therapy ◽

10.1177/000841749806500304 ◽

1998 ◽

Vol 65 (3) ◽

pp. 144-151 ◽

Cited By ~ 14

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.

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Breast Cancer Research to Support Evidence-Based Medicine in Nigeria: A Review of the Literature

JCO Global Oncology ◽

10.1200/go.20.00541 ◽

2021 ◽

pp. 384-390

Author(s):

Omolara A. Fatiregun ◽

Temiloluwa Oluokun ◽

Nwamaka N. Lasebikan ◽

Emmanuella Nwachukwu ◽

Abiola A. Ibraheem ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Research ◽

Randomized Controlled Trials ◽

Evidence Based Medicine ◽

Treatment Guidelines ◽

Breast Cancer Research ◽

Controlled Trials ◽

Evidence Based ◽

Randomized Controlled ◽

Based Medicine

PURPOSE Breast cancer is the most common malignancy in women worldwide. In Nigeria, it accounts for 22.7% of all new cancer cases among women. Evidence-based medicine (EBM) entails using the results from healthcare research to enhance the clinical decision-making process and develop evidence-based treatment guidelines. Level 1 and 2 studies, such as randomized controlled trials, meta-analyses, and systematic reviews of randomized controlled trials, yield more robust types of evidence. This study reviewed the levels of evidence of breast cancer publications in Nigeria. METHODS We conducted an electronic literature search of all studies published on breast cancer in Nigeria from January 1961 to August 2019. We reviewed all the articles found under the search term “Breast Cancer in Nigeria” on medical databases. RESULTS Our search identified 2,242 publications. One thousand two hundred fifty duplicates were removed, and 520 were excluded. A total of 472 articles were considered eligible for this review. Most of these articles were case series or reports (30.7%), qualitative studies (15.7%), followed by cross-sectional studies (13.3%), laboratory studies (12.9%), case-control studies (6.1%), case reports (7%), and cohort (5.7%). CONCLUSION Breast cancer research in Nigeria is yet to produce much evidence of the types considered to best support EBM. The scarcity of data hampers the implementation of EBM in Nigeria. Currently, most treatment guidelines are adapted from those developed in other countries, despite genetic differences among populations and different environmental influencing factors.

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