The Perversion of Scientific Evidence for Policy Advocacy: A Perspective on Avery 2010

Unelected administrative policymakers rely on the domain expertise and technical integrity of scientific information to maintain perceptions of legitimacy. The necessity that regulatory policymakers rely on sound scientific evidence has been formalized at the US federal level through executive order. Yet, the practical impact of scientific evidence on public support and mobilization for policies remains unclear. We investigate whether individual policy activists are more likely to participate in regulatory policymaking when a policy recommendation is substantiated by scientific evidence. We investigate how two separate groups within the public—policy advocates and policy experts—may be affected differentially by scientific evidence. In collaboration with a nationally active policy advocacy group, we conducted a randomized messaging experiment in which members of the group’s e-mail list are sent one of three versions of a policy advocacy message. Results indicate that reference to evidence published in peer reviewed scientific sources increased activism by roughly 1 percentage point among general activists, and decreased activism by 4-5 percentage points among scientific experts.

Download Full-text

Influenza Vaccine Effectiveness in Mainland China: A Systematic Review and Meta-Analysis

Vaccines ◽

10.3390/vaccines9020079 ◽

2021 ◽

Vol 9 (2) ◽

pp. 79

Author(s):

Xiaokun Yang ◽

Hongting Zhao ◽

Zhili Li ◽

Aiqin Zhu ◽

Minrui Ren ◽

...

Keyword(s):

Systematic Review ◽

Influenza Vaccine ◽

Influenza Season ◽

Meta Analysis ◽

Scientific Evidence ◽

Mainland China ◽

The Elderly ◽

Vaccine Effectiveness ◽

Newcastle Ottawa Scale ◽

Evidence For Policy

Influenza endangers human health but can be prevented in part by vaccination. Assessing influenza vaccine effectiveness (VE) provides scientific evidence for developing influenza vaccination policy. We conducted a systematic review and meta-analysis of studies that evaluated influenza VE in mainland China. We searched six relevant databases as of 30 August 2019 to identify studies and used Review Manager 5.3 software to analyze the included studies. The Newcastle–Ottawa scale was used to assess the risk of publication bias. We identified 1408 publications, and after removing duplicates and screening full texts, we included 21 studies in the analyses. Studies were conducted in Beijing, Guangzhou, Suzhou, and Zhejiang province from the 2010/11 influenza season through the 2017/18 influenza season. Overall influenza VE for laboratory confirmed influenza was 36% (95% CI: 25–46%). In the subgroup analysis, VE was 45% (95% CI: 18–64%) for children 6–35 months who received one dose of influenza vaccine, and 57% (95% CI: 50–64%) who received two doses. VE was 47% (95% CI: 39–54%) for children 6 months to 8 years, and 18% (95% CI: 0–33%) for adults ≥60 years. For inpatients, VE was 21% (95% CI: −11–44%). We conclude that influenza vaccines that were used in mainland China had a moderate effectiveness, with VE being higher among children than the elderly. Influenza VE should be continuously monitored in mainland China to provide evidence for policy making and improving uptake of the influenza vaccine.

Download Full-text

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00092 ◽

2020 ◽

Vol 5 (1) ◽

pp. 88-96

Author(s):

Mary R. T. Kennedy

Keyword(s):

College Students ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Sense Of Self ◽

Scientific Evidence ◽

Sudden Onset ◽

Lessons Learned ◽

Speech Language Pathologists ◽

The Brain ◽

Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

Download Full-text

Medical and Legal Issues Raised by the Protz Decision Issued by the Pennsylvania Supreme Court

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2017.julaug03 ◽

2017 ◽

Vol 22 (4) ◽

pp. 12-13

Author(s):

LuAnn Haley ◽

Marjorie Eskay-Auerbach

Keyword(s):

Supreme Court ◽

Scientific Evidence ◽

Workers Compensation ◽

Sixth Edition ◽

Complex Concept ◽

The Supreme Court ◽

Compensation Claims ◽

Recent Edition ◽

Impairment Ratings ◽

Definition Of

Abstract Pennsylvania adopted the impairment rating provisions described in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) in 1996 as an exposure cap for employers seeking predictability and cost control in workers’ compensation claims. In 2017, the Supreme Court of Pennsylvania handed down the Protz decision, which held that requiring physicians to apply the methodology set forth in the most recent edition of the AMA Guides reflected an unconstitutional delegation of legislative power to the American Medical Association. The decision eliminates the impairment-rating evaluation (IRE) mechanism under which claimants were assigned an impairment rating under the most recent edition of the AMA Guides. The AMA Guides periodically are revised to include the most recent scientific evidence regarding impairment ratings, and the AMA Guides, Sixth Edition, acknowledges that impairment is a complex concept that is not yet defined in a way that readily permits an evidence-based definition of assessment. The AMA Guides should not be considered standards frozen in time simply to withstand future scrutiny by the courts; instead, workers’ compensation acts could state that when a new edition of the AMA Guides is published, the legislature shall review and consider adopting the new edition. It appears unlikely that the Protz decision will be followed in other jurisdictions: Challenges to using the AMA Guides in assessing workers’ compensation claims have been attempted in three states, and all attempts failed.

Download Full-text

Comparative Analysis: The State of Colorado Study, Part II

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2004.marapr01 ◽

2004 ◽

Vol 9 (2) ◽

pp. 1-16

Author(s):

Christopher R. Brigham ◽

Kathryn Mueller ◽

Douglas Van Zet ◽

Debra J. Northrup ◽

Edward B. Whitney ◽

...

Keyword(s):

Daily Living ◽

Scientific Evidence ◽

Pain Syndrome ◽

Evidence Based ◽

Clinical Assessments ◽

Physician Judgment ◽

History Of ◽

Key Terms ◽

Causation Analysis ◽

Work Interference

Abstract [Continued from the January/February 2004 issue of The Guides Newsletter.] To understand discrepancies in reviewers’ ratings of impairments based on different editions of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), users can usefully study the history of the revisions as successive editions attempted to provide a comprehensive, valid, reliable, unbiased, and evidence-based system. Some shortcomings of earlier editions have been addressed in the AMA Guides, Fifth Edition, but problems remain with each edition, largely because of the limited scientific evidence available. In the context of the history of the different editions of the AMA Guides and their development, the authors discuss and contextualize a number of key terms and principles including the following: definitions of impairment and normal; activities of daily living; maximum medical improvement; impairment percentages; conversion of regional impairments; combining impairments; pain and other subjective complaints; physician judgment; and causation analysis; finally, the authors note that impairment is not synonymous with disability or work interference. The AMA Guides, Fifth Edition, contrasts impairment evaluations and independent medical evaluations (this was not done in previous editions) and discusses impairment evaluations, rules for evaluations, and report standards. Upper extremity and lower extremity impairment evaluations are discussed in terms of clinical assessments and rating processes, analyzing important changes between editions and problematic areas (eg, complex regional pain syndrome).

Download Full-text

The Role of Zinc in Thyroid Hormones Metabolism

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000262 ◽

2019 ◽

Vol 89 (1-2) ◽

pp. 80-88 ◽

Cited By ~ 6

Author(s):

Juliana Soares Severo ◽

Jennifer Beatriz Silva Morais ◽

Taynáh Emannuelle Coelho de Freitas ◽

Ana Letícia Pereira Andrade ◽

Mayara Monte Feitosa ◽

...

Keyword(s):

Thyroid Hormones ◽

Scientific Evidence ◽

Thyroid Stimulating Hormone ◽

Zinc Transporters ◽

Serum Concentrations ◽

Metabolic Adaptations ◽

Serum T3 ◽

Regulatory Effects ◽

Shed Light

Abstract. Thyroid hormones play an important role in body homeostasis by facilitating metabolism of lipids and glucose, regulating metabolic adaptations, responding to changes in energy intake, and controlling thermogenesis. Proper metabolism and action of these hormones requires the participation of various nutrients. Among them is zinc, whose interaction with thyroid hormones is complex. It is known to regulate both the synthesis and mechanism of action of these hormones. In the present review, we aim to shed light on the regulatory effects of zinc on thyroid hormones. Scientific evidence shows that zinc plays a key role in the metabolism of thyroid hormones, specifically by regulating deiodinases enzymes activity, thyrotropin releasing hormone (TRH) and thyroid stimulating hormone (TSH) synthesis, as well as by modulating the structures of essential transcription factors involved in the synthesis of thyroid hormones. Serum concentrations of zinc also appear to influence the levels of serum T3, T4 and TSH. In addition, studies have shown that Zinc transporters (ZnTs) are present in the hypothalamus, pituitary and thyroid, but their functions remain unknown. Therefore, it is important to further investigate the roles of zinc in regulation of thyroid hormones metabolism, and their importance in the treatment of several diseases associated with thyroid gland dysfunction.

Download Full-text