Applicability of evidence from randomized controlled trials and systematic reviews to clinical practice: A conceptual review

This perspective provides an overview of the randomized controlled trials, systematic reviews, and evidence-based clinical practice guidelines in physical therapy. Data from the Physiotherapy Evidence Database (PEDro) are used to describe key events in the history of physical therapy research and the growth of evidence of effects of interventions used in the various subdisciplines of physical therapy. The 11,494 records that were identified reveal a rich history of physical therapy research dating back to the first trial in 1929. Most of the randomized controlled trials, systematic reviews, and evidence-based clinical practice guidelines in physical therapy have been published since the year 2000. This rapid growth presents a challenge for physical therapists who want to keep up to date in clinical practice.

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The Cochrane Skin Group: Promoting the Best Evidence

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540500900608 ◽

2005 ◽

Vol 9 (6) ◽

pp. 324-331

Author(s):

Avanta Collier ◽

Kathryn R. Johnson ◽

Finola Delamere ◽

Tina Leonard ◽

Robert P. Dellavalle ◽

...

Keyword(s):

Clinical Practice ◽

Randomized Controlled Trials ◽

Systematic Reviews ◽

Cochrane Collaboration ◽

Evidence Base ◽

Therapeutic Interventions ◽

Controlled Trials ◽

Randomized Controlled ◽

The Cochrane Collaboration ◽

Evidence Summaries

Background: The international Cochrane Skin group, established in 1997, organizes, writes and disseminates systematic reviews of therapeutic interventions in dermatology. ObjectiveTo introduce the Cochrane Skin Group and what it offers to cutaneous medicine and surgery providers. Methods: Descriptive review of the structure and output of the Cochrane Collaboration Library and the Cochrane Skin Group. Results: Systematic reviews of randomized controlled trials produced through the Cochrane Skin Group provide a benchmark for evidence summaries for informing clinical decisions in dermatology. Conclusion: The work performed by the Cochrane Skin Group is an important component for informing the evidence base for the clinical practice of cutaneous and surgical dermatology.

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Investigator initiated trials versus industry sponsored trials - translation of randomized controlled trials into clinical practice (IMPACT)

BMC Medical Research Methodology ◽

10.1186/s12874-021-01359-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anette Blümle ◽

Katharina Wollmann ◽

Karin Bischoff ◽

Philipp Kapp ◽

Szimonetta Lohner ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Practice ◽

Randomized Controlled Trials ◽

Systematic Reviews ◽

Controlled Trials ◽

Drug Trials ◽

Journal Articles ◽

Randomized Controlled ◽

Investigator Initiated Trials ◽

German Contribution

Abstract Background Healthcare decisions are ideally based on clinical trial results, published in study registries, as journal articles or summarized in secondary research articles. In this research project, we investigated the impact of academically and commercially sponsored clinical trials on medical practice by measuring the proportion of trials published and cited by systematic reviews and clinical guidelines. Methods We examined 691 multicenter, randomized controlled trials that started in 2005 or later and were completed by the end of 2016. To determine whether sponsorship/funding and place of conduct influence a trial’s impact, we created four sub-cohorts of investigator initiated trials (IITs) and industry sponsored trials (ISTs): 120 IITs and 171 ISTs with German contribution compared to 200 IITs and 200 ISTs without German contribution. We balanced the groups for study phase and place of conduct. German IITs were funded by the German Research Foundation (DFG), the Federal Ministry of Education and Research (BMBF), or by another non-commercial research organization. All other trials were drawn from the German Clinical Trials Register or ClinicalTrials.gov. We investigated, to what extent study characteristics were associated with publication and impact using multivariable logistic regressions. Results For 80% of the 691 trials, results were published as result articles in a medical journal and/or study registry, 52% were cited by a systematic review, and 26% reached impact in a clinical guideline. Drug trials and larger trials were associated with a higher probability to be published and to have an impact than non-drug trials and smaller trials. Results of IITs were more often published as a journal article while results of ISTs were more often published in study registries. International ISTs less often gained impact by inclusion in systematic reviews or guidelines than IITs. Conclusion An encouraging high proportion of the clinical trials were published, and a considerable proportion gained impact on clinical practice. However, there is still room for improvement. For publishing study results, study registries have become an alternative or complement to journal articles, especially for ISTs. IITs funded by governmental bodies in Germany reached an impact that is comparable to international IITs and ISTs.

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Cochrane Schizophrenia Group’s Study-Based Register of Randomized Controlled Trials: Development and Content Analysis

Schizophrenia Bulletin Open ◽

10.1093/schizbullopen/sgaa061 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Farhad Shokraneh ◽

Clive E Adams

Keyword(s):

Content Analysis ◽

Randomized Controlled Trials ◽

Systematic Reviews ◽

Research Policy ◽

Cochrane Review ◽

Gis Mapping ◽

Controlled Trials ◽

Policy And Practice ◽

Randomized Controlled ◽

Review Team

Abstract Background Study-based registers facilitate systematic reviews through shortening the process for review team and reducing considerable waste during the review process. Such a register also provides new insights about trends of trials in a sub-specialty. This paper reports development and content analysis of Cochrane Schizophrenia Group’s Study-Based Register. Methods The randomized controlled trials were collected through systematic searches of major information sources. Data points were extracted, curated and classified in the register. We report trends using regression analyses in Microsoft Excel and we used GIS mapping (GunnMap 2) to visualize the geographical distribution of the origin of schizophrenia trials. Results Although only 17% of trials were registered, the number of reports form registered trials is steadily increasing and registered trials produce more reports. Clinical trial registers are main source of trial reports followed by sub-specialty journals. Schizophrenia trials have been published in 23 languages from 90 countries while 105 nations do not have any reported schizophrenia trials. Only 9.7% of trials were included in at least one Cochrane review. Pharmacotherapy is the main target of trials while trials targeting psychotherapy are increasing in a continuous rate. The number of people randomized in trials is on average 114 with 60 being the most frequent sample size. Conclusions Curated datasets within the register uncover new patterns in data that have implications for research, policy, and practice for testing new interventions in trials or systematic reviews.

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Trends in randomized controlled trials in ENT: a 30-year review

The Journal of Laryngology & Otology ◽

10.1017/s0022215100138101 ◽

1997 ◽

Vol 111 (7) ◽

pp. 611-613 ◽

Cited By ~ 9

Author(s):

K. W. Ah-See ◽

N. C. Molony ◽

A. G. D. Maran

Keyword(s):

Clinical Trials ◽

Clinical Practice ◽

Randomized Controlled Trials ◽

Gold Standard ◽

Controlled Trials ◽

Evidence Based ◽

Controlled Clinical Trials ◽

Medline Search ◽

Randomized Controlled Clinical Trials ◽

Randomized Controlled

AbstractThere is a growth in the demand for clinical practice to be evidence based. Recent years have seen a rise in the number of randomized controlled clinical trials (RCTS). Such trials while acknowledged as the gold standard for evidence can be difficult to perform in surgical specialities. We have recently identified a low proportion of RCTS in the otolaryngology literature. Our aim was to identify any trend in the number of published RCTS within the ENT literature over a 30-year period and to identify which areas of our speciality lend themselves to this form of study design. A Medline search of 10 prominent journals published between 1966 and 1995 was performed. Two hundred and ninety-six RCTS were identified. Only five were published before 1980. Two hundred (71 per cent) of RCTS were in the areas of otology and rhinology. An encouraging trend is seen in RCTS within ENT literature.

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Which Randomized Controlled Trials Are Relevant to Clinical Practice?

Obstetrics and Gynecology ◽

10.1097/01.aog.0000173316.14537.7d ◽

2005 ◽

Vol 106 (2) ◽

pp. 216-218 ◽

Cited By ~ 5

Author(s):

John Collins

Keyword(s):

Clinical Practice ◽

Randomized Controlled Trials ◽

Controlled Trials ◽

Randomized Controlled

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Beware of the difference between randomized controlled trials and daily clinical practice (in reply to “Surgery or antibiotics for acute appendicitis? Take care about study’s design and methodology!”, by Ceresoli M, et al.)

Updates in Surgery ◽

10.1007/s13304-018-0540-6 ◽

2018 ◽

Vol 70 (4) ◽

pp. 565-567

Author(s):

Mauro Podda ◽

Gaetano Poillucci ◽

Nicola Cillara

Keyword(s):

Clinical Practice ◽

Acute Appendicitis ◽

Randomized Controlled Trials ◽

Daily Clinical Practice ◽

Controlled Trials ◽

Randomized Controlled ◽

The Difference

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Tools to Assess the External Validity of Randomized Controlled Trials in Systematic Reviews: a Systematic Review of Measurement Properties

10.21203/rs.3.rs-830181/v1 ◽

2021 ◽

Author(s):

Andres Jung ◽

Julia Balzer ◽

Tobias Braun ◽

Kerstin Luedtke

Keyword(s):

Randomized Controlled Trials ◽

Systematic Reviews ◽

External Validity ◽

Measurement Properties ◽

Controlled Trials ◽

Measurement Instruments ◽

Health Measurement ◽

Quality Of Evidence ◽

Randomized Controlled

Abstract Background: Internal and external validity are the most relevant components when critically appraising randomized controlled trials (RCTs) for systematic reviews. However, there is no gold standard to assess external validity. This might be related to the heterogeneity of terminology as well as to unclear evidence of the measurement properties of available tools. The aim of this review was to identify tools to assess the external validity of RCTs in systematic reviews and to evaluate the quality of evidence regarding their measurement properties.Methods: A two-phase systematic literature search was performed in four databases: MEDLINE via PubMed, Scopus, PsycINFO via OVID, and CINAHL via EBSCO. First, tools to assess the external validity of RCTs were identified. Second, studies aiming to investigate the measurement properties of these tools were selected. The measurement properties of each included tool were appraised using an adapted version of the COnsensus based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.Results: 34 publications reporting on the development or validation of 26 included tools were included. For 62% of the included tools, there was no evidence of any measurement property. For the remaining tools, reliability was assessed most frequently. Reliability was judged as “sufficient” for three tools (very low quality of evidence). Content validity was rated as “sufficient” for one tool (moderate quality of evidence).Conclusions: Based on these results, no available tool can be fully recommended to assess the external validity of RCTs in systematic reviews. Several steps are required to overcome the identified difficulties to either adapt and validate available tools or to develop a new one. There is a need for more research for this purpose.Trial registration: Prospective registration at Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/PTG4D

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Leveraging Data Science for a Personalized Haemodialysis

Kidney Diseases ◽

10.1159/000507291 ◽

2020 ◽

Vol 6 (6) ◽

pp. 385-394

Author(s):

Miguel Hueso ◽

Lluís de Haro ◽

Jordi Calabia ◽

Rafael Dal-Ré ◽

Cristian Tebé ◽

...

Keyword(s):

Clinical Practice ◽

Kidney Disease ◽

Personalized Medicine ◽

Data Collection ◽

Randomized Controlled Trials ◽

Data Science ◽

Controlled Trials ◽

Randomized Controlled ◽

Use Of Data ◽

The Right

Background: The 2019 Science for Dialysis Meeting at Bellvitge University Hospital was devoted to the challenges and opportunities posed by the use of data science to facilitate precision and personalized medicine in nephrology, and to describe new approaches and technologies. The meeting included separate sections for issues in data collection and data analysis. As part of data collection, we presented the institutional ARGOS e-health project, which provides a common model for the standardization of clinical practice. We also pay specific attention to the way in which randomized controlled trials offer data that may be critical to decision-making in the real world. The opportunities of open source software (OSS) for data science in clinical practice were also discussed. Summary: Precision medicine aims to provide the right treatment for the right patients at the right time and is deeply connected to data science. Dialysis patients are highly dependent on technology to live, and their treatment generates a huge volume of data that has to be analysed. Data science has emerged as a tool to provide an integrated approach to data collection, storage, cleaning, processing, analysis, and interpretation from potentially large volumes of information. This is meant to be a perspective article about data science based on the experience of the experts invited to the Science for Dialysis Meeting and provides an up-to-date perspective of the potential of data science in kidney disease and dialysis. Key messages: Healthcare is quickly becoming data-dependent, and data science is a discipline that holds the promise of contributing to the development of personalized medicine, although nephrology still lags behind in this process. The key idea is to ensure that data will guide medical decisions based on individual patient characteristics rather than on averages over a whole population usually based on randomized controlled trials that excluded kidney disease patients. Furthermore, there is increasing interest in obtaining data about the effectiveness of available treatments in current patient care based on pragmatic clinical trials. The use of data science in this context is becoming increasingly feasible in part thanks to the swift developments in OSS.

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