Does the packaging of health information affect the assessment of its reliability? A randomized controlled trial protocol

Background Wikipedia is frequently used as a source of health information. However, the quality of its content varies widely across articles. The DISCERN tool is a brief questionnaire developed in 1996 by the Division of Public Health and Primary Health Care of the Institute of Health Sciences of the University of Oxford. They claim it provides users with a valid and reliable way of assessing the quality of written information. However, the DISCERN instrument’s reliability in measuring the quality of online health information, particularly whether or not its scores are affected by reader biases about specific publication sources, has not yet been explored. Methods This study is a double-blind randomized assessment of a Wikipedia article versus a BMJ literature review using a modified version of the DISCERN tool. Participants will include physicians and medical residents from four university campuses in Ontario and British Columbia and will be randomized into one of four study arms. Inferential statistics tests (paired t-test, multi-level ordinal regression, and one-way ANOVA) will be conducted with the data collected from the study. Outcomes The primary outcome of this study will be to determine whether a statistically significant difference in DISCERN scores exists, which could suggest whether or not how health information is packaged influences how it is assessed for quality. Plain Language Summary The internet, and in particular Wikipedia, is an important way for professionals, students and the public to obtain health information. For this reason, the DISCERN tool was developed in 1996 to help users assess the quality of the health information they find. The ability of DISCERN to measure the quality of online health information has been supported with research, but the role of bias has not necessarily been accounted for. Does how the information is packaged influence how the information itself is evaluated? This study will compare the scores assigned to articles in their original format to the same articles in a modified format in order to determine whether the DISCERN tool is able to overcome bias. A significant difference in ratings between original and inverted articles will suggest that the DISCERN tool lacks the ability to overcome bias related to how health information is packaged.

Incidental Finding of Complete Bilateral Persistent Sciatic Arteries

Persistence of bilateral sciatic arteries (PSA) is a rare congenital vascular anomaly. We report an exceptionally rare case of complete bilateral persistent sciatic arteries, diagnosed incidentally on computed tomography angiography (CTA) in a young female patient who sustained a gunshot wound to the lower limb. The embryology, variants, clinical and imaging findings, potential complications, and treatment options are discussed. PSAs, found incidentally, are unlikely to have clinical significance, however, the unusual anatomy and higher incidence of future complications requires accurate reporting of such variants.

History of penicillin

The history of penicillin was shaped by the contributions of numerous scientists. The ultimate result was the discovery of the mould Penicillium's antibacterial activity and the subsequent development of penicillins, the most widely used antibiotics. Following an accidental discovery of the mould, later identified as Penicillium rubens, as the source of the antibacterial principle (1928) and the production of a pure compound (1942), penicillin became the first naturally derived antibiotic. There is anecdotal evidence of ancient societies using moulds to treat infections and of awareness that various moulds inhibited bacterial growth. However, it is not clear if Penicillium species were the species traditionally used or if the antimicrobial substances produced were penicillin. In 1928, Alexander Fleming was the first to discover the antibacterial substance secreted by the Penicillium mould and concentrate the active substance involved, giving it the name penicillin. His success in treating Harry Lambert's streptococcal meningitis, an infection until then fatal, proved to be a critical moment in the medical use of penicillin. Many later scientists were involved in the stabilisation and mass production of penicillin and in the search for more productive strains of Penicillium. Among the most important were Ernst Chain and Howard Florey, who shared with Fleming the 1945 Nobel Prize in Physiology or Medicine.

Phage Therapy

Phage therapy refers to the use of bacteriophages (phages - bacterial viruses) as therapeutic agents against infectious bacterial diseases. This therapeutic approach emerged in the beginning of the 20th century but was progressively replaced by the use of antibiotics in most parts of the world after the second world war. More recently however, the alarming rise of multidrug-resistant bacteria and the consequent need for antibiotic alternatives has renewed interest in phages as antimicrobial agents. Several scientific, technological and regulatory advances have supported the credibility of a second revolution in phage therapy. Nevertheless, phage therapy still faces many challenges that include: i) the need to increase phage collections from reference phage banks; ii) the development of efficient phage screening methods for the fast identification of the therapeutic phage(s); iii) the establishment of efficient phage therapy strategies to tackle infectious biofilms; iv) the validation of feasible phage production protocols that assure quality and safety of phage preparations; and (v) the guarantee of stability of phage preparations during manufacturing, storage and transport. Moreover, current maladapted regulatory structures represent a significant hurdle for potential commercialization of phage therapeutics. This article describes the past and current status of phage therapy and presents the most recent advances in this domain.

What are Systematic Reviews?

Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question. While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively. Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine, and a review of existing studies is often quicker and cheaper than embarking on a new study. While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful. Systematic reviews may examine clinical tests, public health interventions, environmental interventions, social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations. An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.