Evidence-based Medicine[JOURNAL]

Sun 200 papers

RSS

Placebo might be superior to antipsychotics in management of delirium in the palliative care setting.

Boettger S, Jenewein J

Evid Based Med · 2017 Aug · PMID 28637684 · Publisher ↗

Abstract loading — click title to view on PubMed.

Get PDF PubMed ↗

Grading evidence from test accuracy studies: what makes it challenging compared with the grading of effectiveness studies?

Rogozińska E, Khan K

Evid Based Med · 2017 Jun · PMID 28600330 · Publisher ↗

Guideline panels need to process a sizeable amount of information to issue a decision on whether to recommend a health technology or not. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) is bein... Guideline panels need to process a sizeable amount of information to issue a decision on whether to recommend a health technology or not. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) is being frequently applied in guideline development to facilitate this task, typically for the synthesis of effectiveness research. Questions regarding the accuracy of medical tests are ubiquitous, and they temporally precede questions about therapy. However, literature summarising the experience of applying GRADE approach to accuracy evaluations is not as rich as one for effectiveness evidence. Type of study design (cross-sectional), two-dimensional nature of the performance measures (sensitivity and specificity), propensity towards a higher level of between-study heterogeneity, poor reporting of quality features and uncertainty about how best to assess for publication bias among other features make this task challenging. This article presents solutions adopted to addresses above challenges for judicious estimation of the strength of test accuracy evidence used to inform evidence syntheses for guideline development.

Get PDF PubMed ↗

High-intensity exercise offers no additional benefit to moderate-intensity exercise in reducing liver fat in patients with non-alcoholic fatty liver disease.

Cuthbertson DJ, Sprung VS

Evid Based Med · 2017 Jun · PMID 28578313 · Publisher ↗

Abstract loading — click title to view on PubMed.

Get PDF PubMed ↗

How good is the evidence to support primary care practice?

Ebell MH, Sokol R, Lee A … +2 more , Simons C, Early J

Evid Based Med · 2017 Jun · PMID 28554944 · Publisher ↗

Our goal was to determine the extent to which recommendations for primary care practice are informed by high-quality research-based evidence, and the extent to which they are based on evidence of improved health outcomes... Our goal was to determine the extent to which recommendations for primary care practice are informed by high-quality research-based evidence, and the extent to which they are based on evidence of improved health outcomes (patient-oriented evidence). As a substrate for study, we used Essential Evidence, an online, evidence-based, medical reference for generalists. Each of the 721 chapters makes overall recommendations for practice that are graded A, B or C using the Strength of Recommendations Taxonomy (SORT). SORT A represents consistent and good quality patient-oriented evidence; SORT B is inconsistent or limited quality patient-oriented evidence and SORT C is expert opinion, usual practice or recommendations relying on surrogate or intermediate outcomes. Pairs of researchers abstracted the evidence ratings for each chapter in tandem, with discrepancies resolved by the lead author. Of 3251 overall recommendations, 18% were graded 'A', 34% were 'B' and 49% were 'C'. Clinical categories with the most 'A' recommendations were pregnancy and childbirth, cardiovascular, and psychiatric; those with the least were haematological, musculoskeletal and rheumatological, and poisoning and toxicity. 'A' level recommendations were most common for therapy and least common for diagnosis. Only 51% of recommendations are based on studies reporting patient-oriented outcomes, such as morbidity, mortality, quality of life or symptom reduction. In conclusion, approximately half of the recommendations for primary care practice are based on patient-oriented evidence, but only 18% are based on patient-oriented evidence from consistent, high-quality studies.

Get PDF PubMed ↗