In medical research, an umbrella review is a review of systematic reviews or meta-analyses. [1] [2] [3] They may also be called overviews of reviews, reviews of reviews, summaries of systematic reviews, or syntheses of reviews. [1] Umbrella reviews are among the highest levels of evidence currently available in medicine. [2]
By summarizing information from multiple overview articles, umbrella reviews make it easier to review the evidence and allow for comparison of results between each of the individual reviews. [1] Umbrella reviews may address a broader question than a typical review, such as discussing multiple different treatment comparisons instead of only one. [1] [3] They are especially useful for developing guidelines and clinical practice, and when comparing competing interventions. [1] [3]
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. ... [It] means integrating individual clinical expertise with the best available external clinical evidence from systematic research." The aim of EBM is to integrate the experience of the clinician, the values of the patient, and the best available scientific information to guide decision-making about clinical management. The term was originally used to describe an approach to teaching the practice of medicine and improving decisions by individual physicians about individual patients.
Multiple sclerosis (MS) is an autoimmune disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. Being a demyelinating disease, MS disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. Symptoms include double vision, vision loss, eye pain, muscle weakness, and loss of sensation or coordination. MS takes several forms, with new symptoms either occurring in isolated attacks or building up over time. In relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances. In progressive forms of MS, bodily function slowly deteriorates once symptoms manifest and will steadily worsen if left untreated.
Meta-analysis is a method of synthesis of quantitative data from multiple independent studies addressing a common research question. An important part of this method involves computing a combined effect size across all of the studies. As such, this statistical approach involves extracting effect sizes and variance measures from various studies. By combining these effect sizes the statistical power is improved and can resolve uncertainties or discrepancies found in individual studies. Meta-analyses are integral in supporting research grant proposals, shaping treatment guidelines, and influencing health policies. They are also pivotal in summarizing existing research to guide future studies, thereby cementing their role as a fundamental methodology in metascience. Meta-analyses are often, but not always, important components of a systematic review.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and developmentally-inappropriate.
Cochrane is a British international charitable organisation formed to synthesize medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers. It includes 53 review groups that are based at research institutions worldwide. Cochrane has over 37,000 volunteer experts from around the world.
The Mediterranean diet is a concept first invented in 1975 by the American biologist Ancel Keys and chemist Margaret Keys. The diet took inspiration from the supposed eating habits and traditional food typical of Crete, much of the rest of Greece, and southern Italy, and formulated in the early 1960s. It is distinct from Mediterranean cuisine, which covers the actual cuisines of the Mediterranean countries, and from the Atlantic diet of northwestern Spain and Portugal. While inspired by a specific time and place, the "Mediterranean diet" was later refined based on the results of multiple scientific studies.
Probiotics are live microorganisms promoted with claims that they provide health benefits when consumed, generally by improving or restoring the gut microbiota. Probiotics are considered generally safe to consume, but may cause bacteria-host interactions and unwanted side effects in rare cases. There is some evidence that probiotics are beneficial for some conditions, such as helping to ease some symptoms of irritable bowel syndrome (IBS). However, many claimed health benefits, such as treating eczema, lack substantial scientific support.
A plant-based diet is a diet consisting mostly or entirely of plant-based foods. Plant-based diets encompass a wide range of dietary patterns that contain low amounts of animal products and high amounts of fiber-rich plant products such as vegetables, fruits, whole grains, legumes, nuts and seeds. They do not need to be vegan or vegetarian, but are defined in terms of low frequency of animal food consumption.
Indigestion, also known as dyspepsia or upset stomach, is a condition of impaired digestion. Symptoms may include upper abdominal fullness, heartburn, nausea, belching, or upper abdominal pain. People may also experience feeling full earlier than expected when eating. Indigestion is relatively common, affecting 20% of people at some point during their life, and is frequently caused by gastroesophageal reflux disease (GERD) or gastritis.
In gastronomy, red meat is commonly red when raw, in contrast to white meat, which is pale in color before cooking. In culinary terms, only flesh from mammals or fowl is classified as red or white. In nutritional science, red meat is defined as any meat that has more of the protein myoglobin than white meat. White meat is defined as non-dark meat from fish or chicken.
A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on the topic, then analyzes, describes, critically appraises and summarizes interpretations into a refined evidence-based conclusion. For example, a systematic review of randomized controlled trials is a way of summarizing and implementing evidence-based medicine.
A hierarchy of evidence, comprising levels of evidence (LOEs), that is, evidence levels (ELs), is a heuristic used to rank the relative strength of results obtained from experimental research, especially medical research. There is broad agreement on the relative strength of large-scale, epidemiological studies. More than 80 different hierarchies have been proposed for assessing medical evidence. The design of the study and the endpoints measured affect the strength of the evidence. In clinical research, the best evidence for treatment efficacy is mainly from meta-analyses of randomized controlled trials (RCTs). Systematic reviews of completed, high-quality randomized controlled trials – such as those published by the Cochrane Collaboration – rank the same as systematic review of completed high-quality observational studies in regard to the study of side effects. Evidence hierarchies are often applied in evidence-based practices and are integral to evidence-based medicine (EBM).
Multimorbidity, also known as multiple long-term conditions (MLTC), means living with two or more chronic illnesses. For example, a person could have diabetes, heart disease and depression at the same time. Multimorbidity can have a significant impact on people's health and wellbeing. It also poses a complex challenge to healthcare systems which are traditionally focused on individual diseases. Multiple long-term conditions can affect people of any age, but they are more common in older age, affecting more than half of people over 65 years old.
Many dietary recommendations have been proposed to reduce the risk of cancer, few have significant supporting scientific evidence. Obesity and drinking alcohol have been correlated with the incidence and progression of some cancers. Lowering the consumption of sweetened beverages is recommended as a measure to address obesity.
A review article is an article that summarizes the current state of understanding on a topic within a certain discipline. A review article is generally considered a secondary source since it may analyze and discuss the method and conclusions in previously published studies. It resembles a survey article or, in news publishing, overview article, which also surveys and summarizes previously published primary and secondary sources, instead of reporting new facts and results. Survey articles are however considered tertiary sources, since they do not provide additional analysis and synthesis of new conclusions. A review of such sources is often referred to as a tertiary review.
John P. A. Ioannidis is a Greek-American physician-scientist, writer and Stanford University professor who has made contributions to evidence-based medicine, epidemiology, and clinical research. Ioannidis studies scientific research itself - in other words, meta-research - primarily in clinical medicine and the social sciences.
Evidence-based dentistry (EBD) is the dental part of the more general movement toward evidence-based medicine and other evidence-based practices. The pervasive access to information on the internet includes different aspects of dentistry for both the dentists and patients. This has created a need to ensure that evidence referenced to are valid, reliable and of good quality.
The discipline of evidence-based toxicology (EBT) strives to transparently, consistently, and objectively assess available scientific evidence in order to answer questions in toxicology, the study of the adverse effects of chemical, physical, or biological agents on living organisms and the environment, including the prevention and amelioration of such effects. EBT has the potential to address concerns in the toxicological community about the limitations of current approaches to assessing the state of the science. These include concerns related to transparency in decision making, synthesis of different types of evidence, and the assessment of bias and credibility. Evidence-based toxicology has its roots in the larger movement towards evidence-based practices.
Metascience is the use of scientific methodology to study science itself. Metascience seeks to increase the quality of scientific research while reducing inefficiency. It is also known as "research on research" and "the science of science", as it uses research methods to study how research is done and find where improvements can be made. Metascience concerns itself with all fields of research and has been described as "a bird's eye view of science". In the words of John Ioannidis, "Science is the best thing that has happened to human beings ... but we can do it better."
The relationships between digital media use and mental health have been investigated by various researchers—predominantly psychologists, sociologists, anthropologists, and medical experts—especially since the mid-1990s, after the growth of the World Wide Web and rise of text messaging. A significant body of research has explored "overuse" phenomena, commonly known as "digital addictions", or "digital dependencies". These phenomena manifest differently in many societies and cultures. Some experts have investigated the benefits of moderate digital media use in various domains, including in mental health, and the treatment of mental health problems with novel technological solutions.