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Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". 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.
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting measurements that are expected to have some degree of error. The aim then is to use approaches from statistics to derive a pooled estimate closest to the unknown common truth based on how this error is perceived. It is thus a basic methodology of Metascience. Meta-analytic results are considered the most trustworthy source of evidence by the evidence-based medicine literature.
Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores (wounds) that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.
A randomized controlled trial is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical techniques, medical devices, diagnostic procedures or other medical treatments.
Cochrane is a British international charitable organisation formed to organise 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 approximately 30,000 volunteer experts from around the world.
In a blind or blinded experiment, information which may influence the participants of the experiment is withheld until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that arise from a participants' expectations, observer's effect on the participants, observer bias, confirmation bias, and other sources. A blind can be imposed on any participant of an experiment, including subjects, researchers, technicians, data analysts, and evaluators. In some cases, while blinding would be useful, it is impossible or unethical. For example, it is not possible to blind a patient to their treatment in a physical therapy intervention. A good clinical protocol ensures that blinding is as effective as possible within ethical and practical constraints.
Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the world. The most common symptoms are joint pain and stiffness. Usually the symptoms progress slowly over years. Other symptoms may include joint swelling, decreased range of motion, and, when the back is affected, weakness or numbness of the arms and legs. The most commonly involved joints are the two near the ends of the fingers and the joint at the base of the thumbs, the knee and hip joints, and the joints of the neck and lower back. The symptoms can interfere with work and normal daily activities. Unlike some other types of arthritis, only the joints, not internal organs, are affected.
In published academic research, publication bias occurs when the outcome of an experiment or research study biases the decision to publish or otherwise distribute it. Publishing only results that show a significant finding disturbs the balance of findings in favor of positive results. The study of publication bias is an important topic in metascience.
Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases, stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, abnormal heart rhythms, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.
Peripheral neuropathy, often shortened to neuropathy, is a general term describing damage or disease affecting the nerves. Damage to nerves may impair sensation, movement, gland, or organ function depending on which nerves are affected; in other words, neuropathy affecting motor, sensory, or autonomic nerves result in different symptoms. More than one type of nerve may be affected simultaneously. Peripheral neuropathy may be acute or chronic, and may be reversible or permanent.
Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. They recommend it to prevent infection in those at high risk, but not the general population. The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection. It is taken by mouth, either as a pill or liquid.
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, and summarizes interpretations into a refined 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).
Sir Iain Geoffrey Chalmers is a British health services researcher, one of the founders of the Cochrane Collaboration, and coordinator of the James Lind Initiative, which includes the James Lind Library and James Lind Alliance.
Peter Christian Gøtzsche is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark. He is a co-founder of the Cochrane Collaboration and has written numerous reviews for the organization. His membership in Cochrane was terminated by its Governing Board of Trustees on 25 September 2018.
The Jadad scale, sometimes known as Jadad scoring or the Oxford quality scoring system, is a procedure to assess the methodological quality of a clinical trial by objective criteria. It is named after Canadian-Colombian physician Alex Jadad who in 1996 described a system for allocating such trials a score of between zero and five (rigorous). It is the most widely used such assessment in the world, and as of 2022, its seminal paper has been cited in over 23,000 scientific works.
PRISMA is an evidence-based minimum set of items aimed at helping scientific authors to report a wide array of systematic reviews and meta-analyses, primarily used to assess the benefits and harms of a health care intervention. PRISMA focuses on ways in which authors can ensure a transparent and complete reporting of this type of research. The PRISMA standard superseded the earlier QUOROM standard. It offers the replicability of a systematic literature review. Researchers have to figure out research objectives that answer the research question, states the keywords, a set of exclusion and inclusion criteria. In the review stage, relevant articles were searched, irrelevant ones are removed. Articles are analyzed according to some pre-defined categories.
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.
The Centre for Evidence-Based Medicine (CEBM), based in the Nuffield Department of Primary Care Health Sciences at the University of Oxford, is an academic-led centre dedicated to the practice, teaching, and dissemination of high quality evidence-based medicine to improve healthcare in everyday clinical practice. CEBM was founded by David Sackett in 1995. It was subsequently directed by Brian Haynes and Paul Glasziou. Since 2010 it has been led by Professor Carl Heneghan, a clinical epidemiologist and general practitioner.
Julian P. T. Higgins is a British biostatistician, Professor of Evidence Synthesis and Director of Research at the Department of Population Health Sciences at the University of Bristol. Higgins was previously Chair in Evidence Synthesis at the University of York, and Programme Leader at the MRC Biostatistics Unit in Cambridge. He is also a founding trustee and a Past-President of the Society for Research Synthesis Methodology.
References
- ↑ Earl-Slater A (2002). The Handbook of Clinical Trials and Other Research. Radcliffe Publishing Ltd. ISBN 978-1-85775-485-8.
- ↑ Porta M, Last JM (2008). Dictionary of Epidemiology (5 ed.). OUP USA. ISBN 978-0-19-531450-2.
- ↑ Higgins JP, Green S, eds. (September 2008). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration.
- ↑ Downes MJ, Brennan ML, Williams HC, Dean RS (December 2016). "Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS)". BMJ Open. 6 (12): e011458. doi:10.1136/bmjopen-2016-011458. PMC 5168618 . PMID 27932337.
- 1 2 "Critical Appraisal Tools". Joanna Briggs Institute (JBI). Archived from the original on 1 April 2020. Retrieved 2019-02-24.
- 1 2 Cowie K, Rahmatullah A, Hardy N, Holub K, Kallmes K (2022). "Web-Based Software Tools for Systematic Literature Review in Medicine: Systematic Search and Feature Analysis". JMIR. 10 (5): e33219. doi: 10.2196/33219 . PMC 9112080 . PMID 35499859.
- ↑ Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. (October 2011). "The Cochrane Collaboration's tool for assessing risk of bias in randomised trials". BMJ. 343: d5928. doi:10.1136/bmj.d5928. PMC 3196245 . PMID 22008217.
- ↑ Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. (August 2019). "RoB 2: a revised tool for assessing risk of bias in randomised trials". BMJ. 366: l4898. doi: 10.1136/bmj.l4898 . PMID 31462531.
- ↑ "CASP Checklists". Critical Appraisal Skills Programme (CASP). Retrieved 2019-02-24.
- ↑ Naicker R (2022-12-19). "Critically appraising for antiracism". Education for Information. 38 (4): 291–308. doi: 10.3233/EFI-220052 . S2CID 253128079.
- ↑ Harfield S, Pearson O, Morey K, Kite E, Canuto K, Glover K, et al. (April 2020). "Assessing the quality of health research from an Indigenous perspective: the Aboriginal and Torres Strait Islander quality appraisal tool". BMC Medical Research Methodology. 20 (1): 79. doi: 10.1186/s12874-020-00959-3 . PMC 7147059 . PMID 32276606.