-
Mashup Score: 0Pharmacological interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units: a network meta-analysis - 4 hour(s) ago
Objectives To assess the efficacy and safety of pharmacological interventions for preventing upper gastrointestinal (GI) bleeding in people admitted to intensive care units (ICUs). Design and setting Systematic review and frequentist network meta-analysis using standard methodological procedures as recommended by Cochrane for screening of records, data extraction and analysis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence. Participants Randomised controlled trials involving patients admitted to ICUs for longer than 24 hours were included. Search methods The Cochrane Gut Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Latin American and Caribbean Health Science Information database (LILACS) databases were searched from August 2017 to March 2022. The search in MEDLINE was updated in April 2023. We also searched ClinicalTrials.gov and the World Health O
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet
-
Mashup Score: 1540Risk ratios, odds ratios and the risk difference - 1 day(s) ago
### Scenario As a heart surgeon, you regularly perform aortic valve replacement, using a median sternotomy technique. However, you are aware that less-invasive options are available, and you wonder whether these may be as effective and safe as your current practice. After searching the Cochrane Library, you find a systematic review, ‘Limited versus full sternotomy for aortic valve replacement1’. The authors of the review conclude that ‘upper hemi‐sternotomy may have little to no effect on mortality versus full median sternotomy (risk ratio (RR) 0.93, 95% CI 0.45 to 1.94)’. What does this statistic mean in practice? The risk ratio (also known as RR) illustrates the risk of an event occurring in the intervention group compared with the risk of the same event occurring in the control group. For example, in a hypothetical randomised controlled trial (RCT), 50 out of 100 people who received the experimental drug experienced at least one side effect: the risk (or probability) of the event wa
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Risk ratios, odds ratios and the risk difference #Education by @racherichardson @dwan_kerry @afkanellopoulou @cochranecollab @cochranemthds Link: https://t.co/k7P0aTW1kQ https://t.co/iCUtG2wSMz
-
-
Mashup Score: 19
Binary outcomes, such as mortality and myocardial infarction, are often viewed as most important to patients. However, outcomes that are expressed on a non-dichotomous scale such as quality of life, severity of depression or length of hospitalization, can also be critical to patients. For the purposes of this paper, all of the above examples will be referred to as continuous outcomes. While many binary outcomes are dichotomised from a continuous scale and in some cases can accommodate non-linear associations, such dichotomisation can also lead to loss of information.1 Measures of dispersion (eg, SD or SE) required for conducting a meta-analysis of continuous outcomes are often unavailable in published manuscripts and continuous outcomes are frequently under-reported in published randomised controlled trials, presented with limited details and are at higher likelihood of selective reporting bias.2 Because of these challenges and the unique characteristics of continuous outcomes, we pres
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Meta-analysis of continuous outcomes: a user’s guide for analysis and interpretation #Education by Siedler @EBMUrology et al. @evidencefound @USGRADEnet Link: https://t.co/zsDRlvDx2f https://t.co/9YNA7kLvFM
-
-
Mashup Score: 54Stop searching and you will find it: Search-Resistant Concepts in systematic review searches - 3 day(s) ago
#### WHAT IS ALREADY KNOWN ON THIS TOPIC #### WHAT THIS STUDY ADDS #### HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY Most evidence synthesis projects involving systematic reviewing need a written protocol containing a detailed or brief description of the main review question and its concepts.1 To formulate an answerable question, it is recommended that reviewers follow one of the established frameworks2 that guides them through a better definition and understanding of the review question. The most used framework is known as the PICOS acronym, which stands for its components or concepts: patient, problem or population (P), intervention or index test (I), control or comparison (C), outcome (O) and study design (S). This framework has some limitations,3 and since one size does not fit all and depends on the type of review, study designs and specific needs, many other frameworks and their acronyms have been developed.2 4 While such frameworks help structure the review question,
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Stop searching and you will find it: Search-Resistant Concepts in systematic review searches Education by @FarhadShokrane @EvidenceReviews Link: https://t.co/PAsW4sLzQW https://t.co/dHiMwD7ADt
-
-
Mashup Score: 234
Diagnostic tests are frequently applied within clinical practice to assist with disease diagnosis, differential diagnosis, disease grading and prognosis evaluation. Receiver operating characteristic (ROC) curve analysis is one common approach for analysing discriminative performance of a diagnostic test, where it can determine the optimal cut-off value with the best diagnostic performance.1 However, as a majority of clinicians are non-statisticians, several errors have been observed in clinical research when applying ROC curves. These errors may be misleading in the selection of diagnostic tests and disease diagnosis, thus adding to patient burden. To address these errors, clinicians do not need a deep understanding of the intricate mathematical formulas of ROC analysis, but should develop basic knowledge and skills to prevent or avoid commonly overlooked mistakes. This article aims to guide clinicians to avoid common pitfalls in ROC analysis. The ROC curve is a graphical representatio
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Four overlooked errors in ROC analysis: how to prevent and avoid #Education by He et al. #OpenAccess Link: https://t.co/zF0RzmFbrj https://t.co/XOr1oBWGPH
-
-
Mashup Score: 31Developing guideline recommendations about tests: educational examples of test-management pathways - 5 day(s) ago
Recommendations about healthcare related testing in guidelines are common. Tests can be used for several purposes: screening, surveillance, risk classification, diagnosis, staging, treatment triage, determination of prognosis and monitoring/follow-up.1 The development of testing recommendations in guidelines is challenging, especially because the benefit of a test not only depends on test characteristics, such as sensitivity and specificity, but also on population characteristics and test consequences, such as management.2–4 Furthermore, the role of a new test in comparison to the existing testing scenario should be defined, since this influences the interpretation of the new test’s value. The following roles of new tests have been identified in the literature: triage, replacement, add-on, and parallel/combined.5 As with treatment, testing can have negative consequences, including physical impairment, psychological distress, disease labelling, and costs.6 There is limited evidence on h
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
How to best convey continuous outcomes in patient decision aids #Analysis by @glynelwyn et al. Link: https://t.co/T2hY9EMYfs https://t.co/6i9iBqzi46
-
-
Mashup Score: 54Stop searching and you will find it: Search-Resistant Concepts in systematic review searches - 7 day(s) ago
#### WHAT IS ALREADY KNOWN ON THIS TOPIC #### WHAT THIS STUDY ADDS #### HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY Most evidence synthesis projects involving systematic reviewing need a written protocol containing a detailed or brief description of the main review question and its concepts.1 To formulate an answerable question, it is recommended that reviewers follow one of the established frameworks2 that guides them through a better definition and understanding of the review question. The most used framework is known as the PICOS acronym, which stands for its components or concepts: patient, problem or population (P), intervention or index test (I), control or comparison (C), outcome (O) and study design (S). This framework has some limitations,3 and since one size does not fit all and depends on the type of review, study designs and specific needs, many other frameworks and their acronyms have been developed.2 4 While such frameworks help structure the review question,
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Stop searching and you will find it: Search-Resistant Concepts in systematic review searches Education by @FarhadShokrane @EvidenceReviews Link: https://t.co/PAsW4sLzQW https://t.co/dHiMwD7ADt
-
-
Mashup Score: 19
Binary outcomes, such as mortality and myocardial infarction, are often viewed as most important to patients. However, outcomes that are expressed on a non-dichotomous scale such as quality of life, severity of depression or length of hospitalization, can also be critical to patients. For the purposes of this paper, all of the above examples will be referred to as continuous outcomes. While many binary outcomes are dichotomised from a continuous scale and in some cases can accommodate non-linear associations, such dichotomisation can also lead to loss of information.1 Measures of dispersion (eg, SD or SE) required for conducting a meta-analysis of continuous outcomes are often unavailable in published manuscripts and continuous outcomes are frequently under-reported in published randomised controlled trials, presented with limited details and are at higher likelihood of selective reporting bias.2 Because of these challenges and the unique characteristics of continuous outcomes, we pres
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Meta-analysis of continuous outcomes: a user’s guide for analysis and interpretation #Education by Siedler @EBMUrology et al. @evidencefound @USGRADEnet Link: https://t.co/zsDRlvDx2f https://t.co/9YNA7kLvFM
-
-
Mashup Score: 1543Risk ratios, odds ratios and the risk difference - 9 day(s) ago
### Scenario As a heart surgeon, you regularly perform aortic valve replacement, using a median sternotomy technique. However, you are aware that less-invasive options are available, and you wonder whether these may be as effective and safe as your current practice. After searching the Cochrane Library, you find a systematic review, ‘Limited versus full sternotomy for aortic valve replacement1’. The authors of the review conclude that ‘upper hemi‐sternotomy may have little to no effect on mortality versus full median sternotomy (risk ratio (RR) 0.93, 95% CI 0.45 to 1.94)’. What does this statistic mean in practice? The risk ratio (also known as RR) illustrates the risk of an event occurring in the intervention group compared with the risk of the same event occurring in the control group. For example, in a hypothetical randomised controlled trial (RCT), 50 out of 100 people who received the experimental drug experienced at least one side effect: the risk (or probability) of the event wa
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Risk ratios, odds ratios and the risk difference #Education by @racherichardson @dwan_kerry @afkanellopoulou @cochranecollab @cochranemthds Link: https://t.co/k7P0aTW1kQ https://t.co/iCUtG2wSMz
-
-
Mashup Score: 2Pharmacological interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units: a network meta-analysis - 10 day(s) ago
Objectives To assess the efficacy and safety of pharmacological interventions for preventing upper gastrointestinal (GI) bleeding in people admitted to intensive care units (ICUs). Design and setting Systematic review and frequentist network meta-analysis using standard methodological procedures as recommended by Cochrane for screening of records, data extraction and analysis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence. Participants Randomised controlled trials involving patients admitted to ICUs for longer than 24 hours were included. Search methods The Cochrane Gut Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Latin American and Caribbean Health Science Information database (LILACS) databases were searched from August 2017 to March 2022. The search in MEDLINE was updated in April 2023. We also searched ClinicalTrials.gov and the World Health O
Source: ebm.bmj.comCategories: General Medicine News, PayerTweet-
Pharmacological interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units: a network meta-analysis #OriginalResearch by Toews et al. #OpenAccess Link: https://t.co/nl016iKRB2 https://t.co/I8RHQuYi5r
-
Pharmacological interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units: a network meta-analysis #OriginalResearch by Toews et al. #OpenAccess Link: https://t.co/nl016iKRB2 https://t.co/I8RHQuYi5r