Pub Date : 2017-12-01Epub Date: 2017-11-23DOI: 10.1136/ebmed-2017-110854
David Nunan, Jack O'Sullivan, Carl Heneghan, Annette Pluddemann, Jeffrey Aronson, Kamal Mahtani
In this article we signpost readers to 10 papers we consider essential reading for anyone starting out on an evidence-based medicine journey. We have considered papers consisting a mix of old and new, seminal and cutting-edge that offer insight into what evidence-based medicine is, where it came from, why it matters and what it has achieved. This is balanced against some of the common criticisms of evidence-based medicine and efforts to tackle them. We have also highlighted papers acknowledging the importance of teaching and learning of the principles of evidence-based medicine and how health professionals can better use evidence in clinical decisions with patients.
{"title":"Ten essential papers for the practice of evidence-based medicine.","authors":"David Nunan, Jack O'Sullivan, Carl Heneghan, Annette Pluddemann, Jeffrey Aronson, Kamal Mahtani","doi":"10.1136/ebmed-2017-110854","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110854","url":null,"abstract":"<p><p>In this article we signpost readers to 10 papers we consider essential reading for anyone starting out on an evidence-based medicine journey. We have considered papers consisting a mix of old and new, seminal and cutting-edge that offer insight into what evidence-based medicine is, where it came from, why it matters and what it has achieved. This is balanced against some of the common criticisms of evidence-based medicine and efforts to tackle them. We have also highlighted papers acknowledging the importance of teaching and learning of the principles of evidence-based medicine and how health professionals can better use evidence in clinical decisions with patients.</p>","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"202-204"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110854","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35634299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-09-18DOI: 10.1136/ebmed-2017-110768
David Hubacher
Commentary on: Diedrich JT, Klein DA, Peipert JF, et al . Long-acting reversible contraception in adolescents: a systematic review and meta-analysis. Am J Obstet Gynecol 2017;216:364.e1-364.e12. Long-acting reversible contraception (LARC) consists of intrauterine devices and subdermal implants. LARC is in the highest tier of effectiveness and once started, most women tend to be satisfied and use it for long durations. Historically, LARC use has been concentrated in older, higher parity populations. Dissatisfaction or weariness with shorter-term contraceptives often leads women to try LARC; in addition, LARC retention (continued use) may be linked to stage of life and more resolute, long-term intentions. Thus, most of what we know about LARC effectiveness is biased by self-selection, user characteristics and needs. Women aged 15–19 are not typical LARC users; among those on contraception, 4% use LARC.1 Difficult-to-use, short-term products are the mainstay and it is …
{"title":"Long-acting reversible contraception acceptability and satisfaction is high among adolescents.","authors":"David Hubacher","doi":"10.1136/ebmed-2017-110768","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110768","url":null,"abstract":"Commentary on: Diedrich JT, Klein DA, Peipert JF, et al . Long-acting reversible contraception in adolescents: a systematic review and meta-analysis. Am J Obstet Gynecol 2017;216:364.e1-364.e12.\u0000\u0000Long-acting reversible contraception (LARC) consists of intrauterine devices and subdermal implants. LARC is in the highest tier of effectiveness and once started, most women tend to be satisfied and use it for long durations. Historically, LARC use has been concentrated in older, higher parity populations. Dissatisfaction or weariness with shorter-term contraceptives often leads women to try LARC; in addition, LARC retention (continued use) may be linked to stage of life and more resolute, long-term intentions. Thus, most of what we know about LARC effectiveness is biased by self-selection, user characteristics and needs.\u0000\u0000Women aged 15–19 are not typical LARC users; among those on contraception, 4% use LARC.1 Difficult-to-use, short-term products are the mainstay and it is …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"228-229"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35421718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-11-17DOI: 10.1136/ebmed-2017-110856
Charles Coombs, Igho Onakpoya, Kamal Mahtani, Jeffrey Aronson, Jack O'Sullivan, Annette Pluddemann, Carl Heneghan
Evidence-Based Medicine (EBM) published by BMJ aims to alert clinicians to significant advances in healthcare by selecting original and systematic review articles, from 100 candidate journals, whose results are likely to be both reliable and useful.1 We select articles if they concern topics relevant to internal medicine, general and family practice, surgery, emergency and critical care, psychiatry, paediatrics or obstetrics and gynaecology. Articles are summarised in value-added abstracts and commented on by clinical experts in the field. To better understand the impact our choices may have on clinical practice, we audited 1 year’s worth of the journal’s commentaries, asking what journals we select from, what types of studies we choose and whether we identify articles likely to change practice. To do this, we surveyed EBM commentaries published between December 2016 and September 2017 and extracted the following information: study type, original journal, setting and type of intervention. We used the commentaries from clinical experts …
{"title":"What evidence affects clinical practice? An analysis of Evidence-Based Medicine commentaries.","authors":"Charles Coombs, Igho Onakpoya, Kamal Mahtani, Jeffrey Aronson, Jack O'Sullivan, Annette Pluddemann, Carl Heneghan","doi":"10.1136/ebmed-2017-110856","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110856","url":null,"abstract":"Evidence-Based Medicine (EBM) published by BMJ aims to alert clinicians to significant advances in healthcare by selecting original and systematic review articles, from 100 candidate journals, whose results are likely to be both reliable and useful.1 We select articles if they concern topics relevant to internal medicine, general and family practice, surgery, emergency and critical care, psychiatry, paediatrics or obstetrics and gynaecology. Articles are summarised in value-added abstracts and commented on by clinical experts in the field.\u0000\u0000To better understand the impact our choices may have on clinical practice, we audited 1 year’s worth of the journal’s commentaries, asking what journals we select from, what types of studies we choose and whether we identify articles likely to change practice.\u0000\u0000To do this, we surveyed EBM commentaries published between December 2016 and September 2017 and extracted the following information: study type, original journal, setting and type of intervention. We used the commentaries from clinical experts …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"197"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110856","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35563793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-11-02DOI: 10.1136/ebmed-2017-110806
Clement Lo, Sophia Zoungas
{"title":"Intensive glucose control in patients with diabetes prevents onset and progression of microalbuminuria, but effects on end-stage kidney disease are still uncertain.","authors":"Clement Lo, Sophia Zoungas","doi":"10.1136/ebmed-2017-110806","DOIUrl":"10.1136/ebmed-2017-110806","url":null,"abstract":"","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"219-220"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35219004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-10-22DOI: 10.1136/ebmed-2017-110784
Tej K Mattoo, Ron Thomas
{"title":"Routine prophylaxis is not necessary to prevent renal scarring in children with urinary tract infection.","authors":"Tej K Mattoo, Ron Thomas","doi":"10.1136/ebmed-2017-110784","DOIUrl":"10.1136/ebmed-2017-110784","url":null,"abstract":"","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"208"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35535243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-10-22DOI: 10.1136/ebmed-2017-110805
Joel Meyer, Manu Shankar-Hari
{"title":"Protocolised early goal-directed therapy in patients with sepsis/septic shock does not result in improved survival compared with usual care with less invasive resuscitation strategies.","authors":"Joel Meyer, Manu Shankar-Hari","doi":"10.1136/ebmed-2017-110805","DOIUrl":"10.1136/ebmed-2017-110805","url":null,"abstract":"","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"223"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35535240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-11-08DOI: 10.1136/ebmed-2017-110721
Graziella Filippini
{"title":"Ocrelizumab appears to reduce relapse and disability in multiple sclerosis but quality of evidence is moderate.","authors":"Graziella Filippini","doi":"10.1136/ebmed-2017-110721","DOIUrl":"10.1136/ebmed-2017-110721","url":null,"abstract":"","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"215-216"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35585233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-11-17DOI: 10.1136/ebmed-2017-110860
Jeffrey K Aronson
A journal club is a group of individuals who meet regularly to discuss publications that are relevant to their professional interests; the term is also used to describe such a meeting. The earliest mention of a journal club that I have found is in an 1854 paper by Sir John Forbes in The Association Medical Journal , which was published between 1853 and 1856, and was a forerunner of the BMJ . The Association was in financial straits, as Forbes discussed1: ‘Our dear old ASSOCIATION is in rather a bad plight; but I hope and trust she is not in any risk of death or decay, but is merely passing through a dangerous crisis, to come out of it more vivacious and more vigorous than ever.’ He was mainly concerned about the future of the journal: ‘The Association, if it exists at all, must retain …
{"title":"Journal Clubs: 1. Origins.","authors":"Jeffrey K Aronson","doi":"10.1136/ebmed-2017-110860","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110860","url":null,"abstract":"A journal club is a group of individuals who meet regularly to discuss publications that are relevant to their professional interests; the term is also used to describe such a meeting.\u0000\u0000The earliest mention of a journal club that I have found is in an 1854 paper by Sir John Forbes in The Association Medical Journal , which was published between 1853 and 1856, and was a forerunner of the BMJ . The Association was in financial straits, as Forbes discussed1: ‘Our dear old ASSOCIATION is in rather a bad plight; but I hope and trust she is not in any risk of death or decay, but is merely passing through a dangerous crisis, to come out of it more vivacious and more vigorous than ever.’ He was mainly concerned about the future of the journal: ‘The Association, if it exists at all, must retain …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"231"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35563794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-11-13DOI: 10.1136/ebmed-2017-110843
George W Rutherford, Elvin Geng
{"title":"Supplementary antimicrobials for patients with HIV and <100 CD4 cells/µL are associated with improved survival.","authors":"George W Rutherford, Elvin Geng","doi":"10.1136/ebmed-2017-110843","DOIUrl":"10.1136/ebmed-2017-110843","url":null,"abstract":"","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"209"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35549107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01Epub Date: 2017-10-17DOI: 10.1136/ebmed-2017-110757
William C Stewart, Jeanette A Stewart, Lindsay A Nelson
To survey ophthalmologists regarding sources they trust when incorporating new medical knowledge into their practice. The survey was distributed primarily to US-based ophthalmologists. Questions were derived based on the lead author's research experience from congresses and discussions and from mentions in the medical literature. In total, 77 physicians completed the survey of 1886 sent (4% response rate). Regarding study design, physicians preferred a well-controlled, randomised, double-masked trial (99%) with multicentred investigational site across a wide geographical area (80%). Authorship of a research article was most desired from a well-known key opinion leader (KOL) (75%) or any KOL leader at a university (75%). The most selected journal type was a subspecialty publication (86%) and second a multispecialty high impact journal (77%). Study sponsorship was most desired from the NIH or other government agencies (71%) or a university (71%). Doctors preferred clinical opinions from an ophthalmic medical society (75%). For the source of new clinical data, physicians indicated an unsponsored peer-reviewed journal article (77%) or a lecture at a large ophthalmic congress (74%) as the preferred source. Ophthalmologists generally desire sponsors, study designs and opinions that appear free of bias on which to base their clinical practice decisions.
{"title":"What data sources do ophthalmologists trust?","authors":"William C Stewart, Jeanette A Stewart, Lindsay A Nelson","doi":"10.1136/ebmed-2017-110757","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110757","url":null,"abstract":"<p><p>To survey ophthalmologists regarding sources they trust when incorporating new medical knowledge into their practice. The survey was distributed primarily to US-based ophthalmologists. Questions were derived based on the lead author's research experience from congresses and discussions and from mentions in the medical literature. In total, 77 physicians completed the survey of 1886 sent (4% response rate). Regarding study design, physicians preferred a well-controlled, randomised, double-masked trial (99%) with multicentred investigational site across a wide geographical area (80%). Authorship of a research article was most desired from a well-known key opinion leader (KOL) (75%) or any KOL leader at a university (75%). The most selected journal type was a subspecialty publication (86%) and second a multispecialty high impact journal (77%). Study sponsorship was most desired from the NIH or other government agencies (71%) or a university (71%). Doctors preferred clinical opinions from an ophthalmic medical society (75%). For the source of new clinical data, physicians indicated an unsponsored peer-reviewed journal article (77%) or a lecture at a large ophthalmic congress (74%) as the preferred source. Ophthalmologists generally desire sponsors, study designs and opinions that appear free of bias on which to base their clinical practice decisions.</p>","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":" ","pages":"205-207"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35523612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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