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":null,"pages":null},"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":null,"pages":null},"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: 2017-11-02DOI: 10.1136/ebmed-2017-110806
Clement Lo, Sophia Zoungas
Commentary on: Ruospo M, Saglimbe VM, Palmer SC, et al . Glucose targets for preventing diabetic kidney disease and its progression. Cochrane Database Syst Rev 2017;6:CD010137. Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD). Randomised controlled trials (RCTs) suggest that intensive glycaemic control reduces progression of albuminuria, but effects on later DKD stages and cardiovascular outcomes are less clear. This systematic review evaluated the benefits and harms of intensive versus standard glycaemic control on the onset and progression of DKD and mortality. This meta-analysis of published tabular data included RCTs assigning patients with diabetes (type 1 or 2) with and without kidney disease to intensive (glycated haemoglobin (HbA1c) <7% or fasting blood glucose (FBG) <6.6 mmol/L) or standard glycaemic control (HbA1c ≥7% or FBG ≥6.6 mmol/L). Primary outcomes were doubling of serum creatinine, ESKD, and death or non-fatal myocardial infarction or stroke. Secondary outcomes included measures of albuminuria, serum creatinine, measures of glomerular …
{"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":"https://doi.org/10.1136/ebmed-2017-110806","url":null,"abstract":"Commentary on: Ruospo M, Saglimbe VM, Palmer SC, et al . Glucose targets for preventing diabetic kidney disease and its progression. Cochrane Database Syst Rev 2017;6:CD010137.\u0000\u0000Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD). Randomised controlled trials (RCTs) suggest that intensive glycaemic control reduces progression of albuminuria, but effects on later DKD stages and cardiovascular outcomes are less clear. This systematic review evaluated the benefits and harms of intensive versus standard glycaemic control on the onset and progression of DKD and mortality.\u0000\u0000This meta-analysis of published tabular data included RCTs assigning patients with diabetes (type 1 or 2) with and without kidney disease to intensive (glycated haemoglobin (HbA1c) <7% or fasting blood glucose (FBG) <6.6 mmol/L) or standard glycaemic control (HbA1c ≥7% or FBG ≥6.6 mmol/L). Primary outcomes were doubling of serum creatinine, ESKD, and death or non-fatal myocardial infarction or stroke. Secondary outcomes included measures of albuminuria, serum creatinine, measures of glomerular …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110806","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-2017-110805
Joel Meyer, Manu Shankar-Hari
Commentary on : Rowan KM, Angus DC, Bailey M, et al . Early, goal-directed therapy for septic shock – a patient-level meta-analysis. N Engl J Med 2017;376:2223–34. Early goal-directed therapy for sepsis/septic shock became the standard of care as advocated by the 2004 Surviving Sepsis Campaign Guidelines.1 This guidance was based on a single-centre randomised controlled trial (RCT) by Rivers et al 2 involving 263 patients with sepsis/septic shock admitted to emergency departments. However, three recent multicentre, early goal-directed therapy RCTs3–5 were unable to replicate the treatment effects observed by Rivers et al .2 The current Surviving Sepsis Campaign Guidelines revised the resuscitation recommendations to administering at least 30 mL/kg of intravenous crystalloids in the first 3 hours of sepsis management. …
{"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":"https://doi.org/10.1136/ebmed-2017-110805","url":null,"abstract":"Commentary on : Rowan KM, Angus DC, Bailey M, et al . Early, goal-directed therapy for septic shock – a patient-level meta-analysis. N Engl J Med 2017;376:2223–34.\u0000\u0000Early goal-directed therapy for sepsis/septic shock became the standard of care as advocated by the 2004 Surviving Sepsis Campaign Guidelines.1 This guidance was based on a single-centre randomised controlled trial (RCT) by Rivers et al 2 involving 263 patients with sepsis/septic shock admitted to emergency departments. However, three recent multicentre, early goal-directed therapy RCTs3–5 were unable to replicate the treatment effects observed by Rivers et al .2 The current Surviving Sepsis Campaign Guidelines revised the resuscitation recommendations to administering at least 30 mL/kg of intravenous crystalloids in the first 3 hours of sepsis management. …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110805","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: 2017-10-22DOI: 10.1136/ebmed-2017-110784
Tej K Mattoo, Ron Thomas
Commentary on: Hewitt IK, Pennesi M, Morello W, et al . Antibiotic prophylaxis for urinary tract infection-related renal scarring: a systematic review. Pediatrics 2017;139:e20163145. Renal scarring is a potentially serious long-term complication of acute pyelonephritis, and the risk increases significantly in children with high-grade vesicoureteral reflux (VUR) and recurrent urinary tract infection (UTI).1 For decades it has been a common practice to use antimicrobial prophylaxis or surgical correction to prevent recurrent UTI and renal scarring in children with VUR. Some recent studies have shown that antimicrobial prophylaxis significantly decreases the risk of UTI recurrence in children with VUR but does not significantly impact the risk of renal scarring when compared with placebo or no treatment.2 3 A review of the literature and a meta-analysis were done …
{"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":"https://doi.org/10.1136/ebmed-2017-110784","url":null,"abstract":"Commentary on: Hewitt IK, Pennesi M, Morello W, et al . Antibiotic prophylaxis for urinary tract infection-related renal scarring: a systematic review. Pediatrics 2017;139:e20163145.\u0000\u0000Renal scarring is a potentially serious long-term complication of acute pyelonephritis, and the risk increases significantly in children with high-grade vesicoureteral reflux (VUR) and recurrent urinary tract infection (UTI).1 For decades it has been a common practice to use antimicrobial prophylaxis or surgical correction to prevent recurrent UTI and renal scarring in children with VUR. Some recent studies have shown that antimicrobial prophylaxis significantly decreases the risk of UTI recurrence in children with VUR but does not significantly impact the risk of renal scarring when compared with placebo or no treatment.2 3 \u0000\u0000A review of the literature and a meta-analysis were done …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110784","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: 2017-11-17DOI: 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":null,"pages":null},"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: 2017-11-13DOI: 10.1136/ebmed-2017-110843
George W Rutherford, Elvin Geng
Commentary on : Hakim J, Musiime V, Szubert AJ, et al . Enhanced Prophylaxis plus Antiretroviral Therapy for Advanced HIV Infection in Africa. N Engl J Med 2017;377:233–45. Despite expansion of HIV testing and recommendations to start antiretroviral therapy (ART) immediately, people living with HIV (PLWH) often present late in the disease. In poorer countries, 30%–40% of PLWH starting ART have CD4 counts <200 cells/µL and 20% have a CD4 count <100 cells/µL.1 PLWH with advanced immunosuppression are at greater risk for complications and death, and their care is more complex than those with early disease. The WHO promotes differentiated service delivery2—a strategy that varies the intensity, frequency and location of treatment. To date, this has focused on deintensifying treatment for patients with higher CD4 counts. Hakim and colleagues offer a strategy for PLWH presenting with advanced disease.3 …
{"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":"https://doi.org/10.1136/ebmed-2017-110843","url":null,"abstract":"Commentary on : Hakim J, Musiime V, Szubert AJ, et al . Enhanced Prophylaxis plus Antiretroviral Therapy for Advanced HIV Infection in Africa. N Engl J Med 2017;377:233–45.\u0000\u0000Despite expansion of HIV testing and recommendations to start antiretroviral therapy (ART) immediately, people living with HIV (PLWH) often present late in the disease. In poorer countries, 30%–40% of PLWH starting ART have CD4 counts <200 cells/µL and 20% have a CD4 count <100 cells/µL.1 PLWH with advanced immunosuppression are at greater risk for complications and death, and their care is more complex than those with early disease.\u0000\u0000The WHO promotes differentiated service delivery2—a strategy that varies the intensity, frequency and location of treatment. To date, this has focused on deintensifying treatment for patients with higher CD4 counts. Hakim and colleagues offer a strategy for PLWH presenting with advanced disease.3 …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110843","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: 2017-11-08DOI: 10.1136/ebmed-2017-110721
Graziella Filippini
Commentary on : Hauser SL, Bar-Or A, Comi G, et al . Ocrelizumab versus interferon Beta-1a in relapsing multiple sclerosis. N Engl J Med 2017;376:221–34. Montalban X, Hauser SL, Kappos L, et al . Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 2017;376:209–20. Multiple sclerosis (MS) is a chronic, immune-mediated disorder of the central nervous system, and one of the most common causes of disability in young people, with an annual incidence ranging from 2 to 10 cases/100 000 persons/year. The disease is classified as either relapsing-remitting MS (RRMS) or primary progressive MS (PPMS) based on the initial disease course.1 People with RRMS have recurrent episodes of neurological deficit (relapses) followed by periods of remission and over time an accumulation of residual deficits and a slow progression of fixed disability supervene in about 80% of them (secondary progressive MS). Approximately, 15% of people with PPMS have a slowly progressive course from onset. PPMS presents at an older age (mean age at onset 40 years) than does RRMS. Preventing progressive disability is the key therapeutic goal for MS. Several pathological processes occur in MS, including engagement of the immune system, T cell-mediated and B cell-mediated mechanisms, demyelination, inflammatory injury of axons and glia, postinflammatory gliosis and neurodegeneration. Several disease-modifying drugs (DMDs) are available for RRMS; however, their relative benefit in delaying disability worsening remains unclear due to the limited …
{"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":"https://doi.org/10.1136/ebmed-2017-110721","url":null,"abstract":"Commentary on : Hauser SL, Bar-Or A, Comi G, et al . Ocrelizumab versus interferon Beta-1a in relapsing multiple sclerosis. N Engl J Med 2017;376:221–34. Montalban X, Hauser SL, Kappos L, et al . Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 2017;376:209–20.\u0000\u0000Multiple sclerosis (MS) is a chronic, immune-mediated disorder of the central nervous system, and one of the most common causes of disability in young people, with an annual incidence ranging from 2 to 10 cases/100 000 persons/year. The disease is classified as either relapsing-remitting MS (RRMS) or primary progressive MS (PPMS) based on the initial disease course.1 People with RRMS have recurrent episodes of neurological deficit (relapses) followed by periods of remission and over time an accumulation of residual deficits and a slow progression of fixed disability supervene in about 80% of them (secondary progressive MS). Approximately, 15% of people with PPMS have a slowly progressive course from onset. PPMS presents at an older age (mean age at onset 40 years) than does RRMS. Preventing progressive disability is the key therapeutic goal for MS. Several pathological processes occur in MS, including engagement of the immune system, T cell-mediated and B cell-mediated mechanisms, demyelination, inflammatory injury of axons and glia, postinflammatory gliosis and neurodegeneration. Several disease-modifying drugs (DMDs) are available for RRMS; however, their relative benefit in delaying disability worsening remains unclear due to the limited …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110721","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":null,"pages":null},"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: 2017-10-17DOI: 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":null,"pages":null},"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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