BMJ Evidence-Based Medicine最新文献

Objectives: To develop a core outcome set (COS) for oropharyngeal dysphagia (swallowing disorder) interventions in Parkinson's disease by agreeing core outcomes and definitions, outcome measurement instruments (OMIs) and time points of measurement for these core outcomes.

Design: International online Delphi survey and consensus meetings.

Participants: Individuals living with oropharyngeal dysphagia and Parkinson's disease, family members and caregivers, healthcare professionals and researchers in the field of oropharyngeal dysphagia and Parkinson's disease.

Methods: A long list of outcomes was generated previously through scoping reviews, online surveys and focus groups with key stakeholders. Building on this, an international three-round online Delphi survey was conducted where participants rated the importance of outcomes. In subsequent online consensus meetings, core outcomes, their definitions, OMIs and time points of measurement were agreed on.

Results: 90 participants from 21 countries completed all three rounds of the Delphi survey. Of these, 35 participated in a consensus meeting. Six outcomes were agreed as the core outcomes: 'penetration/aspiration', 'aspiration pneumonia', 'choking', 'oropharyngeal dysphagia severity', 'swallowing related quality of life' and 'post swallow pharyngeal residue'.

Conclusions: The use of a COS in future oropharyngeal dysphagia intervention studies in Parkinson's disease will facilitate comparative effectiveness research and ensure that outcomes are relevant to all key stakeholders. This should help improve the evidence base for oropharyngeal dysphagia interventions in Parkinson's disease.

Registration: The study was registered prospectively with the Core Outcome Measures in Effectiveness Trials Database on 24 September 2021 (www.comet-initiative.org, registration number: 1942).

Background: Misleading information about medical products on social media may cause overuse.

Objectives: Explore interventions targeting the problem of misleading medical information and marketing on social media, with a focus on preventing medical overuse including overdiagnosis.

Eligibility criteria: We included peer-reviewed studies with original data on an intervention targeting misleading medical information on social media and governmental/institutional responses with and without evaluation. We excluded responses relating to COVID-19.

Sources of evidence: four electronic databases: MEDLINE/PubMed, PsycINFO, Academic Search Complete and Web of Science, and searches of grey literature on Google and Google Scholar. Search date: 9 June 2025.

Data charting: We used prespecified data forms populated in duplicate by two reviewers.

Results: We identified 27 peer-reviewed articles and 25 organisational and governmental responses (grey literature). 20 (74%) of the peer-reviewed interventions targeted the consumer to enhance 'media literacy', support decision-making or warn about misinformation trends. Approaches included education, such as videos or information materials, to improve detection of misinformation, as well as correcting misinformation and rebutting claims. Only two (7.4%) of the peer-reviewed approaches were sensitive to the problem of medical overuse: a risk-of-deception tool and an informed decision-making service. The grey literature about government and organisational responses chiefly comprised general advertising regulations and other educational resources for consumers to identify and navigate misinformation. The advertising regulations ranged from self-regulatory codes of practice to mandatory regulations, requiring pre-approval of social media marketing material. Most regulations stated advertising should be truthful, presenting both benefits and harms and not be misleading. Most of the grey literature (64%) was sensitive to medical overuse, though none referred explicitly to the problem.

Conclusions: Current efforts to address misleading medical marketing on social media often overlook the critical issue of medical overuse and fail to provide sufficient consumer protections in this rapidly evolving digital landscape of social media, such as the speed of dissemination, reach and the role of third-party advertising. These gaps in research, regulation and practice present significant opportunities to strengthen evidence-based policies and public health responses. TRIAL REGISTRATION DETAILS: https://doi.org/10.17605/OSF.IO/2NJSH.