When you see a claim that a treatment or intervention has no effect, it is important to examine the evidence as this may be a misleading statement.
When you see a claim that a treatment or intervention has no effect, it is important to examine the evidence as this may be a misleading statement.
Healthcare students are often exposed to significant stressors during their studies and work. Are psychological interventions effective in fostering resilience in this cohort?
This article explores circadian rhythm, the prevalence of its disruption in modern society, and its affects on cancer.
Yousif examines the HIP ATTACK trial, appraises the primary composite endpoint, verifies the assessment and then thinks of ways to interpret the result.
COVID-19 has highlighted the inefficiencies that exist in clinical research, as well as the frailties of the current publishing system. This blog examines two prominent examples from the pandemic.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘paramedic decision-making to commence or withhold resuscitation attempts in the absence of a ‘Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order’.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘effective management by paramedics when caring for patients requiring end of life decision-making’.
This blog presents the abstract of a literature review and critical appraisal on the topic ‘paramedic management of pre-hospital birth in relation to premature neonates’.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘prevalence of depression in emergency ambulance staff’.
The role of social media in the COVID-19 crisis relative to the contribution of scientific research globally.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘the clinical value of pre-hospital point of care cardiac troponin assays in chest pain patients’.
This blog presents the abstract of a literature review on the topic of ‘Paramedics performance of delivering care in a mental health crisis’.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘Common themes surrounding the topic of electrocardiogram (ECG) lead placement’.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘Cardiovascular disease in a shift working population of Paramedics’.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘Morphine administration for patients suffering an acute Myocardial Infarction’.
This blog presents the abstract of a literature review and critical appraisal on the topic of pre-hospital antibiotics for patients with sepsis.
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘Mental Health Considerations in Older Adults’.Â
This blog presents the abstract of a literature review and critical appraisal on the topic of ‘Fascial iliaca Compartment Blocks for femoral fractures’.
What is ‘Responder analysis’ and what are the benefits and limitations of this approach? Read more in this blog from Giorgio Karam.
This blog is a critical appraisal of the following pilot study: Intraexaminer comparison of applied kinesiology manual muscle testing of varying durations.
Sophia discusses a recent Cochrane review entitled ‘Inpatient versus outpatient care, partial hospitalisation and waiting list for people with eating disorders’ and considers the implications of the findings.
In this blog, Lucy discusses a recent Cochrane review which summarises all evidence for interventions relevant to the prevention of preterm birth (PTB) as reported in Cochrane systematic reviews (SRs).
In this blog, Sophia discusses a recent Cochrane review which asked the question: are psychological e-health interventions for children and adolescents with long-term physical conditions effective for reducing depression and anxiety?
In this blog, Giorgio Karam examines the evidence on antihypertensive drugs for primary prevention – when do we start treatment?
In addictions research, there’s a big emphasis on events leading up to recovery. But what about after?
What is the evidence that having high cholesterol, or high LDL (low-density lipoprotein) levels, increases your chance of getting heart disease?
Pain is a recurrent undesirable side effect in orthodontic treatment. This blog by Izabel Oliveira introduces pharmacological and non-pharmacological alternatives for orthodontic pain management.
How accurately have the media reported on the link between dentures and frailty? This blog by Neelam Khan looks at the evidence behind the claim that “Dentures put wearers at risk of malnutrition because they can’t chew healthy food”.
This blog by Saul looks at the Audit Cycle: What is an audit, how does it differ from research, the steps involved in the audit process and how you can get involved.
Critical appraisal tools (CATs) are commonly used by students and researchers alike, as a way of judging a studyâ€™s quality. In this blog, Dennis Neuen addresses the need to appraise these tools and has also collated a list of 12 CATs from all over the world.
Canada is in the midst of an opioid crisis and prescriptions have something to do with it. The question is, what? Lauren Gorfinkel discusses the need for new research which adequately investigates the ways in which prescription opioids enter and influence the lives of not only those who are prescribed opioids, but those that are not.
In this blog, Sasha Lawson-Frost explores what moral values underpin or justify the practice of Evidence-Based Medicine, specifically in response to a recent article which stated “the policy side of evidence-based medicine is basically a form of rule utilitarianism”.
In this blog, Kamal Pandit discusses the findings of three recent Cochrane reviews which assessed the effectiveness of treatments for Coronary heart disease (CHD). He adds personal experience to provide context to treatment of a condition which is the single leading cause of death globally (WHO 2014).
This blog, written by Leonard Goh, was the winner of Cochrane Malaysia and Penang Medical College’s recent evidence-based medicine blog writing competition. Leonard has written an insightful and informative piece to answer the question: ‘Evidence-based health practice: a fairytale or reality’.
Alina provides a critical appraisal of the ARTEMIDA trial (2015) that assessed efficacy of Actovegin in poststroke cognitive impairment.
Debiasing is about trying to account for and eliminate the influence of biases on our decision-making. This blog discusses effective debiasing techniques.
This blog is a Portuguese translation of a blog discussing the problem of evidence-based medicine, with thanks to Cochrane Brazil Evidence Based Medicine is useful for informing healthcare professionals what works, what doesn’t, and helping to determine if the benefits outweigh the harms, but it’s far from perfect. This blog explores some of the issues.
This blog is part of the ‘Understanding Evidence’ series, a collaborative series between Cochrane UK and Students 4 Best Evidence. Selena Ryan-Vig, Cochrane UK’s Knowledge and Engagement Officer, takes a look at Cochrane evidence on cocoa and blood pressure and highlights some important considerations when reading research.
This blog discusses the issue of ‘too much medicine’; a growing concern in the medical community regarding the over-diagnosis, over-treatment and over-testing of various pathologies. In particular, focusing on the overestimation of risk and the base rate fallacy.
This blog discusses fundamental issues affecting healthcare research, which could undermine the field and mean that most medical research may be wrong. Issues discussed include: 1) contradictory findings 2) the illusion of high impact factor journals 3) the reproducibility crisis 4) a lack of translation of research findings from bench to bedside 5) medical reversal 6) bias 7) statistical issues and 8) conflicts of interest and unethical practice. The author then explores possible solutions to these.
Authorship is a way that researchers get recognition for their work. However many issues may arise when assigning the authorship of a paper. Find here what a junior researcher should know.
‘Evidence-based practice’ is a commonly used phrase. But this blog asks the question: ‘just how much can we trust published scientific literature?’ with particular reference to the problems of publication bias and statistical approaches.
This blog is an informal review of the resource: ‘Taking account of the play of chance’, outlining the key points of a chapter from the Testing Treatments book.
This blog discusses problems with peer review in research, and explores possible ways in which the modern peer review process could be improved.
This blog is an informal review of the following resource: Informed Health Choices Podcast: ‘Benefits and harms’.
This blog uses 3 examples to demonstrate that, even though there may be an association between two events or variables, this does not mean that one has caused the other.
In the final blog from our Understanding Evidence launch week, Martin Burton explores absence of evidence… Join in the conversation on Twitter @CochraneUK @MartinJBurton #understandingevidence.
In the fifth blog of our new series, Understanding Evidence, Lynda Ware gives us a flavour of how she’s taking Cochrane and evidence-based medicine to Community Halls. Join in the conversation on Twitter @CochraneUK #understandingevidence.
In the second blog of our new series Understanding Evidence, Iain Chalmers, the founding director of Cochrane UK, looks at developments in research on prenatal corticosteroids since the work which gave rise to the Cochrane logo. Join in the conversation on Twitter @iainchalmersTTi @CochraneUK #understandingevidence
We all need to be able to make sense of evidence, whether we’re making decisions about treatments, or weighing up the latest health story to hit the headlines. We’re partnering with Cochrane UK to put the spotlight on common errors and misunderstandings with a new campaign, Understanding Evidence.
‘O que é medicina baseada em evidências?’ This is a Portuguese translation of the blog ‘What is evidence-based medicine?’
You are sat down with an article or review. Now you want to critically appraise it. This blog features a checklist of 20 questions to allow you to do just that.
Existem quatro passos fundamentais em MBE e os recursos no website estão ligados a estes.
[There are four key steps in EBM and the resources on the website are linked to these].
You might rely too much on big journal brands because you hope they have highly rigorous peer-review processes. But are they always really reliable? Let’s find out.
Let’s figure out how the epidemiologists determine the diagnostic thresholds by studying the cases of anemia and type II diabetes.
Outcome switching is a major problem in clinical trial reporting that distorts the evidence doctors and patients use to make real-world clinical decisions. Numerous prevalence studies have already shown this to be an extremely common problem, even in top medical journals. However the CEBM Outcome Monitoring Project (COMPare) has taken a new approach: writing to journals to correct the record on individual trials, in the hope that individual accountability and open data sharing will help solve this important problem. Our main question was: how will the journals respond? This blog tells the story of COMPare so far.
Reviews tend to provide summaries of the literature on a topic. However, there are differences between them in terms of the stages and applicability of findings. This post will highlight such differences between traditional reviews and systematic reviews.
Doctors must always ensure they are doing the right thing for each patient. But what are benefits and harms, and how do we ‘balance’ them?
Let’s be honest, Evidence-Based Medicine is great. But it’s not perfect. Issues such as the lack of publishing of negative results need to be understood and tackled. In this Youtube video, Prof David Nealy does just that.
Infographics are quick, fun ways to introduce a topic or interest people in new subjects. ‘How Disease Spreads’ is an interesting infographic about the prevalence of different diseases across the world and throughout time, but it gets a little lost upon the way.
Iván Murrieta Álvarez takes an in depth look at determining the probability that a patient has a certain illness, using only a pen and paper.
Does industry sponsorship of research inevitably lead to bias? And does this bias extend to government advice and policy?
Thankfully, this “less is more” idea seems to be a movement gaining serious momentum in the medical world to “wind back the harms of too much medicine”.
In his new book, Dr. Goldacre continues his crusade of exposing quacks and pseudoscience, with an emphasis on how journalists totally mislead the public about what a scientific paper really says. He also chronicles his AllTrials quest by railing against the lack of transparency in clinical trials and publication bias.
Dannky Minkow describes a new initiative aimed at getting health care professionals to take another look at their use of non evidence-based and wasteful practices.
In Richard’s Reviews this week, we look at progress in sharing clinical trial data through the All Trials campaign, and the nature of patient-centred outcomes research.
The relationship between Shared Decision Making and EBM; two separate disciplines or not? Read Ammar’s piece on this subject and have your say.
Advancing techniques and mechanization in every field has led to newer computer or written questionnaires in the field of medicine.
One often is confused whether to rely on these questionnaires or carry out oral history taking which has been prevalent for ages?
here’s an insight to it through various researches…
The rising ills of media affect our lives in ways deeper than we can imagine. As a matter of fact, it is a rising cause of psychiatric disorders, lets have a look why.
Sham devices can have a larger effect than placebo, should they remain to be under-regulated? Yamama tells us more.
University can be tough. Ashline gives some useful tips for getting back into uni and coping to the end of the year!
Next time you visit your doctor you may find that they’re relying on Wikipedia. I went to India to find out why this isn’t as scary as you might think, and how much everyone’s favourite free encyclopaedia is revolutionising the world of medicine.
Here are 10 of the multiple available health apps to improve your efficiency in clinical practice and research. Most of them are free, enjoy…
Key message: Evidence Based Medicine is useful for informing healthcare professionals what works, what doesn’t, and helping to determine if the benefits outweigh the harms, but it’s far from perfect. There are valuable lessons learned about research that we can share across disciplines. What is the Evidence Based Medicine problem? In 2005, Dr. John Ioannidis, a well-known meta-researcher, published an article in PLoS Medicine called Why Most Published Research Findings Are False. This article caused a splash and has been making
After 8 long years of University education I have to admit that I still do it. What’s worse; I’ve even been known to do it for my own area of research. So why do I still Wikipedia when I can access the literature? And why I am becoming a Wikipedia editor for for the S4BE Editathon?
Ever heard of the Placebo effect’s evil twin; the Nacebo Effect? A harmful reaction from a harmless treatment. Read Danny’s blog to know more.
Do placebos really promote physiological change or is it just the patient’s perspective? How are placebos used in practice? And how ethical is it to use placebos in clinical trials?
Richard takes a look at Greenhalgh and colleagues, BMJ article “Evidence based medicine: a movement in crisis?”.
You probably have heard a debate between clinical judgment and Evidence Based Medicine. Is there a real reason to oppose these two concepts? See here for more…
Is this your first contact with evidence-based healthcare? This course is a perfect start…
Ashline takes a look at ethical assessments and considerations in randomised controlled trials and cluster randomised controlled trials.
Sean reviews ‘What is Evidence Based Medicine and Why Should I care?’, an article for students and healthcare professionals which covers Evidence-Based Medicine from first principles to medical statistics in the course of one free paper.
Danny takes us on a tour of the Evidence-Based Medicine Pyramid and the wonders within.
Casper takes a look at the IDEAL Collaboration and evidence-based surgery.
Have you been asked to present some slides on an evidence-based topic? This blog can help!
Danny has reviewed Testing Treatments Interactive, a website to help you understand more about fair tests and research.
Sean reviews The Geek Manifesto by Mark Henderson, a book that asks what governments can learn from the success of Evidence-Based Medicine, how we can improve the public understanding of science and how we can entrench scientific thinking into other aspects of public life.
With this scheme, NICE are aiming to improve the use of evidence by future healthcare professionals by training students to teach their peers how to find the most trustworthy, up to date information.
Danny reviews the book Testing Treatments that aims to help everyone understand fair tests, how to ask questions and understand research.
Danny has reviewed the US Cochrane Center’s online course that aims to help you understand the basics of evidence-based healthcare and why it’s important.
Sense about Science have a long-standing campaign encouraging people to #AskForEvidence and in their new Healthy Evidence forum, in partnership with NHS Choices, they ask patients and the general public to get involved!
Ammar takes a detailed look at CEBM’s evidence-based resources!
In a BMJ editorial last month, Des Spence suggested that EBM may be broken. Alice takes a closer look.
The Lancet has recently published a series of papers looking at problems with waste and inefficiency in research, with recommendations for how these could be overcome.
An introduction to the role of statistical power in the search for evidence.
The universities of Duke and North Carolina have collaborated to produce a very thorough tutorial perfect for anyone new to evidence-based practice.
Find out from Iain Chalmers why we should all be “encouraged to think critically”
David blogs about Open Access. The practice of free, online, immediate access via the Internet to peer-reviewed scholarly research with full re-use rights
Please have a look at this inspiring video about changing education paradigms. What do you think of it?
Evidence-based medicine is not just about applying a systematic review letter for letter – but the ‘art’ of evidence-based medicine is in applying the science.
If you are new to EBM and methods such as critical appraisal, it can be daunting, but the CEBM tools are a useful introduction for beginners.
Anna reminds us of the value of observational evidence in low income countries.
Review by Jorge of “the challenges of over-diagnosis and over-treatment” featuring the co-authors of Over-diagnosed.
Cochrane Student’s Journal Club – An innovative introduction to the world of evidence based medicine.
Want to know what PICO stands for and how to use it? You’ve come to the right place.
Reporting and discussing clinical trials clearly and accurately can be challenging, both for journalists, and also for students. Ruth Francis has compiled 11 top tips to make it easier.
TTextras is a feature of the Testing Treatments interactive website which provides open educational resources such as games, podcasts, and videos that help people understand more about fair tests of treatments.
Conducting trials where the trialled therapeutic must be commenced urgently raises specific practical and ethical problems. Here I discuss a recent New England Journal of Medicine paper looking at the use of intracranial pressure monitoring for severe traumatic brain injury as an example of how these issues may affect a trial’s utility and how this can be managed.
Want to find out how to evaluate a randomised controlled trial? This is the perfect resource for you, brought to you by CASP Tools.
There’s a lot of evidence out there of varying quality. This slideshow looks at the uses of grading medical evidence, and how it can be done.
The BMJ Open Data Campaign seeks to make the data from unpublished trials available, so that decisions can be based on all the evidence.
What is the future of EBM in the US, both in policy and in reality?
Dr Cates provides easy to read re-freshers on statistics and EBM topics
A must-have tutorial on how to critically appraise research.
Your patient has mild hypertension. What should you do?
Treat the hypertension.
Okay, how should you treat the hypertension?
Well, let’s start with HCTZ, that’s well-tolerated.
What will that do?
It’s a diuretic; it’ll help her get rid of the extra volume.
Okay, what will that do?
It’ll lower her blood pressure.
Okay, what will that do?
What do you mean, what will that do?
What will lowering her blood pressure do?
It’ll lower her blood pressure! Seriously—who are you anyway?
Critical appraisal is the process of carefully and systematically examining research to judge its trustworthiness, value and relevance in a particular context (Amanda Burls 2009).
An essay discussing the underpinnings of EBM and the difficulties of using it in clinical practice
Statistically funny – the blog that combines cartoons, humour, and demystifying evidence-based medicine.
CASPin provide many tools to help you systematically read evidence and this specific tool will help you make sense of any case control study and assess its validity in a quick and easy way.
A website providing a detailed guide to the steps researchers have to take before, during and after a clinical study.
A good website from the Centre for Evidence-Based Medicine (CEBM) – with a wide range of tools to help with evidence-based research
The BMJ has on its website a series of articles on how to read papers, including clear explanations of the statistics commonly used and common pitfalls found in studies.
A checklist to help you systematically appraise and understand diagnostic test studies.
Seven short slides giving a brief introduction to evidence-based medicine
The importance of Evidence Based Medicine has been recognized in many countries around the world for decades now. This recognition lead to the formation of organisations promoting EBM and to the introduction of courses preaching EBM principles in universities. Unfortunately, my country, Syria, isn’t one of these countries yet and here’s how it’s going to get there.
AllTrials, putting the evidence back in evidence-based medicine.
PharmAware is a network of students committed to the use of the best evidence in healthcare.
A short poem about regression to the mean illustrated with a few examples!
Evidence-Based Medicine is a growing field that has already made a tremendous impact on world healthcare. It’s only rational to teach it to medical students from the beginning, however, this is not always the case. Let me give you an example: me.
Bias is often an issue within clinical research, and we take many measures to avoid it. However, these measures are often neglected in preclinical animal studies, which give us the results upon which clinical trial study designs are based.
Brilliant reworking of Gotye’s ‘Somebody That I Used to Know’ song but to do with EBM!
This resource is a tutorial, providing a thorough introduction to Evidence-Based Practice (EBP). It describes in detail how to formulate specific questions when searching for evidence on a problem, how to find this evidence using online databases, and how to evaluate and appraise the evidence found. It also outlines the economic modelling and cost-assessments behind healthcare choices.
CASP have created a from to help make sense of the information given in Cohort Studies.
12 questions to help you make sense of economic evaluations.
Download this form if you would like help reading and making sense of qualitative research.
Check out the new Patient Information Forum website. great info on how to produce health information for patients.
PowerPoint by Dr Amanda Burls, on randomized controlled trials and meta-analysis, described through four real-life examples.
List of suggested, helpful resources from the team at CASP. Including: summaries, critical appraisals, meta-analyses, guidelines & databases.
Video of Dr Ben Goldacre at the TED Talks in 2011. Always entertaining, Ben talks about producing fair clinical trials.
Would you like to do peer reviews on biomedical literature? Here is a free online course by the Cochrane Eyes & Vision Group.
This free course, is designed to help users understand the history of drug regulation and the fundamentals of how drugs are approved in the US. We recommend that you register for this Spotlight Session after completing the course, ‘Understanding Evidence-based Healthcare: A Foundation for Action’.
Andrew reviews and online course about understanding evidence-based healthcare
This interactive online course on ‘making sense of research & evidence’, assumes no previous knowledge of research or evidence-based medicine.
This one hour online module on the core principles of EBM aimed at a wide range of healthcare personnel from GP’s to medical students. To access BMJ learning requires a subscription, although if you have a BMA membership it’s available for free.
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