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The impossible clinic : a critical sociology of evidence-based medicine
\"The Impossible Clinic' explores the conundrum of evidence-based medicine's (EBM) attempt to translate evidence from medical research into recommendations for practice. Ironically, when medical institutions combine disciplinary regulations with EBM to produce clinical practice guidelines, the outcomes are antithetical to the aim. Such guidelines fail to increase individual physicians' capacity to judge - as EBM promises - because they externalize judgment while imposing disciplinary control. The Impossible Clinic is the first book to interrogate the history, practice, and the pitfalls of EBM and how it persists due to intersecting relationships between professional medical regulation and liberal governance strategies. \"-- Provided by publisher.
Book
Progress in evidence-based medicine: a quarter century on
In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making. In another progress, EBM incorporated and further developed the science of producing trustworthy clinical practice guidelines pioneered by investigators in the 1980s. EBM's enduring contributions to clinical medicine include placing the practice of medicine on a solid scientific basis, the development of more sophisticated hierarchies of evidence, the recognition of the crucial role of patient values and preferences in clinical decision making, and the development of the methodology for generating trustworthy recommendations.
Journal Article
Meta-analysis accelerator: a comprehensive tool for statistical data conversion in systematic reviews with meta-analysis
Background
Systematic review with meta-analysis integrates findings from multiple studies, offering robust conclusions on treatment effects and guiding evidence-based medicine. However, the process is often hampered by challenges such as inconsistent data reporting, complex calculations, and time constraints. Researchers must convert various statistical measures into a common format, which can be error-prone and labor-intensive without the right tools.
Implementation
Meta-Analysis Accelerator was developed to address these challenges. The tool offers 21 different statistical conversions, including median & interquartile range (IQR) to mean & standard deviation (SD), standard error of the mean (SEM) to SD, and confidence interval (CI) to SD for one and two groups, among others. It is designed with an intuitive interface, ensuring that users can navigate the tool easily and perform conversions accurately and efficiently. The website structure includes a home page, conversion page, request a conversion feature, about page, articles page, and privacy policy page. This comprehensive design supports the tool’s primary goal of simplifying the meta-analysis process.
Results
Since its initial release in October 2023 as Meta Converter and subsequent renaming to Meta-Analysis Accelerator, the tool has gained widespread use globally. From March 2024 to May 2024, it received 12,236 visits from countries such as Egypt, France, Indonesia, and the USA, indicating its international appeal and utility. Approximately 46% of the visits were direct, reflecting its popularity and trust among users.
Conclusions
Meta-Analysis Accelerator significantly enhances the efficiency and accuracy of meta-analysis of systematic reviews by providing a reliable platform for statistical data conversion. Its comprehensive variety of conversions, user-friendly interface, and continuous improvements make it an indispensable resource for researchers. The tool’s ability to streamline data transformation ensures that researchers can focus more on data interpretation and less on manual calculations, thus advancing the quality and ease of conducting systematic reviews and meta-analyses.
Journal Article
What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences
Background
Systematic reviews have been considered as the pillar on which evidence-based healthcare rests. Systematic review methodology has evolved and been modified over the years to accommodate the range of questions that may arise in the health and medical sciences. This paper explores a concept still rarely considered by novice authors and in the literature: determining the type of systematic review to undertake based on a research question or priority.
Results
Within the framework of the evidence-based healthcare paradigm, defining the question and type of systematic review to conduct is a pivotal first step that will guide the rest of the process and has the potential to impact on other aspects of the evidence-based healthcare cycle (evidence generation, transfer and implementation). It is something that novice reviewers (and others not familiar with the range of review types available) need to take account of but frequently overlook. Our aim is to provide a typology of review types and describe key elements that need to be addressed during question development for each type.
Conclusions
In this paper a typology is proposed of various systematic review methodologies. The review types are defined and situated with regard to establishing corresponding questions and inclusion criteria. The ultimate objective is to provide clarified guidance for both novice and experienced reviewers and a unified typology with respect to review types.
Journal Article
European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis
Endometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging (MRI) is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion. This work was performed by a group of radiologists from the European Society of Urogenital Radiology (ESUR), experts in gynaecological imaging and a gynaecologist expert in methodology. The group discussed indications for MRI, technical requirements, patient preparation, MRI protocols and criteria for the diagnosis of pelvic endometriosis on MRI. The expert panel proposed a final recommendation for each criterion using Oxford Centre for Evidence Based Medicine (OCEBM) 2011 levels of evidence.
Key Points
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This report provides guidelines for MRI in endometriosis
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Minimal and optimal MRI acquisition protocols are provided
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Recommendations are proposed for patient preparation
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best MRI sequences and reporting criteria
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Journal Article
Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach
Background
Scoping reviews are a relatively new approach to evidence synthesis and currently there exists little guidance regarding the decision to choose between a systematic review or scoping review approach when synthesising evidence. The purpose of this article is to clearly describe the differences in indications between scoping reviews and systematic reviews and to provide guidance for when a scoping review is (and is not) appropriate.
Results
Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions.
Conclusions
Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa.
Journal Article