Journal of clinical epidemiology
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Review
Systematic reviews supporting practice guideline recommendations lack protection against bias.
To evaluate the quality of systematic reviews (SRs) affecting clinical practice in endocrinology. ⋯ Few recommendations in endocrinology are supported by SRs. The quality of SRs is suboptimal and is not acknowledged by guideline developers.
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Hospitals have strong incentives to decrease readmission rates. Not all hospital readmissions are potentially avoidable. Therefore, only a component of all hospital readmissions can be influenced by interventions designed to decrease them. In this study, we determined how effective interventions must be to attain specific reductions in hospital readmission rates. ⋯ These results highlight that relative reductions in the total number of readmissions are notably lower than that for potentially avoidable readmissions. This separation in relative reduction of all and potentially avoidable readmissions increases as the proportion of readmissions deemed potentially avoidable decreases. These results have important implications for health care planners and researchers.
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Comparative Study
Many scenarios exist for selective inclusion and reporting of results in randomized trials and systematic reviews.
To collate and categorize the ways in which selective inclusion and reporting can occur in randomized controlled trials (RCTs) and systematic reviews. ⋯ An extensive list of examples of selective inclusion and reporting was collated. Increasing trialists' and systematic reviewers' awareness of these examples may minimize their occurrence.
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Comparative Study
Development and pilot test of a process to identify research needs from a systematic review.
To ensure appropriate allocation of research funds, we need methods for identifying high-priority research needs. We developed and pilot tested a process to identify needs for primary clinical research using a systematic review in gestational diabetes mellitus. ⋯ We pilot tested an eight-step process to identify clinically important research needs. Before wider application of this process, it should be tested using systematic reviews of other diseases. Further evaluation should include assessment of the usefulness of the research needs generated using this process for primary researchers and funders.
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Review
Most meta-analyses of drug interventions have narrow scopes and many focus on specific agents.
To assess the extent to which meta-analysis publications of drugs and biologics focus on specific named agents or even only a single agent, and identify characteristics associated with such focus. ⋯ The scope of meta-analysis publications frequently is narrow and shaped to serve particular agents.