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Thoma A, Ignacy TA, Li YK, Coroneos CJ. Reporting the level of evidence in the Canadian Journal of Plastic Surgery: Why is it important? THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2012; 20:12-6. [PMID: 23598760 PMCID: PMC3307675 DOI: 10.1177/229255031202000113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The levels of evidence (LOE) table has been increasingly used by many surgical journals and societies to emphasize the importance of proper study design. Since their origin, LOE have evolved to consider multiple study designs and also the rigour of not only the study type but multiple aspects of its design. The use of LOE aids readers in appraising the literature while encouraging clinical researchers to produce high-quality evidence. The current article discusses the benefits and limitations of the LOE, as well as the LOE of articles published in the Canadian Journal of Plastic Surgery (CJPS). Along with an assessment of the LOE in the CJPS, the authors have provided recommendations to improve the quality and readability of articles published in the CJPS.
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Affiliation(s)
- Achilleas Thoma
- Division of Plastic Surgery
- Surgical Outcomes Research Centre (SOURCE), Department of Surgery
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario
| | - Teegan A Ignacy
- Division of Plastic Surgery
- Surgical Outcomes Research Centre (SOURCE), Department of Surgery
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Brouwers MC, De Vito C, Bahirathan L, Carol A, Carroll JC, Cotterchio M, Dobbins M, Lent B, Levitt C, Lewis N, McGregor SE, Paszat L, Rand C, Wathen N. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline. Implement Sci 2011; 6:112. [PMID: 21958602 PMCID: PMC3222606 DOI: 10.1186/1748-5908-6-112] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 09/29/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? METHODS A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. RESULTS Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale) for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. CONCLUSION Using established guideline development methodologies and the AGREE II as our methodological frameworks, we developed an implementation guideline to advise on interventions to increase the rate of breast, cervical and colorectal cancer screening. While advancements have been made in these areas of implementation science, more investigations are warranted.
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Affiliation(s)
- Melissa C Brouwers
- Program in Evidence-based Care, Cancer Care Ontario, Hamilton, Ont., Canada
- Departments of Oncology and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Canada
| | - Carol De Vito
- Program in Evidence-based Care, Cancer Care Ontario, Hamilton, Ont., Canada
- Departments of Oncology and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Canada
| | - Lavannya Bahirathan
- Program in Evidence-based Care, Cancer Care Ontario, Hamilton, Ont., Canada
- Departments of Oncology and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Canada
| | - Angela Carol
- Hamilton Urban Core Community Centre, Hamilton, Ont., Canada
| | - June C Carroll
- Department of Family and Community Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ont., Canada
| | - Michelle Cotterchio
- Population Studies and Surveillance, Cancer Care Ontario, Toronto, Ont., Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Ont., Canada
| | - Barbara Lent
- Department of Family Medicine, The University of Western Ontario, London, Ont., Canada
| | - Cheryl Levitt
- Department of Family Medicine, McMaster University, Hamilton, Ont., Canada
- Primary Care, Cancer Care Ontario, Toronto, Ont., Canada
| | - Nancy Lewis
- Prevention and Screening, Cancer Care Ontario, Toronto, Ont., Canada
| | - S Elizabeth McGregor
- Population Health Research, Alberta Health Services - Cancer Epidemiology, Prevention and Screening, Calgary, Alb., Canada
| | - Lawrence Paszat
- Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ont., Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Ont., Canada
| | - Carol Rand
- Regional Cancer Prevention and Early Detection Network Hamilton, Niagara, Haldimand, Brant., Canada
- Systemic, Supportive and Regional Cancer Programs, Juravinski Cancer Centre, Hamilton, Ont., Canada
| | - Nadine Wathen
- Faculty of Information and Media Studies, The University of Western Ontario, London, Ont., Canada
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