Access to data and the information explosion: oral contraceptives and risk of cancer

[Developing guidelines for reporting healthcare research: scientific rationale and procedures]

Healthcare research is extremely important, with the clear potential to influence treatment and prevention of disease, possibly on a global scale. Yet deficiencies in how research studies are reported are both well-documented and widespread across all medical specialties, types of interventions and study designs. Although randomised trials have received the most attention in this regard, similar concerns have been expressed about reporting of other types of research including diagnostic and epidemiological studies. If a journal article describes in enough detail what was done at each stage of a study, readers will have enough information to allow them to decide on the merits of the results for themselves. From this simple idea comes the scientific rationale of developing guidelines on how to report research. We consider desirable attributes of such guidelines, emphasising the importance of being evidence-based where possible. We describe recommended processes to produce guidelines that have evolved over several years during the preparation of a sequence of reporting guidelines including CONSORT, QUOROM, STARD and STROBE.

Tackling the growth of the obesity literature: obesity evidence spreads across many journals

OBJECTIVE

This study identified the journals with the highest yield of clinical obesity research articles and surveyed the scatter of such studies across journals. The study exemplifies an approach to establish a journal collection that is likely to contain most new knowledge about a field.

DESIGN AND METHODS

All original studies that were cited in 40 systematic reviews about obesity topics ('included studies') were compiled and journal titles in which they were published were extracted. The journals were ranked by the number of included studies. The highest-yielding journals for clinical obesity and the scatter across journal titles were determined. A subset of these journals was created in MEDLINE (PubMed) to test search recall and precision for high-quality studies of obesity treatment (that is, articles that pass predetermined methodology criteria, including random allocation of participants to comparison groups, assessment of clinical outcomes, and at least 80% follow-up).

RESULTS

Articles in 252 journals were cited in the systematic reviews. The three highest-yielding journals specialized in obesity, but they published only 19.2% of the research, leaving 80.8% scattered across 249 non-obesity journals. The MEDLINE journal subset comprised 241 journals (11 journals were not indexed in MEDLINE) and included 82% of the clinical obesity research articles retrieved by a search for high-quality treatment studies ('recall' of 82%). Of the articles retrieved, 11% were about clinical obesity care ('precision' of 11%), compared with precision of 6% for obesity treatment studies in the full MEDLINE database.

CONCLUSION

Obesity journals captured only a small proportion of the literature on clinical obesity care. Those wishing to keep up in this field will need to develop more inclusive strategies than reading these specialty journals. A journal subset based on these findings may be useful when searching large electronic databases to increase search precision.

Knowledge management: how to keep up with the literature

With the increasing medical literature, staying current with medical information is becoming a major challenge for clinicians. To ensure best practice and treatment for patients, clinicians must access medical information, acquire new knowledge, and achieve information mastery in their field. Without a systematic approach to identify and critically appraise clinical research, they might become dependent on inappropriate or outdated information. In this review, we present a brief synopsis of the multitude of resources available to clinicians for knowledge management, our best-practice suggestions for selecting an evidence-based medicine resource, and a convenient overview and easily adaptable strategy to successfully identify relevant medical literature and evaluate its validity. For rapid retrieval, review, and synthesis of the medical literature, we recommend the systematic approach of retrieve, review, reject, and read. This strategy allows clinicians to more efficiently stay abreast of the medical literature and more effectively translate the best evidence from peer-reviewed publication to patient.

Time trends in the impact factor of Public Health journals

BACKGROUND

Journal impact factor (IF) is linked to the probability of a paper being cited and is progressively becoming incorporated into researchers' curricula vitae. Furthermore, the decision as to which journal a given study should be submitted, may well be based on the trend in the journal's overall quality. This study sought to assess time trends in journal IF in the field of public, environmental and occupational health.

METHODS

We used the IFs of 80 Public Health journals that were registered by the Science Citation Index from 1992 through 2003 and had been listed for a minimum period of the previous 3 years. Impact factor time trends were assessed using a linear regression model, in which the dependent variable was IF and the independent variable, the year. The slope of the model and its statistical significance were taken as the indicator of annual change.

RESULTS

The IF range for the journals covered went from 0.18 to 5.2 in 2003. Although there was no statistical association between annual change and mean IF, most of the fastest growing journals registered mean IFs in excess of 1.5, and some represented emerging areas of public health research. Graphs displaying IF trends are shown.

CONCLUSION

In view of the delay between the publication of IFs and that of any given paper, knowing the trend in IF is essential in order to make a correct choice of journal.

A knowledgebase system to enhance scientific discovery: Telemakus

BACKGROUND

With the rapid expansion of scientific research, the ability to effectively find or integrate new domain knowledge in the sciences is proving increasingly difficult. Efforts to improve and speed up scientific discovery are being explored on a number of fronts. However, much of this work is based on traditional search and retrieval approaches and the bibliographic citation presentation format remains unchanged.

METHODS

Case study.

RESULTS

The Telemakus KnowledgeBase System provides flexible new tools for creating knowledgebases to facilitate retrieval and review of scientific research reports. In formalizing the representation of the research methods and results of scientific reports, Telemakus offers a potential strategy to enhance the scientific discovery process. While other research has demonstrated that aggregating and analyzing research findings across domains augments knowledge discovery, the Telemakus system is unique in combining document surrogates with interactive concept maps of linked relationships across groups of research reports.

CONCLUSION

Based on how scientists conduct research and read the literature, the Telemakus KnowledgeBase System brings together three innovations in analyzing, displaying and summarizing research reports across a domain: (1) research report schema, a document surrogate of extracted research methods and findings presented in a consistent and structured schema format which mimics the research process itself and provides a high-level surrogate to facilitate searching and rapid review of retrieved documents; (2) research findings, used to index the documents, allowing searchers to request, for example, research studies which have studied the relationship between neoplasms and vitamin E; and (3) visual exploration interface of linked relationships for interactive querying of research findings across the knowledgebase and graphical displays of what is known as well as, through gaps in the map, what is yet to be tested. The rationale and system architecture are described and plans for the future are discussed.

What do evidence-based secondary journals tell us about the publication of clinically important articles in primary healthcare journals?

BACKGROUND

We conducted this analysis to determine i) which journals publish high-quality, clinically relevant studies in internal medicine, general/family practice, general practice nursing, and mental health; and ii) the proportion of clinically relevant articles in each journal.

METHODS

We performed an analytic survey of a hand search of 170 general medicine, general healthcare, and specialty journals for 2000. Research staff assessed individual articles by using explicit criteria for scientific merit for healthcare application. Practitioners assessed the clinical importance of these articles. Outcome measures were the number of high-quality, clinically relevant studies published in the 170 journal titles and how many of these were published in each of four discipline-specific, secondary "evidence-based" journals (ACP Journal Club for internal medicine and its subspecialties; Evidence-Based Medicine for general/family practice; Evidence-Based Nursing for general practice nursing; and Evidence-Based Mental Health for all aspects of mental health). Original studies and review articles were classified for purpose: therapy and prevention, screening and diagnosis, prognosis, etiology and harm, economics and cost, clinical prediction guides, and qualitative studies.

RESULTS

We evaluated 60,352 articles from 170 journal titles. The pass criteria of high-quality methods and clinically relevant material were met by 3059 original articles and 1073 review articles. For ACP Journal Club (internal medicine), four titles supplied 56.5% of the articles and 27 titles supplied the other 43.5%. For Evidence-Based Medicine (general/family practice), five titles supplied 50.7% of the articles and 40 titles supplied the remaining 49.3%. For Evidence-Based Nursing (general practice nursing), seven titles supplied 51.0% of the articles and 34 additional titles supplied 49.0%. For Evidence-Based Mental Health (mental health), nine titles supplied 53.2% of the articles and 34 additional titles supplied 46.8%. For the disciplines of internal medicine, general/family practice, and mental health (but not general practice nursing), the number of clinically important articles was correlated withScience Citation Index (SCI) Impact Factors.

CONCLUSIONS

Although many clinical journals publish high-quality, clinically relevant and important original studies and systematic reviews, the articles for each discipline studied were concentrated in a small subset of journals. This subset varied according to healthcare discipline; however, many of the important articles for all disciplines in this study were published in broad-based healthcare journals rather than subspecialty or discipline-specific journals.

Comparison of information processing technologies

OBJECTIVE

To examine the type of information obtainable from scientific papers, using three different methods for the extraction, organization, and preparation of literature reviews.

DESIGN

A set of three review papers was identified, and the ideas represented by the authors of those papers were extracted. The 161 articles referenced in those three reviews were then analyzed using 1) a formalized data extraction approach, which uses a protocol-driven manual process to extract the variables, values, and statistical significance of the stated relationships; and 2) a computerized approach known as "Idea Analysis," which uses the abstracts of the original articles and processes them through a computer software program that reads the abstracts and organizes the ideas presented by the authors. The results were then compared. The literature focused on the human papillomavirus and its relationship to cervical cancer.

RESULTS

Idea Analysis was able to identify 68.9 percent of the ideas considered by the authors of the three review papers to be of importance in describing the association between human papillomavirus and cervical cancer. The formalized data extraction identified 27 percent of the authors' ideas. The combination of the two approaches identified 74.3 percent of the ideas considered important in the relationship between human papillomavirus and cervical cancer, as reported by the authors of the three review articles.

CONCLUSION

This research demonstrated that both a technically derived and a computer derived collection, categorization, and summarization of original articles and abstracts could provide a reliable, valid, and reproducible source of ideas duplicating, to a major degree, the ideas presented by subject specialists in review articles. As such, these tools may be useful to experts preparing literature reviews by eliminating many of the clerical-mechanical features associated with present-day scientific text processing.

More informative abstracts revisited

Following proposals in 1987 and 1988, several medical journals have provided more informative abstracts ("structured abstracts") for articles of clinical interest. Structured abstracts for original studies require authors to systematically disclose the objective, basic research design, clinical setting, participants, interventions (if any), main outcome measurements, results, and conclusions; and for literature reviews the objective, data sources, methods of study selection, data extraction and synthesis, and conclusions. More informative abstracts of this kind can facilitate peer review before publication, assist clinical readers to find articles that are both scientifically sound and applicable to their practices, and allow more precise computerized literature searches. We review the feasibility, acceptability, and dissemination of structured abstracts, reassess the underlying strategy, and describe modifications of the approach. This innovation can aid communication from scientists to clinicians, and other clinical journals are invited to join this effort.