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França TFA. Exploring undiscovered public knowledge in neuroscience. Eur J Neurosci 2024. [PMID: 38782707 DOI: 10.1111/ejn.16396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/21/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
In this essay, I argue that the combination of research synthesis and philosophical methods can fill an important methodological gap in neuroscience. While experimental research and formal modelling have seen their methods progressively increase in rigour and sophistication over the years, the task of analysing and synthesizing the vast literature reporting new results and models has lagged behind. The problem is aggravated because neuroscience has grown and expanded into a vast mosaic of related but partially independent subfields, each with their own literatures. This fragmentation not only makes it difficult to see the full picture emerging from neuroscience research but also limits progress in individual subfields. The current neuroscience literature has the perfect conditions to create what the information scientist Don Swanson called "undiscovered public knowledge"-knowledge that exists in the mutual implications of different published pieces of information but that is nonetheless undiscovered because those pieces have not been explicitly connected. Current methods for rigorous research synthesis, such as systematic reviews and meta-analyses, mostly focus on combining similar studies and are not suited for exploring undiscovered public knowledge. To that aim, they need to be adapted and supplemented. I argue that successful exploration of the hidden implications in the neuroscience literature will require the combination of these adapted research synthesis methods with philosophical methods for rigorous (and creative) analysis and synthesis.
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Affiliation(s)
- Thiago F A França
- Departamento de Psicobiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Bennett-Weston A, Keshtkar L, Jones M, Sanders C, Lewis C, Nockels K, Solomon J, Howick J. Interventions to promote medical student well-being: an overview of systematic reviews. BMJ Open 2024; 14:e082910. [PMID: 38724055 PMCID: PMC11086405 DOI: 10.1136/bmjopen-2023-082910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE To conduct an overview of systematic reviews that explore the effectiveness of interventions to enhance medical student well-being. DESIGN Overview of systematic reviews. DATA SOURCES The Cochrane Library of Systematic Reviews, MEDLINE, APA PsychInfo, CINAHL and Scopus were searched from database inception until 31 May 2023 to identify systematic reviews of interventions to enhance medical student well-being. Ancestry searching and citation chasing were also conducted. DATA EXTRACTION AND SYNTHESIS The Assessing the Methodological Quality of Systematic Reviews V.2 tool was used to appraise the quality of the included reviews. A narrative synthesis was conducted, and the evidence of effectiveness for each intervention was rated. RESULTS 13 reviews (with 94 independent studies and 17 616 students) were included. The reviews covered individual-level and curriculum-level interventions. Individual interventions included mindfulness (n=12), hypnosis (n=6), mental health programmes (n=7), yoga (n=4), cognitive and behavioural interventions (n=1), mind-sound technology (n=1), music-based interventions (n=1), omega-3 supplementation (n=1), electroacupuncture (n=1) and osteopathic manipulative treatment (n=1). The curriculum-level interventions included pass/fail grading (n=4), problem-based curriculum (n=2) and multicomponent curriculum reform (n=2). Most interventions were not supported by sufficient evidence to establish effectiveness. Eleven reviews were rated as having 'critically low' quality, and two reviews were rated as having 'low' quality. CONCLUSIONS Individual-level interventions (mindfulness and mental health programmes) and curriculum-level interventions (pass/fail grading) can improve medical student well-being. These conclusions should be tempered by the low quality of the evidence. Further high-quality research is required to explore additional effective interventions to enhance medical student well-being and the most efficient ways to implement and combine these for maximum benefit.
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Affiliation(s)
- Amber Bennett-Weston
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Leila Keshtkar
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Max Jones
- Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Christopher Sanders
- Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Cara Lewis
- Dartmouth College, Hanover, New Hampshire, USA
| | - Keith Nockels
- University Library, University of Leicester, Leicester, UK
| | - Josie Solomon
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
- University of Lincoln, Lincoln, UK
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
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Smela B, Toumi M, Świerk K, Gawlik K, Clay E, Boyer L. Systematic literature reviews over the years. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2023; 11:2244305. [PMID: 37614556 PMCID: PMC10443963 DOI: 10.1080/20016689.2023.2244305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
Purpose: Nowadays, systematic literature reviews (SLRs) and meta-analyses are often placed at the top of the study hierarchy of evidence. The main objective of this paper is to evaluate the trends in SLRs of randomized controlled trials (RCTs) throughout the years. Methods: Medline database was searched, using a highly focused search strategy. Each paper was coded according to a specific ICD-10 code; the number of RCTs included in each evaluated SLR was also retrieved. All SLRs analyzing RCTs were included. Protocols, commentaries, or errata were excluded. No restrictions were applied. Results: A total of 7,465 titles and abstracts were analyzed, from which 6,892 were included for further analyses. There was a gradual increase in the number of annual published SLRs, with a significant increase in published articles during the last several years. Overall, the most frequently analyzed areas were diseases of the circulatory system (n = 750) and endocrine, nutritional, and metabolic diseases (n = 734). The majority of SLRs included between 11 and 50 RCTs each. Conclusions: The recognition of SLRs' usefulness is growing at an increasing speed, which is reflected by the growing number of published studies. The most frequently evaluated diseases are in alignment with leading causes of death and disability worldwide.
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Affiliation(s)
| | - Mondher Toumi
- Public Health Department, Aix-Marseille University, Marseille, France
| | | | | | | | - Laurent Boyer
- Public Health Department, Aix-Marseille University, Marseille, France
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Rydzewska LHM, Stewart LA, Tierney JF. Sharing individual participant data: through a systematic reviewer lens. Trials 2022; 23:167. [PMID: 35189931 PMCID: PMC8862249 DOI: 10.1186/s13063-021-05787-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/29/2021] [Indexed: 11/20/2022] Open
Abstract
An increasing prevalence of data-sharing models, aimed at making individual participant data (IPD) from clinical trials widely available, should facilitate the conduct of systematic reviews and meta-analyses based on IPD. We have assessed these different data-sharing approaches, from the perspective of experienced IPD reviewers, to examine their utility for conducting systematic reviews based on IPD, and to highlight any challenges. We present an overview of the range of different models, including the traditional, single question approach, topic-based repositories, and the newer generic data platforms, and show that there are benefits and drawbacks to each. In particular, not all of the new models allow researchers to fully realise the well-documented advantages of using IPD for meta-analysis, and we offer potential solutions that can help improve both data quantity and utility. However, to achieve the “nirvana” of an ideal clinical data sharing environment, both for IPD meta-analysis and other secondary research purposes, we propose that data providers, data requestors, funders, and platforms need to adopt a more joined-up and standardised approach.
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Hemilä H, Chalker E. Bias against Vitamin C in Mainstream Medicine: Examples from Trials of Vitamin C for Infections. Life (Basel) 2022; 12:62. [PMID: 35054455 PMCID: PMC8779885 DOI: 10.3390/life12010062] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 02/07/2023] Open
Abstract
Evidence has shown unambiguously that, in certain contexts, vitamin C is effective against the common cold. However, in mainstream medicine, the views on vitamin C and infections have been determined by eminence-based medicine rather than evidence-based medicine. The rejection of the demonstrated benefits of vitamin C is largely explained by three papers published in 1975-two published in JAMA and one in the American Journal of Medicine-all of which have been standard citations in textbooks of medicine and nutrition and in nutritional recommendations. Two of the papers were authored by Thomas Chalmers, an influential expert in clinical trials, and the third was authored by Paul Meier, a famous medical statistician. In this paper, we summarize several flaws in the three papers. In addition, we describe problems with two recent randomized trial reports published in JAMA which were presented in a way that misled readers. We also discuss shortcomings in three recent JAMA editorials on vitamin C. While most of our examples are from JAMA, it is not the only journal with apparent bias against vitamin C, but it illustrates the general views in mainstream medicine. We also consider potential explanations for the widespread bias against vitamin C.
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Affiliation(s)
- Harri Hemilä
- Department of Public Health, University of Helsinki, FI-00014 Helsinki, Finland
| | - Elizabeth Chalker
- Biological Data Science Institute, Australian National University, Canberra, ACT 2600, Australia;
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Rogozińska E, Gargon E, Olmedo-Requena R, Asour A, Cooper NAM, Vale CL, van’t Hooft J. Methods used to assess outcome consistency in clinical studies: A literature-based evaluation. PLoS One 2020; 15:e0235485. [PMID: 32639999 PMCID: PMC7343158 DOI: 10.1371/journal.pone.0235485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023] Open
Abstract
Evaluation studies of outcomes used in clinical research and their consistency are appearing more frequently in the literature, as a key part of the core outcome set (COS) development. Current guidance suggests such evaluation studies should use systematic review methodology as their default. We aimed to examine the methods used. We searched the Core Outcome Measures in Effectiveness Trials (COMET) database (up to May 2019) supplementing it with additional resources. We included evaluation studies of outcome consistency in clinical studies across health subjects and used a subset of A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 (items 1-9) to assess their methods. Of 93 included evaluation studies of outcome consistency (90 full reports, three summaries), 91% (85/93) reported performing literature searches in at least one bibliographic database, and 79% (73/93) was labelled as a "systematic review". The evaluations varied in terms of satisfying AMSTAR 2 criteria, such that 81/93 (87%) had implemented PICO in the research question, whereas only 5/93 (6%) had included the exclusions list. None of the evaluation studies explained how inconsistency of outcomes was detected, however, 80/90 (88%) concluded inconsistency in individual outcomes (66%, 55/90) or outcome domains (20%, 18/90). Methods used in evaluation studies of outcome consistency in clinical studies differed considerably. Despite frequent being labelled as a "systematic review", adoption of systematic review methodology is selective. While the impact on COS development is unknown, authors of these studies should refrain from labelling them as "systematic review" and focus on ensuring that the methods used to generate the different outcomes and outcome domains are reported transparently.
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Affiliation(s)
- Ewelina Rogozińska
- Meta-Analysis Group, Institute of Clinical Trials and Methodology, MRC Clinical Trials Unit at UCL, London, England, United Kingdom
- Women’s Health Research Unit, Queen Mary University of London, London, England, United Kingdom
- * E-mail:
| | - Elizabeth Gargon
- Department of Biostatistics, University of Liverpool, Liverpool, England, United Kingdom
| | - Rocío Olmedo-Requena
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Amani Asour
- Women’s Health Research Unit, Queen Mary University of London, London, England, United Kingdom
| | - Natalie A. M. Cooper
- Women’s Health Research Unit, Queen Mary University of London, London, England, United Kingdom
| | - Claire L. Vale
- Meta-Analysis Group, Institute of Clinical Trials and Methodology, MRC Clinical Trials Unit at UCL, London, England, United Kingdom
| | - Janneke van’t Hooft
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, United States of America
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Pieper D, Allers K, Mathes T, Hoffmann F, Klerings I, Rombey T, Nussbaumer-Streit B. Comparison of protocols and registry entries to published reports for systematic reviews. Hippokratia 2020. [DOI: 10.1002/14651858.mr000053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Dawid Pieper
- Witten/Herdecke University; Institute for Research in Operative Medicine (IFOM) - Department for evidence based health services research; Ostmerheimer Str. 200 (Building 38) Cologne NRW Germany 51109
| | - Katharina Allers
- Carl von Ossietzky University Oldenburg; Department of Health Services Research; Ammerländer Heerstrasse 140 Oldenburg Saxony Germany 26111
| | - Tim Mathes
- Witten/Herdecke University; Institute for Research in Operative Medicine (IFOM) - Department for evidence based health services research; Ostmerheimer Str. 200 (Building 38) Cologne NRW Germany 51109
| | - Falk Hoffmann
- Carl von Ossietzky University Oldenburg; Department of Health Services Research; Ammerländer Heerstrasse 140 Oldenburg Saxony Germany 26111
| | - Irma Klerings
- Danube University Krems; Cochrane Austria, Department for Evidence-based Medicine and Evaluation; Dr.-Karl-Dorrek-Straße 30 Krems Austria 3500a
| | - Tanja Rombey
- Witten/Herdecke University; Institute for Research in Operative Medicine (IFOM) - Department for evidence based health services research; Ostmerheimer Str. 200 (Building 38) Cologne NRW Germany 51109
| | - Barbara Nussbaumer-Streit
- Danube University Krems; Cochrane Austria, Department for Evidence-based Medicine and Evaluation; Dr.-Karl-Dorrek-Straße 30 Krems Austria 3500a
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Peralta-Pizza F, Pinzón DC, Gaitán HG, Eslava-Schmalbach J, Rodriguez-Malagon N. Google Scholar to identify research studies. Hippokratia 2019. [DOI: 10.1002/14651858.mr000049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Fernando Peralta-Pizza
- Universidad del Valle; Section of Neurosurgery, Department of Surgery; Santiago de Cali Colombia
| | - David C Pinzón
- Universidad Nacional de Colombia; Clinical Research Institute; Carrera 30 45-03 School of Medicine, First Floor Bogota D.C. Colombia 111321
| | - Hernando G Gaitán
- Faculty of Medicine, Universidad Nacional de Colombia; Department of Obstetrics and Gynecology; Carrera 30 No. 45-03 Bogota Colombia
| | - Javier Eslava-Schmalbach
- Universidad Nacional de Colombia; Instituto de Investigaciones Clinicas, Hospital Universitario Nacional de Colombia; Ciudad Universitaria, Carrera 30 Calle 45 Facultad de Medicina, oficina 107 Bogotá Cundinamarca Colombia 11001000
| | - Nelcy Rodriguez-Malagon
- National University of Colombia; Department of Statistics, School of Sciences; Carrera 30, Calle 45, Edificio 405 Bogotá, D.C. Colombia
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Abstract
Six years after the launch of Systematic Reviews by Biomed Central, this article is part of the celebration of the journal. It contains personal reflections on the past, present and future of systematic reviews, using examples relevant to the role of systematic reviews in cataloguing and analysing research, assessing quality and planning new studies. The focus is on the most common of the various types of systematic review in health and social care, namely those assessing the effects of interventions.
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Affiliation(s)
- Mike Clarke
- Northern Ireland Methodology Hub, Centre for Public Health, Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Hospitals, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland.
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Glasziou P, Aronson JK. A brief history of clinical evidence updates and bibliographic databases. J R Soc Med 2018; 111:292-301. [PMID: 30102098 PMCID: PMC6100150 DOI: 10.1177/0141076818788819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Paul Glasziou
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland 4229, Australia
| | - JK Aronson
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
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Affiliation(s)
- Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Institute for Health Sciences, Queen's University, Belfast, UK
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Nicholson J, McCrillis A, Williams JD. Collaboration challenges in systematic reviews: a survey of health sciences librarians. J Med Libr Assoc 2017; 105:385-393. [PMID: 28983202 PMCID: PMC5624428 DOI: 10.5195/jmla.2017.176] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. METHODS To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. RESULTS Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. CONCLUSIONS These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges.
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14
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Boylston AW. Early 18th century evidence synthesis. J R Soc Med 2016; 109:294. [PMID: 27496816 DOI: 10.1177/0141076816651205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- A W Boylston
- Nuffield Department of Clinical Laboratory Sciences, Oxford University, The Old Mill, Bayswater Mill Road, Oxford OX3 9SB, UK
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Abstract
Systematic reviews and meta-analyses are at the top of the 'evidence hierarchy' when assessing the effectiveness of health interventions. As such, they are important sources of synthesized information for decision-makers including consumers, clinicians, funders, payers, regulators, and researchers. The main reasons for undertaking systematic reviews and meta-analyses are to minimize bias and to maximize data by collating all the relevant, available evidence on a particular topic. In order to correctly inform decision-makers, but not mislead them, a number of key methodological conditions need to be met when undertaking these types of analysis. In this article we first review the history of systematic reviews and meta-analyses and then outline those conditions that may lead to the correct, or incorrect, use of these types of study. Also, new variations on standard systematic review methods are explored, with the pros and cons of each outlined.
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Affiliation(s)
- Lisa Askie
- Systematic Reviews and Health Technology Assessment, NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia.
| | - Martin Offringa
- Child Health Evaluative Sciences (CHES), Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto/iHPME, Toronto, Ontario, Canada
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