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Hombali A, Mahmood A, Gandhi DBC, Kamalakannan S, Chawla NS, D’souza J, Urimubenshi G, Sebastian IA, Solomon JM. Clinical Practice Guidelines (CPGs) for stroke rehabilitation from Low- and Middle-Income Countries (LMICs): Protocol for systematic review. PLoS One 2023; 18:e0293733. [PMID: 37943755 PMCID: PMC10635447 DOI: 10.1371/journal.pone.0293733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Stroke rehabilitation guidelines promoteclinical decision making, enhance quality of healthcare delivery, minimize healthcare costs, and identify gaps in current knowledge to guide future research. However, there are no published reviews that have exclusively evaluated the quality of existing Clinical Practice Guidelines (CPGs) for stroke rehabilitation from Low- and Middle-Income Countries (LMICs) or provided any insights into the cultural variation, adaptations, or gaps in implementation specific to LMICs. OBJECTIVES To identify CPGs developed by LMICs for stroke rehabilitation and evaluate their quality using AGREE-II and AGREE-REX tool. METHODS The review protocol is prepared in accordance with the PRISMA-P guidelines and the review was registered in PROSPERO (CRD42022382486). The search was run in Medline, EMBASE, CINHAL, PEDro for guidelines published between 2000 till July 2022. Additionally, SUMSearch, Google, and other guideline portals and gray literature were searched. The included studies were then subjected to data extraction for the following details: Study ID, title of the CPG, country of origin, characteristics of CPG (Scope-national/regional, level of care, multidisciplinary/uni-disciplinary), and information on stroke rehabilitation relevant recommendations. The quality of the included CPGs will be subsequently evaluated using AGREE-II and AGREE-REX tool. RESULTS & CONCLUSION This systematic review aims to explore the gaps in existing CPGs specific to LMICs and will aid in development/adaptation/contextualization of CPGs for implementation in LMICs.
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Affiliation(s)
- Aditi Hombali
- Visible Analytics and Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Amreen Mahmood
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dorcas B. C. Gandhi
- Department of Neurology & College of Physiotherapy, Christian Medical College & Hospital, Ludhiana, Punjab, India
| | - Sureshkumar Kamalakannan
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - Nistara S. Chawla
- Department of Neurology & College of Physiotherapy, Christian Medical College & Hospital, Ludhiana, Punjab, India
| | - Jennifer D’souza
- Department of Physiotherapy, St. John’s Medical College Hospital, Bangalore, Karnataka, India
| | - Gerard Urimubenshi
- Department of Physiotherapy, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Ivy A. Sebastian
- Department of Neurology, St. Stephen’s Hospital, New Delhi, India
| | - John M. Solomon
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Burns CS, Nix T, Shapiro RM, Huber JT. MEDLINE search retrieval issues: A longitudinal query analysis of five vendor platforms. PLoS One 2021; 16:e0234221. [PMID: 33956834 PMCID: PMC8101950 DOI: 10.1371/journal.pone.0234221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 03/28/2021] [Indexed: 11/18/2022] Open
Abstract
This study compared the results of data collected from a longitudinal query analysis of the MEDLINE database hosted on multiple platforms that include PubMed, EBSCOHost, Ovid, ProQuest, and Web of Science. The goal was to identify variations among the search results on the platforms after controlling for search query syntax. We devised twenty-nine cases of search queries comprised of five semantically equivalent queries per case to search against the five MEDLINE database platforms. We ran our queries monthly for a year and collected search result count data to observe changes. We found that search results varied considerably depending on MEDLINE platform. Reasons for variations were due to trends in scholarly publication such as publishing individual papers online first versus complete issues. Some other reasons were metadata differences in bibliographic records; differences in the levels of specificity of search fields provided by the platforms and large fluctuations in monthly search results based on the same query. Database integrity and currency issues were observed as each platform updated its MEDLINE data throughout the year. Specific biomedical bibliographic databases are used to inform clinical decision-making, create systematic reviews, and construct knowledge bases for clinical decision support systems. They serve as essential information retrieval and discovery tools to help identify and collect research data and are used in a broad range of fields and as the basis of multiple research designs. This study should help clinicians, researchers, librarians, informationists, and others understand how these platforms differ and inform future work in their standardization.
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Affiliation(s)
- C. Sean Burns
- School of Information Science, University of Kentucky, Lexington, Kentucky, United States of America
- * E-mail:
| | - Tyler Nix
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Robert M. Shapiro
- Robert M. Fales Health Sciences Library - SEAHEC Medical Library, South East Area Health Education Center, Wilmington, North Carolina, United States of America
| | - Jeffrey T. Huber
- School of Information Science, University of Kentucky, Lexington, Kentucky, United States of America
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Jack SM, Munro-Kramer ML, Williams JR, Schminkey D, Tomlinson E, Jennings Mayo-Wilson L, Bradbury-Jones C, Campbell JC. Recognising and responding to intimate partner violence using telehealth: Practical guidance for nurses and midwives. J Clin Nurs 2020; 30:588-602. [PMID: 33141467 DOI: 10.1111/jocn.15554] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/18/2020] [Accepted: 10/23/2020] [Indexed: 11/28/2022]
Abstract
AIMS To synthesise the current, global evidence-informed guidance that supports nurses and midwives to recognise and respond to intimate partner violence (IPV), and how these practices can be translated from face-to-face encounters to care that is delivered through telehealth. BACKGROUND COVID-19-related social and physical distancing measures increase the risk for individuals who are socially isolated with partners who perpetuate violence. Providing support through telehealth is one strategy that can mitigate the pandemic of IPV, while helping patients and providers stay safe from COVID-19. DESIGN AND METHODS In this discursive paper, we describe how practical guidance for safely recognising and responding to IPV in telehealth encounters was developed. The ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical Experts, Integration, Testing, Training) framework was used to guide the novel identification and adaptation of evidence-informed guidance. We focused on the first six stages of the ADAPT-ITT framework. CONCLUSIONS This paper fills a gap in available guidance, specifically for IPV recognition and response via telehealth. We present strategies for prioritising safety and promoting privacy while initiating, managing or terminating a telehealth encounter with patients who may be at risk for or experiencing IPV. Strategies for assessment, planning and intervention are also summarised. System-level responses, such as increasing equitable access to telecommunication technology, are also discussed. RELEVANCE TO CLINICAL PRACTICE Integrating innovative IPV-focused practices into telehealth care is an important opportunity for nurses and midwives during the current global COVID-19 pandemic. There are also implications for future secondary outbreaks, natural disasters or other physically isolating events, for improving healthcare efficiency, and for addressing the needs of vulnerable populations with limited access to health care.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | | | - Jessica R Williams
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donna Schminkey
- School of Nursing, College of Health and Behavioral Studies, James Madison University, Harrisonburg, VA, USA
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Seguin A, Haynes RB, Carballo S, Iorio A, Perrier A, Agoritsas T. Translating Clinical Questions by Physicians Into Searchable Queries: Analytical Survey Study. JMIR MEDICAL EDUCATION 2020; 6:e16777. [PMID: 32310137 PMCID: PMC7199131 DOI: 10.2196/16777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Staying up to date and answering clinical questions with current best evidence from health research is challenging. Evidence-based clinical texts, databases, and tools can help, but clinicians first need to translate their clinical questions into searchable queries. MacPLUS FS (McMaster Premium LiteratUre Service Federated Search) is an online search engine that allows clinicians to explore multiple resources simultaneously and retrieves one single output that includes the following: (1) evidence from summaries (eg, UpToDate and DynaMed), (2) preappraised research (eg, EvidenceAlerts), and (3) non-preappraised research (eg, PubMed), with and without validated bibliographic search filters. MacPLUS FS can also be used as a laboratory to explore clinical questions and evidence retrieval. OBJECTIVE Our primary objective was to examine how clinicians formulate their queries on a federated search engine, according to the population, intervention, comparison, and outcome (PICO) framework. Our secondary objective was to assess which resources were accessed by clinicians to answer their questions. METHODS We performed an analytical survey among 908 clinicians who used MacPLUS FS in the context of a randomized controlled trial on search retrieval. Recording account log-ins and usage, we extracted all 1085 queries performed during a 6-month period and classified each search term according to the PICO framework. We further categorized queries into background (eg, "What is porphyria?") and foreground questions (eg, "Does treatment A work better than B?"). We then analyzed the type of resources that clinicians accessed. RESULTS There were 695 structured queries, after exclusion of meaningless queries and iterations of similar searches. We classified 56.5% (393/695) of these queries as background questions and 43.5% (302/695) as foreground questions, the majority of which were related to questions about therapy (213/695, 30.6%), followed by diagnosis (48/695, 6.9%), etiology (24/695, 3.5%), and prognosis (17/695, 2.5%). This distribution did not significantly differ between postgraduate residents and medical faculty physicians (P=.51). Queries included a median of 3 search terms (IQR 2-4), most often related to the population and intervention or test, rarely related to the outcome, and never related to the comparator. About half of the resources accessed (314/610, 51.5%) were summaries, 24.4% (149/610) were preappraised research, and 24.1% were (147/610) non-preappraised research. CONCLUSIONS Our results, from a large sample of real-life queries, could guide the development of educational interventions to improve clinicians' retrieval skills, as well as inform the design of more useful evidence-based resources for clinical practice. TRIAL REGISTRATION ClinicalTrials.gov NCT02038439; https://www.clinicaltrials.gov/ct2/show/NCT02038439.
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Affiliation(s)
- Aurélie Seguin
- Division of General Internal Medicine, Department Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Robert Brian Haynes
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Sebastian Carballo
- Division of General Internal Medicine, Department Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Arnaud Perrier
- Division of General Internal Medicine, Department Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Thomas Agoritsas
- Division of General Internal Medicine, Department Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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Lunny C, Salzwedel DM, Liu T, Ramasubbu C, Gerrish S, Puil L, Mintzes B, Wright JM. Validation of five search filters for retrieval of clinical practice guidelines produced low precision. J Clin Epidemiol 2020; 117:109-116. [DOI: 10.1016/j.jclinepi.2019.09.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/31/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
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Burns CS, Shapiro RM, Nix T, Huber JT. Search results outliers among MEDLINE platforms. J Med Libr Assoc 2019; 107:364-373. [PMID: 31258442 PMCID: PMC6579582 DOI: 10.5195/jmla.2019.622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/01/2019] [Indexed: 11/30/2022] Open
Abstract
Objective Hypothetically, content in MEDLINE records is consistent across multiple platforms. Though platforms have different interfaces and requirements for query syntax, results should be similar when the syntax is controlled for across the platforms. The authors investigated how search result counts varied when searching records among five MEDLINE platforms. Methods We created 29 sets of search queries targeting various metadata fields and operators. Within search sets, we adapted 5 distinct, compatible queries to search 5 MEDLINE platforms (PubMed, ProQuest, EBSCOhost, Web of Science, and Ovid), totaling 145 final queries. The 5 queries were designed to be logically and semantically equivalent and were modified only to match platform syntax requirements. We analyzed the result counts and compared PubMed’s MEDLINE result counts to result counts from the other platforms. We identified outliers by measuring the result count deviations using modified z-scores centered around PubMed’s MEDLINE results. Results Web of Science and ProQuest searches were the most likely to deviate from the equivalent PubMed searches. EBSCOhost and Ovid were less likely to deviate from PubMed searches. Ovid’s results were the most consistent with PubMed’s but appeared to apply an indexing algorithm that resulted in lower retrieval sets among equivalent searches in PubMed. Web of Science exhibited problems with exploding or not exploding Medical Subject Headings (MeSH) terms. Conclusion Platform enhancements among interfaces affect record retrieval and challenge the expectation that MEDLINE platforms should, by default, be treated as MEDLINE. Substantial inconsistencies in search result counts, as demonstrated here, should raise concerns about the impact of platform-specific influences on search results.
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Affiliation(s)
- Christopher Sean Burns
- Associate Professor, School of Information Science, University of Kentucky, Lexington, KY,
| | - Robert M Shapiro
- Assistant Professor, School of Information Science, University of Kentucky, Lexington, KY,
| | - Tyler Nix
- Informationist, Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI,
| | - Jeffrey T Huber
- Professor, School of Information Science, University of Kentucky, Lexington, KY,
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Badgett RG, Dylla DP, Megison SD, Glynn Harmon E. An experimental search strategy retrieves more precise results than PubMed and Google for questions about medical interventions. PeerJ 2015; 3:e913. [PMID: 25922798 PMCID: PMC4411517 DOI: 10.7717/peerj.913] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 04/05/2015] [Indexed: 11/20/2022] Open
Abstract
Objective. We compared the precision of a search strategy designed specifically to retrieve randomized controlled trials (RCTs) and systematic reviews of RCTs with search strategies designed for broader purposes. Methods. We designed an experimental search strategy that automatically revised searches up to five times by using increasingly restrictive queries as long at least 50 citations were retrieved. We compared the ability of the experimental and alternative strategies to retrieve studies relevant to 312 test questions. The primary outcome, search precision, was defined for each strategy as the proportion of relevant, high quality citations among the first 50 citations retrieved. Results. The experimental strategy had the highest median precision (5.5%; interquartile range [IQR]: 0%-12%) followed by the narrow strategy of the PubMed Clinical Queries (4.0%; IQR: 0%-10%). The experimental strategy found the most high quality citations (median 2; IQR: 0-6) and was the strategy most likely to find at least one high quality citation (73% of searches; 95% confidence interval 68%-78%). All comparisons were statistically significant. Conclusions. The experimental strategy performed the best in all outcomes although all strategies had low precision.
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Affiliation(s)
- Robert G. Badgett
- Department of Internal Medicine, Kansas University School of Medicine - Wichita, Wichita, KS, USA
| | - Daniel P. Dylla
- Katy Campus Library, Houston Community College, Houston, TX, USA
| | | | - E Glynn Harmon
- School of Information, University of Texas at Austin, Austin, TX, USA
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Shi C, Tian J, Wang Q, Petkovic J, Ren D, Yang K, Yang Y. How equity is addressed in clinical practice guidelines: a content analysis. BMJ Open 2014; 4:e005660. [PMID: 25479795 PMCID: PMC4265087 DOI: 10.1136/bmjopen-2014-005660] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/23/2014] [Accepted: 11/18/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). SETTING Content analysis of methodological publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs. DATA SOURCES We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes. PRIMARY OUTCOMES The primary outcomes were methodological themes and processes on how to address equity issues in guideline development. RESULTS 8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes ('scoping questions', 'searching relevant evidence', 'appraising evidence and recommendations', 'formulating recommendations', 'monitoring implementation', 'providing a flow chart to include equity in CPGs', and 'others: reporting of guidelines and comments from stakeholders' for CPG developers and 'assessing the quality of CPGs' for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above. CONCLUSIONS For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual.
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Affiliation(s)
- Chunhu Shi
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Quan Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
- The First Clinical Medicine School, Lanzhou University, Lanzhou, China
| | | | - Dan Ren
- The First Clinical Medicine School, Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yang Yang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Wu MD, Chen SC. Graduate students appreciate Google Scholar, but still find use for libraries. ELECTRONIC LIBRARY 2014. [DOI: 10.1108/el-08-2012-0102] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this study is to examine how graduate students perceive and use Google Scholar. Google Scholar has provided a convenient alternative for finding scholarly documents since its inception in 2004 and has become a favoured tool for numerous academics. Knowledge of patrons’ usage patterns and attitudes towards Google Scholar will assist librarians in designing appropriate instruction programmes to improve students’ research abilities.
Design/methodology/approach
– In this study, 32 graduate students from the National Taiwan University were interviewed whose fields of study are the humanities (10), social sciences (11) and science and technology (11).
Findings
– Students prefer the usability of Google Scholar over library databases. However, they appreciate the quality of documents retrieved from library databases and regard these databases as crucial tools for finding scholarly documents. Science and technology students favoured Google Scholar more than those who study the humanities and social sciences.
Research limitations/implications
– This study only examines the perceptions and behaviour of graduate students. Future studies should include undergraduate students to investigate their use of Google Scholar, thereby obtaining a comprehensive understanding of various patrons of university libraries.
Practical implications
– This study shows that graduate students appreciate and use Google Scholar to find scholarly documents, although some students experience difficulties. The findings of this study may assist university libraries in improving their instruction programmes.
Originality/value
– The majority of previous studies have focused on coverage, quality and retrieval performance of Google Scholar. However, this study evaluates Google Scholar from a user’s perspective.
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Lee GY, Yamada J, Kyololo O, Shorkey A, Stevens B. Pediatric clinical practice guidelines for acute procedural pain: a systematic review. Pediatrics 2014; 133:500-15. [PMID: 24488733 DOI: 10.1542/peds.2013-2744] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Procedural pain assessment and management have been extensively studied through multiple research studies over the past decade. Results of this research have been included in numerous pediatric pain practice guidelines. OBJECTIVE To systematically review the quality of existing practice guidelines for acute procedural pain in children and provide recommendations for their use. METHODS A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, and Scopus from 2000 to July 2013. A gray literature search was also conducted through the Translating Research Into Practice database, Guidelines International Network database, and National Guideline Clearinghouse. Four reviewers rated relevant guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Screening of guidelines, assessment of methodological quality, and data abstraction were conducted by 2 pairs of raters. Disagreements in overall assessments were resolved through consensus. RESULTS Eighteen guidelines from 4930 retrieved abstracts were included in this study. Based on the AGREE II domains, the guidelines generally scored high in the scope and purpose and clarity of presentation areas. Information on the rigor of guideline development, applicability, and editorial independence were specified infrequently. Four of the 18 guidelines provided tools to help clinicians apply the recommendations in practice settings; 5 were recommended for use in clinical settings, and the remaining 13 were recommended for use with modification. CONCLUSIONS Despite the increasing availability of clinical practice guidelines for procedural pain in children, the majority are of average quality. More transparency and comprehensive reporting are needed for the guideline development process.
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Affiliation(s)
- Grace Y Lee
- The Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario; and
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Bramer WM, Giustini D, Kramer BM, Anderson P. The comparative recall of Google Scholar versus PubMed in identical searches for biomedical systematic reviews: a review of searches used in systematic reviews. Syst Rev 2013; 2:115. [PMID: 24360284 PMCID: PMC3882110 DOI: 10.1186/2046-4053-2-115] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 12/13/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The usefulness of Google Scholar (GS) as a bibliographic database for biomedical systematic review (SR) searching is a subject of current interest and debate in research circles. Recent research has suggested GS might even be used alone in SR searching. This assertion is challenged here by testing whether GS can locate all studies included in 21 previously published SRs. Second, it examines the recall of GS, taking into account the maximum number of items that can be viewed, and tests whether more complete searches created by an information specialist will improve recall compared to the searches used in the 21 published SRs. METHODS The authors identified 21 biomedical SRs that had used GS and PubMed as information sources and reported their use of identical, reproducible search strategies in both databases. These search strategies were rerun in GS and PubMed, and analyzed as to their coverage and recall. Efforts were made to improve searches that underperformed in each database. RESULTS GS' overall coverage was higher than PubMed (98% versus 91%) and overall recall is higher in GS: 80% of the references included in the 21 SRs were returned by the original searches in GS versus 68% in PubMed. Only 72% of the included references could be used as they were listed among the first 1,000 hits (the maximum number shown). Practical precision (the number of included references retrieved in the first 1,000, divided by 1,000) was on average 1.9%, which is only slightly lower than in other published SRs. Improving searches with the lowest recall resulted in an increase in recall from 48% to 66% in GS and, in PubMed, from 60% to 85%. CONCLUSIONS Although its coverage and precision are acceptable, GS, because of its incomplete recall, should not be used as a single source in SR searching. A specialized, curated medical database such as PubMed provides experienced searchers with tools and functionality that help improve recall, and numerous options in order to optimize precision. Searches for SRs should be performed by experienced searchers creating searches that maximize recall for as many databases as deemed necessary by the search expert.
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Affiliation(s)
- Wichor M Bramer
- Erasmus MC - University Medical Center Rotterdam, Medical Library, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Boeker M, Vach W, Motschall E. Google Scholar as replacement for systematic literature searches: good relative recall and precision are not enough. BMC Med Res Methodol 2013; 13:131. [PMID: 24160679 PMCID: PMC3840556 DOI: 10.1186/1471-2288-13-131] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/10/2013] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Recent research indicates a high recall in Google Scholar searches for systematic reviews. These reports raised high expectations of Google Scholar as a unified and easy to use search interface. However, studies on the coverage of Google Scholar rarely used the search interface in a realistic approach but instead merely checked for the existence of gold standard references. In addition, the severe limitations of the Google Search interface must be taken into consideration when comparing with professional literature retrieval tools.The objectives of this work are to measure the relative recall and precision of searches with Google Scholar under conditions which are derived from structured search procedures conventional in scientific literature retrieval; and to provide an overview of current advantages and disadvantages of the Google Scholar search interface in scientific literature retrieval. METHODS General and MEDLINE-specific search strategies were retrieved from 14 Cochrane systematic reviews. Cochrane systematic review search strategies were translated to Google Scholar search expression as good as possible under consideration of the original search semantics. The references of the included studies from the Cochrane reviews were checked for their inclusion in the result sets of the Google Scholar searches. Relative recall and precision were calculated. RESULTS We investigated Cochrane reviews with a number of included references between 11 and 70 with a total of 396 references. The Google Scholar searches resulted in sets between 4,320 and 67,800 and a total of 291,190 hits. The relative recall of the Google Scholar searches had a minimum of 76.2% and a maximum of 100% (7 searches). The precision of the Google Scholar searches had a minimum of 0.05% and a maximum of 0.92%. The overall relative recall for all searches was 92.9%, the overall precision was 0.13%. CONCLUSION The reported relative recall must be interpreted with care. It is a quality indicator of Google Scholar confined to an experimental setting which is unavailable in systematic retrieval due to the severe limitations of the Google Scholar search interface. Currently, Google Scholar does not provide necessary elements for systematic scientific literature retrieval such as tools for incremental query optimization, export of a large number of references, a visual search builder or a history function. Google Scholar is not ready as a professional searching tool for tasks where structured retrieval methodology is necessary.
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Affiliation(s)
- Martin Boeker
- Department of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Stefan-Meier-Str. 26, Freiburg i. Br. 79104, Germany
| | - Werner Vach
- Department of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Stefan-Meier-Str. 26, Freiburg i. Br. 79104, Germany
| | - Edith Motschall
- Department of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Stefan-Meier-Str. 26, Freiburg i. Br. 79104, Germany
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Poltawski L, Abraham C, Forster A, Goodwin VA, Kilbride C, Taylor RS, Dean S. Synthesising practice guidelines for the development of community-based exercise programmes after stroke. Implement Sci 2013; 8:115. [PMID: 24079302 PMCID: PMC3851241 DOI: 10.1186/1748-5908-8-115] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/28/2013] [Indexed: 12/02/2022] Open
Abstract
Background Multiple guidelines are often available to inform practice in complex interventions. Guidance implementation may be facilitated if it is tailored to particular clinical issues and contexts. It should also aim to specify all elements of interventions that may mediate and modify effectiveness, including both their content and delivery. We conducted a focused synthesis of recommendations from stroke practice guidelines to produce a structured and comprehensive account to facilitate the development of community-based exercise programmes after stroke. Methods Published stroke clinical practice guidelines were searched for recommendations relevant to the content and delivery of community-based exercise interventions after stroke. These were synthesised using a framework based on target intervention outcomes, personal and programme proximal objectives, and recommended strategies. Results Nineteen guidelines were included in the synthesis (STRIDES; STroke Rehabilitation Intervention-Development Evidence Synthesis). Eight target outcomes, 14 proximal objectives, and 94 recommended strategies were identified. The synthesis was structured to present best practice recommendations in a format that could be used by intervention programme developers. It addresses both programme content and context, including personal factors, service standards and delivery issues. Some recommendations relating to content, and many relating to delivery and other contextual issues, were based on low level evidence or expert opinion. Where opinion varied, the synthesis indicates the range of best practice options suggested in guidelines. Conclusions The synthesis may assist implementation of best practice by providing a structured intervention description that focuses on a particular clinical application, addresses practical issues involved in programme development and provision, and illustrates the range of best-practice options available to users where robust evidence is lacking. The synthesis approach could be applied to other areas of stroke rehabilitation or to other complex interventions.
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Affiliation(s)
- Leon Poltawski
- University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK.
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Crites GE, Markert RJ, Goggans DS, Richardson WS. Local development of MCQ tests for evidence-based medicine and clinical decision making can be successful. TEACHING AND LEARNING IN MEDICINE 2012; 24:341-347. [PMID: 23036002 DOI: 10.1080/10401334.2012.715258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Guidelines for the design of multiple-choice item (MCQ) tests of evidence-based medicine (EBM) and clinical decision making (CDM) have not been published. PURPOSE AND METHODS We describe a strategy to develop an EBM/CDM MCQ test database guided by educational theory and used psychometric analyses, including reliability, validity, and item analyses, to judge the strategy's success. RESULTS The internal consistency reliability of tests derived from the database was in the good-to-excellent range (0.74-0.95) and test-retest reliability was fair (0.51). One test discriminated across three levels of EBM/CDM learners (discriminant validity). Tests also predictively correlated with other medical school assessments according to theory (convergent and discriminant validity). The items were infrequently misclassified, had statistics close to historical standards, and were acceptable after no more than one round of revisions. CONCLUSIONS Our strategy for developing an EBM/CDM MCQ database was successful and tests derived from it can be flexibly sampled to assess different EBM/CDM knowledge domains and three levels of EBM/CDM learners. Assuming the availability of similar resources to support its application, this strategy should be replicable at other settings.
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Affiliation(s)
- Gerald E Crites
- Department of Medicine, Georgia Health Sciences University/University of Georgia Medical Partnership, Athens, GA, USA.
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Workman TE, Hurdle JF. Dynamic summarization of bibliographic-based data. BMC Med Inform Decis Mak 2011; 11:6. [PMID: 21284871 PMCID: PMC3042900 DOI: 10.1186/1472-6947-11-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 02/01/2011] [Indexed: 11/15/2022] Open
Abstract
Background Traditional information retrieval techniques typically return excessive output when directed at large bibliographic databases. Natural Language Processing applications strive to extract salient content from the excessive data. Semantic MEDLINE, a National Library of Medicine (NLM) natural language processing application, highlights relevant information in PubMed data. However, Semantic MEDLINE implements manually coded schemas, accommodating few information needs. Currently, there are only five such schemas, while many more would be needed to realistically accommodate all potential users. The aim of this project was to develop and evaluate a statistical algorithm that automatically identifies relevant bibliographic data; the new algorithm could be incorporated into a dynamic schema to accommodate various information needs in Semantic MEDLINE, and eliminate the need for multiple schemas. Methods We developed a flexible algorithm named Combo that combines three statistical metrics, the Kullback-Leibler Divergence (KLD), Riloff's RlogF metric (RlogF), and a new metric called PredScal, to automatically identify salient data in bibliographic text. We downloaded citations from a PubMed search query addressing the genetic etiology of bladder cancer. The citations were processed with SemRep, an NLM rule-based application that produces semantic predications. SemRep output was processed by Combo, in addition to the standard Semantic MEDLINE genetics schema and independently by the two individual KLD and RlogF metrics. We evaluated each summarization method using an existing reference standard within the task-based context of genetic database curation. Results Combo asserted 74 genetic entities implicated in bladder cancer development, whereas the traditional schema asserted 10 genetic entities; the KLD and RlogF metrics individually asserted 77 and 69 genetic entities, respectively. Combo achieved 61% recall and 81% precision, with an F-score of 0.69. The traditional schema achieved 23% recall and 100% precision, with an F-score of 0.37. The KLD metric achieved 61% recall, 70% precision, with an F-score of 0.65. The RlogF metric achieved 61% recall, 72% precision, with an F-score of 0.66. Conclusions Semantic MEDLINE summarization using the new Combo algorithm outperformed a conventional summarization schema in a genetic database curation task. It potentially could streamline information acquisition for other needs without having to hand-build multiple saliency schemas.
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Affiliation(s)
- T Elizabeth Workman
- Department of Biomedical Informatics, University of Utah, HSEB 5775, Salt Lake City, UT, USA.
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Lau AYS, Coiera E, Zrimec T, Compton P. Clinician search behaviors may be influenced by search engine design. J Med Internet Res 2010; 12:e25. [PMID: 20601351 PMCID: PMC2956236 DOI: 10.2196/jmir.1396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 02/12/2010] [Accepted: 03/17/2010] [Indexed: 11/20/2022] Open
Abstract
Background Searching the Web for documents using information retrieval systems plays an important part in clinicians’ practice of evidence-based medicine. While much research focuses on the design of methods to retrieve documents, there has been little examination of the way different search engine capabilities influence clinician search behaviors. Objectives Previous studies have shown that use of task-based search engines allows for faster searches with no loss of decision accuracy compared with resource-based engines. We hypothesized that changes in search behaviors may explain these differences. Methods In all, 75 clinicians (44 doctors and 31 clinical nurse consultants) were randomized to use either a resource-based or a task-based version of a clinical information retrieval system to answer questions about 8 clinical scenarios in a controlled setting in a university computer laboratory. Clinicians using the resource-based system could select 1 of 6 resources, such as PubMed; clinicians using the task-based system could select 1 of 6 clinical tasks, such as diagnosis. Clinicians in both systems could reformulate search queries. System logs unobtrusively capturing clinicians’ interactions with the systems were coded and analyzed for clinicians’ search actions and query reformulation strategies. Results The most frequent search action of clinicians using the resource-based system was to explore a new resource with the same query, that is, these clinicians exhibited a “breadth-first” search behaviour. Of 1398 search actions, clinicians using the resource-based system conducted 401 (28.7%, 95% confidence interval [CI] 26.37-31.11) in this way. In contrast, the majority of clinicians using the task-based system exhibited a “depth-first” search behavior in which they reformulated query keywords while keeping to the same task profiles. Of 585 search actions conducted by clinicians using the task-based system, 379 (64.8%, 95% CI 60.83-68.55) were conducted in this way. Conclusions This study provides evidence that different search engine designs are associated with different user search behaviors.
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Affiliation(s)
- Annie Y S Lau
- Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
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Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Spine J 2010; 10:514-29. [PMID: 20494814 DOI: 10.1016/j.spinee.2010.03.032] [Citation(s) in RCA: 265] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 02/24/2010] [Accepted: 03/29/2010] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Low back pain (LBP) is a prevalent, costly, and challenging condition to manage. Clinicians must choose among numerous assessment and management options. Several recent clinical practice guidelines (CPGs) on LBP have attempted to inform these decisions by evaluating and summarizing the best available supporting evidence. The quality and consistency of recommendations from these CPGs are currently unknown. PURPOSE To conduct a systematic review of recent CPGs and synthesize their recommendations on assessing and managing LBP for clinicians. STUDY DESIGN/SETTING Systematic review. METHODS Literature search using MEDLINE, National Guidelines Clearinghouse, National Institute for Clinical Excellence, Internet search engines, and references of known articles. Only CPGs related to both assessment and management of LBP written in English were eligible; CPGs that summarized evidence from before the year 2000 were excluded. Data related to methods and recommendations for assessment and management of LBP were abstracted independently by two reviewers. Methodological quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument by two reviewers. RESULTS The search uncovered 669 citations, of which 95 were potentially relevant and 10 were included in the review; 6 discussed acute LBP, 6 chronic LBP, and 6 LBP with neurologic involvement. Methods used to develop CPGs varied, but the overall methodological quality was high as defined by AGREE scores. Recommendations for assessment of LBP emphasized the importance of ruling out potentially serious spinal pathology, specific causes of LBP, and neurologic involvement, as well as identifying risk factors for chronicity and measuring the severity of symptoms and functional limitations, through the history, physical, and neurologic examination. Recommendations for management of acute LBP emphasized patient education, with short-term use of acetaminophen, nonsteroidal anti-inflammatory drugs, or spinal manipulation therapy. For chronic LBP, the addition of back exercises, behavioral therapy, and short-term opioid analgesics was suggested. Management of LBP with neurologic involvement was similar, with additional consideration given to magnetic resonance imaging or computed tomography to identify appropriate candidates willing to undergo epidural steroid injections or decompression surgery if more conservative approaches are not successful. CONCLUSIONS Recommendations from several recent CPGs regarding the assessment and management of LBP were similar. Clinicians who care for patients with LBP should endeavor to adopt these recommendations to improve patient care. Future CPGs may wish to invite coauthors from targeted clinician user groups, increase patient participation, update their literature searches before publication, conduct their own quality assessment of studies, and consider cost-effectiveness and other aspects in their recommendations more explicitly.
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Lloyd K, Cella M, Tanenblatt M, Coden A. Analysis of clinical uncertainties by health professionals and patients: an example from mental health. BMC Med Inform Decis Mak 2009; 9:34. [PMID: 19591679 PMCID: PMC2716317 DOI: 10.1186/1472-6947-9-34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Accepted: 07/10/2009] [Indexed: 11/21/2022] Open
Abstract
Background The first step in practising Evidence Based Medicine (EBM) has been described as translating clinical uncertainty into a structured and focused clinical question that can be used to search the literature to ascertain or refute that uncertainty. In this study we focus on questions about treatments for schizophrenia posed by mental health professionals and patients to gain a deeper understanding about types of questions asked naturally, and whether they can be reformulated into structured and focused clinical questions. Methods From a survey of uncertainties about the treatment of schizophrenia we describe, categorise and analyse the type of questions asked by mental health professionals and patients about treatment uncertainties for schizophrenia. We explore the value of mapping from an unstructured to a structured framework, test inter-rater reliability for this task, develop a linguistic taxonomy, and cross tabulate that taxonomy with elements of a well structured clinical question. Results Few of the 78 Patients and 161 clinicians spontaneously asked well structured queries about treatment uncertainties for schizophrenia. Uncertainties were most commonly about drug treatments (45.3% of clinicians and 41% of patients), psychological therapies (19.9% of clinicians and 9% of patients) or were unclassifiable.(11.8% of clinicians and 16.7% of patients). Few naturally asked questions could be classified using the well structured and focused clinical question format (i.e. PICO format). A simple linguistic taxonomy better described the types of questions people naturally ask. Conclusion People do not spontaneously ask well structured clinical questions. Other taxonomies may better capture the nature of questions. However, access to EBM resources is greatly facilitated by framing enquiries in the language of EBM, such as posing queries in PICO format. People do not naturally do this. It may be preferable to identify a way of searching the literature that more closely matches the way people naturally ask questions if access to information about treatments are to be made more broadly available.
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Affiliation(s)
- Keith Lloyd
- Institute of Life Science, School of Medicine, Swansea University, Swansea, SA2 8PP, UK.
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McIntosh HM, Neal RD, Rose P, Watson E, Wilkinson C, Weller D, Campbell C. Follow-up care for men with prostate cancer and the role of primary care: a systematic review of international guidelines. Br J Cancer 2009; 100:1852-60. [PMID: 19436297 PMCID: PMC2714251 DOI: 10.1038/sj.bjc.6605080] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 04/07/2009] [Accepted: 04/08/2009] [Indexed: 11/24/2022] Open
Abstract
The optimal role for primary care in providing follow-up for men with prostate cancer is uncertain. A systematic review of international guidelines was undertaken to help identify key elements of existing models of follow-up care to establish a theoretical basis for evaluating future complex interventions. Many guidelines provide insufficient information to judge the reliability of the recommendations. Although the PSA test remains the cornerstone of follow-up, the diversity of recommendations on the provision of follow-up care reflects the current lack of research evidence on which to base firm conclusions. The review highlights the importance of transparent guideline development procedures and the need for robust primary research to inform future evidence-based models of follow-up care for men with prostate cancer.
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Affiliation(s)
- H M McIntosh
- Community Health Sciences - General Practice, University of Edinburgh, 20 West Richmond Street, Edinburgh EH9 9DX, UK.
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Affiliation(s)
- Yasuharu Tokuda
- Department of Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo City, Tokyo, Japan.
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