Acceptance of a systematic review as a thesis: survey of biomedical doctoral programs in Europe

Quality Assessment of Systematic Reviews Performed As An Undergraduate thesis in A Peruvian University: A Systematic Review

Objective

To determine the quality of systematic reviews submitted as a thesis in the Medical School of Ricardo Palma University.

Methods

We conducted a systematic review. We included systematic reviews submitted as theses from Ricardo Palma University, and we excluded narrative reviews, editorials, clinical experiments, and those with incomplete data. We performed a structured search on EMBASE, PubMed, Scopus, and Institutional Repository from the Ricardo Palma University and RENATI. The risk of bias assessment was performed through the AMSTAR-2 and the modified AMSTAR-2 tools. The primary outcome was review quality. A qualitative synthesis of the information was performed.

Results

One thousand four hundred eighty-seven theses were identified, and exclusion criteria were applied, whereby 11 theses were selected for review and thorough consultation. Of the 11 selected theses, and through the AMSTAR-2 and modified AMSTAR-2 tools, the findings reached were that 90.9% of the included theses presented critically low quality that was not modified even when the quality was reevaluated after its publication as a scientific article.

Conclusion

The systematic reviews presented as undergraduate thesis in the Medical School of Ricardo Palma University showed low and critically low quality. Improvement in systematic review training is required for both students and institutional advisors.

Methods proposed for monitoring the implementation of evidence-based research: a cross-sectional study

OBJECTIVES

Evidence-based research (EBR) is the systematic and transparent use of prior research to inform a new study so that it answers questions that matter in a valid, efficient, and accessible manner. This study surveyed experts about existing (e.g., citation analysis) and new methods for monitoring EBR and collected ideas about implementing these methods.

STUDY DESIGN AND SETTING

We conducted a cross-sectional study via an online survey between November 2022 and March 2023. Participants were experts from the fields of evidence synthesis and research methodology in health research. Open-ended questions were coded by recurring themes; descriptive statistics were used for quantitative questions.

RESULTS

Twenty-eight expert participants suggested that citation analysis should be supplemented with content evaluation (not just what is cited but also in which context), content expert involvement, and assessment of the quality of cited systematic reviews. They also suggested that citation analysis could be facilitated with automation tools. They emphasized that EBR monitoring should be conducted by ethics committees and funding bodies before the research starts. Challenges identified for EBR implementation monitoring were resource constraints and clarity on responsibility for EBR monitoring.

CONCLUSION

Ideas proposed in this study for monitoring the implementation of EBR can be used to refine methods and define responsibility but should be further explored in terms of feasibility and acceptability. Different methods may be needed to determine if the use of EBR is improving over time.

Diversity in medical PhD curricula: a call for harmonisation

BACKGROUND

Globalisation has increased human movements around the world, spurring greater connectiveness and opportunities to collaborate. In an increasingly connected world, quality assurance among professionals is paramount, particularly in medical research where PhD (Doctor of Philosophy) degree holders are expected to be at the peak of their field and play advanced-level research, education and leadership roles. While some regional efforts have been made to ensure comparability in the standards of advanced degree training, no previous study has compared these standards for a PhD in medicine across the globe.

AIMS

To explore the structural diversity of medical PhD degrees and identify which aspects benefit from greater harmonisation.

METHODS

In 2021, the 10 best-ranked universities from each of the top five Western countries, and the top Asian country, were identified based on Quacquarelli Symonds World University Ranking. Data were collected for each university based on individual website information regarding the level of degree required to gain entry into a PhD programme in medicine and requirements for completion of coursework, journal publication and oral defence.

RESULTS

Significant variations exist in the requirements for medical PhDs across the world in terms of prerequisite degree and inclusion of coursework. Oral defence is near universal, but a mandatory requirement for publication is largely absent.

CONCLUSIONS

Harmonisation of medical PhD degrees through international standards should be considered to encourage quality improvement and benchmarking between institutions, as well as to facilitate greater ease of movement within the medical research community, improving international collaboration and individual career opportunities accordingly.

Systematic Review Reporting - Writing concisely and precisely

Systematic reviews rank at the top of the evidence hierarchy. Concise writing implies drafting the systematic review article succinctly, i.e. using as few words to express as full an extent of the research effort as possible. Precise writing means drafting the text with accuracy especially with respect to the methodological and statistical aspects. The Abstract ought to be succinct and structured to allow for editors, peer reviewers and readers to get the gist of the key aspects of the systematic review with a quick read. The readership needs to be able to critically appraisal systematic reviews for their internal and external validity rapidly. The Abstract also needs to be standalone, representing an independent summary that can be fully understood without the need for reading the full paper. The standard structure of the main text of a scientific article called IMRaD (Introduction, Methods, Results and Discussion) applies equally to systematic reviews in the same way as it does to any other kinds of research manuscripts whether related to laboratory experiments or clinical trials. Restricting the word count limits to those imposed by journals may at first seem difficult, even unfair, to systematic reviewers. However, with the availability of online appendices to transparently and fully report the details of the methods, results and other aspects of the work undertaken allows for a succinct print or PDF article. Writing a shorter manuscript is more effortful than writing a longer report. This commentary is aimed at novice systematic reviewers to help them learn the written and unwritten writing rules in order to assist them in producing impactful publications to support evidence-based medicine.

Creating an online educational intervention to improve knowledge about systematic reviews among healthcare workers: mixed-methods pilot study

BACKGROUND

Lack of knowledge about systematic reviews (SRs) could prevent individual healthcare workers (HCWs) from using SRs as a source of information in their clinical practice or discourage them from participating in such research. In this study, we aimed to explore in-depth the opinion of a sample of HCWs about the newly created online educational intervention designed to improve knowledge about SRs.

METHODS

We created a brief online educational intervention on SRs, consisting of 11 textual modules. We evaluated it among practicing HCWs who graduated from a university-level health sciences program using a mixed-methods pilot study that consisted of pre- and post-intervention questionnaires and qualitative evaluation via semi-structured interviews. We assessed participants' knowledge about SR methodology before and after the intervention, and compared the responses. We sought their opinions about the characteristics of SRs. Also, the participants were presented with four scientific abstracts, where they were asked to distinguish whether those abstracts presented summaries of a systematic or a non-systematic review.

RESULTS

Twelve participants took part in the study. In the pilot study, the participants' knowledge about SRs was improved after the intervention compared to the baseline. Participants provided positive feedback regarding the educational intervention. Suggestions to improve the educational intervention were to provide more details about the forest plot, add more digital content or images, provide more details about the methodological steps of an SR, add descriptions about practical applications of SRs and provide links to additional educational materials. The participants suggested that HCWs could be motivated to take part in such an education if it is offered as continuing medical education (CME) course or credit for academic/career advancement.

CONCLUSION

HCWs provided positive feedback about the newly designed online educational intervention on SRs; they considered it an appropriate tool for learning about SRs and resulted in increased knowledge about SRs. In addition, participants gave suggestions for improving education, which can be used to tailor the education for end-users. In future studies, it would be useful to examine the effectiveness of the modified educational intervention on increasing knowledge in a larger sample and in the form of a randomized controlled trial.

Web-Based Educational Intervention to Improve Knowledge of Systematic Reviews Among Health Science Professionals: Randomized Controlled Trial

Background

Lack of knowledge of systematic reviews (SRs) could prevent individual health care professionals from using SRs as a source of information in their clinical practice or discourage them from participating in such research.

Objective

In this randomized controlled trial, we evaluated the effect of a short web-based educational intervention on short-term knowledge of SRs.

Methods

Eligible participants were 871 Master’s students of university health sciences studies in Croatia; 589 (67.6%) students who agreed to participate in the trial were randomized using a computer program into 2 groups. Intervention group A (294/589, 49.9%) received a short web-based educational intervention about SR methodology, and intervention group B (295/589, 50.1%) was presented with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. The participants’ knowledge of SRs was assessed before and after the intervention. The participants could not be blinded because of the nature of the intervention. The primary outcome was the difference in the percentage of correct answers about SR methodology per participant between the groups after the intervention, expressed as relative risk and 95% CI.

Results

Results from 162 and 165 participants in the educational intervention and PRISMA checklist groups, respectively, were available for analysis. Most of them (educational intervention group: 130/162, 80.2%; PRISMA checklist group: 131/165, 79.4%) were employed as health care professionals in addition to being health sciences students. After the intervention, the educational intervention group had 23% (relative risk percentage) more correct answers in the postintervention questionnaire than the PRISMA checklist group (relative risk=1.23, 95% CI 1.17-1.29).

Conclusions

A short web-based educational intervention about SRs is an effective tool for short-term improvement of knowledge of SRs among health care studies students, most of whom were also employed as health care professionals. Further studies are needed to explore the long-term effects of the tested education.

Trial Registration

OSF Registries 10.17605/OSF.IO/RYMVC; https://osf.io/rymvc

Evidence-Based Research Series-Paper 1: What Evidence-Based Research is and why is it important?

OBJECTIVES

There is considerable actual and potential waste in research. Evidence-based research ensures worthwhile and valuable research. The aim of this series, which this article introduces, is to describe the evidence-based research approach.

STUDY DESIGN AND SETTING

In this first article of a three-article series, we introduce the evidence-based research approach. Evidence-based research is the use of prior research in a systematic and transparent way to inform a new study so that it is answering questions that matter in a valid, efficient, and accessible manner.

RESULTS

We describe evidence-based research and provide an overview of the approach of systematically and transparently using previous research before starting a new study to justify and design the new study (article #2 in series) and-on study completion-place its results in the context with what is already known (article #3 in series).

CONCLUSION

This series introduces evidence-based research as an approach to minimize unnecessary and irrelevant clinical health research that is unscientific, wasteful, and unethical.

Academia Europaea Position Paper on Translational Medicine: The Cycle Model for Translating Scientific Results into Community Benefits

Introduction: Translational science has gained prominence in medicine, but there is still much work to be done before scientific results are used optimally and incorporated into everyday health practice. As the main focus is still on generating new scientific data with financial resources primarily available for that purpose, other activities that are necessary in the transition from research to community benefit are considered less needy. The European Statistical Office of the European Commission has recently reported that 1.7 million people under 75 years of age died in Europe in 2016, with around 1.2 million of those deaths being avoidable through effective primary prevention and public health intervention. Therefore, Academia Europaea, one of the five Pan-European networks that form SAPEA (Science Advice for Policy by European Academies), a key element of the European Commission’s Scientific Advice Mechanism (SAM), has launched a project to develop a model to facilitate and accelerate the utilisation of scientific knowledge for public and community benefit. Methods: During the process, leaders in the field, including prominent basic and clinical researchers, editors-in-chief of high-impact journals publishing translational research articles, translational medicine (TM) centre leaders, media representatives, academics and university leaders, developed the TM cycle, a new model that we believe could significantly advance the development of TM. Results: This model focuses equally on the acquisition of new scientific results healthcare, understandable and digestible summation of results, and their communication to all participants. We have also renewed the definition in TM, identified challenges and recommended solutions. Conclusion: The authors, including senior officers of Academia Europaea, produced this document to serve as a basis for revising thinking on TM with the end result of enabling more efficient and cost-effective healthcare.

Acceptance of systematic reviews as Master/PhD theses in Brazilian graduate programs in dentistry

OBJECTIVE

This study aimed to evaluate whether a master and PhD thesis in Brazilian graduate programs in dentistry can be based on a systematic review (SR).

METHODS

In this cross-sectional study, we surveyed the coordinators of Brazilian graduate programs in dentistry using a self-administered questionnaire including questions about whether an SR meets requirements for approval of a master or PhD thesis, instructions regarding how to use an SR as the method for a master or PhD thesis, and reasons and barriers that SRs were not recognized as acceptable for a master or PhD thesis. The responses were analyzed descriptively, and tables and graphs were created to summarize the data.

RESULTS

Among 101 graduate programs invited to participate in the study, 38 (37.6%) returned the questionnaire. Over three-quarters of surveyed programs (n = 30, 78.1%) answered that SRs, in whole or in part, meet the criteria for a master or PhD thesis. Likewise, most programs answered that a master or PhD thesis could be exclusively based on an SR (n = 28, 73.7%). The same number of programs pointed out that one possible reason for not recognizing SRs as a master or PhD thesis is either the lack of SR expertise among committee members (n = 28, 73.7%) or the lack of adequate training of candidates in SR methodology (n = 26, 68.4%).

CONCLUSIONS

SRs are well accepted as a master or PhD thesis by Brazilian graduate programs in dentistry. Educational initiatives should be encouraged to promote understanding of SR methodology and increase acceptance among graduate programs worldwide.

Attitudes of editors of core clinical journals about whether systematic reviews are original research: a mixed-methods study

OBJECTIVES

In 2009, not all journal editors considered systematic reviews (SRs) to be original research studies, and not all PubMed Core Clinical Journals published SRs. The aim of this study was to conduct a new analysis about editors' opinion regarding SRs as original research.

DESIGN

We conducted a survey and qualitative interview study of journal editors.

PARTICIPANTS

All editors listed as editor-in chief of 118 PubMed Core Clinical Journals.

METHODS

We contacted editors via email and asked them whether they considered SRs original research, whether they published SRs in the journal and, if yes, in which section. We searched PubMed for any SRs (or meta-analyses) published in the included journals in 2017; if we did not find any, we hand-searched these journals. Editors were invited to participate in a follow-up qualitative interview study.

RESULTS

We received responses from 73 editors representing 72 (62%) journals. Fifty-two (80%) editors considered SRs original research, either for any type of SR (65%) or only for SRs with a meta-analysis (15%) and almost all (91%) of editors published SRs. Compared with the results of the 2009 study of Core Clinical Journals, a similar proportion of editors considered SRs to be original studies (71%), accepted SRs as original on certain condition such as presence of meta-analysis (14%) or published SRs (94%). Interviews with editors showed that they used various criteria to decide whether a SR is original research, including methodology, reproducibility, originality of idea and level of novelty.

CONCLUSION

The majority of editors of core clinical journals consider that SRs are original research. Among editors, there was no uniform approach to defining what makes a SR, or any study, original. This indicates that the concepts of originality of SRs and research are evolving and that this would be a relevant topic for further discussion.