Quality of reporting of trial abstracts needs to be improved: using the CONSORT for abstracts to assess the four leading Chinese medical journals of traditional Chinese medicine.

BACKGROUND: Due to language limitations, the abstract of journal article may be the only way for people of non-Chinese speaking countries to know about trials in traditional Chinese medicine (TCM). However, little is known about the reporting quality of these trial abstracts. Our study is to assess the reporting quality of abstracts of randomized controlled trials (RCT) published in four leading Chinese medical journals of TCM, and to identify any differences in reporting between the Chinese and English version of the same abstract publication. METHOD: Two reviewers hand-searched the Chinese Journal of Integrated Traditional and Western Medicine, the Chinese Journal of Integrative Medicine, the China Journal of Chinese Materia Medica and the Chinese Acupuncture & Moxibustion for all abstracts of RCTs published between 2006 and 2007. Two reviewers independently assessed the reporting quality of the Chinese and English version of all eligible abstracts based on a modified version of the CONSORT for reporting randomised trials in journal and conference abstracts (CONSORT for abstracts). RESULTS: We identified a total of 345 RCTs of TCM with both a Chinese and English abstract. More than half of Chinese abstracts reported details of the trial participants (68%; 234/345), control group intervention (52%; 179/345), the number of participants randomized (73%; 253/345) and benefits when interpreting the trial results (55%; 190/345). Reporting of methodological quality or key features of trial design and trial results were poor; only 2% (7/345) included details of the trial design, 3% (11/345) defined the primary outcome, 5% (17/345) described the methods of random sequence generation, and only 4% (13/345) reported the number of participants analyzed. No abstracts provided details on allocation concealment and trial registration. The percentage agreement in reporting (between the Chinese and English version of the same abstract) ranged from 84% to 100% across individual checklist item. CONCLUSION: The reporting quality of abstracts of RCTs published in these four TCM journals needs to be improved. Since none of the four journals adopted CONSORT for Abstracts, we hope that the introduction and adoption of CONSORT for Abstracts by TCM journals will lead to an improvement in reporting quality.

[CONSORT for reporting randomized controlled trials in journal and conference abstracts: explanation and elaboration].

BACKGROUND: Clear, transparent, and sufficiently detailed abstracts of conferences and journal articles related to randomized controlled trials (RCTs) are important, because readers often base their assessment of a trial solely on information in the abstract. Here, we extend the CONSORT (Consolidated Standards of Reporting Trials) Statement to develop a minimum list of essential items, which authors should consider when reporting the results of a RCT in any journal or conference abstract. METHODS AND FINDINGS: We generated a list of items from existing quality assessment tools and empirical evidence. A three-round, modified-Delphi process was used to select items. In all, 109 participants were invited to participate in an electronic survey; the response rate was 61%. Survey results were presented at a meeting of the CONSORT Group in Montebello, Canada, January 2007, involving 26 participants, including clinical trialists, statisticians, epidemiologists, and biomedical editors. Checklist items were discussed for eligibility into the final checklist. The checklist was then revised to ensure that it reflected discussions held during and subsequent to the meeting. CONSORT for Abstracts recommends that abstracts relating to RCTs have a structured format. Items should include details of trial objectives; trial design (e.g., method of allocation, blinding/masking); trial participants (i.e., description, numbers randomized, and number analyzed); interventions intended for each randomized group and their impact on primary efficacy outcomes and harms; trial conclusions; trial registration name and number; and source of funding. We recommend the checklist be used in conjunction with this explanatory document, which includes examples of good reporting, rationale, and evidence, when available, for the inclusion of each item. CONCLUSIONS: CONSORT for Abstracts aims to improve reporting of abstracts of RCTs published in journal articles and conference proceedings. It will help authors of abstracts of these trials provide the detail and clarity needed by readers wishing to assess a trial's validity and the applicability of its results.

[Petroleum substances--human health hazards. I. Classification of petroleum substances on the list of dangerous substances and assessment of existing hazards]. / Pochodne ropy naftowej--zagrozenia dla zdrowia czlowieka. I. Klasyfikacja substancji ropopochodnych w wykazie substancji niebezpiecznych a ocena rzeczywistych zagrozen.

Complex products derived from petroleum are widely used as fuels, greases, solvents, and intermediates in many branches of industry. Petroleum exposure-related human health hazards, observed in occupationally exposed people and in the general population, are a serious sanitary problem. Complex and variable composition of individual petroleum products makes the actual assessment of human health hazards difficult. Potential hazards, and resulting classification of individual petroleum substance groups, are discussed in the presented work. This should prove to be helpful to work safety and hygiene services as well as to supervising institutions, mainly the sanitary inspection, in a proper assessment of the hazards, and consequently in taking appropriate preventive actions. In Part I., general issues concerning the hazard assessment and legal aspects of petroleum substances classification are presented. In Part. II., individual groups of petroleum substances are discussed with respect to health hazards, resulting from both physicochemical properties and toxicity, and their classification based on this analysis is suggested.

"No language restrictions" in database searches: what does this really mean?

The aim of this study was to investigate the coverage of non-English journals by MEDLINE((R)) and EMBASE, the two major biomedical databases used for identifying studies for possible inclusion in systematic reviews and meta-analyses. A series of searches were conducted to compare the coverage of journals in languages other than English. The results were compared against listings in Ulrich's Periodicals Directory, an authoritative source of information on periodicals published in more than 200 countries. This study has highlighted the existence of a database coverage bias, in terms of the systematic exclusion of journals from certain countries and/or in certain languages. Searching that relies only on English language databases may result in failure to find many relevant studies published in languages other than English, irrespective of the research question and the avoidance of any language restrictions.

Exploring the evidence: the challenges of searching for research on acupuncture.

In complementary and alternative medicine, a number of basic problems exist for people who search for research-based information, one of which is the way that articles are indexed within the major databases. An exploration of the indexing of acupuncture studies was conducted as part of a review of research on the effectiveness of specific complementary therapies in cancer. Examination of several thesauri demonstrated variability in the terminology used for acupuncture and acupuncture-related therapies. Search strategies reported in published reviews also varied. Consequently, a series of acupuncture-related terms were used to search six major databases. The results provide an indication of the specificity and sensitivity of each term and also suggest which terms may be required for a relatively sensitive search for studies on the effectiveness of acupuncture therapy. A more detailed analysis of relevant research articles revealed a further issue for consideration--that of the variability in indexing by study type. While on MEDLINE randomized controlled trials are routinely identified as a specific publication type, on other databases and for other study types, the situation is less straightforward.

Spinal palpation: The challenges of information retrieval using available databases.

PURPOSE: This study addressed 2 questions: first, what is the yield of PubMed MEDLINE for complementary and alternative medicine (CAM) studies compared to other databases; second, what is an effective search strategy to answer a sample research question on spinal palpation? METHODS: We formulated the following research question: "What is the reliability of spinal palpation procedures?" We identified specific Medical Subject Headings (MeSH) and key terms as used in osteopathic medicine, allopathic medicine, chiropractic, and physical therapy. Using PubMed, we formulated an initial search template and applied it to 12 additional selected databases. Subsequently, we applied the inclusion criteria and evaluated the yield in terms of precision and sensitivity in identifying relevant studies. RESULTS: The online search result of the 13 databases identified 1189 citations potentially addressing the research question. After excluding overlapping and nonpertinent citations and those not meeting the inclusion criteria, 49 citations remained. PubMed yielded 19, while MANTIS (Manual Alternative and Natural Therapy Index System), a manual therapy database, yielded 35 citations. Twenty-six of the 49 online citations were repeatedly indexed in 3 or more databases. Content experts and selective manual searches identified 11 additional studies. In all, we identified 60 studies that addressed the research question. The cost of the databases used for conducting this search ranged from free-of-charge to $43,000 per year for a single network subscription. CONCLUSIONS: Commonly used databases often do not provide accurate indexing or coverage of CAM publications. Subject-specific specialized databases are recommended. Access, cost, and ease of using specialized databases are limiting factors.

Searching biomedical databases on complementary medicine: the use of controlled vocabulary among authors, indexers and investigators.

BACKGROUND: The optimal retrieval of a literature search in biomedicine depends on the appropriate use of Medical Subject Headings (MeSH), descriptors and keywords among authors and indexers. We hypothesized that authors, investigators and indexers in four biomedical databases are not consistent in their use of terminology in Complementary and Alternative Medicine (CAM). METHODS: Based on a research question addressing the validity of spinal palpation for the diagnosis of neuromuscular dysfunction, we developed four search concepts with their respective controlled vocabulary and key terms. We calculated the frequency of MeSH, descriptors, and keywords used by authors in titles and abstracts in comparison to standard practices in semantic and analytic indexing in MEDLINE, MANTIS, CINAHL, and Web of Science. RESULTS: Multiple searches resulted in the final selection of 38 relevant studies that were indexed at least in one of the four selected databases. Of the four search concepts, validity showed the greatest inconsistency in terminology among authors, indexers and investigators. The use of spinal terms showed the greatest consistency. Of the 22 neuromuscular dysfunction terms provided by the investigators, 11 were not contained in the controlled vocabulary and six were never used by authors or indexers. Most authors did not seem familiar with the controlled vocabulary for validity in the area of neuromuscular dysfunction. Recently, standard glossaries have been developed to assist in the research development of manual medicine. CONCLUSIONS: Searching biomedical databases for CAM is challenging due to inconsistent use of controlled vocabulary and indexing procedures in different databases. A standard terminology should be used by investigators in conducting their search strategies and authors when writing titles, abstracts and submitting keywords for publications.

Quality of hospital discharge and physician data for type of breast cancer surgery.

OBJECTIVE: The quality of coding for breast surgical procedures was examined by comparing hospital discharge abstracts and physician claims with data abstracted from records of women diagnosed with node-negative breast cancer from April 1, 1991, to December 31, 1991. METHODS: The node-negative breast cancer cohort was linked with a population registry file. Hospital discharge abstracts and physician billing claims were retrieved for matched subjects. Overall agreement between two data sets was defined as the number of cases for which there was a match by specific type of procedure out of all eligible cases that were matched with the health care utilization file. Specific agreement was assessed by the kappa statistic, using only those records in the administrative data set that were coded for mastectomy or breast-conserving surgery. RESULTS: Of 735 eligible cases in the node-negative breast cancer cohort, 655 (89.1%) were linked to a health care utilization file. Overall agreement between surgeon billing claims and charts was 95.4% (CI = 93.5, 96.9) for most definitive procedure. Agreement for breast surgery type was 98.1% (kappa = 0.96; CI = 0.87,1.0) for cases coded as breast-conserving surgery or mastectomy. When hospital discharge and chart data were compared, overall agreement was 86.2% (CI = 83.4, 88.8), whereas agreement for breast surgery type was 93.2% (kappa = 0.86; CI = 0.77, 0.94). CONCLUSION: Overall, definitive surgical procedure in the two administrative databases accurately reflected information recorded in patients' charts. Physician claims appeared to provide more accurate information than did hospital discharge data.

Summary of ICD-9-CM Coordination and Maintenance Committee meeting.

The ICD-9-CM Coordination and Maintenance Committee, cosponsored by the National Center for Health Statistics (NCHS) and the Health Care Financing Administration (HCFA), recently met in Baltimore, MD. Donna Pickett, RRA (NCHS), and Patricia Brooks, RRA (HCFA), cochaired the meeting. Proposed modifications to ICD-9-CM were presented and are summarized below. Unless otherwise indicated, the audience generally supported the proposed changes.

Integrated healthcare delivery systems: an overview for health information managers.

As integrated healthcare delivery systems stake their claims for the future, it is rapidly becoming the health information manager's duty to integrate and manage healthcare data. Read on for a general outlook on the changes surrounding integration activities, from new trends to integration's impact on the profession.

A successful methodology for improving the quality of clinical data.

In search of accurate, timely, and consistent information, Kaiser Permanente's Northern California Region set out to improve the quality of its clinical data. Analysis of documentation patterns resulted in consistency of clinical data, improved reimbursement, and a new dialogue between coding and medical staffs.