Systematic reviews and meta-analyses in neurosurgery Part II: a guide to designing the protocol.

Despite clearly established guidelines, recent audits have found the conduct and reporting of systematic reviews and meta-analyses (SRMAs) within neurosurgery to be relatively lackluster in methodological rigor and compliance. Protocols of SRMAs allow for planning and documentation of review methods, guard against arbitrary decision-making during the review process, and enable readers to assess for the presence of selective reporting. To aid transparency, authors should provide sufficient detail in their protocol so that the readers could reproduce the study themselves. Development of our guideline drew heavily from the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) initiative. The objective of this article is not to enumerate every detail of this checklist, but to provide guidance to authors preparing their protocol, with examples, for a systematic review in neurosurgery. Particularly, we emphasize on the PICO framework - population (P), interventions (I), comparators (C), outcomes (O) - which is central to constructing a clinical question, defining the scope of the systematic review, defining and prioritizing the primary outcome, to specifying the eligibility criteria, designing the search strategy, and identifying potential sources of heterogeneity. We encourage our readers to make use of this guideline alongside the PRISMA-P 2015 statement, when drafting and appraising systematic review protocols.

Beyond human-likeness: Socialness is more influential when attributing mental states to robots.

We sought to replicate and expand previous work showing that the more human-like a robot appears, the more willing people are to attribute mind-like capabilities and socially engage with it. Forty-two participants played games against a human, a humanoid robot, a mechanoid robot, and a computer algorithm while undergoing functional neuroimaging. We confirmed that the more human-like the agent, the more participants attributed a mind to them. However, exploratory analyses revealed that the perceived socialness of an agent appeared to be as, if not more, important for mind attribution. Our findings suggest top-down knowledge cues may be equally or possibly more influential than bottom-up stimulus cues when exploring mind attribution in non-human agents. While further work is now required to test this hypothesis directly, these preliminary findings hold important implications for robotic design and to understand and test the flexibility of human social cognition when people engage with artificial agents.

Polygraph-based deception detection and Machine Learning. Combining the Worst of Both Worlds?

At a time when developments in computational approaches, often associated with the now much-vaunted terms Machine Learning (ML) and Artificial Intelligence (AI), face increasing challenges in terms of fairness, transparency and accountability, the temptation for researchers to apply mainstream ML methods to virtually any type of data seems to remain irresistible. In this paper we critically examine a recent proposal to apply ML to polygraph screening results (where human interviewers have made a conclusion about deception), which raises several questions about the purpose and the design of the research, particularly given the vacuous scientific status of polygraph-based procedures themselves. We argue that in high-stake environments such as criminal justice and employment practice, where fundamental rights and principles of justice are at stake, the legal and ethical considerations for scientific research are heightened. Specifically, we argue that the combination of ambiguously labelled data and ad hoc ML models does not meet this requirement. Worse, such research can inappropriately legitimise otherwise scientifically invalid, indeed pseudo-scientific methods such as polygraph-based deception detection, especially when presented in a reputable scientific journal. We conclude that methodological concerns, such as those highlighted in this paper, should be addressed before research can be said to contribute to resolving any of the fundamental validity issues that underlie methods and techniques used in legal proceedings.

An Indigenous-informed scoping review study methodology: advancing the science of scoping reviews.

BACKGROUND: Historically, Indigenous voices have been silent in health research, reflective of colonial academic institutions that privilege Western ways of knowing. However, Indigenous methodologies and methods with an emphasis on the active involvement of Indigenous peoples and centering Indigenous voices are gaining traction in health education and research. In this paper, we map each phase of our scoping review process and weave Indigenous research methodologies into Arksey and O'Malley's (2005) framework for conducting scoping reviews. METHODS: Guided by an advisory circle consisting of Indigenous Knowledge Keepers and allied scholars, we utilized both Indigenous and Western methods to conduct a scoping review. As such, a circle of Knowledge Keepers provided guidance and informed our work, while our methods of searching and scoping the literature remained consistent with PRISMA-ScR guidelines. In keeping with an Indigenous methodology, the scoping review protocol was not registered allowing for an organic development of the research process. RESULTS: We built upon Arksey and O'Malley's 5-stages and added an additional 3 steps for a combined 8-stage model to guide our research: (1) Exploration and Listening, (2) Doing the Groundwork, (3) Identifying and Refining the Research Question, (4) Identifying Relevant Studies, (5) Study Selection, (6) Mapping Data, (7) Collating, Summarizing and Synthesizing the Data, and lastly, (8) Sharing and Making Meaning. Engagement and listening, corresponding to Arksey and O'Malley (2005)'s optional "consultation stage," was embedded throughout, but with greater intensity in stages 1 and 8. CONCLUSION: An Indigenous approach to conducting a scoping review includes forming a team with a wide array of experience in both Indigenous and Western methodologies, meaningful Indigenous representation, and inclusion of Indigenous perspectives to shape the analysis and presentation of findings. Engaging Indigenous peoples throughout the entire research process, listening, and including Indigenous voices and perspectives is vital in reconciliation research, producing both credible and useable information for both Indigenous communities and academia. Our Indigenous methodology for conducting a scoping review can serve as a valuable framework for summarizing Indigenous health-related research.

Determining an Appropriate Sample Size for Qualitative Interviews to Achieve True and Near Code Saturation: Secondary Analysis of Data.

BACKGROUND: In-depth interviews are a common method of qualitative data collection, providing rich data on individuals' perceptions and behaviors that would be challenging to collect with quantitative methods. Researchers typically need to decide on sample size a priori. Although studies have assessed when saturation has been achieved, there is no agreement on the minimum number of interviews needed to achieve saturation. To date, most research on saturation has been based on in-person data collection. During the COVID-19 pandemic, web-based data collection became increasingly common, as traditional in-person data collection was possible. Researchers continue to use web-based data collection methods post the COVID-19 emergency, making it important to assess whether findings around saturation differ for in-person versus web-based interviews. OBJECTIVE: We aimed to identify the number of web-based interviews needed to achieve true code saturation or near code saturation. METHODS: The analyses for this study were based on data from 5 Food and Drug Administration-funded studies conducted through web-based platforms with patients with underlying medical conditions or with health care providers who provide primary or specialty care to patients. We extracted code- and interview-specific data and examined the data summaries to determine when true saturation or near saturation was reached. RESULTS: The sample size used in the 5 studies ranged from 30 to 70 interviews. True saturation was reached after 91% to 100% (n=30-67) of planned interviews, whereas near saturation was reached after 33% to 60% (n=15-23) of planned interviews. Studies that relied heavily on deductive coding and studies that had a more structured interview guide reached both true saturation and near saturation sooner. We also examined the types of codes applied after near saturation had been reached. In 4 of the 5 studies, most of these codes represented previously established core concepts or themes. Codes representing newly identified concepts, other or miscellaneous responses (eg, "in general"), uncertainty or confusion (eg, "don't know"), or categorization for analysis (eg, correct as compared with incorrect) were less commonly applied after near saturation had been reached. CONCLUSIONS: This study provides support that near saturation may be a sufficient measure to target and that conducting additional interviews after that point may result in diminishing returns. Factors to consider in determining how many interviews to conduct include the structure and type of questions included in the interview guide, the coding structure, and the population under study. Studies with less structured interview guides, studies that rely heavily on inductive coding and analytic techniques, and studies that include populations that may be less knowledgeable about the topics discussed may require a larger sample size to reach an acceptable level of saturation. Our findings also build on previous studies looking at saturation for in-person data collection conducted at a small number of sites.

Pain cues override identity cues in baby cries.

Baby cries can convey both static information related to individual identity and dynamic information related to the baby's emotional and physiological state. How do these dimensions interact? Are they transmitted independently, or do they compete against one another? Here we show that the universal acoustic expression of pain in distress cries overrides individual differences at the expense of identity signaling. Our acoustic analysis show that pain cries, compared with discomfort cries, are characterized by a more unstable source, thus interfering with the production of identity cues. Machine learning analyses and psychoacoustic experiments reveal that while the baby's identity remains encoded in pain cries, it is considerably weaker than in discomfort cries. Our results are consistent with the prediction that the costs of failing to signal distress outweigh the cost of weakening cues to identity.

Barriers and Facilitators to Youth Decision-Making Involvement in Families Referred for Stem Cell Transplant.

Youth prefer to be involved in treatment decisions, yet youth participation is minimally present in decisions like stem cell transplant (SCT) that require frequent medications and social isolation to be successful in curing cancer and chronic illness. The purpose of our study is to identify the barriers and facilitators to youth decision-making involvement in the youth-parent interaction when referred for treatment with SCT. We report qualitative findings from our theory-driven mixed-methods study. We thematically analyzed our field notes of youth and parent observations and audio-recordings during SCT consultations and semi-structured interviews. Data were collected from 10 youth, 8 to 16 (median 12) years of age, and their parents (n = 20). Three themes emerged: (a) Reluctant unless motivated, (b) Uncertain but capable, and (c) Limited unless supported. Our findings emphasize the critical role parents may take in facilitating youth involvement in decisions.

The Role of Philosophical Tools in Nursing Research.

The objective of this article is to illustrate the importance of the role philosophy and its tools play in the designing and undertaking of nursing research and its importance to be understood by the practicing researcher to ensure the selected methodology and the tools used provide the framework for obtaining reliable and valid answers to their research questions. The article discusses the three major paradigms (Positivism, Interpretivism, and Pragmatism) which have characterized much of health-related research together with a set of essential and practical tools with no metaphysical assumptions that will hopefully provide an explicit framework and a nomenclature which can be applied as we proceed through the research process.

Systematic reviews and meta-analyses in neurosurgery part I: interpreting and critically appraising as a guide for clinical practice.

Neurosurgeons are inundated with the Herculean task to keep abreast with the rapid pace at which clinical research is proliferating. Systematic reviews and meta-analyses (SRMAs) have consequently surged in popularity because when executed properly, they constitute the highest level of evidence, and may save busy neurosurgeons many hours of combing the literature. Well-executed SRMAs may prove instructive for clinical practice, but poorly conducted reviews sow confusion and may potentially cause harm. Unfortunately, many SRMAs within neurosurgery are relatively lackluster in methodological rigor. When neurosurgeons apply the results of an SRMA to patient care, they should start by evaluating the extent to which the employed methods have likely protected against misleading results. The present article aims to educate the reader about how to interpret an SRMA, to assess the potential relevance of its results in the special context of the neurosurgical patient population.

Advancing health equity in the aftermath of COVID-19: Confronting intensifying racial disparities.

The COVID-19 pandemic has exposed and exacerbated the persistent racial and ethnic health disparities in the United States. The pandemic has also had profound spillover effects on other aspects of health and wellbeing, such as mental health, chronic diseases, education, and income, for marginalized groups. In this article, we provide a thorough analysis of the pandemic's impact on racial and ethnic health disproportionalities, highlighting the multifaceted and interrelated factors that contribute to these inequities. We also argue for a renewed focus on health equity in healthcare policy and practice, emphasizing the need for systemic changes that address both the immediate and long-term consequences of these imbalances. We propose a framework for achieving health equity that involves creating equitable systems, care, and outcomes for all individuals, regardless of their race or ethnicity.

[How to: correctly read scientific articles : Research design and methodology]. / How to: einen wissenschaftlichen Artikel richtig lesen : Forschungsdesign und Methodik.

Criteria for assessment of the significance of scientific articles are presented. The focus is on research design and methodology, illustrated by the classical study on prehospital volume treatment of severely injured individuals with penetrating torso injuries by Bickell et al. (1994). A well-thought out research design is crucial for the success of a scientific study and is documented in a study protocol beforehand. A hypothesis is a provisional explanation or prediction and must be testable, falsifiable, precise, and relevant. There are various types of randomization methods, with the randomized controlled trial being the gold standard for clinical interventional studies. When reading a scientific article it is important to verify whether the research design and setting align with the research question and whether potential sources of error have been considered and controlled. Critical scrutiny should also be applied to references, the funding and expertise of the researchers.

Prioritized neural processing of social threats during perceptual decision-making.

Emotional signals, notably those signaling threat, benefit from prioritized processing in the human brain. Yet, it remains unclear whether perceptual decisions about the emotional, threat-related aspects of stimuli involve specific or similar neural computations compared to decisions about their non-threatening/non-emotional components. We developed a novel behavioral paradigm in which participants performed two different detection tasks (emotion vs. color) on the same, two-dimensional visual stimuli. First, electroencephalographic (EEG) activity in a cluster of central electrodes reflected the amount of perceptual evidence around 100 ms following stimulus onset, when the decision concerned emotion, not color. Second, participants' choice could be predicted earlier for emotion (240 ms) than for color (380 ms) by the mu (10 Hz) rhythm, which reflects motor preparation. Taken together, these findings indicate that perceptual decisions about threat-signaling dimensions of facial displays are associated with prioritized neural coding in action-related brain regions, supporting the motivational value of socially relevant signals.

A scoping review shows that no single existing risk of bias assessment tool considers all sources of bias for cross-sectional studies.

OBJECTIVES: Different tools to assess the potential risk of bias (RoB) for cross-sectional studies have been developed, but it is unclear whether all pertinent bias concepts are addressed. We aimed to identify RoB concepts applicable to cross-sectional research validity and to explore coverage for each in existing appraisal tools. STUDY DESIGN AND SETTING: This scoping review followed the Joanna Briggs Institute methodology. We included records of any study design describing or reporting methods, concepts or tools used to consider RoB in health research reported to be descriptive/prevalence survey or analytic/association (cross-sectional) study designs. Synthesis included quantitative and qualitative analysis. RESULTS: Of the 4556 records screened, 90 were selected for inclusion; 67 (74%) described the development of, or validation process for, appraisal tools, 15 (17%) described methodological content or theory relevant to RoB for cross-sectional studies and 8 (9%) records of methodological systematic reviews. Review of methodological reports identified important RoB concepts for both descriptive/prevalence and analytic/association studies. Tools identified (n = 64 unique tools) were either intended to appraise quality or assess RoB in multiple study designs including cross-sectional studies (n = 21; 33%) or cross-sectional designs alone (n = 43; 67%). Several existing tools were modified (n = 17; 27%) for application to cross-sectional studies. The RoB items most frequently addressed in the RoB tools were validity and reliability of the exposure (53%) or outcome (65%) measurement and representativeness of the study population (59%). Most tools did not consider nonresponse or missingness appropriately or at all. CONCLUSION: Assessing cross-sectional studies involve unique RoB considerations. We identified RoB tools designed for broad applicability across various study designs as well as those specifically tailored for cross-sectional studies. However, none of the identified tools comprehensively address all potential biases pertinent to cross-sectional studies. Our findings indicate a need for continued improvement of RoB tools and suggest that the development of context-specific or more precise tools for this study design may be necessary.

The art and science of research methodology, biostatistics, manuscript writing, and publication ethics: An invigorating training for improving research aptitudes in southern Indian biomedical institutions.

The basic concepts of research are learned through systematic literature searches which form the basis of a research statement and research topic. Then the research question, hypothesis, aim, and objectives, as well as the experimental design, are developed. Given the context provided, the primary focus is on the importance of adequately training postgraduates and young research investigators in research methodology and project development. It is evident that there is a lack of proper training in these areas, and the rapid expansion of colleges in India exacerbates this issue. To address this, research students must receive comprehensive instruction in scientific research methodology, experimental design, statistics, scientific writing, publishing, and research ethics. Our team has been conducting workshops and symposia for more than two decades to improve the current teaching methods in these areas. Most recently, we organized a series of national and international workshops and seminars in multiple states across India to fortify the core concepts of scientific research for students and faculty members. This report highlights the key aspects of these workshops and the positive outcomes experienced by participants.

Assessment of knowledge and self-efficacy among health professionals and clinical scientists following the Cameroon HIV/AIDS Research Forum (CAM-HERO 2022) research methodology and bioethics training.

To inform public health policymakers that the generation of local evidence-based knowledge is key. Research capacity in low- and middle-income countries (LMIC) to generate medical knowledge is often weak and insufficiently resourced and efforts to tackle these challenges are not standardized. Continuous research training can equip researchers with the required knowledge and research skills, but its effectiveness largely depends on the quality and pertinence of the training methods used. We aim to assess the effectiveness of the Cameroon HIV/AIDS Research Forum (CAM-HERO) 2022 Research Methodology and Bioethics Training with the objective to describe the knowledge gained and the self-efficacy of health professionals and clinical scientists. A survey was conducted during the one-day training among health professionals and clinical scientists. Participants took an online self-administered questionnaire before and after the training related to the topics taught. The questionnaire consisted of two parts: 1) 18 Multiple Choice Questions (MCQs) to assess knowledge and 2) Nine items to evaluate self-efficacy using a five-point Likert scale. Mean scores were calculated, analysed, and compared using paired t-test for the pre- and post-test results. A total of 30 participants (57% women) completed the socio-demographic form. The median age (IQR) of participants was 33.5 (13.3) years. We registered 38 respondents for the pre-test and 33 respondents for the post-test. There was a rise in knowledge mean score from 13.0 to 14.8 (p=0.001) and an improvement in the perception of self-efficacy with a mean score increase from 2.9 to 3.7 (p < 0.001). Knowledge and perception of self-efficacy on research methodology improved among participants after the training. These results suggest that the CAM-HERO 2022 training had an immediate positive impact on skills and self-efficacy. Hence, we recommend the implementation of this training on a larger scale, periodically, and with long-term follow-up to evaluate its impact.

Evaluating a research methodology workshop among postgraduate students using Kirkpatrick's model.

BACKGROUND: In this era of evidence-based medicine, only systematic research can help in providing judicious and precise healthcare to individual patients based on updated knowledge and skills. However, many medical professionals do not feel competent and confident enough to conduct research. One of the reasons could be the lack of a research-based curriculum in undergraduate courses. The National Medical Council has also stressed the need for formal training in research methodology for healthcare professionals. The research methodology workshops help to familiarize the participants with basic, clinical, and translational research required to impart optimum patient care. The objective of our study was to evaluate a research methodology workshop conducted for postgraduate students by assessing the participant's knowledge, feedback, and expected impact using Kirkpatrick's evaluation model. MATERIALS AND METHODS: A quasi-experimental, single-group study was conducted among 132 first-year postgraduate students. The four levels of Kirkpatrick's model were applied for evaluation. Feedback forms, scores of the pretest and posttest, quality of the research proposal drafted by the postgraduates for their thesis, and finally successful submission of the research proposal were the components used to evaluate the four levels of outcome of Kirkpatrick's model. STATISTICAL ANALYSIS: Data collected were compiled and tabulated into MS Excel. Proportions were calculated for categorical variables and mean and standard deviation (SD) for scores. A comparison of means between pre- and postworkshop scores was made with paired t-test. A value of P < 0.05 was considered statistically significant. Statistical analysis was done using IBM SPSS Statistics version 20.0 software. RESULTS: Out of 132 participants, 29% (38) were males and 71% (94) were females. The mean ± SD pretest and posttest scores at a 95% confidence interval were 10.55 ± 2.537 and 12.43 ± 2.484, respectively. The difference was found to be statistically significant by paired sample t-test (P < 0.001). CONCLUSION: Participant feedback is vital for improving research methodology workshops. The workshop met the overall requirements of the participants. There was a significant improvement in the knowledge of participants after the workshop completion.

Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation tool for rigor in mixed methods implementation research.

BACKGROUND: Implementation science helps generate approaches to expedite the uptake of evidence in practice. Mixed methods are commonly used in implementation research because they allow researchers to integrate distinct qualitative and quantitative methods and data sets to unravel the implementation process and context and design contextual tools for optimizing the implementation. To date, there has been limited discussion on how to ensure rigor in mixed methods implementation research. PURPOSE: To present Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation (PEARL) as a practical tool for understanding various components of rigor in mixed methods implementation research. DATA SOURCES: This methodological discussion is based on a nurse-led mixed methods implementation study. The PEARL tool was developed based on an interpretive, critical reflection, and purposive reading of selected literature sources drawn from the researchers' knowledge, experiences of designing and conducting mixed methods implementation research, and published methodological papers about mixed methods, implementation science, and research rigor. CONCLUSION: An exemplar exploratory sequential mixed methods study in nursing is provided to illustrate the application of the PEARL tool. The proposed tool can be a useful and innovative tool for researchers and students intending to use mixed methods in implementation research. The tool offers a straightforward approach to learning the key rigor components of mixed methods implementation research for application in designing and conducting implementation research using mixed methods. CLINICAL RELEVANCE: Rigorous implementation research is critical for effective uptake of innovations and evidence-based knowledge into practice and policymaking. The proposed tool can be used as the means to establish rigor in mixed methods implementation research in nursing and health sciences.