What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences.

BACKGROUND: Systematic reviews have been considered as the pillar on which evidence-based healthcare rests. Systematic review methodology has evolved and been modified over the years to accommodate the range of questions that may arise in the health and medical sciences. This paper explores a concept still rarely considered by novice authors and in the literature: determining the type of systematic review to undertake based on a research question or priority. RESULTS: Within the framework of the evidence-based healthcare paradigm, defining the question and type of systematic review to conduct is a pivotal first step that will guide the rest of the process and has the potential to impact on other aspects of the evidence-based healthcare cycle (evidence generation, transfer and implementation). It is something that novice reviewers (and others not familiar with the range of review types available) need to take account of but frequently overlook. Our aim is to provide a typology of review types and describe key elements that need to be addressed during question development for each type. CONCLUSIONS: In this paper a typology is proposed of various systematic review methodologies. The review types are defined and situated with regard to establishing corresponding questions and inclusion criteria. The ultimate objective is to provide clarified guidance for both novice and experienced reviewers and a unified typology with respect to review types.

Addition of a Decision Point in Evidence-Based Practice Process Steps to Distinguish EBP, Research and Quality Improvement Methodologies.

This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741--6787.

Evidencia viva frente al SARS-CoV-2 / LivingevidenceforSARS-CoV-2

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Grades for quality of evidence were associated with distinct likelihoods that treatment effects will remain stable.

OBJECTIVES: We sought to determine whether producers or users of systematic reviews using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach or a close variation give the same meanings to terms intended to convey uncertainty about treatment effects when interpreting grades for the quality or strength of evidence. STUDY DESIGN AND SETTING: Following exploratory interviews with stakeholders and user testing, we conducted an international Web-based survey among producers and users of systematic reviews. For each quality grade (high, moderate, low, very low/insufficient), we asked participants to assign a minimum likelihood that treatment effects will not change substantially as new studies emerge. Using multivariate analysis of covariance, we tested whether the estimated likelihoods differed between producers and users. RESULTS: In all, 244 participants completed the survey. The associated minimum likelihoods that treatment effects will not change substantially for high, moderate, and low grades of quality of evidence (QOE) were 86% [95% confidence interval (CI): 85%, 87%], 61% (95% CI: 59%, 63%), and 34% (95% CI: 32%, 36%), respectively (very low was preset at 0%). Likelihoods for each grade were similar between producers and users of systematic reviews (P > 0.05 for all comparisons). CONCLUSION: GRADE is, in general, a suitable method to convey uncertainties for systematic review producers to users. The wide ranges of likelihoods associated with GRADE terms suggest that current definitions of levels of QOE that rely exclusively on qualitative certainty expressions should be augmented by numerical predictions once such data are available.

Towards an evidence-based taxonomy of nonpharmacologic treatments for ADHD.

We have created an evidence-based guide for clinicians to the relative utility of nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD). This article uses the term evidence-based in the sense applied by the Oxford Center for Evidenced-Based Medicine to help readers understand the degree to which nonpharmacologic treatments are supported by the scientific literature. This article also reviews the magnitude of the treatment effect expressed as the standardized mean difference effect size (also known as Cohen D). It then describes a meta-algorithm to describe how to integrate pharmacologic and nonpharmacologic treatments for ADHD.

[Evidence-based public health decision-making tools which can also be used for prioritising disease]. / Herramientas para la toma de decisiones en salud pública basadas en la evidencia y priorización de enfermedades.

He use of research-based evidence has been promoted during recent years, due to the increasing development of evidence-based medicine,and it has been reported that transferring the concept of "evidence-based" from clinical to public health practice has not been as straight forward as expected.Much research-based evidence for supporting public health recommendations has come from studies whose evidence has been qualified as being low or very low quality in the medical hierarchy based on classic evidence and the grading of recommendations, assessment, development and evaluation (GRADE)approach. This paper was aimed at presenting two methods of rating evidence, as well as their limitations and applications as public health decision-making tools.

Exploiting classification correlations for the extraction of evidence-based practice information.

Crucial study data in research articles, such as patient details, study design and results, need to be extracted and presented explicitly for the ease of applicability and validity judgment in evidence-based practice. To perform this extraction, we propose to use two soft classifications, one at the sentence level and the other at the word level, and exploit the correlations between them for better accuracy. Our evaluation results show that propagating the results from the first classification to second improves performance of the second and vice versa. Moreover, the two classifications may benefit each other and help improve performance through joint inference algorithms. Another key finding of our work is that irrelevant sentences in the training data need to be properly filtered out; otherwise they compromise system accuracy and make joint inference models less scalable and more expensive to train.

Staphylococcus aureus en quemaduras: estudio de incidencia, tendencia y pronóstico / Staphylococcus aureus in burns: study of incidence, tendency and presage

Realizamos un estudio descriptivo, longitudinal, retrospectivo de los últimos 10 años, en la Unidad de quemados del Hospital Universitario “Arnaldo Milián Castro” de Santa Clara, en Villa Clara, Cuba, con el objetivo de caracterizar el comportamiento del aislamiento de Staphylococcus aureus en heridas por quemaduras de pacientes ingresados. Se realizó con 1065 muestras tomadas por método cualitativo de hisopado, entre enero del 2002 y diciembre del 2011. Las variables utilizadas fueron: mes y año de realización, resultado del aislamiento, grupo de microorganismos y especies aisladas, series temporales y tasa pronóstico. Staphylococcus aureus resultó ser el microorganismos Gram positivo más frecuentemente aislado (68,3%), representando entre el 7 y el 31,8% de las muestras realizadas cada año, con tasas de incidencias oscilando entre el 6,3 y 37,2 por cada 100 pacientes ingresados. Las tasas de incidencia mensuales se mantuvieron predominantemente en zonas de alerta y de seguridad durante los años 2011 y también en el seguimiento en 2012, sin que se produjeran picos epidémicos, mostrando una ligera tendencia al decremento con respecto al comportamiento de los 3 últimos años. Comprobamos después que la tasa de aislamiento para el siguiente año, 2012 fue de 9,5 por cada 100 ingresos, dentro de los límites del intervalo pronosticado según los estudios recogidos hasta 2011 (0 y 46,7 por cada 100 ingresos) (AU)

A retrospective longitudinal descriptive study of the last 10 years in the Burns Unit of “Arnaldo Milián Castro” Hospital in Santa Clara, Villa Clara, Cuba, was carried out with the objective of characterizing the behaviour of isolated Staphylococcus aureus in wounds caused by burns in admitted patients. It was done with 1065 samples taken with the qualitative swab method, between January 2002 and December 2011. Variables used were month and year it was done, results of the isolation, group of the microorganisms and isolated species, temporal series and prognostic rate. Staphylococcus aureus was the Gram positive organism more frequently an isolated with (68.3%), representing between 7 y 31,8% of the samples taken every year, with an annual incidence rate between 6,3 y 37,2 every 100 admitted patients. Month incidence rate were predominantly in alert zone during 2011, without epidemic peaks. The trend study showed a light tendency to decrease with respect to the last 3 years. In the follow-up we found that the isolation rate for 2012 was of 9,5 every 100 discharged patients, between the limit rate predicted (0 and 46,7 every 100 discharged patients)

Conocimientos de medicina basada en evidencia en profesionales de la medicina / Knowledge of medical professionals on evidence - based medicine

La medicina basada en evidencia (MBE) representa un nuevo modelo de investigación y en la práctica médica es sinónimo de actualización. Esta práctica permite identificar la evidencia obteniendo resultados óptimos en la atención de pacientes. Objetivo: Determinar el conocimiento sobre el signifi-cado de medicina basada en evidencia y la forma correcta de aplicarla por parte de los profesionales de la medicina. Se aplicaron entrevistas en el Congreso Médico Nacional realizado en San Pedro Sula en el 2011. Metodos: Estudio descriptivo, de corte transversal sobre los conocimientos de los profesionales de la medicina en el tema de MBE previo consentimiento informado para la aplicación de la entrevista. Se entrevistaron un total de 428 médicos aprovechando la realización del Congreso Médico Nacional en la Ciudad de San Pedro Sula en Agosto del 2011. Resultados: La gran mayoría de los entrevistados no conocen el concepto de medicina basada en evidencia y no la aplicarán a su práctica clínica diaria. Conclusiones: El conocimiento sobre MBE del profesional de la medicina, es prácticamente nulo. Se evidencia la necesidad de formar desde estudiante al profesional de la medicina y aprofesores de pregrado en las escuelas de formación de recursos médicos...(AU)

Herramientas para la toma de decisiones en salud pública basadas en la evidencia y priorización de enfermedades / Evidence-based public health decision-making tools which can also be used for prioritising disease

RESUMEN En los últimos años se ha promovido el uso de evidencia proveniente de la investigación debido al creciente desarrollo del movimiento de medicina basada en la evidencia y se ha descrito que la transferencia del concepto "Basado en la Evidencia" desde la práctica clínica hacia la práctica de la salud pública no ha sido tan directa como se esperaba. Gran parte de la evidencia disponible para apoyar las recomendaciones en materia de salud pública proviene deestudios quese califican como evidencia de bajao muy baja calidad en la jerarquía medicina basada en la evidencia clásica y en el enfoque de GRADE. El objetivo del presente artículo es presentar dos métodos de calificación de evidencia, sus limitaciones y aplicaciones como herramientas para la toma de decisiones en salud pública.

ABSTRACT he use ofresearch-basedevidence has been promoted during recentyears, due to the increasingdevelopment ofevidence-basedmedicine,andit has been reported that transferringthe concept of "evidence-based" fromclinical to public health practice hasnot beenas straightforwardas expected.Much research-based evidence for supporting publichealth recommendationshas come fromstudies whose evidence has been qualified as beinglow or very lowquality in the medicalhierarchy based onclassicevidence and the grading of recommendations, assessment, development and evaluation (GRADE)approach. Thispaper was aimed at presentingtwo methods ofratingevidence, as well as their limitations and applicationsas public health decision-making tools.