Showing posts with label Evidence-based Medicine. Show all posts
Showing posts with label Evidence-based Medicine. Show all posts

Wednesday, January 11, 2023

Opinion on "rapid" reviews vs systematic reviews

 A colleague shared this with me, and I thought the broader WHSLA community would appreciate it, too. 

The Dark Side of Rapid Reviews: a Retreat from Systematic Approaches and the Need for Clear Expectations and Reporting 

The authors’ opinion piece from Annals of Internal Medicine lobbies to change the language about “rapid reviews” which omit key methods for systematic science.  They point out these reviews should be known as restricted reviews or partial systematic reviews.  They ask for funding agencies and journals to limit these partial reviews unless well  justified and disclose methods ( or lack of  them) transparently. They fear if more “rapid reviews” proliferate, we will return to poor and sloppy reporting and more confusion about the science reported to the public.   This is a good article to refer to when patrons indicate they are undertaking rapid reviews.   As librarians, we should teach the value of methodical (and yes time consuming)  approach which is transparent.   Ultimately it will improve the chances of publication and is a better contribution to evidence based knowledge.


https://www.acpjournals.org/doi/10.7326/M22-2603
The Dark Side of Rapid Reviews: A Retreat From Systematic Approaches and the Need for Clear Expectations and Reporting | Annals of Internal Medicine (acpjournals.org)



Monday, April 27, 2020

TWIV Podcast: Evidence-Based Science and Medicine for Covid-19: TWIV 606


TWIV 606: Evidence-Based Science and Covid-19 [Listen to the podcast; get more info and links mentioned in the episode.]




As a Medical Librarian living and working in the current time of Coronavirus,  I've been struggling with what to send people asking for research on Covid-19, when the best available "evidence" is only just emerging and appears on pre-print servers and hasn't had time to perk through all the usual peer review and filters of fully-formed evidence-based practice.  In other words, it's not what we're used to as gold-standard evidence.  What we are seeing is much lower on the evidence pyramid. 

On the one hand, it's an exciting time to see the research emerge and evolve, to witness so many people around the world working to solve this emerging and evolving pandemic-sized infectious disease. It's also more than a little alarming to see the state of the evidence ...

Researchers and physicians are willing to try something/anything if it might help solve some small part of the Covid-19 puzzle.  If they put together very small studies with no control to compare outcomes, what is that study really worth?   

I'm not the only one with these concerns, which is why I was glad to see the TWIV podcasters addressing this topic.   Give it a listen ...    at least the first 45 minutes where
Dr. Daniel Griffin gives a nice description of how physicians make decisions, running the gamut from the ultimate goal of evidence-based practice to all these other varieties we've seen since the onset of Covid-19: 

  • Experience-based medicine (including experience bias)
  • Vehemence-based medicine
  • Eloquence-based medicine (More spin than science.)
  • Diffidence-based medicine ("No good answers here.")
  • Defensive-based medicine
  • Careful observation and experience based medicine 
    • Did it help or hurt?  Stand there and think about it.  Did it work?
  • Evidence-based medicine
Always remember, Physicians are human.  They are subject to the same stress and overwhelm everyone else gets.  Early on in this pandemic, there was an emotional, anxious, desperate response to do something/anything to make a difference in outcomes for Covid patients.  Do everything and see what sticks ...   Now Dr Griffin's advice is to "Don't just DO something: Stand there ... and see if it worked."

What are you listening to to keep up with Covid-19 developments?