“The notion of systematic review – looking at the totality of evidence – is quietly one of the most important innovations in medicine over the past 30 years.” – Ben Goldacre, 2011 What would make someone speak so highly of this type of research? Let us answer that by considering a case study, which itself … More A CRASH course on the importance of systematic reviews in healthcare
In a previous blog, we discussed the value of reducing waste by conducting appropriate and timely systematic reviews. But how might we increase research efficiency? Well-conducted randomised controlled trials remain the most reliable way to demonstrate the true efficacy and cost-effectiveness for the majority of medical treatments. However, they are not without limitations. The average … More Can randomised controlled trials be more efficient?
Kamal R. Mahtani and Ben Goldacre, part of the COMPare project, write about the prevalence of outcome switching and why it matters. We have been monitoring outcome switching in five top journals, and writing letters to correct the record wherever we have found misreporting. You can read more about our project here, here and here. One peculiar response has been: “you’ve … More How often are outcomes switched in clinical trials? And why does it matter?
You don’t have to look too far to see the benefits of systematic reviews and their summary results. The well known Cochrane logo depicts a real example, highlighting the value of systematically pooling data for meta-analysis and in this case demonstrating the clear benefit of corticosteroids in accelerating lung maturation in preterm babies. Systematic reviews … More Utilising systematic reviews: is another trial necessary or ethical?
Selective reporting of outcomes is just one type of reporting bias and there are a number of ways in which it can arise. In the previous linked blog we gave an example of the effect of selective reporting bias through under-reporting of data. So what could have been done to avoid the “SwitchBP” scenario? Perhaps … More Selective reporting bias: types, impact and ways to reduce it
Definition of bias ‘Any process at any stage of inference which tends to produce results or conclusions that differ systematically from the truth’. (Adapted from Murphy. The Logic of Medicine. Baltimore: John Hopkins University Press. 1976.) One of the key steps in evidence based medicine, and sadly one that is often forgotten, is to … More Bias – alive and kicking
Neat pic posted on twitter by Prof Ieuan Ellis. Useful picture for teaching. Sadly an all too common misunderstanding.