Patient-recorded outcomes and quality of life in evidence-based medicine databases on most common ear, throat and nose procedures: a systematic review

2012 ◽  
Vol 37 (6) ◽  
pp. 436-445 ◽  
Author(s):  
A Alakärppä ◽  
O.-P Alho
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine

scholarly journals The Square Curve Paradigm for Research in Alternative, Complementary, and Holistic Medicine: A Cost-Effective, Easy, and Scientifically Valid Design for Evidence-Based Medicine and Quality Improvement

2003 ◽  
Vol 3 ◽  
pp. 1117-1127 ◽  
Author(s):  
Soren Ventegodt ◽  
Niels JØrgen Andersen ◽  
Joav Merrick
Keyword(s):  
Quality Of Life ◽  
Evidence Based Medicine ◽  
Cost Effective ◽  
Holistic Medicine ◽  
Evidence Based ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
New Research ◽  
Based Medicine

In this paper we present a new research paradigm for alternative, complementary, and holistic medicine — a low-cost, effective, and scientifically valid design for evidence-based medicine. Our aim is to find the simplest, cheapest, and most practical way to collect data of sufficient quality and validity to determine: (1) which kinds of treatment give a clinically relevant improvement to quality of life, health, and/or functionality; (2) which groups of patients can be aided by alternative, complementary, or holistic medicine; and (3) which therapists have the competence to achieve the clinically relevant improvements. Our solution to the problem is that a positive change in quality of life must be immediate to be taken as caused by an intervention. We define “immediate” as within 1 month of the intervention. If we can demonstrate a positive result with a group of chronic patients (20 or more patients who have had their disease or state of suffering for 1 year or more), who can be significantly helped within 1 month, and the situation is still improved 1 year after, we find it scientifically evidenced that this cure or intervention has helped the patients. We call this characteristic curve a “square curve”. If a global, generic, quality-of-life questionnaire like QOL5 or, even better, a QOL-Health-Ability questionnaire (a quality-of-life questionnaire combined with a self-evaluated health and ability to function questionnaire) is administered to the patients before and after the intervention, it is possible to document the effect of an intervention to a cost of only a few thousand Euros/USD. A general acceptance of this new research design will solve the problem that there is not enough money in alternative, complementary, and holistic medicine to pay the normal cost of a biomedical Cochrane study. As financial problems must not hinder the vital research in nonbiomedical medicine, we ask the scientific community to accept this new research standard.

Evidence-based medicine, utilities, and quality of life

1999 ◽  
Vol 10 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Melissa M. Brown ◽  
Gary C. Brown ◽  
Sanjay Sharma ◽  
Stephen Garrett
Keyword(s):  
Quality Of Life ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine

scholarly journals Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 6. Systematic Reviews and Meta-Analyses of Observational Studies

2008 ◽  
Vol 5;12 (5;9) ◽  
pp. 819-850
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Observational Studies ◽  
Meta Analysis ◽  
Evidence Based ◽  
Confounding Bias ◽  
Meta Analyses ◽  
Based Medicine

Observational studies provide an important source of information when randomized controlled trials (RCTs) cannot or should not be undertaken, provided that the data are analyzed and interpreted with special attention to bias. Evidence-based medicine (EBM) stresses the examination of evidence from clinical research and describes it as a shift in medical paradigm, in contrast to intuition, unsystematic clinical experience, and pathophysiologic rationale. While the importance of randomized trials has been created by the concept of the hierarchy of evidence in guiding therapy, much of the medical research is observational. The reporting of observational research is often not detailed and clear enough with insufficient quality and poor reporting, which hampers the assessment of strengths and weaknesses of the study and the generalizability of the mixed results. Thus, in recent years, progress and innovations in health care are measured by systematic reviews and meta-analyses. A systematic review is defined as, “the application of scientific strategies that limit bias by the systematic assembly, clinical appraisal, and synthesis of all relevant studies on a specific topic.” Meta-analysis usually is the final step in a systematic review. Systematic reviews and meta-analyses are labor intensive, requiring expertise in both the subject matter and review methodology, and also must follow the rules of EBM which suggests that a formal set of rules must complement medical training and common sense for clinicians to integrate the results of clinical research effectively. While expertise in the review methods is important, the expertise in the subject matter and technical components is also crucial. Even though, systematic reviews and meta-analyses, specifically of RCTs, have exploded, the quality of the systematic reviews is highly variable and consequently, the opinions reached of the same studies are quite divergent. Numerous deficiencies have been described in methodologic assessment of the quality of the individual articles. Consequently, observational studies can provide an important complementary source of information, provided that the data are analyzed and interpreted in the context of confounding bias to which they are prone. Appropriate systematic reviews of observational studies, in conjunction with RCTs, may provide the basis for elimination of a dangerous discrepancy between the experts and the evidence. Steps in conducting systematic reviews of observational studies include planning, conducting, reporting, and disseminating the results. MOOSE, or Meta-analysis of Observational Studies in Epidemiology, a proposal for reporting contains specifications including background, search strategy, methods, results, discussion, and conclusion. Use of the MOOSE checklist should improve the usefulness of meta-analysis for authors, reviewers, editors, readers, and decision-makers. This manuscript describes systematic reviews and meta-analyses of observational studies. Authors frequently utilize RCTs and observational studies in one systematic review; thus, they should also follow the reporting standards of the Quality of Reporting of Meta-analysis (QUOROM) statement, which also provides a checklist. A combined approach of QUOROM and MOOSE will improve reporting of systematic reviews and lead to progress and innovations in health care. Key words: Observational studies, evidence-based medicine, systematic reviews, metaanalysis, randomized trials, case-control studies, cross-sectional studies, cohort studies, confounding bias, QUOROM, MOOSE

scholarly journals Association of tooth loss with morbidity and mortality by diabetes status in older adults: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karen Raju ◽  
George W. Taylor ◽  
Peggy Tahir ◽  
Susan Hyde
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Evidence Based Medicine ◽  
Tooth Loss ◽  
Critical Appraisal ◽  
Morbidity And Mortality ◽  
Evidence Based ◽  
Cross Sectional ◽  
Based Medicine

Abstract Objective This systematic review assesses the association of tooth loss (TL), as the exposure, with morbidity and mortality by diabetes mellitus (DM) status, as the outcome, in older adults. Background Individuals with DM have higher prevalence of severe TL and increased risk of developing morbidities and mortality. No systematic review has evaluated the association between TL with morbidity and mortality by DM status. Material and methods Comprehensive searches used multiple publication databases containing reports published between 01/01/2000 and 04/21/2021. Two authors independently evaluated included studies for quality and risk of bias using the Critical Appraisal Skills Programme (CASP) checklist for cohort and Center for Evidence-Based Medicine (CEBM) critical appraisal sheet for cross-sectional studies, while a third author arbitrated decisions to resolve disagreements. Results Thirteen studies met the inclusion criteria: eight cross-sectional and five cohort. Qualitative review of the included studies indicated TL is associated with increased incidence and prevalence of DM. TL is also associated with DM-related morbidities including greater prevalence of heart disease, diabetic retinopathy, metabolic syndrome; poorer health-related quality of life; poorer survival of participants with chronic kidney disease; and increased medical expenditure. Overall, the quality of the evidence reviewed was medium, as per the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. Conclusions/practical implications This review found significant associations of TL with prevalence and incidence of DM and adverse DM-related outcomes. An interprofessional team-care approach that includes an oral health component could benefit the prevention and management of DM.

Sign in / Sign up

Export Citation Format

Share Document