Evidence-based risk assessment and recommendations for physical activity clearance: an introduction1This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S1-S2 ◽  
Author(s):  
Darren E.R. Warburton ◽  
Veronica K. Jamnik ◽  
Shannon S.D. Bredin ◽  
Don C. McKenzie ◽  
James Stone ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Assessment ◽  
Risk Stratification ◽  
Review Process ◽  
Peer Review Process ◽  
Screening Tools ◽  
Health Conditions ◽  
Systematic Evaluation ◽  
Evidence Based ◽  
Clearance Process

The Physical Activity Readiness Questionnaire (PAR-Q) and the Physical Activity Readiness Medical Evaluation (PARmed-X) are internationally renowned and extensively used preparticipation screening tools. However, recent feedback from end-users has identified limitations to the existing PAR-Q and PARmed-X screening process. As such, a systematic evaluation of the PAR-Q and PARmed-X forms was conducted, adhering to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. Recognized experts in physical activity (PA) and prominent health conditions worked with an expert consensus panel to increase the effectiveness of the PAR-Q and PARmed-X PA participation clearance process. The systematic review process established that the health benefits of PA participation far outweigh the risks in the vast majority of asymptomatic and symptomatic individuals. A new risk continuum and decision tree process was created to allow for the effective risk stratification of prominent health conditions, reducing greatly the barriers to PA participation for the majority of individuals. The new PA participation clearance process is available in new paper and online versions (PAR-Q+) and the PARmed-X was replaced with an online interactive computer programme (ePARmed-X+). It is anticipated that this new risk stratification and PA clearance process will reduce markedly the barriers for PA participation for both asymptomatic and symptomatic individuals.

Evidence-based risk assessment and recommendations for physical activity clearance: established cardiovascular disease1This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S190-S213 ◽  
Author(s):  
Scott G. Thomas ◽  
Jack M. Goodman ◽  
Jamie F. Burr
Keyword(s):  
Physical Activity ◽  
Risk Assessment ◽  
Adverse Events ◽  
Lower Risk ◽  
Peer Review Process ◽  
Screening Tools ◽  
Systematic Evaluation ◽  
Computer Assisted ◽  
Evidence Based ◽  
Intermediate Risk

Physical activity is an effective lifestyle therapy for patients at risk for, or with, documented cardiovascular disease (CVD). Current screening tools — the Physical Activity Readiness Questionnaire (PAR-Q) and the Physical Activity Readiness Medical Evaluation (PARmed-X) — require updating to align with risk/benefit evidence. We provide evidence-based recommendations to identify individuals with CVD at lower risk, intermediate risk, or higher risk of adverse events when participating in physical activity. Forms of exercise and the settings that will appropriately manage the risks are identified. A computer-assisted search of electronic databases, using search terms for CVD and physical activity risks and benefits, was employed. The Appraisal of Guidelines for Research and Evaluation were applied to assess the evidence and assign a strength of evidence rating. A strength rating for the physical activity participation clearance recommendation was assigned on the basis of the evidence. Recommendations for physical activity clearance were made for specific CVD groups. Evidence indicates that those who are medically stable, who are involved with physical activity, and who have adequate physical ability can participate in physical activity of lower to moderate risk. Patients at higher risk can exercise in medically supervised programs. Systematic evaluation of evidence indicates that clinically stable individuals with CVD may participate in physical activity with little risk of adverse events. Therefore, changes in the PAR-Q should be undertaken and a process of assessment and consultation to replace the PARmed-X should be developed. Patients at lower risk may exercise at low to moderate intensities with minimal supervision. Those at intermediate risk should exercise with guidance from a qualified exercise professional. Patients at higher risk should exercise in medically supervised programs.

Evidence-based risk assessment and recommendations for physical activity clearance: Consensus Document 20111This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S266-S298 ◽  
Author(s):  
Darren E.R. Warburton ◽  
Norman Gledhill ◽  
Veronica K. Jamnik ◽  
Shannon S.D. Bredin ◽  
Don C. McKenzie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Assessment ◽  
Risk Stratification ◽  
Chronic Conditions ◽  
Peer Review Process ◽  
Core Competencies ◽  
Screening Tools ◽  
Evidence Based ◽  
Consensus Document ◽  
Human Lifespan

The Physical Activity Readiness Questionnaire (PAR-Q) and the Physical Activity Readiness Medical Evaluation (PARmed-X) are internationally known preparticipation screening tools developed on the basis of expert opinion. The primary purposes of this consensus document were to seek evidence-based support for the PAR-Q and PARmed-X forms, to identify whether further revisions of these instruments are warranted, to determine how people responding positively to questions on the PAR-Q can be safely cleared without medical referral, and to develop exercise clearance procedures appropriate for various clinical conditions across the human lifespan. Seven systematic reviews were conducted, examining physical-activity-related risks and effective risk-stratification procedures for various prevalent chronic conditions. An additional systematic review assessed the risks associated with exercise testing and training of the general population. Two gap areas were identified and evaluated systematically: the role of the qualified exercise professional and the requisite core competencies required by those working with various chronic conditions; and the risks associated with physical activity during pregnancy. The risks associated with being physically inactive are markedly higher than transient risks during and following an acute bout of exercise in both asymptomatic and symptomatic populations across the lifespan. Further refinements of the PAR-Q and the PARmed-X (including online versions of the forms) are required to address the unique limitations imposed by various chronic health conditions, and to allow the inclusion of individuals across their entire lifespan. A probing decision-tree process is proposed to assist in risk stratification and to reduce barriers to physical activity. Qualified exercise professionals will play an essential role in this revised physical activity clearance process.

Enhancing the effectiveness of clearance for physical activity participation: background and overall process1This paper is one of a selection of papers published in the Special Issue entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal's usual peer-review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S3-S13 ◽  
Author(s):  
Veronica K. Jamnik ◽  
Darren E.R. Warburton ◽  
Julie Makarski ◽  
Donald C. McKenzie ◽  
Roy J. Shephard ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Peer Review Process ◽  
Evidence Base ◽  
Screening Tools ◽  
Evidence Based ◽  
Highly Qualified ◽  
Direct Role ◽  
Agree Instrument ◽  
Clearance Process

Recent feedback from physical activity (PA) participants, fitness professionals, and physicians has indicated that there are limitations to the utility and effectiveness of the existing PAR-Q and PARmed-X screening tools for PA participation. The aim of this study was to have authorities in exercise and chronic disease management to work with an expert panel to increase the effectiveness of clearance for PA participation using an evidence-based consensus approach and the well-established Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. Systematic reviews were conducted to develop a new PA clearance protocol involving risk stratification and a decision-tree process. Evidence-based support was sought for enabling qualified exercise professionals to have a direct role in the PA participation clearance process. The PAR-Q+ was developed to use formalized probes to clarify problematic responses and to explore issues arising from currently diagnosed chronic disease or condition. The original PARmed-X tool is replaced with an interactive computer program (ePARmed-X+) to clear prospective PA participants for either unrestricted or supervised PA or to direct them to obtain medical clearance. Evidence-based validation was also provided for the direct role of highly qualified university-educated exercise professionals in the PA clearance process. The risks associated with exercise during pregnancy were also evaluated. The systematic review and consensus process, conforming to the AGREE Instrument, has provided a sound evidence base for enhanced effectiveness of the clearance process for PA participation of both asymptomatic populations and persons with chronic diseases or conditions.

Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease1This paper is one of a selection of papers published in the Special Issue entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer-review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S80-S100 ◽  
Author(s):  
Neil D. Eves ◽  
Warren J. Davidson
Keyword(s):  
Physical Activity ◽  
Risk Assessment ◽  
Adverse Events ◽  
Exercise Intervention ◽  
Peer Review Process ◽  
Chronic Obstructive ◽  
Evidence Based ◽  
Screening Process ◽  
Obstructive Pulmonary Disease ◽  
Asthma Patients

The 2 most common respiratory diseases are chronic obstructive pulmonary disease (COPD) and asthma. Growing evidence supports the benefits of exercise for all patients with these diseases. Due to the etiology of COPD and the pathophysiology of asthma, there may be some additional risks of exercise for these patients, and hence accurate risk assessment and clearance is needed before patients start exercising. The purpose of this review was to evaluate the available literature regarding the risks of exercise for patients with respiratory disease and provide evidence-based recommendations to guide the screening process. A systematic review of 4 databases was performed. The literature was searched to identify adverse events specific to exercise. For COPD, 102 randomized controlled trials that involved an exercise intervention were included (n = 6938). No study directly assessed the risk of exercise, and only 15 commented on exercise-related adverse events. For asthma, 30 studies of mixed methodologies were included (n = 1278). One study directly assessed the risk of exercise, and 15 commented on exercise-related adverse events. No exercise-related fatalities were reported. The majority of adverse events in COPD patients were musculoskeletal or cardiovascular in nature. In asthma patients, exercise-induced bronchoconstriction and (or) asthma symptoms were the primary adverse events. There is no direct evidence regarding the risk of exercise for patients with COPD or asthma. However, based on the available literature, it would appear that with adequate screening and optimal medical therapy, the risk of exercise for these respiratory patients is low.

Evidence-based risk assessment and recommendations for physical activity clearance: cancer1This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S101-S112 ◽  
Author(s):  
Lee W. Jones
Keyword(s):  
Physical Activity ◽  
Risk Assessment ◽  
Exercise Training ◽  
Cancer Patients ◽  
Exercise Testing ◽  
Peer Review Process ◽  
Evaluation Criteria ◽  
Adverse Event Rate ◽  
Evidence Based ◽  
Data Reporting

Physical activity is becoming increasingly acknowledged as an integral component of in the multidisciplinary management of cancer patients. Intensive inquiry in this area is likely to increase further over the next decade; however, cancer-specific, evidence-based risk assessment and recommendations for physical activity are not available. A systematic literature review was performed of all studies conducting an exercise training intervention and (or) any form of objective exercise test among adults diagnosed with cancer. Studies were assessed according to evaluation criteria developed by a panel of experts. A total of 118 studies involving 5529 patients were deemed eligible. Overall, the results suggest that exercise training and maximal and submaximal exercise testing are relatively safe procedures with a total nonlife-threatening adverse event rate of <2%. There was only 1 exercise training-related death. However, the quality of exercise testing methodology and data reporting is less than optimal. Thus, whether the low incidence of events reflects the true safety of exercise training and exercise testing in cancer patients or less than optimal methodology and (or) data reporting remains to be determined. Evidence-based absolute and relative contraindications to physical activity and exercise training and testing are provided as well as probing decision-trees to optimize the adoption and safety of physical activity in persons diagnosed with cancer.

Evidence-based risk assessment and recommendations for physical activity clearance: cognitive and psychological conditions1This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S113-S153 ◽  
Author(s):  
Ryan E. Rhodes ◽  
Viviene A. Temple ◽  
Holly A. Tuokko
Keyword(s):  
Physical Activity ◽  
Risk Assessment ◽  
Intellectual Disability ◽  
Adverse Events ◽  
Psychotic Disorders ◽  
Peer Review Process ◽  
Risk Of Bias ◽  
Psychological Disorder ◽  
Atlantoaxial Instability ◽  
Evidence Based

Physical activity has established mental and physical health benefits, but related adverse events have not received attention. The purpose of this paper was to review the documented adverse events occurring from physical activity participation among individuals with psychological or cognitive conditions. Literature was identified through electronic database (e.g., MEDLINE, psychINFO) searching. Studies were eligible if they described a published paper examining the effect of changes on physical activity behaviour, included a diagnosed population with a cognitive or psychological disorder, and reported on the presence or absence of adverse events. Quality of included studies was assessed, and the analyses examined the overall evidence by available subcategories. Forty trials passed the eligibility criteria; these were grouped (not mutually exclusively) by dementia (n = 5), depression (n = 10), anxiety disorders (n = 12), eating disorders (n = 4), psychotic disorders (n = 4), and intellectual disability (n = 15). All studies displayed a possible risk of bias, ranging from moderate to high. The results showed a relatively low prevalence of adverse events. Populations with dementia, psychological disorders, or intellectual disability do not report considerable or consequential adverse events from physical activity independent of associated comorbidities. The one exception to these findings may be Down syndrome populations with atlantoaxial instability; in these cases, additional caution may be required during screening for physical activity. This review, however, highlights the relative paucity of the reported presence or absence of adverse events, and finds that many studies are at high risk of bias toward reporting naturally occurring adverse events.

EVIDENCE-BASED EDITING—AT LAST!

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 203-203
Author(s):  
Student
Keyword(s):  
Peer Review ◽  
Review Process ◽  
Peer Review Process ◽  
Evidence Based

Editors and others are beginning to research the process of peer review. Most questions about the peer review process cannot yet be answered on the basis of evidence, but some can: for instance, we have evidence that blinding reviewers to the identity of authors leads them to produce better opinions and that structured abstracts contain more information than unstructured ones.

scholarly journals AI-assisted peer review

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Checco ◽  
Lorenzo Bracciale ◽  
Pierpaolo Loreti ◽  
Stephen Pinfield ◽  
Giuseppe Bianchi
Keyword(s):  
Peer Review ◽  
Review Process ◽  
Peer Review Process ◽  
Working Hours ◽  
Unintended Consequences ◽  
Screening Tools ◽  
Ethical Concerns ◽  
Automated Screening ◽  
Textual Content

AbstractThe scientific literature peer review workflow is under strain because of the constant growth of submission volume. One response to this is to make initial screening of submissions less time intensive. Reducing screening and review time would save millions of working hours and potentially boost academic productivity. Many platforms have already started to use automated screening tools, to prevent plagiarism and failure to respect format requirements. Some tools even attempt to flag the quality of a study or summarise its content, to reduce reviewers’ load. The recent advances in artificial intelligence (AI) create the potential for (semi) automated peer review systems, where potentially low-quality or controversial studies could be flagged, and reviewer-document matching could be performed in an automated manner. However, there are ethical concerns, which arise from such approaches, particularly associated with bias and the extent to which AI systems may replicate bias. Our main goal in this study is to discuss the potential, pitfalls, and uncertainties of the use of AI to approximate or assist human decisions in the quality assurance and peer-review process associated with research outputs. We design an AI tool and train it with 3300 papers from three conferences, together with their reviews evaluations. We then test the ability of the AI in predicting the review score of a new, unobserved manuscript, only using its textual content. We show that such techniques can reveal correlations between the decision process and other quality proxy measures, uncovering potential biases of the review process. Finally, we discuss the opportunities, but also the potential unintended consequences of these techniques in terms of algorithmic bias and ethical concerns.

scholarly journals Treatment Fidelity: Its Importance and Reported Frequency in Aphasia Treatment Studies

2013 ◽  
Vol 22 (2) ◽  
Author(s):  
Jacqueline J. Hinckley ◽  
Natalie F. Douglas
Keyword(s):  
Review Process ◽  
Research Study ◽  
Peer Review Process ◽  
Treatment Fidelity ◽  
Clinical Settings ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Independent Variables ◽  
Treatment Research ◽  
Aphasia Treatment

Purpose Treatment fidelity is a measure of the reliability of the administration of an intervention in a treatment study. It is an important aspect of the validity of a research study, and it has implications for the ultimate implementation of evidence-supported interventions in typical clinical settings. Method Aphasia treatment studies published in the last 10 years in 3 journals were reviewed using coding techniques that were adapted from Gresham, Gansle, Noell, Cohen, and Rosenblum (1993). The following items were noted: identifying information, study design, description of both the dependent and independent variables, and whether a measure of treatment fidelity was explicitly included. Results Of the aphasia treatment studies published in the last 10 years, 14% explicitly reported treatment fidelity. Most studies reporting treatment fidelity used checking of videotaped sessions by independent raters. Of the reviewed studies, 45% provided sufficient treatment description to support replication. Conclusion Treatment fidelity is widely acknowledged as being critical to research validity and is a foundation for the implementation of evidence-based practices, but only a small percentage of aphasia treatment studies published in the last 10 years explicitly reported treatment fidelity. Recommendations for research practices include increased attention to matters of treatment fidelity in the peer review process and explicit incorporation of 3 levels of treatment fidelity in treatment research.

Evidence-based risk assessment and recommendations for physical activity clearance: stroke and spinal cord injury1This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

2011 ◽  
Vol 36 (S1) ◽  
pp. S214-S231 ◽  
Author(s):  
E. Paul Zehr
Keyword(s):  
Physical Activity ◽  
Risk Assessment ◽  
Spinal Cord ◽  
Adverse Events ◽  
Functional Capacity ◽  
Autonomic Dysreflexia ◽  
Exercise Stress ◽  
Evidence Based ◽  
Exercise Participation ◽  
Cord Injury

Physical activity (PA) has potential benefits after stroke or spinal cord injury (SCI), especially in improving efficiency and functional capacity in activities of daily living. Currently, many who could benefit from PA may be routinely excluded from participation because of myths related to functional capacity and the concern for harm. The purpose of this review was to evaluate the literature for reports of adverse events during exercise after stroke or SCI, and to provide recommendations regarding exercise participation in supervised and unsupervised environments. Studies were evaluated for quality, and the summary level and quality of evidence were evaluated using the AGREE rubric, modified to address the main outcome measure of adverse events. Levels of exercise stress were evaluated for aerobic activities, using an established rubric. Included in the current analysis were 32 studies for stroke and 4 for SCI. In aggregate, this yielded a total of 730 experimental participants with stroke and 143 with SCI. It should be noted that almost all studies were not designed to examine naturally occurring adverse events from PA. Significant contraindications to unsupervised exercise include manifestation of autonomic dysreflexia in SCI and cardiovascular comorbidity after stroke. There are clear benefits of exercise training on physiological outcomes in stroke and SCI, but the relation between outcomes and safety remains unclear. However, taken on balance, the risk-to-benefit ratio favors the recommendation of exercise. This recommendation is based on studies in which participants were almost universally screened for participation in supervised environments. Thus, the grading of evidence for finding adverse events to support this conclusion is inadequate.

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