Health

Clinical trial comparing a blended learning (BL) versus didactic learning (DL) approach for teaching EBM, concluding that a multifaceted approach incorporating BL may be best suited for medical students. [2015]

Detailed guidance on how to conduct a systematic review or meta-analysis, with accompanying lectures developed by the University of Edinburgh's Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE).

Discusses and details the important concept of conducting systematic reviews and meta-analyses for preclinical (in vitro and in vovo) research. [2014]

Details how the design, conduct, and analysis of animal experiments may be optimized through the use of systematic reviews. [2014]

Comprehensive guide to conducting a meta-analysis, including a detailed case study (43 pp.). [2014]

A review of adaptive clinical trial design and adpative randomization, examining their impact, challenges, obstacles, and strategies for effective deployment. [2008]

Critically examines the potential benefits and disadvantages of adaptive trial designs, which use accumulating results in the trial to modify the trial's course. [2010]

Raises serious questions about the ethical propriety of adaptive designs where the probability of being assigned to one treatment versus its comparator is dependent on emerging data. [2015]

Systematic review of guideline appraisal tools identifying and comparing existing tools and their relative degrees of validation. [2013]

Compilation of a comprehensive checklist of items linked to the relevant resources and tools that guideline developers should consider. [2014]

Demonstrates how observational studies may provide moderate- to (rarely) high-strength evidence in systematic reviews. [2014]

An update on and clarification of various random allocation techniques, especially simple randomization, blocking, stratified random allocation, and minimization, and a critique of non-random approaches. [2014]

Review of the strengths and weaknesses of observational versus interventional study design. [2014]

An introduction to and rationale for meta-analysis, including presentation, interpretation, and biases. [2010]

Five-part author's guide to performing systematic reviews; illustrated, with examples. [2013]

Reviews the distinct roles, occasional tensions, and relative strengths and limitations of RCTs versus population-based observational studies, proposed as complementary forms of research. [2014]

Discusses how significant results of many RCTs hinge on very few events, and suggests that reporting the number of events required to make a statistically significant result nonsignificant (the Fragility Index) in RCTs can allow for more informed decisions about the confidence warranted by reported RCT results. [2014]

Presents three practical methods for actively teaching critical appraisal skills in an evidence-based medicine curriculum. [2013]

Presentation on the use of the R statistical package in Evidence-Based Medicine, especially in Clinical Research, intended mainly for, but not limited to, Bio-statisticians, especially those using SAS.

Critical review of RCT and non-RCT studies, finding that the implementation of RCT methods and the interpretation of the results can be flawed by poor trial design, observer bias, incentive bias, or simple misinterpretation. [2013]

Details the basic steps of evidence-based practice and provides signposts to more detailed information and assistance. Compiled by the Evidence-Based Practice Group South East and the Health Service Executive of Ireland. [2014]

A review of guideline-assessing instruments, finding that alongside the comprehensive instruments such as AGREE II and DELBI, rapid-assessment instruments can be convenient tools for gaining a quick impression of the value of a guideline. [2015]

Given rapid development of new genomic biomarkers, this paper explores whether and how we can make randomized trials more adaptable to a changing landscape, and whether we still need such trials at all. [2013]

Discusses the nature, types, and pros and cons of adaptive designs in oncology trials that use accumulating data to modify the ongoing trial without undermining the integrity and validity of the trial. [2014]

Examination of how to develop trustworthy clinical practice guidelines that besides examining what is medically best also allow consistency with patients’ priorities, concerns, and preferences, thus delivering customized care at the level of individuals and their families. [2015]

Examines the effect of EBM in changing physicians’ attitude towards clinical guidelines, and describes the facilitators and barriers to implementing those clinical guidelines in clinical practice. [2015]

A bibliometric analysis examing the scientific productivity of EBM research and publication trends over decades. [2015]

Standard definitions for efficacy end points and events in early-stage adjuvant breast cancer clinical trials, from Memorial Sloan Kettering. [2007]

Evaluation of the reporting of survival end points in cancer RCTs. [2008]

Review of which locoregional endpoints are used in studies of breast cancer, and how these endpoints and their components are defined. [2014]

Explores the historic use of different endpoints, and the associated degree of regulatory flexibility shown, by the FDA to support regular and accelerated approval of cancer drugs. [2013]

Describes the random allocation process, and the associated methods of allocation concealment. [2010]

Reflections growing out of a conversation by John Ioannidis with David Sackett in 2004 about evidence-based medicine (EBM), the movement Sackett had spearheaded, updated to developments through 2016. [2016]

A review of common randomization strategies, and how to choose betweeen them. [2016]

An overview of the methodological approaches used in Mendelian randomization studies, with a discussion of MR assumptions and reporting of statistical methods. and a checklist for the reporting of MR studies. [2015]

Critical review of the current status of and progress in Mendelian randomization studies, along with its potential limitations. [2015]

Presents the fundamental principles of EBM, provides methods for incorporating EBM into clinical work, and discusses future directions of EBM. [2019]

A review of EBM principles, as well as how it is complemented by personalized medicine; precision medicine; and artificial intelligence and big data. [2019]

Evidence-based medicine (EBM) is defined as the integration of best research evidence with clinical expertise and patient values. This chapter describes the key principles of EBM and the process of...

Argues that confidence intervals are underutilized, and shows that interval estimation is a valuable form of statistical inference with certain advantages over conventional hypothesis testing based on tests of significance. [1998]

Critical examination of the pros and caveats about meta-analysis, and how the limitations can be overcome; also includes a illustrative case vignette. From CEB, the Basel Institute for Clinical Epidemiology and Biostatistics. [2012]

Strong defense of EBM, by reviewing practical examples of conflicting topics that evidence-based medicine has positively clarified to allow providing the best possible patient care. [2012]

Resources for using the Cochrane Library, including quick training videos, user guides and webinars.

Proposes an integration of the two approaches to evidence-based medicine, evidence-based guidelines (EBG) and evidence-based individual decision making (EBID). [2005]

Exceptional learning resource: a comprehensive (300+ pp. as slides) course on the systematic review process, on their strengths and limitations, with step-by-step guidance, examples and case studies on how to perform a quality systematic review. In six downloadable (as PDFs) lessons, from McGill University.

Comprehensive (74 pp., as downloadable PDF) tutorial on GRADE, the leading consensus approach to grading quality of evidence and strength of recommendations. From McMaster University.

Five calculators for evidence-based factors, including ones for numbers needed to treat (NNT), and for case-control studies, prospective studies, and randomized control trials (RCT). From the Knowledge Translation Program of St. Michael's Hospital (Toronto).

An overview of several evidence grading systems, including the Oxford Center for Evidence-Based Medicine, the U.S. Preventive Services Task Force, and the journal of the American Academy of Family Physicians. [2011]

Essentials of systematic reviews, and a step-by-step guide for how to conduct one. From Library Services of King's College, London. [2014]

Argues for the communicative advantage of confidence intervals (CIs) over P values for statistical significance. [2010]