Systematic reviews in the prevention of research waste in emergency medicine randomized controlled trials

Before a randomized controlled trial (RCT) is performed, systematic reviews (SR) of the topic need to be cited to ensure new, meaningful information is being added. Studies that do not do this can cause wasted resources such as funding and time. We analyzed RCTs in the top emergency medicine journals for indication of SR citations. We searched PubMed for studies that were published between 01/01/2014 and 12/31/2017.This search resulted in 615 studies. Of those 615 studies, we found that 275 of them fulfilled the requirements of a RCT. The bibliographies of the 275 studies were analyzed for evidence of SR citation. If a SR citation was present, we determined if information from the citation was used to justify the RCT. Of the 275 studies, we found that 66%, 95%, and 74% studies did not use SR citations as justification or did not have SR citations at all in the introduction, methods, and discussion sections respectively. The average sample size of each RCT was 294 participants. 40% of the studies did not report the type of funding, and 20% of studies received funding from government resources. The most common trial type was a parallel group trial contributing to 69% of our studies.The results from this study reveal that there is a lack of justification for RCTs in emergency medicine research due to the underutilization of meaningful SR citations. Trialists in emergency medicine should be more proactive in citing SRs in their studies to prevent wasted resources

CHSI/VA collaborative development of an asynchronous digital solution to increase veteran access to smoking cessation medications

Introduction: Smoking is a major modifiable health risk factor in the United States especially for veterans. Approximately, 10 million adults search online for assistance in quitting smoking each year. These signify a need for decreased barriers to smoking cessation medications, especially for smokers with a desire to quit.Research Question or Hypothesis: The aim of this study is to develop a digital solution to increase veteran access to smoking cessation medications.Study Design: Quality Improvement StudyMethods: Design and development of an online smoking cessation platform that allows online request for smoking cessation medications. This platform will also measure adoption and use by smokers when offered by physicians.Results: We successfully developed an asynchronous online platform that allows the following: (1) secure invitation from a physician; (2) a quick consultation in form of a questionnaire filled out by the patient; (3) review of patient profile by physician; (4) prescription of medication and (5) continuous evaluation of patients as they progress through the program.Conclusion: This platform was successfully developed and is in the process of being tested for effectiveness at the VA Hospital in Muskogee, Oklahoma

Lack of Reproducibility in Addiction Medicine

Background and aims: Credible research emphasizes transparency, openness, and reproducibility. These characteristics are fundamental to promoting and maintaining research integrity. This aim of this study was to evaluate the current state of transparency and reproducibility in the field of addiction science. Design: Cross-sectional design Measurements: This study used the National Library of Medicine catalog to search for all journals using the subject terms tag: Substance-Related Disorders [ST]. Journals were then searched via PubMed in the timeframe of January 1, 2014 to December 31, 2018 and 300 publications were randomly selected. A pilot-tested Google form containing reproducibility/transparency characteristics was used for data extraction by two investigators who performed this process in a duplicate and blinded fashion. Findings: Slightly more than half of the publications were open access (152/293, 50.7%). Few publications had pre-registration (7/244, 2.87%), material availability (2/237, 1.23%), protocol availability (3/244 ,0.80%), data availability (28/244, 11.48%), and analysis script availability (2/244, 0.82%). Most publications provided a conflict of interest statement (221/293, 75.42%) and funding sources (268/293, 91.47%). One replication study was reported (1/244, 0.04%). Few publications were cited (64/238, 26.89%) and 0 were excluded from meta-analyses and/or systematic reviews. Conclusion: Our study found that current practices that promote transparency and reproducibility are lacking, and thus, there is much room for improvement. First, investigators should preregister studies prior to commencement. Researchers should also make the materials, data, analysis script publicly available. To foster reproducibility, individuals should remain transparent about funding sources for the project and financial conflicts of interest. Research stakeholders should work together toward improved solutions on these matters. With these protections in place, the field of addiction medicine can lead in dissemination of information necessary to treat patients