Are Researchers Registering Systematic Reviews in ClinicalTrials.gov?

BACKGROUND: ClinicalTrials.gov (CT) is an increasingly important resource for systematic reviewers attempting to identify published and unpublished clinical studies. In addition to clinical studies, however, some searches of the CT database also return systematic reviews (SRs). When I inquired about the SRs appearing in the results, the NLM Help Desk responded that “We do not recommend that systematic reviews be entered in ClinicalTrials.gov, since we only want the results of a clinical trial entered once. However, we will not refuse them if they are entered.” I wanted to find out how many SRs are included, describe their characteristics, and suggest search strategies for those wishing to exclude them. METHODS: Conduct a CT search for “systematic review” without limiting by field in case an SR was not explicitly titled as such. Screen the results for those records representing SRs as opposed to, e.g., mentioning one in the background to a clinical trial. Identify the total number of SRs. Test strategies for their ability to exclude them and calculate sensitivity, precision and specificity. RESULTS: I ran a search for “systematic review” (in quotes) in the advanced search \u3e Search Terms (field) on July 14, 2016, and applying no other limits, downloaded 181 results for analysis from among the 220,113 total number of records in the CT database. Of the 181 records, 47 (26%) were systematic reviews. All 47 were listed as Study Type: Observational. The remaining 134 records that were not SRs included a mix of Observational (21, 15.7%) and Interventional (113, 84.3%) study types. Title searching offers an effective way to avoid SRs: all but two true SRs had “systematic review” or “meta-analysis” in the Brief or Official Title. So in the expert search you could add the filter: NOT ( systematic review [TITLES] OR metaanalysis [TITLES] ). This filter has a sensitivity of 94.8%, precision of 96.9%, and specificity of 91.5%. CONCLUSION: The number of systematic reviews registered in CT is small at this time. They can be accurately avoided if you are looking for interventional studies by using the Study Type field, but not if you are looking for observational studies. Using the proposed title searching filter offers an effective way to avoid them. Librarians should advise their teams to register systematic reviews in appropriate sources such as PROSPERO (http://www.crd.york.ac.uk/PROSPERO/), but not ClinicalTrials.gov

Replacement for the 10 page paper? A pilot project using blogs and wikis for a collaborative EBM assignment in a 3rd year internal medical clerkship

Objective Pilot a group assignment using blogs and wikis to develop evidence-based medicine skills in third year medical students on an internal medicine clerkship. Instead of the clerkship’s previous individual ten-page paper assignment, the students were divided into four groups of sixteen. During the clerkship, students are on geographically dispersed rotations. The earlier ten-page paper had required the students to complete a patient history and physical write-up. With the pilot project, each group was assigned a librarian and a physician faculty mentor. Each student recorded on the blog a clinical scenario and question they encountered. They were encouraged to communicate with the librarian to construct a well formed clinical question. Each student group then came to consensus on which question to pursue and collaborated on a wiki including a list of citations to the best available evidence, a critique of the studies, and implications for the patient

WATER alert!: disseminating drinking water quality information to South Africans

Drinking water quality, especially in many parts of South Africa, is far below acceptable standards. With an annual estimate of 43,000 deaths from diarrheal diseases, 3 million cases of illness, and treatment costs of over half a billion US dollars, the impact is critical [4]. This research addresses the challenge of reporting complex and critical water quality information in a way that is accessible to all South Africans as required by law. In a country with high illiteracy rates, 11 official languages and limited-to-no access to technology in many areas, this is no easy feat. We describe the details of WATER Alert!, a prototype mobile phone application designed to alert and report critical water quality information to consumers who subscribe to it. Our initial evaluation of this design with users suggests that such an application would help to improve consumers' understanding of water quality information. The symbol-based messages make critical water quality information more accessible to illiterate or low-literate users, or non-native English or Afrikaans speakers. Additionally, the use of a tool and interface design most of our users are familiar with (the mobile phone) lowers the learning curve

Health Education in Rural Communities with Locally Produced and Locally Relevant Multimedia Content

Health education in rural communities is one of the main ways in which developing countries are addressing prevalent health issues like maternal and child mortality, HIV/Aids, tuberculosis (TB) and malaria. In many rural villages, Community Health Workers (CHWs) act as proxies through which health education information is spread in their communities. In this paper, we discuss important principles to consider when designing solutions for creating and distributing digital health content in rural communities, based on previous work in the area of health education and the training of CHWs. We then introduce our model of content creation and distribution, which involves providing tools that allow rural health professionals to independently create health content from within their local communities. We also present the lessons learned from our deployment of this model in Lesotho - highlighting the opportunities presented by the use of locally produced hence locally relevant digital content in health education

Working with NGOs through Fair Partnerships

This paper highlights how Non-Governmental Organizations (NGOs) can be utilized during the design of Information Communication Technologies for Development (ICT4D). We use the design process of a voter education system as a case study, which incorporated three NGOs from two African countries. Of key interest to us are the ways in which we can avoid exploiting these NGOs and make sure the ICT intervention meets their goals, as well as those of the researcher

Sister chromatid cohesion establishment occurs in concert with lagging strand synthesis

Cohesion establishment is central to sister chromatid tethering reactions and requires Ctf7/Eco1-dependent acetylation of the cohesin subunit Smc3. Ctf7/Eco1 is essential during S phase, and a number of replication proteins (RFC complexes, PCNA and the DNA helicase Chl1) all play individual roles in sister chromatid cohesion. While the mechanism of cohesion establishment is largely unknown, a popular model is that Ctf7/Eco1 acetylates cohesins encountered by and located in front of the fork. In turn, acetylation is posited both to allow fork passage past cohesin barriers and convert cohesins to a state competent to capture subsequent production of sister chromatids. Here, we report evidence that challenges this pre-replicative cohesion establishment model. Our genetic and biochemical studies link Ctf7/Eco1 to the Okazaki fragment flap endonuclease, Fen1. We further report genetic and biochemical interactions between Fen1 and the cohesion-associated DNA helicase, Chl1. These results raise a new model wherein cohesin deposition and establishment occur in concert with lagging strand-processing events and in the presence of both sister chromatids

Supporting the Occupational Therapy Student in the Production and Dissemination of Systematic Reviews: An Interprofessional Collaboration among Librarians and Occupational Therapy Faculty

Objectives This poster describes the outcomes of a curriculum-based collaboration between librarians and OT faculty (‘collaboration’) to enhance graduate student skills for conducting a systematic review (SR); the collaboration included database instruction, bibliographic management software, and culminated in student presentations to healthcare practitioners for continuing education credit. Three outcome areas are discussed: impact of the collaboration on student satisfaction and perceived competence; characteristics of the included literature; and the dissemination of SR findings to healthcare practitioners. Methods Three librarians participated in the instruction and the institutional repository (Jefferson Digital Commons; JDC) deposits. A total of 132 students over a period of two years (2013-2014) completed the curriculum, engaging with librarians and OT faculty to iteratively build on skills. At the conclusion of their curriculum, the capstone presentations were recorded and made freely available through the JDC. Quantitative data were examined with descriptive statistics in SPSS, and qualitative data were thematically coded by hand: course evaluations, practitioner attendance, bibliographic evaluations of the systematic reviews, and download statistics from the institutional repository. Results Students reported on open-ended course evaluation questions that among the top three concepts learned was ‘how to conduct a replicable and effective search.’ On multiple answer questions 83.6% of students selected the ‘collaborative librarian-faculty lecture’ as among the most helpful lectures offered, and 78.2% selected ‘working with librarian staff and course mentors to develop a search strategy’ as highly rated among course activities. Bibliographic data were extracted from 22 of 28 capstone presentations available for analysis (2013-2014) in the institutional repository, which contained 305 citations from 157 journals. The average of age of included articles was 4.8 years (SD=4.2, Range=0-24). Among the top 10 cited journals were 2 occupational therapy, 5 rehabilitation, and 3 specialty. Overall health care practitioner attendance at student capstones from 2012-2014 was 323. JDC recordings (as of 1/6/2015) had been accessed from 25 different countries, and are located most frequently via Google, JDC, and GoogleScholar. The total number of views was 1,446, and the total number of hours viewed was 163 hours. Conclusions Librarian-faculty collaborations resulted in high student perception of competence to conduct systematic reviews, utilization of a broad variety of peer-reviewed journals, and enhanced dissemination of evidence

Switching the World's Salt Supply—Learning from Iodization to Achieve Potassium Enrichment

Sodium is an essential dietary component, but excess sodium intake can lead to high blood pressure and an increased risk of cardiovascular disease. Many national and international bodies, including the World Health Organization, have advocated for population-wide sodium reduction interventions. Most have been unsuccessful due to inadequate sodium reduction by food industry and difficulties in persuading consumers to add less salt to food. Recent research highlights potassium-enriched salt as a new, feasible, acceptable, and scalable approach to reducing the harms caused by excess sodium and inadequate potassium consumption. Modeling shows that a global switch from regular salt to potassium-enriched salt has the potential to avert millions of strokes, heart attacks, and premature deaths worldwide each year. There will be many challenges in switching the world's salt supply to potassium-enriched salt, but the success of universal salt iodization shows that making a global change to the manufacture and use of salt is a tractable proposition. This in-depth review of universal salt iodization identified the importance of a multisectoral effort with strong global leadership, the support of multilateral organizations, engagement with the salt industry, empowered incountry teams, strong participation of national governments, understanding the salt supply chain, and a strategic advocacy and communication plan. Key challenges to the implementation of the iodization program were costs to government, industry, and consumers, industry concerns about consumer acceptability, variance in the size and capabilities of salt producers, inconsistent quality control, ineffective regulation, and trade-related regulatory issues. Many of the opportunities and challenges to universal salt iodization will likely also be applicable to switching the global salt supply to iodized and potassium-enriched salt