A guide to performing a peer review of randomised controlled trials

Peer review of journal articles is an important step in the research process. Editors rely on the expertise of peer reviewers to properly assess submissions. Yet, peer review quality varies widely and few receive training or guidance in how to approach the task. This paper describes some of the main steps that peer reviewers in general and, in particular, those performing reviewes of randomised controlled trials (RCT), can use when carrying out a review. It can be helpful to begin with a brief read to acquaint yourself with the study, followed by a detailed read and a careful check for flaws. These can be divided into ‘major’ (problems that must be resolved before publication can be considered) and ‘minor’ (suggested improvements that are discretionary) flaws. Being aware of the appropriate reporting checklist for the study being reviewed (such as CONSORT and its extensions for RCTs) can also be valuable. Competing interests or prejudices might corrode the review, so ensuring transparency about them is important. Finally, ensuring that the paper’s strengths are acknowledged along with a dissection of the weaknesses provides balance and perspective to both authors and editors. Helpful reviews are constructive and improve the quality of the paper. The proper conduct of a peer review is the responsibility of all who accept the role

The Minimal Set of Electroweak Precision Parameters

We present a simple method for analyzing the impact of precision electroweak data above and below the Z-peak on flavour-conserving heavy new physics. We find that experiments have probed about ten combinations of new physics effects, which to a good approximation can be condensed into the effective oblique parameters Shat, That, Uhat, V, X, W, Y (we prove positivity constraints W, Y >= 0) and three combinations of quark couplings (including a distinct parameter for the bottom). We apply our method to generic extra Z' vectors.Comment: 22 pages, 3 figure

Parents' beliefs and knowledge about the management of acute otitis media: A qualitative study

BACKGROUND: Acute otitis media is a common reason for antibiotic prescribing, despite strong evidence that antibiotics provide minimal benefit. Studies have demonstrated that patients’ (or parents’) expectations of antibiotics often influence general practitioners’ (GPs) decision to prescribe antibiotics, but few have explored parents’ expectations of the management of infections in children, or which factors influence the development of these expectations. This study aimed to explore parents’ knowledge and beliefs about the management of acute otitis media in children. METHODS: Individual semi-structured interviews were conducted with 15 parents of children who had recently presented to their GP with acute otitis media. Parents were recruited at childcare centres or playgroups in Brisbane, Australia. RESULTS: Many parents did not have an accurate understanding of what causes acute otitis media. GPs were primarily consulted for the management of symptoms such as pain and fever. Others specifically wanted reassurance or were concerned about hearing loss. Most parents assumed that antibiotics were the best treatment option. Parents’ perceptions about the best treatment were mainly based on their previous experience and the advice of the GP. Pain relief medications, such as paracetamol and non-steroidal anti-inflammatory drugs, were not considered by parents to be sufficient treatment on their own. CONCLUSION: There is discrepancy between parents’ beliefs and expectations of management of acute otitis media and the evidence-based recommendations. This study provides insights into parents’ expectations of management of acute otitis media, which may help inform clinicians about perceptions and misperceptions that may be valuable to elicit and discuss

Rotorcraft convertible engine study

The objective of the Rotorcraft Convertible Engine Study was to define future research and technology effort required for commercial development by 1988 of convertible fan/shaft gas turbine engines for unconventional rotorcraft transports. Two rotorcraft and their respective missions were defined: a Fold Tilt Rotor aircraft and an Advancing Blade Concept (ABC) rotorcraft. Sensitivity studies were conducted with these rotorcraft to determine parametrically the influence of propulsion characteristics on aircraft size, mission fuel requirements, and direct operating costs (DOC). The two rotorcraft were flown with conventional propulsion systems (separate lift/cruise engines) and with convertible propulsion systems to determine the benefits to be derived from convertible engines. Trade-off studies were conducted to determine the optimum engine cycle and staging arrangement for a convertible engine. Advanced technology options applicable to convertible engines were studied. Research and technology programs were identified which would ensure technology readiness for commercial development of convertible engines by 1988

Topical analgesia for acute otitis media

BACKGROUND: Acute otitis media (AOM) is a spontaneously remitting disease of which pain is the most distressing symptom. Antibiotics are now known to have less benefit than previously assumed. Topical pain relief may be a satisfactory intervention for AOM sufferers and encourage clinicians to prescribe fewer antibiotics. OBJECTIVES: To assess the effectiveness of topical analgesia for AOM in adults and children. SEARCH METHODS: For this second update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), Ovid MEDLINE (2008 to February Week 1 2011), Ovid MEDLINE (In‐Process & Other Non‐Indexed Citations 10 February 2011), Ovid EMBASE (2008 to 2011 Week 05), EBSCO CINAHL (2008 to 4 February 2011) and Ovid AMED (2008 to April 2011). SELECTION CRITERIA: Double‐blind randomised controlled trials (RCTs) or quasi‐RCTs comparing an otic preparation with an analgesic effect (excluding antibiotics) versus placebo or an otic preparation with an analgesic effect (excluding antibiotics) versus any other otic preparation with an analgesic effect, in adults or children presenting at primary care settings with AOM without perforation. DATA COLLECTION AND ANALYSIS: Three review authors independently screened studies, assessed trial quality and extracted data. Attempts to obtain additional information from the trial authors of the included trials were unsuccessful. MAIN RESULTS: Five trials including 391 children aged three to 18 years met our criteria. Two studies (117 children) compared anaesthetic ear drops versus placebo immediately at diagnosis. All children received some form of oral pain relief. In all five studies it was clear that ear pain diminishes rapidly for most sufferers. Nevertheless there was a statistically significant difference in the proportion of children achieving a 50% reduction in pain in favour of anaesthetic drops 10 minutes after instillation (risk ratio (RR) 2.13, 95% confidence interval (CI) 1.19 to 3.80) and 30 minutes after instillation (RR 1.43, 95% CI 1.12 to 1.81) on the day AOM was diagnosed but not at 20 minutes (RR 1.24, 95% CI 0.88 to 1.74). Three trials (274 children) compared anaesthetic ear drops with naturopathic herbal ear drops. Naturopathic drops were favoured 15 and 30 minutes after instillation, one to three days after diagnosis, but the differences were not statistically significant. Only one trial looked at adverse reactions and found none. Overall the findings of this review are based on trial evidence that is at low or unclear risk of bias. AUTHORS' CONCLUSIONS: Evidence from five RCTs, only two of which addressed the most relevant question of primary effectiveness, provides limited evidence that ear drops are effective 30 minutes after administration in older children with AOM. Uncertainty exists as to the magnitude of this effect and more high‐quality studies are needed

Low-Metallicity Gas Clouds in a Galaxy Proto-Cluster at Redshift 2.38

We present high resolution spectroscopy of a QSO whose sight-line passes through the halo of a pair of elliptical galaxies at redshift 2.38. This pair of galaxies probably lies at the center of a galaxy proto-cluster, and is embedded in a luminous extended Ly-alpha nebula. The QSO sight-line intersects two small gas clouds within this halo. These clouds have properties similar to those of high velocity clouds (HVCs) seen in the halo of the Milky Way. The gas is in a cool (< 2 x 10^4 K) and at least 20% neutral phase, with metallicities in the range -3.0 < [Fe/H] < -1.1 and neutral hydrogen column densities of ~10^19.5 /cm^2. The origin of these clouds is unclear. The presence of low metallicity gas within this possible proto-cluster implies either that the intra-cluster medium has not been enriched with metals at this redshift, or the clouds are embedded within a hot, ionized, metal-rich gas phase.Comment: Accepted to appear in ApJ Letter

Educational interventions to improve people's understanding of key concepts in assessing the effects of health interventions: a systematic review

Abstract Background Health information is readily accessible but is of variable quality. General knowledge about how to assess whether claims about health interventions are trustworthy is not common, so people’s health decisions can be ill-informed, unnecessarily costly and even unsafe. This review aims to identify and evaluate studies of educational interventions designed to improve people’s understanding of key concepts for evaluating claims about the effects of health interventions. Methods/Design We searched multiple electronic databases and sources of grey literature. Inclusion criteria included all study types that included a comparison, any participants (except health professionals or health professional students) and educational interventions aimed at improving people’s understanding of one or more of the key concepts considered necessary for assessing health intervention claims. Knowledge and/or understanding of concepts or skills relevant to evaluating health information were our primary outcome measures. Secondary outcomes included behaviour, confidence, attitude and satisfaction with the educational interventions. Two authors independently screened search results, assessed study eligibility and risk of bias and extracted data. Results were summarised using descriptive synthesis. Results Among 24 eligible studies, 14 were randomised trials and 10 used other study designs. There was heterogeneity across study participants, settings and educational intervention type, content and delivery. The risk of bias was high in at least one domain for all randomised studies. Most studies measured outcomes immediately after the educational intervention, with few measuring later. In most of the comparisons, measures of knowledge and skills were better among those who had received educational interventions than among controls, and some of these differences were statistically significant. The effects on secondary outcomes were inconsistent. Conclusions Educational interventions to improve people’s understanding of key concepts for evaluating health intervention claims can improve people’s knowledge and skills, at least in the short term. Effects on confidence, attitude and behaviour are uncertain. Many of the studies were at moderate or greater risk of bias. Improvements in study quality, consistency of outcome measures and measures of longer-term effects are needed to improve confidence in estimates of the effects of educational interventions to improve people’s understanding of key concepts for evaluating health intervention claims. Systematic review registration PROSPERO CRD4201603310