Will Spam Overwhelm Our Defenses? Evaluating Offerings for Drugs and Natural Health Products

At least one-third of spam e-mails include offers of health products, according to this new study

Does updating improve the methodological and reporting quality of systematic reviews?

BACKGROUND: Systematic reviews (SRs) must be of high quality. The purpose of our research was to compare the methodological and reporting quality of original versus updated Cochrane SRs to determine whether updating had improved these two quality dimensions. METHODS: We identifed updated Cochrane SRs published in issue 4, 2002 of the Cochrane Library. We assessed the updated and original versions of the SRs using two instruments: the 10 item enhanced Overview Quality Assessment Questionnaire (OQAQ), and an 18-item reporting quality checklist and flow chart based upon the Quality of Reporting of Meta-analyses (QUOROM) statement. At least two reviewers extracted data and assessed quality. We calculated the percentage (with a 95% confidence interval) of 'yes' answers to each question. We calculated mean differences in percentage, 95% confidence intervals and p-values for each of the individual items and the overall methodological quality score of the updated and pre-updated versions using OQAQ. RESULTS: We assessed 53 SRs. There was no significant improvement in the global quality score of the OQAQ (mean difference 0.11 (-0.28; 0.70 p = 0.52)). Updated reviews showed a significant improvement of 18.9 (7.2; 30.6 p < .01) on the OQAQ item assessing whether the conclusions drawn by the author(s) were supported by the data and/or analysis presented in the SR. The QUOROM statement showed that the quality of reporting of Cochrane reviews improved in some areas with updating. Improvements were seen on the items relating to data sources reported in the abstract, with a significant difference of 17.0 (9.8; 28.7 p = 0.01), review methods, reported in the abstract 35 (24.1; 49.1 p = 0.00), searching methods 18.9 (9.7; 31.6 p = 0.01), and data abstraction 18.9 (11.7; 30.9 p = 0.00). CONCLUSION: The overall quality of Cochrane SRs is fair-to-good. Although reporting quality improved on certain individual items there was no overall improvement seen with updating and methodological quality remained unchanged. Further improvement of quality of reporting is possible. There is room for improvement of methodological quality as well. Authors updating reviews should address identified methodological or reporting weaknesses. We recommend to give full attention to both quality domains when updating SRs

A Methodology for Performing Meta-analyses of Developers Attitudes Towards Programming Practices

Programming practices are often labelled as “best practice” and “bad practice” by developers. This label can be subjective but we can see trends among developers. A methodology for performing meta-analyses of articles discussing any given practice was created to determine programmers overall attitudes towards any given practice while accounting for factors such as whether they considered alternative approaches

Converting systematic reviews to Cochrane format: a cross-sectional survey of Australian authors of systematic reviews

BACKGROUND: Despite the growing reputation and subject coverage of the Cochrane Database of Systematic Reviews, many systematic reviews continue to be published solely in paper-based health care journals. This study was designed to determine why authors choose to publish their systematic reviews outside of the Cochrane Collaboration and if they might be interested in converting their reviews to Cochrane format for publication in the Cochrane Database of Systematic Reviews. METHODS: Cross-sectional survey of Australian primary authors of systematic reviews not published on the Cochrane Database of Systematic Reviews identified from the Database of Abstracts of Reviews of Effectiveness. RESULTS: We identified 88 systematic reviews from the Database of Abstracts of Reviews of Effectiveness with an Australian as the primary author. We surveyed 52 authors for whom valid contact information was available. The response rate was 88 per cent (46/52). Ten authors replied without completing the survey, leaving 36 valid surveys for analysis. The most frequently cited reasons for not undertaking a Cochrane review were: lack of time (78%), the need to undergo specific Cochrane training (46%), unwillingness to update reviews (36%), difficulties with the Cochrane process (26%) and the review topic already registered with the Cochrane Collaboration (21%). (Percentages based on completed responses to individual questions.) Nearly half the respondents would consider converting their review to Cochrane format. Dedicated time emerged as the most important factor in facilitating the potential conversion process. Other factors included navigating the Cochrane system, assistance with updating and financial support. Eighty-six per cent were willing to have their review converted to Cochrane format by another author. CONCLUSION: Time required to complete a Cochrane review and the need for specific training are the primary reasons why some authors publish systematic reviews outside of the Cochrane Collaboration. Encouragingly, almost half of the authors would consider converting their review to Cochrane format. Based on the current number of reviews in the Database of Abstracts of Reviews of Effectiveness, this could result in more than 700 additional Cochrane reviews. Ways of supporting these authors and how to provide dedicated time to convert systematic reviews needs further consideration

Estrategia de marca personal para una artista musical

Con la llegada dei mundo digital y las nuevas tecnologías, la industria musical ha sufrido una serie de repercusiones que la han obligado a modificar su forma de producir y distribuir la música. Por ¡o tanto, en este mundo globalizado, donde cada vez es más fácil crear música y compartirla a nivel mundial sin la necesidad de una disquera, la competencia se vuelve más complicada. Artistas emergentes necesitan encontrar una manera de proyectarse y diferenciarse del resto de músicos y para esto deben desarrollar estrategias atractivas que les permita cumplir este objetivo. Este trabajo de grado se enfoca en la importancia de tener una marca personal para un artista musical debido a que este sello es lo que le permitirá posicionarse como una marca llamativa. En este mundo cambiante, la marca personal permanece constante y es io que caracteriza y diferencia al artista de su competencia. Coco iadad es la artista de la cual trata esta tesis y cuya marca personal fue desarrollada en un Brand Book que contiene su esencia.With the arrival of the digital world and the new technologies, the musíc industry has suffered a series of repercussions that have altered its way of producing and distributing music. Therefore, in this globalized world, where it is increasingly easy to create and share music globally without the need of a record company, the competition becomes more complicated. Artists are looking for a different way to project and differentiate themselves from the rest of musicians, and for this they must develop attractive strategies that can allow them to fulfill this objective. This work focuses on the ¡mportance of having a personal brand for a musical artist. In other words, it is this label the one that will position the artist as a striking brand. In this changing world, the personal brand wiii remain constant and as a matter of fact, it is what characterizes and differentiates the artist from its competition. Coco Jadad is the artist that deais with this work. Therefore, her personal brand was developed into a Brand Book that contains her essenceComunicador (a) SocialPregrad

The development of QUADAS : a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews

BACKGROUND: In the era of evidence based medicine, with systematic reviews as its cornerstone, adequate quality assessment tools should be available. There is currently a lack of a systematically developed and evaluated tool for the assessment of diagnostic accuracy studies. The aim of this project was to combine empirical evidence and expert opinion in a formal consensus method to develop a tool to be used in systematic reviews to assess the quality of primary studies of diagnostic accuracy. METHODS: We conducted a Delphi procedure to develop the quality assessment tool by refining an initial list of items. Members of the Delphi panel were experts in the area of diagnostic research. The results of three previously conducted reviews of the diagnostic literature were used to generate a list of potential items for inclusion in the tool and to provide an evidence base upon which to develop the tool. RESULTS: A total of nine experts in the field of diagnostics took part in the Delphi procedure. The Delphi procedure consisted of four rounds, after which agreement was reached on the items to be included in the tool which we have called QUADAS. The initial list of 28 items was reduced to fourteen items in the final tool. Items included covered patient spectrum, reference standard, disease progression bias, verification bias, review bias, clinical review bias, incorporation bias, test execution, study withdrawals, and indeterminate results. The QUADAS tool is presented together with guidelines for scoring each of the items included in the tool. CONCLUSIONS: This project has produced an evidence based quality assessment tool to be used in systematic reviews of diagnostic accuracy studies. Further work to determine the usability and validity of the tool continue

Rehabilitation interventions for foot drop in neuromuscular disease

"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases

Use of Online Health Forums by Patients with Chronic Cough: Qualitative Study

Background: Online health discussion forums are used by different patient groups for sharing advice and information. Chronic cough is a common problem, and people with chronic cough use online health forums alongside formal medical therapies. Objective: The objective of this study was to assess how chronic cough sufferers use online health forums, including the treatment advice they share with one another and the possible clinical uses of online forums in chronic cough. Methods: Three open-access health forums were searched for threads related to chronic cough. Identified threads were screened against inclusion and exclusion criteria adapted from the British Thoracic Society (BTS) Guidelines related to chronic cough diagnosis. Included data were subjected to qualitative thematic analysis. All study data were cross-validated by a second author and discrepancies were resolved. Results: In total, 96 threads were included in the analysis, consisting of posts by 223 forum users. Three main themes were identified: the effect of chronic cough on the lives of patients, the treatment advice shared between users, and the provision of support within forums. Conclusions: Chronic cough symptoms had impacts on multiple aspects of patients’ health and well-being. To try and combat these issues, forum users suggested a variety of treatments to one another, ranging from mainstream traditional therapies to odd alternative remedies. The provision of support and empathy were also prominent themes in discussion threads. Online forums themselves may provide increasing benefit to users through the addition of a moderator

Examination of overall treatment effect and the proportion attributable to contextual effect in osteoarthritis: meta-analysis of randomised controlled trials

Objective: To examine the overall treatment effect and the proportion attributable to contextual effect (PCE) in randomised controlled trials (RCTs) of diverse treatments for osteoarthritis (OA). Methods: We searched MEDLINE, EMBASE, CENTRAL, Science Citation Index, AMED, CINAHL through October 2014, supplemented with manual search of reference lists, published meta-analyses and systematic reviews. Included were RCTs in OA comparing placebo with representative complementary, pharmacological, non-pharmacological and surgical treatments. The primary outcome was pain. Secondary outcomes were function and stiffness. The overall treatment effect was defined as the improvement from baseline in the treatment group. The contextual effect was defined as that of the placebo group. The PCE was calculated by dividing the contextual effect over the overall treatment effect. The effect size (ES) of overall treatment effect and the PCE were pooled using random-effects model. Subgroup analysis and meta-regression were conducted to examine determinants of the PCE. Results: In total, 215 trials (41,392 participants) were included. The overall treatment effect for pain-reduction ranged from the smallest with lavage (ES=0.46, 95%CI: 0.24, 0.68) to the largest with topical NSAIDs (ES=1.37, 95%CI 1.19, 1.55). On average, 75% (PCE=0.75, 95%CI 0.72, 0.79) of pain reduction was attributable to contextual effect. It varied by treatment from 47% (PCE=0.47, 95%CI: 0.32, 0.70) for intra-articular corticosteroid to 91% (PCE=0.91, 95%CI: 0.60, 1.37) for joint lavage. Similar results were observed for function and stiffness. Treatment delivered by needle/injection and other means but oral medication, longer duration of treatment, larger sample size (≥100 per arm) and public funding source were associated with increased PCE for pain-reduction. Conclusions: The majority (75%) of the overall treatment effect in OA RCTs is attributable to contextual effects, rather than the specific effect of treatments. Reporting overall treatment effect and PCE, in addition to traditional ES over placebo, permits a more balanced, clinically meaningful interpretation of RCT results. This would help dispel the frequent discordance between conclusions from RCT evidence and clinical experience - the “efficacy paradox”