1,226 research outputs found
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
Industry-supported meta-analyses compared with meta-analyses with non-profit or no support: Differences in methodological quality and conclusions
<p>Abstract</p> <p>Background</p> <p>Studies have shown that industry-sponsored meta-analyses of drugs lack scientific rigour and have biased conclusions. However, these studies have been restricted to certain medical specialities. We compared all industry-supported meta-analyses of drug-drug comparisons with those without industry support.</p> <p>Methods</p> <p>We searched PubMed for all meta-analyses that compared different drugs or classes of drugs published in 2004. Two authors assessed the meta-analyses and independently extracted data. We used a validated scale for judging the methodological quality and a binary scale for judging conclusions. We divided the meta-analyses according to the type of support in 3 categories: industry-supported, non-profit support or no support, and undeclared support.</p> <p>Results</p> <p>We included 39 meta-analyses. Ten had industry support, 18 non-profit or no support, and 11 undeclared support. On a 0–7 scale, the median quality score was 6 for meta-analyses with non-profit or no support and 2.5 for the industry-supported meta-analyses (P < 0.01). Compared with industry-supported meta-analyses, more meta-analyses with non-profit or no support avoided bias in the selection of studies (P = 0.01), more often stated the search methods used to find studies (P = 0.02), searched comprehensively (P < 0.01), reported criteria for assessing the validity of the studies (P = 0.02), used appropriate criteria (P = 0.04), described methods of allocation concealment (P = 0.05), described methods of blinding (P = 0.05), and described excluded patients (P = 0.08) and studies (P = 0.15). Forty percent of the industry-supported meta-analyses recommended the experimental drug without reservations, compared with 22% of the meta-analyses with non-profit or no support (P = 0.57).</p> <p>In a sensitivity analysis, we contacted the authors of the meta-analyses with undeclared support. Eight who replied that they had not received industry funding were added to those with non-profit or no support, and 3 who did not reply were added to those with industry support. This analysis did not change the results much.</p> <p>Conclusion</p> <p>Transparency is essential for readers to make their own judgment about medical interventions guided by the results of meta-analyses. We found that industry-supported meta-analyses are less transparent than meta-analyses with non-profit support or no support.</p
Colaboración internacional y buenas prácticas en la gestión de enfermedades crónicas complejas a través de herramientas web 2.0: Observatorio de prácticas innovadoras en el manejo de enfermedades crónicas complejas OPIMEC
Ponencias de la Segunda Conferencia internacional sobre brecha digital e inclusión social, celebrada del 28 al 30 de octubre de 2009 en la Universidad Carlos III de MadridLas enfermedades crónicas (EC) constituyen un reto de salud mundial en el siglo XXI. La OMS las define como enfermedades de larga duración por lo general de progresión lenta y prevé que en 2020 serán responsables del 73% de las muertes y del 60% de la carga global de enfermedad (World Health Organization, 2002). Es primordial que la comunidad internacional de salud pública y de gestión sanitaria conozca y comparta información sobre los avances en las prácticas tecnológicas y organizativas más innovadoras en gestión de EC, con énfasis en las EC Complejas (ECC) asociadas a una mayor pérdida de autonomía y grado de dependencia y discapacidad. Con este propósito, a mediados de 2006, la Dirección General de Innovación Sanitaria, Sistemas y Tecnología de la Consejería de Salud de la Junta de Andalucía crea el «Observatorio de Prácticas Innovadoras para el Manejo de Enfermedades Crónicas Complejas» (OPIMEC) que impulsa la participación y generación de conocimiento en información sanitaria para profesionales y una Plataforma de Red en el ámbito de la gestión de ECC para el fomento de alianzas y colaboraciones desde Andalucía basadas en dar y recibir conocimiento abierto entre personas, equipos y organizaciones (Jadad AR, 1999, p. 761-764; Jadad AR, 2000, p.362-365). La Web del Observatorio de Prácticas Innovadoras en el Manejo de Enfermedades Crónicas Complejas (OPIMEC), http://www.opimec.org, va centrada en la creación de una plataforma basada en la Web 2.0. que permite el acceso y la edición colaborativa de contenidos para profesionales. El objetivo fundamental de esta plataforma es compartir y colaborar en la generación y difusión de conocimiento, todo ello facilitado con herramientas innovadoras de la Web 2.0. como son la publicación de contenidos, la votación, comentarios sobre los contenidos, la sindicación de contenidos y la creación de comunidades abiertas de trabajo colaborativo. El proyecto OPIMEC cuenta con una cadena de procesos de gestión de la información de los que podemos destacar su forma colaborativa de crear conocimiento por todas las personas usuarias de la plataforma, un equipo editorial encargado de asegurar la calidad de los contenidos y una evaluación por pares de las prácticas y organizaciones propuestas en la Web. Desde la edición, hasta la publicación y su distribución final el conocimiento es examinado metódicamente. Este proceso es automatizado a través de herramientas de software libre creadas para OPIMEC y asesorado por su Consejo Asesor Internacional. Así pues, la plataforma Web 2.0 que da soporte al observatorio OPIMEC está construida sobre tecnologías libres como: Framework Web Django (impulsado por Google Inc. entre otros), MySQL y GNU/Linux. La elección de esta combinación tecnológica se ha realizado tras un análisis exhaustivo sobre las tecnologías abiertas disponibles, en base a criterios de eficiencia, productividad y adaptabilidad a las necesidades actuales y futuras de OPIMEC. La Web OPIMEC tiene intención y vocación de convertirse en un destacado proyecto a nivel mundial con clara vertiente de cooperación internacional e innovación, mejorando la calidad de vida de la ciudadanía, aprovechando las herramientas que ofrece la difundida red global de Internet y promocionando la participación e iniciativa de los y las profesionales. Nuestra Web OPIMEC está estructurada en espacios que facilitan y propician la participación y consecución de los objetivos del proyecto, con el fin de que la asimilación de sus contenidos por parte de las personas usuarias sea eficiente y efectiva. Podemos encontrar en ella, herramientas existentes en las redes sociales así como algunas nuevas desarrolladas específicamente para OPIMEC, como son los “documentos colaborativos”, que facilitarán el trabajo, la conexión y la participación de profesionales desde cualquier parte del mundo, pudiendo así aprovechar los recursos al máximo, Se dispone por tanto de destacadas herramientas como una base de datos actualizada de eventos, noticias, recursos y documentos, directorios y mapas de organizaciones, prácticas y personas innovadoras, espacios de comunidad en las que los equipos de trabajo pueden desarrollarse, comunicarse y complementarse con otras personas usuarias, compartiendo buenas prácticas, innovación y contenidos novedosos en el manejo de enfermedades crónicas complejas. El aspecto importante de la plataforma es que las personas usuarias son de forma democrática, creadores, evaluadores y consumidores de los contenidos publicados, siendo así una herramienta de trabajo construida, ampliada, valorada y seguida por toda la comunidad de profesionales; facilitando la difusión del conocimiento construido por y para todos y todas los profesionales sanitarios, personal investigador, ciudadanos y ciudadanas en general en el manejo de enfermedades crónicas complejas. Un conocimiento ampliamente compartido es la clave para aumentar y mejorar el bienestar social y la calidad de vida
Evolving Music with Emotional Feedback
This research aims to develop evolutionary methods that automate the synthesis of a diverse range of complex consonant digital music with minimal user interaction. The key notion is that such music evolution is mainly directed by physiological feedback from the user’s parasympathetic responses to evolving music
Optimal search strategies for identifying sound clinical prediction studies in EMBASE
BACKGROUND: Clinical prediction guides assist clinicians by pointing to specific elements of the patient's clinical presentation that should be considered when forming a diagnosis, prognosis or judgment regarding treatment outcome. The numbers of validated clinical prediction guides are growing in the medical literature, but their retrieval from large biomedical databases remains problematic and this presents a barrier to their uptake in medical practice. We undertook the systematic development of search strategies ("hedges") for retrieval of empirically tested clinical prediction guides from EMBASE. METHODS: An analytic survey was conducted, testing the retrieval performance of search strategies run in EMBASE against the gold standard of hand searching, using a sample of all 27,769 articles identified in 55 journals for the 2000 publishing year. All articles were categorized as original studies, review articles, general papers, or case reports. The original and review articles were then tagged as 'pass' or 'fail' for methodologic rigor in the areas of clinical prediction guides and other clinical topics. Search terms that depicted clinical prediction guides were selected from a pool of index terms and text words gathered in house and through request to clinicians, librarians and professional searchers. A total of 36,232 search strategies composed of single and multiple term phrases were trialed for retrieval of clinical prediction studies. The sensitivity, specificity, precision, and accuracy of search strategies were calculated to identify which were the best. RESULTS: 163 clinical prediction studies were identified, of which 69 (42.3%) passed criteria for scientific merit. A 3-term strategy optimized sensitivity at 91.3% and specificity at 90.2%. Higher sensitivity (97.1%) was reached with a different 3-term strategy, but with a 16% drop in specificity. The best measure of specificity (98.8%) was found in a 2-term strategy, but with a considerable fall in sensitivity to 60.9%. All single term strategies performed less well than 2- and 3-term strategies. CONCLUSION: The retrieval of sound clinical prediction studies from EMBASE is supported by several search strategies
A review of the methodological features of systematic reviews in maternal medicine
Background
In maternal medicine, research evidence is scattered making it difficult to access information for clinical decision making. Systematic reviews of good methodological quality are essential to provide valid inferences and to produce usable evidence summaries to guide management. This review assesses the methodological features of existing systematic reviews in maternal medicine, comparing Cochrane and non-Cochrane reviews in maternal medicine.
Methods
Medline, Embase, Database of Reviews of Effectiveness (DARE) and Cochrane Database of Systematic Reviews (CDSR) were searched for relevant reviews published between 2001 and 2006. We selected those reviews in which a minimum of two databases were searched and the primary outcome was related to the maternal condition. The selected reviews were assessed for information on framing of question, literature search and methods of review.
Results
Out of 2846 citations, 68 reviews were selected. Among these, 39 (57%) were Cochrane reviews. Most of the reviews (50/68, 74%) evaluated therapeutic interventions. Overall, 54/68 (79%) addressed a focussed question. Although 64/68 (94%) reviews had a detailed search description, only 17/68 (25%) searched without language restriction. 32/68 (47%) attempted to include unpublished data and 11/68 (16%) assessed for the risk of missing studies quantitatively. The reviews had deficiencies in the assessment of validity of studies and exploration for heterogeneity. When compared to Cochrane reviews, other reviews were significantly inferior in specifying questions (OR 20.3, 95% CI 1.1–381.3, p = 0.04), framing focussed questions (OR 30.9, 95% CI 3.7- 256.2, p = 0.001), use of unpublished data (OR 5.6, 95% CI 1.9–16.4, p = 0.002), assessment for heterogeneity (OR 38.1, 95%CI 2.1, 688.2, p = 0.01) and use of meta-analyses (OR 3.7, 95% CI 1.3–10.8, p = 0.02).
Conclusion
This study identifies areas which have a strong influence on maternal morbidity and mortality but lack good quality systematic reviews. Overall quality of the existing systematic reviews was variable. Cochrane reviews were of better quality as compared to other reviews. There is a need for good quality systematic reviews to inform practice in maternal medicine
Missing the forest (plot) for the trees? A critique of the systematic review in tobacco control
<p>Abstract</p> <p>Background</p> <p>The systematic review (SR) lies at the core of evidence-based medicine. While it may appear that the SR provides a reliable summary of existing evidence, standards of SR conduct differ. The objective of this research was to examine systematic review (SR) methods used by the Cochrane Collaboration ("<it>Cochrane</it>") and the Task Force on Community Preventive Services ("the <it>Guide</it>") for evaluation of effectiveness of tobacco control interventions.</p> <p>Methods</p> <p>We searched for all reviews of tobacco control interventions published by Cochrane (4<sup>th </sup>quarter 2008) and the <it>Guide</it>. We recorded design rigor of included studies, data synthesis method, and setting.</p> <p>Results</p> <p>About a third of the Cochrane reviews and two thirds of the Guide reviews of interventions in the community setting included uncontrolled trials. Most (74%) Cochrane reviews in the clinical setting, but few (15%) in the community setting, provided pooled estimates from RCTs. Cochrane often presented the community results narratively. The Guide did not use inferential statistical approaches to assessment of effectiveness.</p> <p>Conclusions</p> <p>Policy makers should be aware that SR methods differ, even among leading producers of SRs and among settings studied. The traditional SR approach of using pooled estimates from RCTs is employed frequently for clinical but infrequently for community-based interventions. The common lack of effect size estimates and formal tests of significance limit the contribution of some reviews to evidence-based decision making. Careful exploration of data by subgroup, and appropriate use of random effects models, may assist researchers in overcoming obstacles to pooling data.</p
Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials
Objective
Mindfulness-based interventions (MBIs) can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs) of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder.
Method
Post-intervention between-group Hedges g effect sizes were calculated using a random effects model. Moderator analyses of primary diagnosis, intervention type and control condition were conducted and publication bias was assessed.
Results
Twelve studies met inclusion criteria (n = 578). There were significant post-intervention between-group benefits of MBIs relative to control conditions on primary symptom severity (Hedges g = −0.59, 95% CI = −0.12 to −1.06). Effects were demonstrated for depressive symptom severity (Hedges g = −0.73, 95% CI = −0.09 to −1.36), but not for anxiety symptom severity (Hedges g = −0.55, 95% CI = 0.09 to −1.18), for RCTs with an inactive control (Hedges g = −1.03, 95% CI = −0.40 to −1.66), but not where there was an active control (Hedges g = 0.03, 95% CI = 0.54 to −0.48) and effects were found for MBCT (Hedges g = −0.39, 95% CI = −0.15 to −0.63) but not for MBSR (Hedges g = −0.75, 95% CI = 0.31 to −1.81).
Conclusions
This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population
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