Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews

This study aims to summarise the evidence on more than 140 pharmacological and non-pharmacological treatment options for major depressive disorder (MDD) and to evaluate the confidence that patients and clinicians can have in the underlying science about their effects

User testing of an adaptation of fishbone diagrams to depict results of systematic reviews

Abstract Background Summary of findings tables in systematic reviews are highly informative but require epidemiological training to be interpreted correctly. The usage of fishbone diagrams as graphical displays could offer researchers an effective approach to simplify content for readers with limited epidemiological training. In this paper we demonstrate how fishbone diagrams can be applied to systematic reviews and present the results of an initial user testing. Methods Findings from two systematic reviews were graphically depicted in the form of the fishbone diagram. To test the utility of fishbone diagrams compared with summary of findings tables, we developed and pilot-tested an online survey using Qualtrics. Respondents were randomized to the fishbone diagram or a summary of findings table presenting the same body of evidence. They answered questions in both open-ended and closed-answer formats; all responses were anonymous. Measures of interest focused on first and second impressions, the ability to find and interpret critical information, as well as user experience with both displays. We asked respondents about the perceived utility of fishbone diagrams compared to summary of findings tables. We analyzed quantitative data by conducting t-tests and comparing descriptive statistics. Results Based on real world systematic reviews, we provide two different fishbone diagrams to show how they might be used to display complex information in a clear and succinct manner. User testing on 77 students with basic epidemiological training revealed that participants preferred summary of findings tables over fishbone diagrams. Significantly more participants liked the summary of findings table than the fishbone diagram (71.8% vs. 44.8%; p < .01); significantly more participants found the fishbone diagram confusing (63.2% vs. 35.9%, p < .05) or indicated that it was difficult to find information (65.8% vs. 45%; p < .01). However, more than half of the participants in both groups were unable to find critical information and answer three respective questions correctly (52.6% in the fishbone group; 51.3% in the summary of findings group). Conclusions Fishbone diagrams are compact visualizations that, theoretically, may prove useful for summarizing the findings of systematic reviews. Initial user testing, however, did not support the utility of such graphical displays

Participants’ expectations and experiences with periodic health examinations in Austria - a qualitative study

Abstract Background The engagement of citizens in the development of evidence-based screening programs is internationally supported. The aim of our research was to explore the motivations and reasons of adult citizens in Austria for attending periodic health examinations (PHE) as well as their satisfaction with the way PHE are organized. Methods We conducted three focus groups with a random sample of previous attenders of PHE. Participants were stratified by age, gender, and education. The discussions were recorded, transcribed, and analyzed using a thematic analysis approach. Results Main motivations of attenders (n = 30) were to detect diseases early, to prevent suffering, and to live a long, healthy life. They believed that PHE work as an incentive of health behavior change. As possible reasons not to attend PHE, participants mentioned lack of awareness, time constraints, unpleasant prior experiences, and fear of harm or negative consequences. They wanted the range of examinations to be selected based on individual risks and to be more comprehensive. Some participants expressed frustration with the lack of time doctors dedicated to the examination or discussion of the results. Throughout the discussion, participants realized there is a great diversity among doctors in the quality of health examinations and how content is delivered. Conclusion The study showed that attenders of PHE have high expectations concerning the beneficial outcomes of PHE. They requested a comprehensive and individualized program that does not reflect the scientific evidence from effectiveness studies of PHE. These findings indicate serious shortcomings in the communication of benefits and harms of screening interventions and highlight the need for a more proactive communication about aims and content of the program

Assessing the validity of abbreviated literature searches for rapid reviews: protocol of a non-inferiority and meta-epidemiologic study

Abstract Background Systematic reviews offer the most reliable and valid support for health policy decision-making, patient information, and guideline development. However, they are labor intensive and frequently take longer than 1 year to complete. Consequently, they often do not meet the needs of those who need to make decisions quickly. Rapid reviews have therefore become a pragmatic alternative to systematic reviews. They are knowledge syntheses that abbreviate certain methodological aspects of systematic reviews to produce information more quickly. Methodological shortcuts often take place in literature identification. A potential drawback is less reliable results. To date, the impact of abbreviated searches on estimates of treatment effects and subsequent conclusions has not been analyzed systematically across multiple bodies of evidence. We aim to answer the research question: Do bodies of evidence that are based on abbreviated literature searches lead to different conclusions about benefits and harms of interventions compared with bodies of evidence that are based on comprehensive, systematic literature searches? Methods We will use a non-inferiority and meta-epidemiologic design. The primary outcome is the proportion of discordant conclusions based on different search approaches. Drawing of a pool of Cochrane reports published between 2012 and 2016, we will randomly select 60 reports. Eligible reports are those that present a summary-of-findings table, draw a clear conclusion, present data for meta-analyses, and document the search strategy clearly. We will conduct several abbreviated searches to detect whether included studies in these Cochrane reviews could be detected. If searches could not detect all studies, we will revise the original summary-of-findings table and ask review authors whether the missed evidence would change conclusions of their report. We will determine the proportion of discordant conclusions for each abbreviated search approach. We will consider an abbreviated search as non-inferior if the lower limit of the 95% confidence interval of the proportion of discordant conclusions is below the non-inferiority margin, which is determined based on results of a survey for clinical and public health scenarios. Discussion This will be the first study to assess whether the reduced sensitivity of abbreviated searches has an impact on conclusions across multiple bodies of evidence, not only on effect estimates

Single-reviewer abstract screening missed 13 percent of relevant studies:a crowd -based, randomized controlled trial

Objectives: To determine the accuracy of single-reviewer screening in correctly classifying abstracts as relevant or irrelevant for literature reviews. Study Design and Setting: We conducted a crowd-based, parallel-group randomized controlled trial. Using the Cochrane Crowd platform, we randomly assigned eligible participants to 100 abstracts each of a pharmacological or a public health topic. After completing a training exercise, participants screened abstracts online based on predefined inclusion and exclusion criteria. We calculated sensitivities and specificities of single- and dual-reviewer screening using two published systematic reviews as reference standards. Results: Two hundred and eighty participants made 24,942 screening decisions on 2,000 randomly selected abstracts from the reference standard reviews. On average, each abstract was screened 12 times. Overall, single-reviewer abstract screening missed 13% of relevant studies (sensitivity: 86.6%; 95% confidence interval [CI], 80.6%e91.2%). By comparison, dual-reviewer abstract screening missed 3% of relevant studies (sensitivity: 97.5%; 95% CI, 95.1%e98.8%). The corresponding specificities were 79.2% (95% CI, 77.4%e80.9%) and 68.7% (95% CI, 66.4%e71.0%), respectively. Conclusions: Single-reviewer abstract screening does not appear to fulfill the high methodological standards that decisionmakers expect from systematic reviews. It may be a viable option for rapid reviews, which deliberately lower methodological standards to provide decision makers with accelerated evidence synthesis products. (C) 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

User testing of an adaptation of fishbone diagrams to depict results of systematic reviews

Abstract Background Summary of findings tables in systematic reviews are highly informative but require epidemiological training to be interpreted correctly. The usage of fishbone diagrams as graphical displays could offer researchers an effective approach to simplify content for readers with limited epidemiological training. In this paper we demonstrate how fishbone diagrams can be applied to systematic reviews and present the results of an initial user testing. Methods Findings from two systematic reviews were graphically depicted in the form of the fishbone diagram. To test the utility of fishbone diagrams compared with summary of findings tables, we developed and pilot-tested an online survey using Qualtrics. Respondents were randomized to the fishbone diagram or a summary of findings table presenting the same body of evidence. They answered questions in both open-ended and closed-answer formats; all responses were anonymous. Measures of interest focused on first and second impressions, the ability to find and interpret critical information, as well as user experience with both displays. We asked respondents about the perceived utility of fishbone diagrams compared to summary of findings tables. We analyzed quantitative data by conducting t-tests and comparing descriptive statistics. Results Based on real world systematic reviews, we provide two different fishbone diagrams to show how they might be used to display complex information in a clear and succinct manner. User testing on 77 students with basic epidemiological training revealed that participants preferred summary of findings tables over fishbone diagrams. Significantly more participants liked the summary of findings table than the fishbone diagram (71.8% vs. 44.8%; p < .01); significantly more participants found the fishbone diagram confusing (63.2% vs. 35.9%, p < .05) or indicated that it was difficult to find information (65.8% vs. 45%; p < .01). However, more than half of the participants in both groups were unable to find critical information and answer three respective questions correctly (52.6% in the fishbone group; 51.3% in the summary of findings group). Conclusions Fishbone diagrams are compact visualizations that, theoretically, may prove useful for summarizing the findings of systematic reviews. Initial user testing, however, did not support the utility of such graphical displays

Monument du costume physique et moral de la fin du dix-huitième siècle, ou Tableaux de la vie. Orné de figures dessinées et gravées par M. Moreau le jeune et par d'autres célèbres artistes

Mammography. Summary of Findings Table for Mammography Screening Word File (DOCX 51 kb

Additional file 4: of User testing of an adaptation of fishbone diagrams to depict results of systematic reviews

Supplementary Results. Supplementary Results of User Testing Word File (DOCX 107 kb

User testing of an adaptation of fishbone diagrams to depict results of systematic reviews

Abstract Background Summary of findings tables in systematic reviews are highly informative but require epidemiological training to be interpreted correctly. The usage of fishbone diagrams as graphical displays could offer researchers an effective approach to simplify content for readers with limited epidemiological training. In this paper we demonstrate how fishbone diagrams can be applied to systematic reviews and present the results of an initial user testing. Methods Findings from two systematic reviews were graphically depicted in the form of the fishbone diagram. To test the utility of fishbone diagrams compared with summary of findings tables, we developed and pilot-tested an online survey using Qualtrics. Respondents were randomized to the fishbone diagram or a summary of findings table presenting the same body of evidence. They answered questions in both open-ended and closed-answer formats; all responses were anonymous. Measures of interest focused on first and second impressions, the ability to find and interpret critical information, as well as user experience with both displays. We asked respondents about the perceived utility of fishbone diagrams compared to summary of findings tables. We analyzed quantitative data by conducting t-tests and comparing descriptive statistics. Results Based on real world systematic reviews, we provide two different fishbone diagrams to show how they might be used to display complex information in a clear and succinct manner. User testing on 77 students with basic epidemiological training revealed that participants preferred summary of findings tables over fishbone diagrams. Significantly more participants liked the summary of findings table than the fishbone diagram (71.8% vs. 44.8%; p < .01); significantly more participants found the fishbone diagram confusing (63.2% vs. 35.9%, p < .05) or indicated that it was difficult to find information (65.8% vs. 45%; p < .01). However, more than half of the participants in both groups were unable to find critical information and answer three respective questions correctly (52.6% in the fishbone group; 51.3% in the summary of findings group). Conclusions Fishbone diagrams are compact visualizations that, theoretically, may prove useful for summarizing the findings of systematic reviews. Initial user testing, however, did not support the utility of such graphical displays