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A. Cours magistraux / Lectures

B. Grille de lecture critique d’un article médical / Critical Appraisal Template Sheets

C. Article du mois - Revue / Article of month - Review

D. Quizz

E. Newsletter

 

 

Cours magistraux / Lectures

 

23.02.2023 - EBM Lesson 3, Randomized controlled trials

 

26.01.2023 - EBM Lesson 2, Study design : an introduction / a brief overview

 

 

15.12.2022 - EBM Lesson 1, Introduction 

 

Grille de lecture critique d’un article médical / Critical Appraisal Template Sheets

 

Resources in EBM / clinical research / research on research

 

You will find here under a non-exhaustive list of Journals, books, website, and other electronic tools that will help you conduct your own research or help you understand, evaluate and critically appraise the research of others.

Please feel free to write to me if there are any errors, or if you are aware of some documentation that could be of help other researchers (EBMteaching@hotmail.com)

 

1. Journals

Here below are the main Journals, classified according to their main research interest. Some are free to access, some require a subscription. In the latter case, check with your school or university, they might have a contribution for all the students. You can copy and paste the internet address of each Journal in your search engine.

For each of them you can browse the content, and then access the paper of interest if you have free access or a granted (paid) access. You can also require the Journal to send you the Table of Content (TOC) to keep you informed.

All these Journals were accessed on 07.10.2022

In green: open access

In orange: limited access

In red: no free access, paying content, subscription

In bold: the few Journals every person interested in EBM / clinical research / biostatistics should read

 

1.1. Methodology Journals

The one you should read:

Good Journal for general methodology in clinical research

The other ones:

 

1.2. Statistics Journals

The one you should read:

Statistics in Medicine (Statistics in Medicine: List of Issues - Wiley Online Library) no free access, paying content, subscription

A must read Journal in the field of biostatistics

The other ones:

 

1.3. Systematic reviews Journals

The one you should read:

The other ones:

 

1.4. Trials Journals

The one you should read:

Journal of the Society for Clinical Trials

 

The other ones:

 

1.5. Evidence Based Medicine Journals

The one you should read:

Limited access

The other ones:

 

1.6. Epidemiology Journals

The one you should read:

  • American Journal of Epidemiology ()

The other ones:

Epidemiology (Epidemiology (lww.com)) no free access, paying content, subscription

 

1.7. Statistic educational series in medical journals (methodology series in pubmed free text)

In the following journal, you will find a collection of papers on biostatistics and research methodology

https://jamanetwork.com/collections/44042/guide-to-statistics-and-medicine

Indian journal of dermatology methodology series

Eur J Gen Pract 2018

J Clin Psychopharmacol 2018

BMC Biol 2020

J Clin Epidemiol 2017

Vet pathol 2018

Emerg Med 2019

Int Crit Care Nurs 2005

 

 

2. Books

Biostatistics / probability

-        Ouellet G. Statistics et probabilités. Les éditions Le Griffon d’argile.

-        Rousson V. Statistiques appliquées aux sciences de la vie. Edt Lavoisier

-        Peacock J et al. Oxford handbook of medical statistics. OUP 2011

-        O’Kelly M et al. Clinical trials with missing data. A guide for practioners. Edt Wiley 2014

-        Machin D et al. Sample sizes for clinical, laboratory and epidemiology studies. Edt Wiley 2018

-        Motulsky H. Biostatistique. Une approche intuitive. De Boeck 2010

-        Bate S et al. The design and statistical analysis of animal experiments. Edt Cambridge 2014

-        Hulley SB et al. Designing cinical research. Edt Lippincott 2001

Research methodology / trials

-        Prognosis research in healthcare. OUP 2019

-        Pepe M. The statistical evaluation of medical tests for classification and prediction. OPU 2003

-        Piantadosi S et al. Clinical trials. A methodologic perspective. Edt Wiley 2017

EBM/Critical appraisal

-        Strauss E et al. Evidence-based Medicine. How to practice and teach EBM. Edt Elsevier 2005

-        Ajetunmobi O. Making sense of critical appraisal. Edt Hodder Arnold 2002

-        Elwood M. Critical appraisal of epidemiological studies and clinical trials. OUP 2017

-        Gosall N et al. The doctor’s guide to critical appraisal. Edt Pastest 2015

-        Wang D et al. Clinical trials. A practical guide to design, analysis and reporting. Edt Remedica 2006

-        Simpson A et al. Epidémiologie appliquée. Une initiation à la lecture critique en sciences de la santé. Edt Chenelière Education 2017

Systematic reviews / meta-analysis

-        Systematic reviews in health care. Meta-analysis in context. BMJ Books 2001

-        Cochrane handbook for systematic reviews of interventions. Edt Wiley Blackwell 2008

STATA

-        Introduction to time series using STATA

-        Taffé P. Probabilité et statistique pour les sciences de la vie. STATA press 2014

-        Acock A. A gentle introduction to STATA. STATA press 2014

History of EBM

-        Trohler U. “to improve the evidence of Medicine”. The 18th century British origins of a critical approach. Royal College of Physicians of Edinburgh, 2000

-        Howick J. The Philosophy of Evidence-Based Medicine. Edt Wiley-Blackwell 2011

 

 

3. Electronic databases and tools to perform clinical research such as, and not limited to:

3.1. Literature databases:

Literature search datas:

-        Pubmed (PubMed (nih.gov)) open access

-        Embase (Welcome - Embase) fee

-        Cinahl (CINAHL Complete | EBSCO) fee

-        Cochrane database of systematic reviews (Search | Cochrane Library) open access

-        Cochrane Central (Search | Cochrane Library) open access

-        Grey literature open access

-        ClinicalTrial.gov  (Home | Beta ClinicalTrials.gov) open access

 

3.2. Literature sorting, sharing and saving:

-        Endnote (EndNote | The best reference management tool) fee

-        Zotero (Zotero | Your personal research assistant) open access

-        Revman (https://revman.cochrane.org) open access

-        Ryyan (Rayyan – Intelligent Systematic Review - Rayyan) fee

 

 

3.3. Biostatistic:

-        STATA (Statistical software for data science | Stata) fee

-        SAS (Statistical Analysis Software, SAS/STAT | SAS) fee

-        R (R: The R Project for Statistical Computing (r-project.org)) open access

-        SPSS (SPSS Statistics - Suisse | IBM) fee

 

3.4. Meta-analysis tools:

Revman (Covidence - Better systematic review management) open access

 

3.5. Epidemiology tools:

-        Epi-info (Epi Info™ | CDC) open access

-        Epitool (Epitools - Home (ausvet.com.au)) open access

 

3.6. Sample size calculation

G*Power tool open access

-        Download tool (free) from the University of Dusseldorf (University of Düsseldorf: G*Power (hhu.de))

-        Instruction in the accompanying book (Verma JP et al. Determination of Sample Size and Power analysis with G*Power Software, 2017. www.jpverma.org

-        Hyun Kang. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021; 18: 17

 

 

4. EBM centers of excellence

http://www.cebm.net/ (accessed 09.10.2022)

 

 

Article du mois - Revue / Article of month - Review

 

A VENIR ! 

 

Quizz

 

Evidence based medicine / biostatistics introduction course 

Lesson 1: Databases, literature searching 

Questions 

One or more answers per question can be correct

 

1. EBM is a very new concept. EBM did not exist until the mid of the 20th century. Justify your answer with an example.

a) True

b) False

 

2. EBM can only apply to interventional studies, i.e. placebo controlled randomized controlled trials

a) True

b) False

 

3. The PICO acronym stands for

a) Pediatric, Individual, Control, Outcome

b) Patient, Intervention, Control, Observation

c) Patient, Intervention, Control, Outcome

 

4. The overlap between PubMed and Embase is approximately:

a) < 10%

b) 30%

c) 70%

d) > 90%

e) I do not know the difference between Embase and Pubmed, or I do not know Embase

 

5. What is/are the major bias (es) when searching the medical literature?

a) File drawer bias

b) Language bias

c) Novelty bias

d) Cognitive bias

e) None of the above

f) All of the above

  

6. Searching with free text compared to with Mesh Term in PubMed

a) Retrieve the same number of papers

b) Retrieve more papers

c) Retrieve more recent papers

 

7. Searching with free text compared to with Mesh Terms in Pubmed

a) Is more specific and more sensitive

b) Is less specific and less sensitive

c) Is more specific and less sensitive

d) Is less specific and more sensitive

 

 

Evidence based medicine / biostatistics introduction course 

Lesson 1: Databases, literature searching 

Answers

  

One or more answers per question can be correct

Correct answers are in bold characters

 

1. EBM is a very new concept. EBM did not exist until the mid of the 20th century. Justify your answer with an example.

 a) True

b) False

EBM is not new. In the book of Daniel is reported what we consider the first ever trial. The trial was conducted by Nebuchadnezzar, approx. 500 BC. He ordered his people to eat only meat and drink only wine. However, a group of young men objected, preferring vegetables and water. The king agreed, and the first trial lasted ten days. After ten days, the group of young man looked healthier, and king Nebuchadnezzar agreed for vegetables lovers to continue their diet.

You will notice the apparent lack of randomization and of blinding! Also the participants of the second group, described as “young men”, might have been already, before the trial, significantly healthier than the first group.

Centuries later, James Lind, a navy captain, to reduce the incidence of scurvy, designed the first “modern” trial, ordering the constitution of several groups, only different by the food their were assigned. Only the groups receiving oranges or lemon improved.

Of note, it took several years for the findings to be implemented in the royal navy.

Closer to us, the EBM movement really came to prominence with pioneer such as Gordon Guyatt, in 1990, in the McMasters University Internal Medicine department. Other preceded or followed, like Archie Cochrane, Paul Glaziou, David Sackett or Ian Chalmers, to mention a few.

 

2. EBM can only apply to interventional studies, i.e., placebo controlled randomized controlled trials

a) True

b) False

EBM can apply to other studies than randomized controlled trials (RCT). Although EBM consider RCT as very high on the level of evidence, it also truly recognizes that not all interventions can be tested by trials. For instance, it would be unethical to subject participants to toxics compound, to prove their negative impact on human health (tobacco for instance). It is in that context that non-interventional studies, or cohort studies, show their full potential. EBM recognize non-interventional studies, and has developed many tools to appraise them specifically, such as Robin-1 and 2 tools.  

 

 3. The PICO acronym stands for         

a) Pediatric, Individual, Control, Outcome

b) Patient, Intervention, Control, Observation

c) Patient, Intervention, Control, Outcome

The acronym PICO stands for Patient, Intervention, Control (group) and Outcome. PICO helps formulate a clear (and answerable) question. PICO helps narrow the number of retrieved papers for a given question, and it increases the specificity of each paper retrieved.

For systematic reviews / meta-analysis, PICO should be reported in the methods section. It is recommended to report the search strategy in a complete and reproducible manner. Of note, the NICE (National Institute for Clinical Excellence) promotes other structure than PICO, such as: SPICE (Setting, Perspective, Intervention, Comparison, Evaluation), or multistranded approaches.

 

4. The overlap between PubMed and Embase is approximately:

a) < 10%

b) 30%

c) 70%

d) > 90%

e) I do not know the difference between Embase and Pubmed, or I do not know Embase

Both databases are completely independent. This page What's the difference between PubMed, Medline & Embase? - Research Tips - LibGuides at King Edward Memorial Hospital can help the reader distinguish between the two databases.

Searching Embase retrieve more citations than PubMed. Embase often retrieve more European Journals, and also Journals with a focus on chemistry or physic. For a systematic review, both databases should be searched, for the following reasons:

1) Mesh term is unique to PubMed

2) Although there is a significant overlap, many citations will only be found in one (or the other) database. Of the 4,800 journals indexed in EMBASE, 1,800 are not indexed in MEDLINE. Similarly, of the 5,200 journals indexed in MEDLINE, 1,800 are not indexed in EMBASE.

Many agencies recommend searching both databases, plus one another (Cinahl or Cochrane Central (for RCT).

For rapid reviews, a single database search is acceptable. This should be well reported in the methods section.

 

5. What is/are the major bias (es) when searching the medical literature?

a) File drawer bias

b) Language bias

c) Novelty bias

d) Cognitive bias

e) None of the above

f) All of the above

Bias is defined as any factor that leads to conclusions that are systematically different from the truth. Contrary to error or imprecision, it does not happen at random. Biases are often difficult to detect, and they can severely distort the truth.

File drawer bias is the result of some studies never being published (because of early stopping, or of negative results). It is easy to imagine how importantly it can distort the reality if some or all negative trials were not included in a systematic review / meta-analysis.

In the same vein, language and novelty bias result from exclusion of citations based on language publication, year of citation, respectively. Cognitive bias results from a systematic biased error in thinking and processing and interpreting information.

 

6. Searching with free text compared to with Mesh Term in PubMed         

a) Retrieve the same number of papers

b) Retrieve more papers

c) Retrieve more recent papers

Using free text search, in Medline via PubMed, in the text, including the title and abstract, often retrieve slightly more citations than using the Mesh terms. On average, in comparative studies, using Mesh terms retrieve 10% less papers than using free text.

 

7. Searching with free text compared to with Mesh Terms in Pubmed

a) Is more specific and more sensitive

b) Is less specific and less sensitive

c) Is more specific and less sensitive

d) Is less specific and more sensitive

Using Mesh term will retrieve more specific terms. Librarians at the National Library of Medicine assign, after reading the paper, specific Mesh terminology. This allows 1) to retrieve more specific papers, 2) to improve the replicability of literature searching. However, if a Mesh term did not cover a specific free text term, using Mesh term might miss some valuable citations. Finally, using Mesh term does not retrieve papers published in the last 6 months, due to the time it takes to assign these Mesh terms by the librarians.

For a systematic review, it is recommended that both free text and Mesh terms should be used, acknowledging their (large) overlap.

 

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