Write an evidence-based clinical literature review – Pubrica
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How do you Write an Evidence-Based Clinical Literature Review? An Academic presentation by Dr. Nancy Agnes, Head, Technical Operations, Pubrica Group: www.pubrica.com Email: [email protected]
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Systematic reviews and meta-analyses are not the same as traditional clinical review papers, usually known as updates. Updates evaluate the medical literature selectively while covering a broad topic for Physician Writing.
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Transcript of Write an evidence-based clinical literature review – Pubrica
How do you Write anEvidence-BasedClinical LiteratureReview?
An Academic presentation byDr. Nancy Agnes, Head, Technical Operations, PubricaGroup: www.pubrica.comEmail: [email protected]
02
In brief
Introduction
Topic Selection
Searching the Literature
Patient-Oriented vs Disease-Oriented Evidence
Levels of Evidence
Format of the Review
Conclusion
About Pubrica
TODAY'S DISCUSSION
Systematic reviews and meta-analyses are not the sameas traditional clinical review papers, usually known asupdates. Updates evaluate the medical literature selectivelywhile covering a broad topic for Physician Writing.
Nonquantitative systematic reviews analyze the medicalliterature in depth, attempting to find and synthesize allrelevant data to establish the optimal diagnostic ortreatment strategy.
Meta-analyses (systematic quantitative reviews) utilizesophisticated statistical analysis of pooled research papersto address a specific clinical question. The guidelines forauthoring an evidence-based clinical review article forphysicians are presented in this article.
IN BRIEF
INTRODUCTIONThe most acceptable clinical review articles base their discussionson current systematic reviews and meta-analyses, and they includeall relevant research results on how to treat a specific condition.
These evidence-based updates give readers concise summariesas well as solid therapeutic advice.
Criteria for producing an evidence-based clinical review article,particularly one intended for continuing medical education (CME)and include CME objectives in its structure.
The article's bias, a lack of adequate supporting evidence, or otherconsiderations to conduct a study of the Literature reviewmethodologies and, when possible, assign a score to essentialpieces of evidence. This method helps to accentuate the article'smain themes.
Choose a prevalent clinical condition and avoidthemes that are rare or uncommon illnesspresentations or that are merely interesting for thesake of curiosity.
Choose common issues for which there is newknowledge on diagnosis or therapy whereverpossible.
Recent data indicating spironolactone medicationincreases survival in patients with severe congestiveheart failure, for example, might drive a clinicalpractice change if it is valid.
TOPIC SELECTION
Contd...
Similarly, new evidence indicating that a narrative literature review ofconventional treatment is no longer effective and may even be hazardous shouldbe reported.
Patching most acute corneal abrasions, for example, may exacerbate symptomsand delay healing.
Look for relevant recommendations on the conditionbeing discussed's diagnosis, treatment, or prevention.
Include any high-quality suggestions that are relatedto the issue.
Look for all primary Clinical Literature reviewsuggestions concerning diagnosis and, especially,therapy in the initial draught.
Attempt to ensure that all suggestions are based onthe most up-to-date evidence.
SEARCHING THE LITERATURE
PATIENT-ORIENTED VSDISEASE-ORIENTED EVIDENCE
Patient-Oriented Evidence that Matters (POEM) isconcerned with patient-relevant outcomes such as changesin morbidity, mortality, or quality of life.
POEM-type evidence differs from disease-orientedevidence (DOE), which Systematic literature reviewfocuses on surrogate endpoints such as test results or otherresponse indicators.
Indicate that foremost clinical advice lacks the backing ofoutcomes evidence when DOE is the only guidelineprovided.
LEVELS OF EVIDENCE
Takes all significant outcomes Comprehensive search tacticswere used to conduct a high-quality meta-analysis (systematicquantitative review).
A comprehensive nonquantitative review with effectivesearch tactics and well-supported findings.
The quality of the evidence supporting the essential clinicalrecommendations on diagnosis and therapy is critical informationfor readers. In the medical literature, several different gradingsystems of varying complexity and clinical usefulness arereported.
Contd...
A well-designed, nonrandomized clinical study is considered Level B (otherevidence).
Lower-quality RCTs, clinical cohort studies, and case-controlled studies withnon-biased participant selection and consistent findings are included.
Other data, such as well-designed epidemiologic studies with compelling findingsor high-quality, historical, uncontrolled investigations, is also included.
Level C (consensus/expert opinion): Expert opinion or consensus position.
The review's topic and objective should be defined inthe introduction and its relevance to family practice.
The natural way of achieving this is to talk about thedisease's epidemiology, which includes how manyindividuals have it at any particular moment(prevalence) and what percentage of the population isprojected to get it over time (incidence).
INTRODUCTION
Contd...
FORMAT OF THE REVIEW
A more exciting approach to accomplish this is to show how many times aregular family physician meet this problem in a week, month, year, or career.
Emphasize and summarise the review's primary CME objectives in a separatetable labelled "CME Objectives."
Contd...
The methodology section should briefly describe how the literaturesearch was carried out and the primary evidence sources.
Indicate which studies were included or excluded based on predefinedcriteria (e.g., studies had to be independently rated as high quality byan established evaluation process, such as the CochraneCollaboration).
Make a thorough effort to locate all significant relevant research.
Avoid using solely the material that supports your findings as areference. If an issue is controversial, discuss the entire extent of theargument.
METHODS
Contd...
After then, the discussion might take on the shape ofa clinical review article.
It should cover aetiology, clinical presentation (signsand symptoms), pathophysiology, diagnosticevaluation (history, physical examination, diagnosticimaging, laboratory evaluation, and), differentialdiagnosis, treatment (goals, medical/surgical therapy,laboratory testing, patient education, and follow-up),prognosis, prevention, and future directions).
DISCUSSIONS
Contd...
The references should contain the most current andessential sources of support (i.e., studies referred to,controversial material, new information, specificquantitative data, and information that would notusually be found in most general reference textbooks).
These usually are significant evidence-basedrecommendations, meta-analyses, or Systematicliterature reviews, seminal studies. While other journalspublish lengthy lists of reference citations, AFP prefersto provide a concise list of relevant references.
REFERENCES
Contd...
Evidence-based evaluations may help select how todeploy health-care services, particularly preventativeprogrammes, in some instances.
Some high-quality cost-effectiveness studies wereappropriate to assist understand the costs and healthbenefits of various strategies for achieving a particularhealth result.
In the discussion, highlight significant aspectsconcerning diagnosis and therapy. These points arenot always the same as the significantrecommendations, which are ranked according to theirdegree of evidence.
CONCLUSION
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