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No abstract available.
Clinical trial data are essential for assessments of the effectiveness of health care interventions. Information about ongoing or completed, but not yet formally published, trials has been more difficult to identify until the development of clinical trials registers and portals. This paper summarises research evidence on identifying sources of trial data, how and when to search those sources, and which future developments may enhance access to and retrieval of unpublished trial evidence.
We conducted a literature search for relevant studies and provide a narrative review of the evidence from these studies. Clinical trial data can be found in resources including clinical trials registers, regulatory agency sources, health technology assessment websites and manufacturers' websites, and submissions for regulatory approval. The challenges of searching these resources are described. Trials registers are relatively unsophisticated in terms of their search interfaces, and searchers need to adapt to each individual register. There is overlap across registers, but little research on the degree and nature of overlap and how best to search. Despite these challenges, trials registers and other resources can be rich sources of additional unique trial data, which may not be available from journal reports. New initiatives, such as OpenTrials, aim to consolidate and link all structured data and documentation related to clinical trials.
No single resource gives access to all trials, and multiple registers should be searched as sensitively as possible. Searching is challenging and should be adequately resourced. Information specialists should monitor new developments which may reduce the challenges over the coming years.
This chapter focuses on evidence synthesis and, in particular, systematic reviews, including meta-analysis. Narrative literature reviews, critical reviews, expert elicitation, systematic reviews and meta-analyses, combined or separate, are examples of evidence-synthesis approaches. A well-executed systematic review is a rigorous and replicable approach to identifying, evaluating and summarizing scientific evidence relevant to a specific clinical or policy question. Systematic review questions can be classified as questions about interventions, causes, disease burden and detection. An extensive literature search is a cornerstone of the systematic review. One of the key features of systematic reviews is the emphasis on extraction and reporting of the magnitude of outcomes and precision of estimates. The essential elements of a meta-analysis are planning, conduct and interpretation. Planning requires deciding which comparisons to make, what summary effect measure to use, which statistical model to use, and which sources of heterogeneity to assess.
No abstract available.
INTRODUCTION: Systematic review methods are now being used for reviews of food production, food safety and security, plant health, and animal health and welfare. Information retrieval methods in this context have been informed by human health-care approaches and ideally should be based on relevant research and experience.
OBJECTIVE: This narrative review seeks to identify and summarize current research-based evidence and experience on information retrieval for systematic reviews in food and feed topics.
METHODS: MEDLINE (Ovid), Science Citation Index (Web of Science), and ScienceDirect (http://www.sciencedirect.com/) were searched in 2012 and 2016. We also contacted topic experts and undertook citation searches. We selected and summarized studies reporting research on information retrieval, as well as published guidance and experience.
RESULTS: There is little published evidence on the most efficient way to conduct searches for food and feed topics. There are few available study design search filters, and their use may be problematic given poor or inconsistent reporting of study methods. Food and feed research makes use of a wide range of study designs so it might be best to focus strategy development on capturing study populations, although this also has challenges. There is limited guidance on which resources should be searched and whether publication bias in disciplines relevant to food and feed necessitates extensive searching of the gray literature.
CONCLUSIONS: There is some limited evidence on information retrieval approaches, but more research is required to inform effective and efficient approaches to searching to populate food and feed reviews.
CONTEXT: Previously, the authors had developed and evaluated a framework to evaluate systematic review (SR) lifecycle tools.
GOAL: The goal of this study was to use the experiences of researchers in other domains to further evaluate and refine the evaluation framework.
METHOD: We investigate the opinions of researchers with experience of systematic reviews in the healthcare and social sciences domains. We used semi-structured interviews to elicit their experiences of systematic reviews and SR support tools.
RESULTS: Study participants found broadly the same problems as software engineering (SE) researchers with the SR process. They agreed with the tool features we had included in our evaluation framework. Furthermore although there were some differences the majority of the importance assessments were very close.
CONCLUSIONS: In the context of SRs, experiences of researchers in other domains can be useful to software engineering researchers. The evaluation framework for SR lifecycle tools appeared quite robust.
OBJECTIVE: To estimate the cost-effectiveness of Nasal High Flow (NHF) in the intensive care unit (ICU) compared with standard oxygen or non-invasive ventilation (NIV) from a UK NHS perspective.
METHODS: Three cost-effectiveness models were developed to reflect scenarios of NHF use: first-line therapy (pre-intubation model); post-extubation in low-risk, and high-risk patients. All models used randomized control trial data on the incidence of intubation/re-intubation, events leading to intubation/re-intubation, mortality and complications. NHS reference costs were primarily used. Sensitivity analyses were conducted.
RESULTS: When used as first-line therapy, Optiflow™ NHF gives an estimated cost-saving of £469 per patient compared with standard oxygen and £611 versus NIV. NHF cost-savings for high severity sub-group were £727 versus standard oxygen, and £1,011 versus NIV.
For low-risk post-intubation patients, NHF generates estimated cost-saving of £156 versus standard oxygen. NHF decreases the number of re-intubations required in these scenarios. Results were robust in most sensitivity analyses.
For high-risk post-intubation patients, NHF cost-savings were £104 versus NIV. NHF results in a non-significant increase in re-intubations required. However, reduction in respiratory failure offsets this.
CONCLUSIONS: For patients in ICU who are at risk of intubation or re-intubation, NHF cannula is likely to be cost-saving.
