{"id":1875,"date":"2018-12-03T12:43:57","date_gmt":"2018-12-03T12:43:57","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/?p=1875"},"modified":"2019-02-26T09:48:40","modified_gmt":"2019-02-26T09:48:40","slug":"how-do-you-find-practice-changing-research-evidence","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2018\/12\/03\/how-do-you-find-practice-changing-research-evidence\/","title":{"rendered":"Finding practice-changing research evidence"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><em><a href=\"https:\/\/ebmlive.org\" rel=\"attachment wp-att-1860\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-1860 size-full\" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2018\/11\/EBM-Live-banner.png\" alt=\"\" width=\"986\" height=\"167\" srcset=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2018\/11\/EBM-Live-banner.png 986w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2018\/11\/EBM-Live-banner-300x51.png 300w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2018\/11\/EBM-Live-banner-768x130.png 768w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2018\/11\/EBM-Live-banner-640x108.png 640w\" sizes=\"auto, (max-width: 986px) 100vw, 986px\" \/><\/a><\/em><\/p>\n<p>How<em> do we find the evidence that might be of interest to individual health professionals?\u00a0\u00a0<\/em><\/p>\n<p style=\"text-align: right\"><strong>Jon Brassey<\/strong><\/p>\n<hr \/>\n<p>We<a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2018\/12\/03\/how-do-you-find-practice-changing-research-evidence\/picture3-3\/\" rel=\"attachment wp-att-1876\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-1876 alignleft gr-progress\" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2018\/12\/Picture3-150x150.png\" alt=\"\" width=\"150\" height=\"150\" \/><\/a>\u2019re all aware of the explosion of medical knowledge: \u201c<a href=\"https:\/\/journals.plos.org\/plosmedicine\/article?id=10.1371\/journal.pmed.1000326\">Seventy-Five Trials and Eleven Systematic Reviews a Day: How Will We Ever Keep Up<\/a>?\u201d sums up the problem in the title alone, while the NEJM reports \u201c<em><a href=\"https:\/\/knowledgeplus.nejm.org\/blog\/staying-current-in-medicine-advice-for-new-doctors\/\">In 1950, doctors in practice could expec<\/a><a href=\"https:\/\/knowledgeplus.nejm.org\/blog\/staying-current-in-medicine-advice-for-new-doctors\/\">t the total amount of medical knowledge to double every 50 years. By 2020, it will take just 73 days<\/a><\/em><em>.<\/em>\u201d<\/p>\n<p>The majority of knowledge is unlikely to be of interest to a single health professional, particularly specialists.\u00a0 But that still leaves stacks of evidence that might be of interest to individual health professionals.\u00a0 The problem is not one of <em>information overload<\/em> but one of <em>filter failure<\/em>.<\/p>\n<p>Information specialist\u2019s role is to filter out the noise amongst all of this information, trying to arrive at the good stuff.\u00a0 In my role as an associate editor at BMJ EBM, I have been tasked with finding practice-changing research &#8211; the good stuff &#8211; to the editors to allow them to select the research evidence that matters to clinical practice for the <a href=\"https:\/\/ebm.bmj.com\/pages\/authors\/?gclid=Cj0KCQiA3IPgBRCAARIsABb-iGJ_GVoX8r6tJc_X9p31vzRnTo_S2Z4U1AiXX4UgblkOQ5Un4q6-Vm0aAmewEALw_wcB#ebm_verdict\">EBM Verdict<\/a>.<\/p>\n<p>So, what does this entail? \u00a0It\u2019s early stages in the process, and we\u2019ll be monitoring the performance of the filters that we introduce, but here are a few criteria we\u2019ve developed:<\/p>\n<ul>\n<li>Definitive conclusions \u2013 should this be started (or stopped) in practice? No \u2018<em>needs more research<\/em>\u2019 or \u2018<em>these results might\u2026.<\/em>\u2019.<\/li>\n<li>Robust \u2013 are the conclusions based on high-quality research?<\/li>\n<li>Is the type of study the right one to answer the question?<\/li>\n<li>Is the research likely to be of broad interest?<\/li>\n<\/ul>\n<p>The top two criteria are used to help create a long list of articles generated by two main methods.<\/p>\n<ul>\n<li>Harnessing of existing systems to support article selection. For instance, there are already systems, such as <a href=\"https:\/\/plus.mcmaster.ca\/evidencealerts\/\">EvidenceAlerts<\/a> and <a href=\"https:\/\/discover.dc.nihr.ac.uk\/portal\/search\/signals\">NIHR Signals<\/a>, which have a role of filtering the mass of journal articles.\u00a0 Evidence Alerts scans over a hundred journals and filters them based on quality, newsworthiness and relevance to clinical practice.\u00a0 We look through these outputs and look for those with definitive conclusions and add these to our long list of articles.<\/li>\n<li>We scan the big five internal medical journals (BMJ, NEJM, Lancet, JAMA and Annals of Internal Medicine). Again, we use the criteria of definitive conclusions as inclusion criteria to the long-list.<\/li>\n<\/ul>\n<p>For every included article we obtain the Altmetric score (<a href=\"https:\/\/www.altmetric.com\/\">https:\/\/www.altmetric.com\/<\/a>) which we use as a proxy for interest.\u00a0 This is not an inclusion\/exclusion criteria but more to guide the editors\/writers in selecting articles that are likely to be of most interest to our readers.<\/p>\n<p>In the first attempt at the long-list around 50 articles were highlighted \u2013 is that too many for one month (as we\u2019re only likely to cover 8 per publication) or too few (as the editors don\u2019t have enough to choose for their interest\/speciality)?<\/p>\n<p>Is Altmetric a reasonable proxy for interest?\u00a0 If an article has a sizeable Altmetric score, has it already been seen and discussed by our readers. Altmetric might also introduce \u2018<a href=\"https:\/\/catalogofbias.org\/biases\/hot-stuff-bias\/\">hot stuff bias\u2019<\/a>, as fashionable (\u2018hot\u2019)\u00a0 research may be less critical in its approach and therefore less useful.<\/p>\n<p>A further potential issue is understanding the role of BMJ EBM in unearthing useful, practice-changing research.\u00a0 Is it the case that such research can be found using the methods outlined above?\u00a0 Probably not, but how do we make sure we find them?\u00a0 We don\u2019t yet have the answers.<\/p>\n<p>So, we\u2019d like to hear from you to help guide the development of the methods in creating the long-list and refining it. Get in touch and help make BMJ EBM <em>Verdicts<\/em> better, more useful and practice changing.<\/p>\n<hr \/>\n<p>BMJ\u00a0<a href=\"http:\/\/ebm.bmj.com\/\">Evidence-Based Medicine<\/a>\u00a0\u2013\u00a0original evidence-based research, insights and opinion<\/p>\n<p>Read more in the\u00a0<a href=\"http:\/\/ebm.bmj.com\/content\/early\/2018\/01\/24\/bmjebm-2018-110906\">Welcome to BMJ Evidence-Based Medicine Editorial<\/a>.<\/p>\n<hr \/>\n<p><b> Competing interests<\/b><\/p>\n<p>I run the search engine the Trip Database (www.tripdatabase.com) and own 50% of the shares in the company, and I am an Associate Editor at BMJ EBM.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; How do we find the evidence that might be of interest to individual health professionals?\u00a0\u00a0 Jon Brassey We\u2019re all aware of the explosion of medical knowledge: \u201cSeventy-Five Trials and Eleven Systematic Reviews a Day: How Will We Ever Keep Up?\u201d sums up the problem in the title alone, while the NEJM reports \u201cIn 1950, [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2018\/12\/03\/how-do-you-find-practice-changing-research-evidence\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":1878,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14397,14398],"tags":[],"class_list":["post-1875","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ebm-verdict","category-jon-brassey"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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