Top Medical Journals Research Articles

The natural history of rotator cuff tears: a systematic review.

To analyse the current scientific evidence regarding the natural history of the clinical and anatomical progression of rotator cuff tears. A broad systematic review of the literature (PubMed database through January 2014) which was guided, conducted and reported according to PRISMA criteria. This article focuses on the rotator cuff tears. Articles had to meet an inclusion criteria. The methodological quality of each study was individually assessed using a recently developed general assessment tool AMQPP (assessing the methodological quality of published papers). Seven articles dealing with rotator cuff tears were included, one of them was a high-quality study. Three papers assessed the natural history and the natural course of rotator cuff rupture directly. The other studies indirectly assessed the natural history with reports on non-operative and operative therapy trends. All of these articles had been published in four different top medical journals according to 2013 ranking. We found no articles which clearly referred to the role of regression to the mean of rotator cuff tears. The development of symptoms and anatomical deterioration are often directly correlated. Spontaneous recovery to normal levels of function has been successfully achieved, and standardised non-operative treatment programmes are an effective alternative to surgery for many patients. Follow-up is necessary to avoid irreparable stage. However, surgery is still favoured by young active people and highly professional persons who need to get fit in a short period of time. Further research is still necessary. The AMQPP score system is simple and reliable. It works as a quick quality-checking tool which helps researchers to identify the key points in each paper and reach a decision regarding the eligibility of the paper more easily.

How case reports have contributed to the progress of surgery.

Editorial The now well-known Zollinger-Ellison syndrome was recognized by Professor Zollinger at Ohio State University and his student, Dr. Ellison, based on their insightful observations of two young women who suffered from refractory peptic ulcers requiring repeated surgery [1]. The index case for Kasabach-Merritt syndrome was a 2-month-old male infant who underwent radiation therapy for a huge and growing capillary hemangioma in the left thigh causing extensive purpura [2]. Dr. Kasabach was a radiologist and Dr. Merritt was a colleague pediatrician at Columbia University. The first successful right lobectomy of the liver was performed by Professor Honjo at Kyoto University in 1949 to remove a large liver metastasis from rectal cancer in a 22-year-old man [3]. Professor Honjo reported this epoch-making progress in liver surgery as a case report in an English journal. The first three cases of human liver transplantation were reported by Professor Starzl from the University of Colorado in 1963 [4]. Nevertheless, case reports or case series are ranked as low level 4 evidence [5] in the hierarchy of evidence-based medicine. Most of the top medical or surgical journals now restrict the acceptance of case reports to an extreme degree because such reports, in general, are seldom cited and thus would reduce the journal's impact factor. However, we must recognize how previous reports of a few unusual cases, observed and treated by excellent physicians, have contributed greatly to the progress of medical science. In addition to the outstanding case reports mentioned above, there have been a number of amazing discoveries made by surgeons in their daily practice. Sir James Cantlie, a surgeon at the University of Hong Kong, started his anatomical research on the liver after

A Tribute to Leon F. Burmeister, PhD (1941-2014).

Leon F. Burmeister, statistical editor of Obstetrics & Gynecology from 1986 to 2013, died suddenly at his home in Iowa City, Iowa, on October 29, 2014. The evolution of statistical analysis in the Green Journal, in which Dr. Burmeister's role was central, was described in a recent publication.1 During his 27-year tenure with the journal (which, incidentally, represents nearly half of its existence), he personally evaluated thousands of manuscripts, sometimes identifying fatal flaws in statistics or design and more often making suggestions to improve the final product. He also provided educational programs for the Editorial Board at its annual meeting, and he was co-author on a number of publications describing the journal's research into its processes.FigureAn Iowan through and through, he exemplified all that is good about the heartland of America. Iowa expects its best people to be self-effacing and to shun self-promotion or any other activity that might distract from work and accomplishment. Leon was certainly true to this heritage. Born on a farm, he became an outstanding scholar and a star athlete in high school and then went on to Iowa State University, where he received his BA, MA, and PhD in statistics. He took a faculty appointment at the University of Iowa, where he would spend the next 42 years, retiring in 2011 as Professor of Biostatistics and Associate Dean for Research and Academic Affairs in the College of Public Health. Early in his time at the University of Iowa, Dr. Burmeister became Director of Biostatistics for the Clinical Research Center, leading to a professional career of working with clinicians and helping them understand statistics and experimental design. He understood that research involving humans can impose constraints on the scientific approach. Further, he appreciated fully the distinction between statistical and clinical significance, and, in fact, he quite often emphasized this distinction himself. He was willing to communicate directly with authors to help them understand the weaknesses in their manuscripts, and often he suggested how those weaknesses might be addressed. These communications, as indeed everything else Leon did, were marked by unfailing respect and graciousness. In our contacts with other medical journals, including those with the very strongest reputations, editors regularly expressed admiration for the Green Journal's system of evaluating statistics and design. In particular, editors were envious of the consistency of having a single statistical editor to conduct a thorough and prompt review. More than one asked, not entirely facetiously, about the prospect of hiring Leon away from the Green Journal. The period of 1986–2013 was one of remarkable growth in the Green Journal's reputation, as over this time it took its place among the top medical journals in the world. It is also the time of Leon Burmeister's service. If we were to ask Leon about this relationship, he would undoubtedly point out that it is an association and not necessarily cause and effect. In this case, however, the Editors Emeriti would overrule him.

Compliance to the CONSORT Statement on Participant Flow Diagrams in Infectious Disease Randomized Clinical Trials

Background: The Consolidated Standard of Reporting Trials (CONSORT) Guidelines were developed to support adequate reporting of randomized controlled trials (RCTs). Method: A systematic review was conducted including RCTs of infectious diseases published in the top general medical and infectious disease journals in 2010. The level of compliance to flow diagram and its association with the CONSORT endorsement by the journals were evaluated. Results: A total of 67 studies were included in the analysis and a half of the studies were HIV/AIDS RCTs. About 78% of the studies included the flow diagram and 66% of the studies described an intention-to-treat approach. However, explicit descriptions of the study populations were the most lacking during the follow-up stage. The journals that endorsed the CONSORT statement had significantly lower odds of including the CONSORT flow diagram as compared with non-endorsing journals (OR=0.144; 95% CI 0.036-0.575, p<0.05). Conclusions: About one out of four published RCTs in the top medical- and infectious disease journals did not include the CONSORT diagram in 2010, and inconsistency in the reporting of the study population was observed. Clear and complete description of the attrition, especially on the follow-up process, can enhance valid interpretations of the findings by clinical pharmacists.

Handling missing data in RCTs; a review of the top medical journals.

BackgroundMissing outcome data is a threat to the validity of treatment effect estimates in randomized controlled trials. We aimed to evaluate the extent, handling, and sensitivity analysis of missing data and intention-to-treat (ITT) analysis of randomized controlled trials (RCTs) in top tier medical journals, and compare our findings with previous reviews related to missing data and ITT in RCTs.MethodsReview of RCTs published between July and December 2013 in the BMJ, JAMA, Lancet, and New England Journal of Medicine, excluding cluster randomized trials and trials whose primary outcome was survival.ResultsOf the 77 identified eligible articles, 73 (95%) reported some missing outcome data. The median percentage of participants with a missing outcome was 9% (range 0 – 70%). The most commonly used method to handle missing data in the primary analysis was complete case analysis (33, 45%), while 20 (27%) performed simple imputation, 15 (19%) used model based methods, and 6 (8%) used multiple imputation. 27 (35%) trials with missing data reported a sensitivity analysis. However, most did not alter the assumptions of missing data from the primary analysis. Reports of ITT or modified ITT were found in 52 (85%) trials, with 21 (40%) of them including all randomized participants. A comparison to a review of trials reported in 2001 showed that missing data rates and approaches are similar, but the use of the term ITT has increased, as has the report of sensitivity analysis.ConclusionsMissing outcome data continues to be a common problem in RCTs. Definitions of the ITT approach remain inconsistent across trials. A large gap is apparent between statistical methods research related to missing data and use of these methods in application settings, including RCTs in top medical journals.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2288-14-118) contains supplementary material, which is available to authorized users.

How is research blogged? A content analysis approach

Blogs that cite academic articles have emerged as a potential source of alternative impact metrics for the visibility of the blogged articles. Nevertheless, to evaluate more fully the value of blog citations, it is necessary to investigate whether research blogs focus on particular types of articles or give new perspectives on scientific discourse. Therefore, we studied the characteristics of peer‐reviewed references in blogs and the typical content of blog posts to gain insight into bloggers' motivations. The sample consisted of 391 blog posts from 2010 to 2012 in Researchblogging.org's health category. The bloggers mostly cited recent research articles or reviews from top multidisciplinary and general medical journals. Using content analysis methods, we created a general classification scheme for blog post content with 10 major topic categories, each with several subcategories. The results suggest that health research bloggers rarely self‐cite and that the vast majority of their blog posts (90%) include a general discussion of the issue covered in the article, with more than one quarter providing health‐related advice based on the article(s) covered. These factors suggest a genuine attempt to engage with a wider, nonacademic audience. Nevertheless, almost 30% of the posts included some criticism of the issues being discussed.

The obstacles facing scientific and medical publishing in Saudi Arabia.

BACKGROUND AND OBJECTIVESMedical and scientific publishing in Saudi Arabia has flourished in the last ten years. Such a form of publishing faces its own obstacles and the experience of the Annals of Saudi Medicine if analyzed can delineate such obstacles. The aim of this study is to identify the workflow obstacles facing the Annals of Saudi Medicine.METHODSRoot-cause analysis of the workflow process and output from submission till publication for the period January 2012–December 2013. Key performance indicators were developed and analyzed after being extracted from the online submission system.RESULTSFor the period of the study, 1058 manuscripts were received annually. These manuscripts originated in descending order from: Saudi Arabia 34%, Turkey 16%, India 12%, China 8% and Western Countries 3%. Categories of the submissions were: original articles 53%, case reports 31% and others 16%. Only 103 of the submissions were accepted annually for publication. Out of 7,709 requests to review a manuscript, only 1,579 (20%) resulted in a review. Out of a sample of 744 rated reviews, only 10% were poor in quality. The average turnaround time for review was 79 days. The main reason for the delay was the low response of the reviewers.CONCLUSIONThe Annals of Saudi Medicine is a regional or continental journal with substantial submissions as case reports. This affected its Impact Factor and Hirsch Index. Moreover, the review process is delayed due to the poor response of the reviewers.

Effect of blood donor characteristics on transfusion outcomes: a protocol for systematic review and meta-analysis

BackgroundOptimal selection of blood donors is of paramount importance in ensuring the safety of blood products. The current selection process is concerned principally with the safety of the blood donor and the safety of the patient that receives the blood. Recent evidence suggests that the characteristics of the donor may affect transfusion outcomes for the recipient.MethodsWe will conduct a systematic review of the association between major blood donor characteristics and red blood cell (RBC) transfusion outcomes. The primary objective is to assess the association of blood donor characteristics and the risk of adverse short-term and long-term clinical outcomes after RBC transfusion. We will search MEDLINE, EMBASE, Cochrane Central databases, as well as perform manual searches of top transfusion medical journals for prospective and retrospective studies. Study characteristics will be reported and the methodological quality of studies will be assessed. When appropriate, we will provide pooled odds ratio with 95% confidence intervals of the effect estimates, study clinical heterogeneity using pre-defined sensitivity and subgroup analyses, and study statistical heterogeneity using the I2 test.DiscussionThe results of this systematic review will provide an evidence base regarding the potential clinical effects of donor characteristics on transfusion recipients to better guide policy and clinical practice. The evidence gathered from this review will also identify strengths and weaknesses of published studies regarding donor characteristics and transfusion outcomes and will identify knowledge gaps to inform future research in this field of transfusion medicine.Trial registrationPROSPERO Registration Number: CRD42013006726

Journalwatch@pcrj.

Here's the best of the rest: summary reviews of relevant papers from the top respiratory and general medical journals worldwide. Journalwatch@pcrj is produced by the PCRJ Editors-in-Chief — reviews were selected and written by Dr Paul Stephenson and edited by Professor Aziz Sheikh.Each summary contains the name of the first author, the title of the paper, the Vancouver reference and/or doi number, and a link to the abstract of the paper. In the majority of cases these are subscription journals, so to view the full text you will need to subscribe to the journal or pay to view on an individual article basis.These reviews were originally published by the Doctors.net.uk Journal Watch service, which covers other specialties as well as respiratory medicine. Doctors.net.uk is the largest network of GMC-registered doctors in the UK. To find out about membership, click on Doctors.net.uk.The opinions expressed herein may not necessarily reflect the views of the authors of the original articles.

Natural Antivirals against Human Viruses

Over the past two decades there has been intense study of antivirals from plants that have antiviral activity against viruses affecting plant and animal kingdoms. This volume of Virology and Mycology has a report by Awasthi et al. [1] on the antiviral activity against plant mosaic viruses affecting commercial important bean plants. A number of viruses that can cause diseases in humans can be either neutralized or its replication can be inhibited. There has been an explosion of research in the antiviral activity in recent years against human diseases caused by pathogenic viruses, which are known to affect millions of people across the globe and cause significant morbidity and mortality. As a champion of evidence based natural products of preventive and therapeutic agents, I would like to dedicate this editorial to those who have labored on researching natural products against all odds, often experiencing a hostile and elitist opposition to the discovery of natural products. The challenges to translating the findings of natural products are many and this editorial will conclude with steps one needs to take in order to obtain regulatory approval from agencies like the FDA and the EU regulatory group. Very few of the newly found compounds are anywhere close to finding human use. The one Secomet V (the active agent of which is Fulvic acid) that has reached human observational trial stage in HIV patients reported by Van Rensburg et al. in 2010 is a precursor to more proper trials, which have been presumably underway [2]. But the promise of Secomet V, a broad spectrum natural product, first reported by Kotwal et al., [3] takes exceedingly long periods to go from bench (discovery and laboratory testing) to bedside (administered in patients). This passage of over a decade is due to the underfunding of natural products evidence based research in the western world and the low impact they make in the publication arena in top medical journals like Nature Medicine, who look down upon the struggling researchers from the natural products field. Then there are those like pomegranate, found and consumed universally and known to have health benefit and documented to have broad spectrum activity (Table 1) against enveloped viruses like HIV, Influenza, Herpes and non-enveloped food borne viruses Noroviruses, have yet to establish therapeutic levels for human use, making them less practical for realization of their valuable potential. There are a number of naturally found compounds that have been identified against medically important viruses, which together contribute to annual infections of over billion people around the globe, and have been grouped here and summarized in tables. They include the antivirals to human hepatitis viruses (Table 2), viruses causing respiratory infections (Table 3), picornaviruses which cause a number of diseases (Table 4), human herpes viruses (Table 5) and Human Immunodeficiency virus (Table 5). In addition to the medically important viruses included in the tables there are other viruses of pediatric importance viz the Rota virus which causes diarrhea leading to severe dehydration and significant infant deaths also has a natural antiviral that has been identified [4]. With such a wide range of a repertoire of identified antivirals from natural sources like plants, what are the possibilities of how they could find human use? As in the case of Fulvic acid and pomegranate juice, they could be therapeutically used to neutralize pathogenic viruses like HIV, Influenza in human tissues and thus described as the enveloped virus neutralizing compounds (EVNCs). The advantage of such compounds is that they are not susceptible to the vagaries of mutations and drug resistance due to their mode of action, which is not dependent on the changes in amino acid sequence due to mutations [5]. EVNCs could be used in prophylaxis, as vaccine generating agents and maybe even as microbicides. Although microbicides have yet to realize their promise in providing women control over their sexual activity while ensuring that transmission is blocked. Finally, what steps will have to be taken following identification of antiviral activity? Guidelines are summarized in Table 7. The science preceding the translation has to be robust, if not the long path to human use can be costly waste of time and resources. It will be evident from the work in the field of natural antivirals that scientists from China are the leaders in the field and hopefully will continue to receive support to take on the long journey to finding their way into human use. A decade ago, in an editorial, I had envisioned that HIV could be eradicated by 2050 [49]. But amongst the medicines that could achieve that goal, I had an expectation that natural medicine would play a significant role. After reviewing the

Journalwatch@pcrj.

Here's the best of the rest: summary reviews of relevant papers from the top respiratory and general medical journals worldwide. Journalwatch@pcrj is produced by the PCRJ Editors-in-Chief — reviews were selected and written by Dr Paul Stephenson and edited by Professor Aziz Sheikh.Each summary contains the name of the first author, the title of the paper, the Vancouver reference and/or doi number, and a link to the abstract of the paper. In the majority of cases these are subscription journals, so to view the full text you will need to subscribe to the journal or pay to view on an individual article basis.These reviews were originally published by the Doctors.net.uk Journal Watch service, which covers other specialties as well as respiratory medicine. Doctors.net.uk is the largest network of GMC-registered doctors in the UK. To find out about membership, click on Doctors.net.uk.The opinions expressed herein may not necessarily reflect the views of the authors of the original articles.

Discussion: An estimate of the science-wise false discovery rate and applications to top medical journals by Jager and Leek

The original paper by Ioannidis (2005) has done much to raise the awareness to the possible sources of biases in current scientific work. However, Ioannidis described what may be happening in the scientific literature if scientists use blindly the marginal 0.05 significance level rule throughout their work. From this possibility, he reached the alarming conclusion that most research findings are false. In the current work, Prof. Jager and Prof. Leek took it upon themselves to find what actually is happening in current medical research if we assume that the practice is to publish only the findings significant at the 0.05 level. Since Ioannidis was actually arguing about the false discovery rate (FDR) in research (without using this terminology), they utilized FDR methods that are being used in a single research project to study the phenomenon across studies. They further developed modeling tools to address the peculiarities of the data they encountered, such as rounding to specific digits, and they developed relevant text extraction algorithms, allowing them to collect data on the entire population of important medical papers. Finally, they produced the analysis in a reproducible way, which allows everyone to repeat, check, and modify their analysis (as we did). All in all, we congratulate them for shouldering the challenge in such a way. We raise three questions. (1) Does the ∼ 14± 1% science-wise FDR reflect the situation in medical research? (2) How can we improve the estimation? (3) Whatever the actual number is, if it is well above the perceived 5% FDR, how can it be brought under control? (1) Is it 14± 1%? Unfortunately, this is not clear. There are problems with some of the decisions made as to the statements collected for the analysis: (i) only “p < 0.05” and typographical variations to it, but not “p 0.05”, (ii) only statements regarding significance expressed as “p =” and typographical variations to it, but not confidence intervals, and (iii) only statements from the Abstracts were analyzed. Each one of these decisions affects the estimate.

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Journalwatch@pcrj.

Here's the best of the rest: summary reviews of relevant papers from the top respiratory and general medical journals worldwide. Journalwatch@pcrj is produced by the PCRJ Editors-in-Chief — reviews were selected and written by Dr Paul Stephenson and edited by Professor Aziz Sheikh.Each summary contains the name of the first author, the title of the paper, the Vancouver reference and/or doi number, and a link to the abstract of the paper. In the majority of cases these are subscription journals, so to view the full text you will need to subscribe to the journal or pay to view on an individual article basis.These reviews were originally published by the Doctors.net.uk Journal Watch service, which covers other specialties as well as respiratory medicine. Doctors.net.uk is the largest network of GMC-registered doctors in the UK. To find out about membership, click on Doctors.net.uk.The opinions expressed herein may not necessarily reflect the views of the authors of the original articles.

Journalwatch@pcrj.

Here's the best of the rest: summary reviews of relevant papers from the top respiratory and general medical journals worldwide. Journalwatch@pcrj is produced by the PCRJ Editors-in-Chief — reviews were selected and written by Dr Paul Stephenson and edited by Professor Aziz Sheikh.Each summary contains the name of the first author, the title of the paper, the Vancouver reference and/or doi number, and a link to the abstract of the paper. In the majority of cases these are subscription journals, so to view the full text you will need to subscribe to the journal or pay to view on an individual article basis.These reviews were originally published by the Doctors.net.uk Journal Watch service, which covers other specialties as well as respiratory medicine. Doctors.net.uk is the largest network of GMC-registered doctors in the UK. To find out about membership, click on Doctors.net.uk.The opinions expressed herein may not necessarily reflect the views of the authors of the original articles.

Reporting of meta-analyses of randomized controlled trials with a focus on drug safety: An empirical assessment

Due to the sparse nature of serious drug-related adverse events (AEs), meta-analyses combining data from several randomized controlled trials (RCTs) to evaluate drug safety issues are increasingly being conducted and published, influencing clinical and regulatory decision making. Evaluation of meta-analyses involves the assessment of both the individual constituent trials and the approaches used to combine them. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting framework is designed to enhance the reporting of systematic reviews and meta-analyses. However, PRISMA may not cover all critical elements useful in the evaluation of meta-analyses with a focus on drug safety particularly in the regulatory-public health setting. This work was conducted to (1) evaluate the adherence of a sample of published drug safety-focused meta-analyses to the PRISMA reporting framework, (2) identify gaps in this framework based on key aspects pertinent to drug safety, and (3) stimulate the development and validation of a more comprehensive reporting tool that incorporates elements unique to drug safety evaluation. We selected a sample of meta-analyses of RCTs based on review of abstracts from high-impact journals as well as top medical specialty journals between 2009 and 2011. We developed a preliminary reporting framework based on PRISMA with specific additional reporting elements critical for the evaluation of drug safety meta-analyses of RCTs. The reporting of pertinent elements in each meta-analysis was reviewed independently by two authors; discrepancies in the independent evaluations were resolved through discussions between the two authors. A total of 27 meta-analyses, 12 from highest impact journals, 13 from specialty medical journals, and 2 from Cochrane reviews, were identified and evaluated. The great majority (>85%) of PRISMA elements were addressed in more than half of the meta-analyses reviewed. However, the majority of meta-analyses (>60%) did not address most (>80%) of the additional reporting elements critical for the evaluation of drug safety. Some of these elements were not addressed in any of the reviewed meta-analyses. This review included a sample of meta-analyses, with a focus on drug safety, recently published in high-impact journals; therefore, we may have underestimated the extent of the reporting problem across all meta-analyses of drug safety. Furthermore, temporal trends in reporting could not be evaluated in this review because of the short time interval selected. While the majority of PRISMA elements were addressed by most studies reviewed, the majority of studies did not address most of the additional safety-related elements. These findings highlight the need for the development and validation of a drug safety reporting framework and the importance of the current initiative by the Council for International Organizations of Medical Sciences (CIOMS) to create a guidance document for drug safety information synthesis/meta-analysis, which may improve reporting, conduct, and evaluation of meta-analyses of drug safety and inform clinical and regulatory decision making.

Journalwatch@pcrj.

Here's the best of the rest: summary reviews of relevant papers from the top respiratory and general medical journals worldwide. Journalwatch@pcrj is produced by the PCRJ Editors-in-Chief — reviews were selected and written by Dr Paul Stephenson and edited by Professor Aziz Sheikh.Each summary contains the name of the first author, the title of the paper, the Vancouver reference and/or doi number, and a link to the abstract of the paper. In the majority of cases these are subscription journals, so to view the full text you will need to subscribe to the journal or pay to view on an individual article basis.These reviews were originally published by the Doctors.net.uk Journal Watch service, which covers other specialties as well as respiratory medicine. Doctors.net.uk is the largest network of GMC-registered doctors in the UK. To find out about membership, click on Doctors.net.uk.The opinions expressed herein may not necessarily reflect the views of the authors of the original articles.

Modelling and simulating early stopping of RCTs: a case study of early stop due to harm

Despite efforts from regulatory agencies (e.g. NIH, FDA), recent systematic reviews of randomised controlled trials (RCTs) show that top medical journals continue to publish trials without requiring authors to report details for readers to evaluate early stopping decisions carefully. This article presents a systematic way of modelling and simulating interim monitoring decisions of RCTs. By taking an approach that is both general and rigorous, the proposed framework models and evaluates early stopping decisions of RCTs based on a clear and consistent set of criteria. The framework allows decision analysts to generate and quickly answer ‘what-if’ questions by simulating alternate trial scenarios. I illustrate the framework with a case study of an RCT that was stopped early due to harm. This was a trial of vitamin A supplement in relation to HIV transmission from mother-to-child through breastfeeding.

Journalwatch@pcrj.

Here's the best of the rest: summary reviews of relevant papers from the top respiratory and general medical journals worldwide. Journalwatch@pcrj is produced by the PCRJ Editors-in-Chief - reviews were selected and written by Dr Paul Stephenson and edited by Professor Aziz Sheikh. Each summary contains the name of the first author, the title of the paper, the Vancouver reference and/or doi number, and a link to the abstract of the paper. In the majority of cases these are subscription journals, so to view the full text you will need to subscribe to the journal or pay to view on an individual article basis. These reviews were originally published by the Doctors.net.uk Journal Watch service, which covers other specialties as well as respiratory medicine. Doctors.net.uk is the largest network of GMC-registered doctors in the UK. To find out about membership, click on Doctors.net.uk. The opinions expressed herein may not necessarily reflect the views of the authors of the original articles.

An introduction to evidence-based medicine

Evidence-Based Medicine (EBM) is about offering support to make the right decision in choosing the best treatment for our patients. Since it first appeared in top medical journals in 19921&nbsp;, EBM has revolutionized medical practice and infiltrated other disciplines (such as dentistry) along the way as a tool to support the decision-making process in the provision of medical care.