Jonathan Koffel

Use of recommended search strategies in systematic reviews and the impact of librarian involvement: a cross-sectional survey of recent authors.

Background Previous research looking at published systematic reviews has shown that their search strategies are often suboptimal and that librarian involvement, though recommended, is low. Confidence in the results, however, is limited due to poor reporting of search strategies the published articles. Objectives To more accurately measure the use of recommended search methods in systematic reviews, the levels of librarian involvement, and whether librarian involvement predicts the use of recommended methods. Methods A survey was sent to all authors of English-language systematic reviews indexed in the Database of Abstracts of Reviews of Effects (DARE) from January 2012 through January 2014. The survey asked about their use of search methods recommended by the Institute of Medicine, Cochrane Collaboration, and the Agency for Healthcare Research and Quality and if and how a librarian was involved in the systematic review. Rates of use of recommended methods and librarian involvement were summarized. The impact of librarian involvement on use of recommended methods was examined using a multivariate logistic regression. Results 1560 authors completed the survey. Use of recommended search methods ranged widely from 98% for use of keywords to 9% for registration in PROSPERO and were generally higher than in previous studies. 51% of studies involved a librarian, but only 64% acknowledge their assistance. Librarian involvement was significantly associated with the use of 65% of recommended search methods after controlling for other potential predictors. Odds ratios ranged from 1.36 (95% CI 1.06 to 1.75) for including multiple languages to 3.07 (95% CI 2.06 to 4.58) for using controlled vocabulary. Conclusions Use of recommended search strategies is higher than previously reported, but many methods are still under-utilized. Librarian involvement predicts the use of most methods, but their involvement is under-reported within the published article.

Reproducibility of Search Strategies Is Poor in Systematic Reviews Published in High-Impact Pediatrics, Cardiology and Surgery Journals: A Cross-Sectional Study.

Background A high-quality search strategy is considered an essential component of systematic reviews but many do not contain reproducible search strategies. It is unclear if low reproducibility spans medical disciplines, is affected by librarian/search specialist involvement or has improved with increased awareness of reporting guidelines. Objectives To examine the reporting of search strategies in systematic reviews published in Pediatrics, Surgery or Cardiology journals in 2012 and determine rates and predictors of including a reproducible search strategy. Methods We identified all systematic reviews published in 2012 in the ten highest impact factor journals in Pediatrics, Surgery and Cardiology. Each search strategy was coded to indicate what elements were reported and whether the overall search was reproducible. Reporting and reproducibility rates were compared across disciplines and we measured the influence of librarian/search specialist involvement, discipline or endorsement of a reporting guideline on search reproducibility. Results 272 articles from 25 journals were included. Reporting of search elements ranged widely from 91% of articles naming search terms to 33% providing a full search strategy and 22% indicating the date the search was executed. Only 22% of articles provided at least one reproducible search strategy and 13% provided a reproducible strategy for all databases searched in the article. Librarians or search specialists were reported as involved in 17% of articles. There were strong disciplinary differences on the reporting of search elements. In the multivariable analysis, only discipline (Pediatrics) was a significant predictor of the inclusion of a reproducible search strategy. Conclusions Despite recommendations to report full, reproducible search strategies, many articles still do not. In addition, authors often report a single strategy as covering all databases searched, further decreasing reproducibility. Further research is needed to determine how disciplinary culture may encourage reproducibility and the role that journal editors and peer reviewers could play.

An interprofessional train-the-trainer evidence-based practice workshop: Design and evaluation

Abstract Evidence-based practice (EBP) is a core skill of health professionals and one that is regularly taught in health sciences programs. This report covers the design and results of an interprofessional EBP workshop at a large university aimed at improving faculty’s confidence in practicing and teaching EBP. The two-day workshop was designed by the University’s Health Sciences Libraries and emphasized small-group work, with the first day focused on critical appraisal and searching and the second on effective teaching strategies. Twenty-five faculty from the schools and colleges of Medicine, Nursing, Pharmacy, Dentistry, and Veterinary Medicine and the Center for Allied Health Programs attended this study. Nine faculty and librarians served as instructors. Attendees rated the workshop and individual lectures highly and reported that it improved their ability to both practice and teach EBP. In addition, they reported a preference for learning in an interprofessional environment. This report suggests that a short EBP workshop can improve faculty members’ self-reported confidence and ability to practice and teach core EBP skills.

What definition is used to describe second impact syndrome in sports? A systematic and critical review

Concern about what has been termed, “second impact syndrome” (SIS) is a major factor determining return-to-play decisions after concussion. However, definitions of SIS vary. We used Scopus to conduct a systematic review and categorize the definitions used to describe SIS. Of the 91 sources identified, 79 (87%) clearly specified that SIS involved either cerebral edema or death after a concussion when a prior concussion had not resolved. Twelve articles (13%) could be interpreted as merely the events of two consecutive concussions. Among the articles that listed mortality rates, nearly all (33/35, 94%) said the rate of death was “high” (e.g., 50% to 100%). Our review found that most articles define SIS as a syndrome requiring catastrophic brain injury after consecutive concussive episodes. Given that it is unclear how common it is to have a second concussion while not fully recovered from a first concussion, the actual mortality rate of SIS is unknown.

Statistical testing of baseline differences in sports medicine RCTs: a systematic evaluation

Background/Aim The CONSORT (Consolidated Standards of Reporting Trials) statement discourages reporting statistical tests of baseline differences between groups in randomised controlled trials (RCTs). However, this practice is still common in many medical fields. Our aim was to determine the prevalence of this practice in leading sports medicine journals. Methods We conducted a comprehensive search in Medline through PubMed to identify RCTs published in the years 2005 and 2015 from 10 high-impact sports medicine journals. Two reviewers independently confirmed the trial design and reached consensus on which articles contained statistical tests of baseline differences. Results Our search strategy identified a total of 324 RCTs, with 85 from the year 2005 and 239 from the year 2015. Overall, 64.8% of studies (95% CI (59.6, 70.0)) reported statistical tests of baseline differences; broken down by year, this percentage was 67.1% in 2005 (95% CI (57.1, 77.1)) and 64.0% in 2015 (95% CI (57.9, 70.1)). Conclusions Although discouraged by the CONSORT statement, statistical testing of baseline differences remains highly prevalent in sports medicine RCTs. Statistical testing of baseline differences can mislead authors; for example, by failing to identify meaningful baseline differences in small studies. Journals that ask authors to follow the CONSORT statement guidelines should recognise that many manuscripts are ignoring the recommendation against statistical testing of baseline differences.

Measuring the health literacy of the Upper Midwest

Objectives Health literacy—the ability to obtain, process, and understand basic health information—is a major determinant of an individual’s overall health and health care utilization. In this project, the authors examined predictors of health literacy levels, including numeracy and graphic literacy, among an adult population in the Upper Midwest. Methods The research was conducted at the Minnesota State Fair. Three previously validated scales were used to assess health literacy: Newest Vital Sign, the General Health Numeracy Test, and questions from Galesic and Garcia-Retamero’s Graph Literacy Scale. Demographic information—such as age, educational attainment, zip code, and other potential predictors and modifiers—was collected. Multivariate linear regression was conducted to examine the independent effects of educational attainment, race, ethnicity, gender, and rural or urban location on overall health literacy and scores on each of the individual instruments. Results A total of 353 Upper Midwest residents completed the survey, with the majority being white, college-educated, and from an urban area. Having a graduate or professional degree or being under the age of 21 were associated with increased health literacy scores, while having a high school diploma or some high school education, being Asian American, or being American Indian/Alaska Native were associated with lower health literacy scores. Conclusion Advanced health literacy skills, including the ability to calculate and compare information, were problematic even in well-educated populations. Understanding numerical and graphical information was found to be particularly difficult, and more research is needed to understand these deficits and how best to address them.

PharmGuide: Your Guide to Free Online Drug Information

PharmGuide is an annotated directory of high quality, freely available, online drug information resources intended for use by librarians, pharmacists, and the public. Given the plethora of drug information websites with varying levels of authoritativeness and accuracy, PharmGuide is intended to facilitate the search for resources by providing links to only those sources that have been critically appraised and that meet specific quality criteria. Methods used in developing the site, evidence of its utility based on usage statistics, and examples of its application in practice are presented within the context of the drug information landscape.

Free, Authoritative Online Drug Information Directory: PharmGuide

Many free Web sites provide drug information, but it can be difficult to determine if these sites are trustworthy and correct. PharmGuide (http://goo.gl/f14Me) is an online directory of Web sites providing accurate, authoritative, and free information about prescription and over-the-counter drugs. It was created and is maintained by the Pharmacy and Drug Information Section of the Medical Library Association. Nine criteria are used to assess Web sites, ensuring that selected sites are current, unbiased, and authoritative. Intended for use by librarians, health care professionals, and consumers, PharmGuide provides annotations describing the content and navigation of free drug information Web sites.