The PRESS 2015 Guideline Statement should help to guide and improve the peer review of electronic literature search strategies.

Introduction Assessing the process used to synthesize the evidence in clinical practice guidelines enables users to determine the trustworthiness of the recommendations. Clinicians are increasingly dependent on guidelines to keep up with vast quantities of medical literature, and guidelines are followed to avoid malpractice suits. We aimed to assess whether systematic methods were used when synthesizing the evidence for guidelines; and to determine the type of review cited in support of recommendations. Methods Guidelines published in 2017 and 2018 were retrieved from the TRIP and Epistemonikos databases. We randomly sorted and sequentially screened clinical guidelines on all topics to select the first 50 that met our inclusion criteria. Our primary outcomes were the number of guidelines using either a systematic or non-systematic process to gather, assess, and synthesise evidence; and the numbers of recommendations within guidelines based on different types of evidence synthesis (systematic or non-systematic reviews). If a review was cited, we looked for evidence that it was critically appraised, and recorded which quality assessment tool was used. Finally, we examined the relation between the use of the GRADE approach, systematic review process, and type of funder. Results Of the 50 guidelines, 17 (34%) systematically synthesised the evidence to inform recommendations. These 17 guidelines clearly reported their objectives and eligibility criteria, conducted comprehensive search strategies, and assessed the quality of the studies. Of the 29/50 guidelines that included reviews, 6 (21%) assessed the risk of bias of the review. The quality of primary studies was reported in 30/50 (60%) guidelines. Conclusions High quality, systematic review products provide the best available evidence to inform guideline recommendations. Using non-systematic methods compromises the validity and reliability of the evidence used to inform guideline recommendations, leading to potentially misleading and untrustworthy results.

ObjectiveTo investigate pharmaceutical or medical device industry funding of patient groups.DesignSystematic review with meta-analysis.Data sourcesOvid Medline, Embase, Web of Science, Scopus, and Google Scholar from inception to January 2018; reference lists of eligible studies and experts in the field.Eligibility criteria for selecting studiesObservational studies including cross sectional, cohort, case-control, interrupted time series, and before-after studies of patient groups reporting at least one of the following outcomes: prevalence of industry funding; proportion of industry funded patient groups that disclosed information about this funding; and association between industry funding and organisational positions on health and policy issues. Studies were included irrespective of language or publication type.Review methodsReviewers carried out duplicate independent data extraction and assessment of study quality. An amended version of the checklist for prevalence studies developed by the Joanna Briggs Institute was used to assess study quality. A DerSimonian-Laird estimate of single proportions with Freeman-Tukey arcsine transformation was used for meta-analyses of prevalence. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to assess the quality of the evidence for each outcome.Results26 cross sectional studies met the inclusion criteria. Of these, 15 studies estimated the prevalence of industry funding, which ranged from 20% (12/61) to 83% (86/104). Among patient organisations that received industry funding, 27% (175/642; 95% confidence interval 24% to 31%) disclosed this information on their websites. In submissions to consultations, two studies showed very different disclosure rates (0% and 91%), which appeared to reflect differences in the relevant government agency’s disclosure requirements. Prevalence estimates of organisational policies that govern corporate sponsorship ranged from 2% (2/125) to 64% (175/274). Four studies analysed the relationship between industry funding and organisational positions on a range of highly controversial issues. Industry funded groups generally supported sponsors’ interests.ConclusionIn general, industry funding of patient groups seems to be common, with prevalence estimates ranging from 20% to 83%. Few patient groups have policies that govern corporate sponsorship. Transparency about corporate funding is also inadequate. Among the few studies that examined associations between industry funding and organisational positions, industry funded groups tended to have positions favourable to the sponsor. Patient groups have an important role in advocacy, education, and research, therefore strategies are needed to prevent biases that could favour the interests of sponsors above those of the public.Systematic review registrationPROSPERO CRD42017079265.

Analysis 1.5. Comparison 1 Antihypertensive drug therapy versus control, Outcome 5 Withdrawal due to adverse events. Analysis 1.6. Comparison 1 Antihypertensive drug therapy versus control, Outcome 6 Decrease in systolic blood pressure. Analysis 1.7. Comparison 1 Antihypertensive drug therapy versus control, Outcome 7 Decrease in diastolic blood pressure.

Background: A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence-based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web-based platform and using hand-held devices and computers with Web access. Librarians were given technical training in evidence-based medicine, including how to summarise evidence. Objectives: To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Methods: Evaluation included librarian interviews and a clinician exit satisfaction survey. Results: Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important 'lessons learned' in the clinical use of hand-held devices, knowledge translation and training for clinicians and librarians. Conclusions: The Just-in-Time Librarian Consultation Service showed that it was possible to provide evidence-based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.

This review provided no evidence that the use of EHI translates into improved clinical practice or patient outcomes, though it does suggest that when practitioners are provided with EHI and education or training, the use of EHI increases. We have defined use as the activity of logging into an EHI resource, but based on our findings use does not automatically translate to the application of EHI in practice. While using EHI may be an important component of evidence-based medicine, alone it is insufficient to improve patient care or clinical practices. For EHI to be applied in patient care, it will be necessary to understand why practitioners' are reluctant to apply EHI when treating people, and to determine the most effective way(s) to reduce this reluctance.

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Objectives: The aim of the study was to validate search filters for retrieval of clinical practice guidelines (CPGs) in MEDLINE, Embase, and PubMed. Study Design and Setting: A search for filters for identifying CPGs was conducted in Google and the InterTASC Information Specialists SubGroup Search Filter Resource. To retrieve a random sample of CPGs to test sensitivity and precision of the filters, we used the TRIP and Epistemonikos databases. The citations were screened independently by two researchers. The sensitivity and precision were calculated. Results: Five search filters were retrieved: two from the Canadian Agency for Drugs and Technologies in Health (CADTH), two from the University of Texas, and one from the MD Anderson Cancer Center Library. A total of 478 records were screened to identify 109 CPGs, which comprised the sample for testing sensitivity and precision. The sensitivity ranged from 87% to 98% for the five search filters and very low precision (!1%) across all databases. Conclusion: Knowledge users who are interested in retrieving all relevant CPGs can use the CADTH broad filter with the highest sensitivity. However, our analysis shows that it remains difficult to efficiently identify CPGs because of low precision of five search filters. We recommend searching guideline-specific resources as a more time-efficient approach than searching bibliographic databases.