Key PointsQuestionWhat percentage of clinical trials published in high-impact journals in 2017 generated evidence that could feasibly be replicated using observational methods and data sources?FindingsIn this cross-sectional study of 220 clinical trials published in high-impact journals in 2017, only 15% could feasibly be replicated using currently available real-world data sources.MeaningThis study suggests that, although the increasing use of real-world evidence in medical research presents opportunities to supplement or even replace some clinical trials, observational methods are not likely to obviate the need for traditional clinical trials.

Automatic detection and recording of GTCS to an online database is feasible and may be more informative than seizure logging in a paper diary.

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Importance: Climate change is one of the most pressing global public health issues and is increasingly gaining attention from governments and researchers as a critical policy and research focus. While research on the effects of climate change on human health has grown significantly over the past few decades, there remain known gaps in research on non-physical health topics, like mental health, and in research on low-income countries. Objective: To better understand the current state of research on the human health effects of climate change, including exposures, health conditions, populations, areas of the world studied, funding sources, and publication characteristics, with a focus on topics that are relevant for vulnerable populations. Evidence Review: We searched the National Institute of Environmental Health Sciences (NIEHS) Climate Change and Human Health Literature Portal, a curated bibliographic database of global peer-reviewed research and gray literature on the science of climate impact on human health, to identify peer-reviewed original research investigating the health effects of climate change published from 2012 to 2019. The database combines searches of multiple search engines including PubMed, Web of Science, and Google Scholar and includes added-value expert tagging of climate change exposures and health impacts. We filtered our search by year published, limited to original research articles published in English. After identifying all original research articles, we selected a 5% random sample to manually perform a detailed characterization of research topics and publication information. Findings: There were 7082 original research articles published between 2012 and 2019, and the number of articles increased by 23% annually. In our random sample of 348 articles, we found that there were several gaps in research topics that are particularly relevant to vulnerable populations, such as those in the Global South (159; 45.7%) and the elderly (55; 15.8%). Additionally, fewer first authors were from the Global South (110; 31.6%), which may in part explain why there is disproportionally less research focusing on these countries. Conclusions and Relevance: Our results help elucidate gaps in research that, once addressed, may help us better understand and mitigate some of the most devastating effects of climate change on human health.

This study provides Class II evidence that single doses of MPH improve cognitive performance on some measures of attention and processing speed in patients with epilepsy and cognitive complaints.