Presentation of evidence in continuing medical education programs: A mixed methods study *

Allen, Michael; MacLeod, Tanya; Handfield-Jones, Richard; Sinclair, Douglas; Fleming, Michael

doi:10.1002/chp.20086

Cited by 9 publications

(8 citation statements)

References 15 publications

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“…For instance, both formats did not address the obstacle ‘failure to define important terms . ’ This prompted the addition of a definition of odds ratio to the case-based format, given the supporting evidence that statistics commonly found in medical journals are not readily understood by clinicians [45-48]. The decision was made to add this to only one shortened format, since the next tool development step will be to run focus groups to gain input from end-users.…”

Section: Resultsmentioning

confidence: 99%

Development of two shortened systematic review formats for clinicians

Perrier

Persaud

et al. 2013

Implementation Sci

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BackgroundSystematic reviews provide evidence for clinical questions, however the literature suggests they are not used regularly by physicians for decision-making. A shortened systematic review format is proposed as one possible solution to address barriers, such as lack of time, experienced by busy clinicians. The purpose of this paper is to describe the development process of two shortened formats for a systematic review intended for use by primary care physicians as an information tool for clinical decision-making.MethodsWe developed prototypes for two formats (case-based and evidence-expertise) that represent a summary of a full-length systematic review before seeking input from end-users. The process was composed of the following four phases: 1) selection of a systematic review and creation of initial prototypes that represent a shortened version of the systematic review; 2) a mapping exercise to identify obstacles described by clinicians in using clinical evidence in decision-making; 3) a heuristic evaluation (a usability inspection method); and 4) a review of the clinical content in the prototypes.ResultsAfter the initial prototypes were created (Phase 1), the mapping exercise (Phase 2) identified components that prompted modifications. Similarly, the heuristic evaluation and the clinical content review (Phase 3 and Phase 4) uncovered necessary changes. Revisions were made to the prototypes based on the results.ConclusionsDocumentation of the processes for developing products or tools provides essential information about how they are tailored for the intended user. One step has been described that we hope will increase usability and uptake of these documents to end-users.

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Section: Resultsmentioning

confidence: 99%

Development of two shortened systematic review formats for clinicians

Perrier

Persaud

et al. 2013

Implementation Sci

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“…The intestinal microbiota plays a crucial role in the pathogenesis of gastrointestinal disorders [26][27][28] and an increasing number of studies are targeting probiotic therapy [29][30][31][32][33][34][35][36][37][38][39][40][41] for infants and adults.…”

Section: Discussionmentioning

confidence: 99%

Probiotics for preventing and treating gastro-oesophageal reflux/gastro-oesophageal reflux disease in infants: A systematic review and meta-analysis

Foster¹,

Dahlen

Fijan

et al. 2019

Preprint

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Background Gastro-oesophageal reflux (GOR) and Gastro-oesophageal reflux disease (GORD) are common during infancy and can cause substantial discomfort in infants, parental distress and financial burden on parents and the health care system. Effective treatment regimens, however, remain elusive. Probiotics given to women during pregnancy and lactation, and babies may have therapeutic effects when it comes to GOR/GORD. The objective of this systematic review and meta-analysis is to evaluate the efficacy of probiotic supplementation for the prevention and treatment of GOR/GORD in infants.Methods Literature searches were conducted using MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials. Only randomised controlled trials (RCTs) were included. A meta-analysis of included trials was performed using the Cochrane Collaboration methodology where possible. Results Six RCTs examined the prevention or treatment with probiotics on GOR. There were no studies examining probiotics for GORD. A meta-analysis of 3 studies showed a statistically significant reduction in regurgitation episodes for the probiotic group compared to the placebo group [mean difference -1.44 episodes/day; 95% CI -1.71 to -1.17] but there was high heterogeneity (96%). Meta-analysis of two studies found a statistically significant increased number of stools per day in the probiotic group compared to the placebo group [mean difference 1.26, 95% CI 1.12 to 1.41]. However, there was moderate heterogeneity (69%). Individual studies reported: a decrease in crying time, increased gastric emptying rate, infant length and head circumference, visits to an emergency department or health professional, and loss of parent working days were significantly less with infants receiving probiotic compared to a placebo but more research is needed. Meta-analysis of two studies showed no difference in body weight between the two groups (minimal heterogeneity 23%). None of the studies reported any adverse effects for the women or infants. Conclusions Probiotic therapy appears promising with some evidence of benefit but most studies are small and there was high heterogeneity between the studies. The use of probiotics could potentially be a non-invasive, cost effective and preventative positive health strategy for both women and their babies. Further well controlled RCTs examining the effect of probiotics for GOR /GORD are warranted.

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“…3,4 In part, this means that speakers should base their recommendations on the best available clinical research, provide quantitative interpretation of the data using absolute risk reduction (ARR) and the number needed to treat (NNT), and explicitly describe the strengths and weaknesses of studies. 5 Several Academy members learned of a new evidence-based CME format and proposed a trial annual meeting using this approach with minimal pharmaceutical industry support.…”

Section: Why We Undertook This Initiativementioning

confidence: 99%

Continuing Education That Matters: A Successful, Evidence-Based Course With Minimal Pharmaceutical Funding

Wolfrey

Brown

Ebell

et al. 2012

Journal of Continuing Education in the Health Professions

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Presentation of evidence in continuing medical education programs: A mixed methods study *

Abstract: Presentation of research data in most CME programs is inadequate to allow learners to make fully informed therapeutic decisions. Speakers and learners need professional development to improve their presentation and understanding of research data.

Cited by 9 publications

References 15 publications

Development of two shortened systematic review formats for clinicians

Development of two shortened systematic review formats for clinicians

Probiotics for preventing and treating gastro-oesophageal reflux/gastro-oesophageal reflux disease in infants: A systematic review and meta-analysis

Continuing Education That Matters: A Successful, Evidence-Based Course With Minimal Pharmaceutical Funding

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