Dear all,

This has been an interesting topic of conversation. Regarding systematic reviews as a business, John Ioannidis spoke about this (and more) recently at the Cochrane Colloquium in Vienna. You may be interested in his presentation here: https://www.youtube.com/watch?v=h2giHu8pHFY&index=2&list=PLCo8P5_ppmQgoKl5ofhvBn-0yZnylWoMD

DISCLAIMER: I am a huge supporter and believer in the importance of systematic reviews!

Kind Regards,

Zac

Dr Zachary Munn

Director of Transfer Science

Learning and Teaching Coordinator

The Joanna Briggs Institute
The University of Adelaide

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From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Susan Fowler
Sent: Tuesday, 8 December 2015 2:35 AM
To: [log in to unmask]
Subject: Re: Why do we do systematic reviews?

Ben Goldacre is a big supporter of systematic reviews. ...

“Instead of just mooching through the research literature, consciously or unconsciously picking out papers here and there that support [our] pre-existing beliefs, [we] take a scientific, systematic approach to the very process of looking for scientific evidence, ensuring that [our] evidence is as complete and representative as possible of all the research that has ever been done.” (Ben Goldacre 2012) 

I have no idea who is making lots of money conducting systematic reviews. I complete about 30 systematic reviews, some rapid some regular) a year and I promise you, I have not received a raise nor am I am making anymore then any other academic medical librarian. The physicians I work with see patients, teach students, and conduct research. They have chosen to take on that kind of workload because they believe in practicing and advancing genuinely good medicine. 

Doctors who practice bad medicine not based on evidence is exactly why evidence based medicine was developed and systematic reviews are one necessary part of that. There is room for rapid reviews and systematic reviews. It is unnecessary and counter-productive to favor one over the other in broad general terms. 

Doctors who do not work with their patients and discuss lifestyle changes is exactly why EBM pushes shared decision making. How odd that the structures behind EBM are being blamed for bad doctors. 

On Sat, Dec 5, 2015 at 11:29 AM, Wouter Havinga <[log in to unmask]> wrote:

Dear Rod, Amy, Catherine and Jon,

I write from a GP perspective and have a rather bad impression of pharmaceutical research as again pointed out by Ben Goldacre here
http://retractionwatch.com/2015/12/04/did-a-clinical-trial-proceed-as-planned-new-project-finds-out/
and no "Big Data" will improve fabricated data http://www.labtimes.org/editorial/e_654.lasso

Therefore SR appear futile to me, to waste again time and money over these numbers. It's better to ask doctors what they think would be a good research topic then to swallow Big Pharma indoctrination.

My impression as a GP with patients is as follows: take for example
- "painkillers" but most need to actually address life events / stress (nothing to do with the analgesic)
- "antidepressants" again people's needs are to address personal and social circumstances (https://www.youtube.com/watch?v=dozpAshvtsA
- "antipyretics" health professionals instead need to educate parents how to support the child through feverish episodes
- COPD - help people stop smoking
- NIDDM - help people to have better life styles
- NCD non-communicable diseases such as asthma, eczema, hayfever, IBD, ADHD, ASD, etc - check whether vaccines have contributed to this (ISAAC has consistently ignored this) https://m.youtube.com/watch?list=PLiC5xPiBbjJXuX5xNvArmK9DbvnvVhD9B&v=SOLft-jJlKE&index=9

I would be interested to hear what Jon means with moving things on at Cochrane, for me it was good that Catherine alerted me that there are SR about life style interventions and also from Jon about a project to assign P, I, C, O elements to articles in Trip, including qualitative evidence, which might make it more relevant for me in the GP consultation room.

Paul Glasziou's research should become mainstream - doctor led research, rather than shareholder led. http://www.racgp.org.au/your-practice/guidelines/handi/

Maybe Paul Glaziou's suggestions for SR are helpful for your Jon for Trip, PICO project http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001419

BW

--

Susan Fowler, MLIS
Medical Librarian
Coordinator, Systematic Review Services

Evidence at Becker:
http://beckerguides.wustl.edu/ebm

Systematic Reviews Guide:
http://beckerguides.wustl.edu/SystematicReviews

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