On Sun, September 25, 2016 11:31 am, Birnbaum, David wrote:
> Brian, Huw and Ben all raise good points. I would suggest that
> discussion of critical appraisal really needs to consider the skill and
> practice in three key groups:
>
> 1. manuscript reviewers for biomedical journals (a proactive opportunity
> to question and improve what gets published, recognizing that skilled
> editors can't be expected to spot everything themselves alone), 2. the
> intended immediate audience (a reactive opportunity, the research
> community), and 3. third-party audiences (both a proactive opportunity,
> journalists, as well as a reactive opportunity, the general public and
> policy decision-makers).
>
> All of these groups, working in concert, are our best insurance against
> research fraud persisting (e.g. the classic example of investigative
> journalist Brian Deer, not peer-review, discovering fraudulence in Andrew
> Wakefield's published research which had such a strong impact on vaccine
> uptake). All of these can do better in recognizing how presentation
> format helps or hinders critical appraisal and true understanding (see,
> for example, Gigerenzer et al., Psychological Science in the Public
> Interest 2007;8(2)), and advancing "balanced reporting" beyond just
> giving equal time to all sides regardless of what is fundamentally
> untruthful or clearly misleading. On the other hand, influence of
> popular media in today's news-as-entertainment world cannot be
> overlooked.
>
>
>
> Discussion thus far seems to have focused on RCT and quality of initial
> scientific publication. Broad discussion might shed more light on why
> patients and consumers are confused about choices (rather than just
> willing to knowingly accept higher risk when in desperate nothing-to-lose
> type situations), and on what might be done to present EBM in a more
> convincing public format. See, for example, my viewpoint commentary
> "Buyer beware: health choices information broadcast to the public" in
> International Journal of Health Governance 2016;21(1)
> (http://www.emeraldinsight.com/doi/abs/10.1108/IJHG-12-2015-0035).
>
>
>
>
> David
>
>
> -------------------------------
>
>
> David Birnbaum, PhD, MPH
>
>
> Adjunct Professor
>
>
> School of Population and Public Health
>
>
> University of British Columbia
>
>
> Principal
>
>
> Applied Epidemiology
>
>
> British Columbia, Canada
>
>
David, I believe there is a fourth group that should become more active in
fostering critical appraisal. Governmental agencies and those funding
medical research must actively participate in ensuring that investigators
possess certain key EBM skills. A recent example of this is the recently
announced NIH Good Clinical Practice (GCP)-- a training program aimed at
ensuring that all NIH investigators and staff engaged in overseeing and
conducting clinical trials have appropriate knowledge about the design,
conduct, monitoring, recording, analysis and reporting of clinical trials
Michael E Stuart MD
President and Medical Director, Delfini Group
Clinical Asst Professor, UW School of Medicine
6831 31st Ave N.E.
Seattle, Washington 98115
206-854-3680 Mobile Phone
206-527-6146 Home Office
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