Saturday, January 20, 2007

BMC variety post: EBM, medical errors, research design and synthesis

A few interesting BioMed Central articles that I've read recently:

- Khan KS, Coomarasamy A. A hierarchy of effective teaching and learning to acquire competence in evidence-based medicine. BMC Medical Education 2006, 6:59 - proposes a hierarchical structure of strategies for educating yourself and others about EBM principles and implementation strategies, ranging from classroom didactic at level 3 to interactive, clinically integrated activities at Level 1

- Jansen YJ, Bal R, Bruijnzeels M, Foets M, Frenken R, de Bont A. Coping with methodological dilemmas; about establishing the effectiveness of interventions in routine medical practice. BMC Health Services Research 2006, 6:160 - discusses research design and conduct in one example of pragmatic research, a clinical trial constructed to explore the effectiveness of strategies used in routine clinical practice

- Berendsen AJ, Benneker WH, Meyboom-de Jong B, Klazinga NS, Schuling J. Motives and preferences of general practitioners for new collaboration models with medical specialists: a qualitative study. BMC Health Services Research 2007, 7:4 - a qualitative study exploring Dutch general practitioners views and preferences for developing new collaborations with specialty consultants; the discussion of motivational factors (e.g. developing personal relationships; gaining mutual respect) may be useful for researching models for clinician consultation with librarians

- Elder NC, Pallerla H, Regan S. What do family physicians consider an error? A comparison of definitions and physician perception. BMC Family Practice 2006, 7:73 - systematic review of the literature for working definitions of "medical error" and pilot survey of clinicians' perceptions of those definitions and examined how clinicians responded to 5 error scenarios, illuminating lack of consensus in the literature and in family physicians' perceptions about what constitutes a true medical error. The authors note: "...we found that three areas may affect how physicians make decisions about error: the process that occurred vs. the outcome that occurred, rare vs. common occurrences and system vs. individual responsibility."

- Bornhöft G, Maxion-Bergemann S, Wolf U, Kienle GS, Michalsen A, Vollmar HC, Gilbertson S, Matthiessen PF. Checklist for the qualitative evaluation of clinical studies with particular focus on external validity and model validity. BMC Medical Research Methodology 2006, 6:56 - proposes a checklist for use in examining internal validity and model validity, to help in uncovering potential sources of bias during the process of research design and evaluating existing research reports

- Lucas PJ, Arai L, Baird J, Law C, Roberts HM. Worked examples of alternative methods for the synthesis of qualitative and quantitative research in systematic reviews. BMC Medical Research Methodology 2007, 7:4 - compares and contrasts two different strategies (textual narrative and thematic synthesis) for synthesizing qualitative aspects of clinical research for inclusion in systematic reviews. The authors conclude, "Thematic synthesis holds most potential for hypothesis generation, but may obscure heterogeneity and quality appraisal. Textual narrative synthesis is better able to describe the scope of existing research and account for the strength of evidence, but is less good at identifying commonality."

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