evidence appraisal

  • 文章类型: Journal Article
    使用PubMed摘要自动进行科学索赔验证。
    我们开发了CliVER,一个端到端的科学索赔验证系统,利用检索增强技术自动检索相关的临床试验摘要,提取相关的句子,并使用PICO框架来支持或反驳科学主张。我们还创建了三个最先进的深度学习模型的集合,以对支持的基本原理进行分类,反驳,中立。然后我们建造了Covert,一个新的COVID验证数据集,包括15项PICO编码的药物声明,以及96份人工选择和标记的临床试验摘要,这些摘要支持或驳斥了每项声明.我们使用CoVERT和SciFact(一个公共科学声明验证数据集)来评估CliVER在预测标签方面的表现。最后,我们将CliVER与临床医生进行了比较,验证了来自6个疾病领域的19项索赔,使用189.648PubMed摘要提取2010年1月至2021年10月。
    在CoVERT上评估标签预测精度时,CliVER的F1得分为0.92,突显了检索增强模型的功效。集成模型在F1评分中从3%到11%的绝对增加优于每个单独的最新模型。此外,与四名临床医生相比,CliVER的摘要检索精度为79.0%,67.4%的句子选择,标签预测为63.2%,分别。
    CliVER展示了其使用检索增强策略自动进行科学声明验证的早期潜力,以利用PubMed中丰富的临床试验摘要。未来的研究有必要进一步测试其临床实用性。
    UNASSIGNED: To automate scientific claim verification using PubMed abstracts.
    UNASSIGNED: We developed CliVER, an end-to-end scientific Claim VERification system that leverages retrieval-augmented techniques to automatically retrieve relevant clinical trial abstracts, extract pertinent sentences, and use the PICO framework to support or refute a scientific claim. We also created an ensemble of three state-of-the-art deep learning models to classify rationale of support, refute, and neutral. We then constructed CoVERt, a new COVID VERification dataset comprising 15 PICO-encoded drug claims accompanied by 96 manually selected and labeled clinical trial abstracts that either support or refute each claim. We used CoVERt and SciFact (a public scientific claim verification dataset) to assess CliVER\'s performance in predicting labels. Finally, we compared CliVER to clinicians in the verification of 19 claims from 6 disease domains, using 189 648 PubMed abstracts extracted from January 2010 to October 2021.
    UNASSIGNED: In the evaluation of label prediction accuracy on CoVERt, CliVER achieved a notable F1 score of 0.92, highlighting the efficacy of the retrieval-augmented models. The ensemble model outperforms each individual state-of-the-art model by an absolute increase from 3% to 11% in the F1 score. Moreover, when compared with four clinicians, CliVER achieved a precision of 79.0% for abstract retrieval, 67.4% for sentence selection, and 63.2% for label prediction, respectively.
    UNASSIGNED: CliVER demonstrates its early potential to automate scientific claim verification using retrieval-augmented strategies to harness the wealth of clinical trial abstracts in PubMed. Future studies are warranted to further test its clinical utility.
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  • 文章类型: Journal Article
    增加体力活动(PA)和改善营养的策略将为人口带来巨大的健康益处,包括降低几种癌症的风险。数字技术的日益普及意味着这些工具可能有助于改善年轻人的健康行为。
    我们进行了系统评价,以评估有关旨在增加年轻人亚人群(学龄儿童,学院/大学生,仅限年轻人(18岁以上)以及青少年和年轻人(<25岁))。
    在包括KSREvidence(www。ksrevidence.com),Cochrane系统评论数据库(CDSR)和效果评论摘要数据库(DARE;CRD)。记录由两名审阅者通过标题和摘要独立筛选,并获得被认为合格的记录进行全文筛选。使用系统评价偏差风险评估工具(ROBIS)工具评估偏差风险(RoB)。我们采用了叙事分析并开发了证据差距图。
    纳入了24条评价,每个亚人群至少有一条评价,并采用了一系列数字干预措施。证据的质量有限,在24篇综述中,只有一篇被认为RoB较低。“数字干预”的定义在不同的系统评价中差异很大,一些报告的干预措施属于一个以上的类别(即,互联网干预也可以是移动电话或计算机干预),然而,使用了相关综述中报告的定义.没有评论报告癌症发病率或相关结果。现有证据受到亚人群和干预类型的限制,但是证据在学龄儿童中最为明显。在学龄儿童电子健康干预中,定义为互联网提供的校本课程,电脑,片剂,移动技术,或者远程保健方法,改善结果。加速度计测量(标准化平均差[SMD]0.33,95%置信区间[CI]:0.05至0.61)和自我报告(SMD:0.14,95%CI:0.05至0.23)PA增加,水果和蔬菜摄入量也是如此(SMD:0.11,95%CI:0.03至0.19)(评价为低RoB,结果之间的异质性最小到相当大)。干预后的脂肪消费量(SMD:-0.06,95%CI:-0.15至0.03)或含糖饮料(SSB)和零食消费量联合干预后(SMD:-0.02,95%CI:-0.10至0.06)没有差异,或在干预后的随访(研究报告2周至36个月的随访)(SMD:-0.06,95%CI:-0.15至0.03)(评价为低ROB,结果之间的最小到实质性异质性)。基于智能手机的干预利用短消息服务(SMS),与对照组相比,应用或组合方法也改善了使用客观和主观方法测量的PA(SMD:0.44,95%CI:0.11至0.77),随着总PA[加权平均差(WMD)每天32.35分钟的增加,95%CI:10.36至54.33]和每日步数(大规模杀伤性武器:1,185,95%CI:303至2,068)(评估为高RoB,结果之间的中度到实质性异质性)。对于所有结果,解释在RoB和存在无法解释的异质性方面存在局限性。
    这次审查发现了有限的证据,表明数字干预措施有可能增加PA和,在较小程度上,改善学龄儿童的营养。然而,影响可能很小,而且基于不太可靠的证据。证据的特点是相当大的异质性,不清楚/重叠的人群和干预定义,系统评价的方法论质量较低。当年龄(年龄较大vs.最近),交互性(反馈/调查与没有/更少的反馈/调查),并考虑了数字干预的可访问性(设备类型)。这突显了在技术快速发展的领域中综合证据的困难,以及在推荐在公共卫生中使用数字技术方面所带来的挑战。迫切需要使用当代技术和适当的方法进行进一步的研究。
    UNASSIGNED: Strategies to increase physical activity (PA) and improve nutrition would contribute to substantial health benefits in the population, including reducing the risk of several types of cancers. The increasing accessibility of digital technologies mean that these tools could potentially facilitate the improvement of health behaviours among young people.
    UNASSIGNED: We conducted a review of systematic reviews to assess the available evidence on digital interventions aimed at increasing physical activity and good nutrition in sub-populations of young people (school-aged children, college/university students, young adults only (over 18 years) and both adolescent and young adults (<25 years)).
    UNASSIGNED: Searches for systematic reviews were conducted across relevant databases including KSR Evidence (www.ksrevidence.com), Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE; CRD). Records were independently screened by title and abstract by two reviewers and those deemed eligible were obtained for full text screening. Risk of bias (RoB) was assessed with the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS) tool. We employed a narrative analysis and developed evidence gap maps.
    UNASSIGNED: Twenty-four reviews were included with at least one for each sub-population and employing a range of digital interventions. The quality of evidence was limited with only one of the 24 of reviews overall judged as low RoB. Definitions of \"digital intervention\" greatly varied across systematic reviews with some reported interventions fitting into more than one category (i.e., an internet intervention could also be a mobile phone or computer intervention), however definitions as reported in the relevant reviews were used. No reviews reported cancer incidence or related outcomes. Available evidence was limited both by sub-population and type of intervention, but evidence was most pronounced in school-aged children. In school-aged children eHealth interventions, defined as school-based programmes delivered by the internet, computers, tablets, mobile technology, or tele-health methods, improved outcomes. Accelerometer-measured (Standardised Mean Difference [SMD] 0.33, 95% Confidence Interval [CI]: 0.05 to 0.61) and self-reported (SMD: 0.14, 95% CI: 0.05 to 0.23) PA increased, as did fruit and vegetable intake (SMD: 0.11, 95% CI: 0.03 to 0.19) (review rated as low RoB, minimal to considerable heterogeneity across results). No difference was reported for consumption of fat post-intervention (SMD: -0.06, 95% CI: -0.15 to 0.03) or sugar sweetened beverages(SSB) and snack consumption combined post-intervention (SMD: -0.02, 95% CI:-0.10 to 0.06),or at the follow up (studies reported 2 weeks to 36 months follow-up) after the intervention (SMD:-0.06, 95% CI: -0.15 to 0.03) (review rated low ROB, minimal to substantial heterogeneity across results). Smartphone based interventions utilising Short Messaging Service (SMS), app or combined approaches also improved PA measured using objective and subjective methods (SMD: 0.44, 95% CI: 0.11 to 0.77) when compared to controls, with increases in total PA [weighted mean difference (WMD) 32.35 min per day, 95% CI: 10.36 to 54.33] and in daily steps (WMD: 1,185, 95% CI: 303 to 2,068) (review rated as high RoB, moderate to substantial heterogeneity across results). For all results, interpretation has limitations in terms of RoB and presence of unexplained heterogeneity.
    UNASSIGNED: This review of reviews has identified limited evidence that suggests some potential for digital interventions to increase PA and, to lesser extent, improve nutrition in school-aged children. However, effects can be small and based on less robust evidence. The body of evidence is characterised by a considerable level of heterogeneity, unclear/overlapping populations and intervention definitions, and a low methodological quality of systematic reviews. The heterogeneity across studies is further complicated when the age (older vs. more recent), interactivity (feedback/survey vs. no/less feedback/surveys), and accessibility (type of device) of the digital intervention is considered. This underscores the difficulty in synthesising evidence in a field with rapidly evolving technology and the resulting challenges in recommending the use of digital technology in public health. There is an urgent need for further research using contemporary technology and appropriate methods.
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  • 文章类型: Journal Article
    Teosinte,来自墨西哥和中美洲的野生玉米近缘种,在法国和西班牙成为一种有害的农业杂草。2016年,欧洲食品安全局(EFSA)发布了一份技术报告,评估了有关teosinte的可用科学信息,以评估其与转基因(GM)玉米MON810,Bt11,1507和GA21种植的环境风险评估(ERA)和风险管理(RM)的相关性。结论是,转基因玉米杂种后代(可能通过转基因玉米和玉米之间的杂交获得)的抗虫性和/或除草剂耐受性对目标和非目标生物的影响,在欧盟条件下,非生物环境和生物地球化学循环将非常低。根据欧盟委员会的要求,EFSA评估了EFSA(2016)的ERA结论和RM建议是否仍然适用,或需要根据自EFSA(2016)发布以来已获得的有关teosinte的新科学证据进行修订。制定了一项议定书,以澄清对任务授权职权范围的解释并使其运作。评估依赖于通过广泛的文献检索和法国和西班牙主管当局的报告检索的证据,以及听取专家证词.检索并评估了有限的18种相关性和质量各不相同的出版物。根据这些证据,得出的结论是,EFSA(2016)的ERA结论和RM建议仍然适用,除了与在玉米GA21上使用草甘膦除草剂有关的那些,这些除草剂应根据法规(EC)No1107/2009考虑。在受感染的农业地区(尤其是玉米MON810广泛种植的地区),杂草管理措施实施监测,控制和/或根除teosinte必须留在原地,因为它们将有助于进一步降低转基因玉米和欧盟teosinte之间的低垂直基因流动潜力。
    Teosinte, wild maize relatives originating from Mexico and Central America, emerged as a noxious agricultural weed in France and Spain. In 2016, the European Food Safety Authority (EFSA) issued a technical report that assessed the available scientific information on teosinte for its relevance for the environmental risk assessment (ERA) and risk management (RM) of genetically modified (GM) maize MON810, Bt11, 1507 and GA21 for cultivation. It was concluded that the impact of insect resistance and/or herbicide tolerance in GM teosinte hybrid progeny (potentially acquired through hybridisation between GM maize and teosinte) on target and non-target organisms, the abiotic environment and biogeochemical cycles would be very low under EU conditions. Following a request of the European Commission, EFSA evaluated whether the ERA conclusions and RM recommendations of EFSA (2016) remain applicable, or require revision in light of new scientific evidence on teosinte that has become available since the publication of EFSA (2016). A protocol was developed to clarify the interpretation of the terms of reference of the mandate and make them operational. The assessment relied on evidence retrieved via an extensive literature search and from reports of the Competent Authorities of France and Spain, and on hearing expert testimonies. A limited collection of 18 publications of varying relevance and quality was retrieved and assessed. Based on this evidence, it is concluded that the ERA conclusions and RM recommendations of EFSA (2016) remain applicable, except those pertaining to the use of glyphosate-based herbicides on maize GA21 which should be considered under Regulation (EC) No 1107/2009. In infested agricultural areas (especially in regions where maize MON810 is widely grown), weed management measures implemented to monitor, control and/or eradicate teosinte must remain in place, as they will contribute to further reduce the low vertical gene flow potential between GM maize and EU teosinte.
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  • 文章类型: Journal Article
    EFSA要求其科学委员会准备一份关于评估和整合流行病学研究证据的指导文件,用于EFSA的科学评估。该指导文件介绍了流行病学研究,并说明了不同流行病学研究设计的典型偏见。它描述了与证据评估相关的关键流行病学概念。关于研究的可靠性,协会的措施,暴露评估,统计推断,解释了系统误差和效应修正。关于研究相关性,该指南描述了外部有效性的概念。阐述了评估流行病学研究的原则,并给出了偏差风险(RoB)工具的概述。开发了决策树,以帮助选择适当的偏差风险工具,根据研究问题,人口和设计。解释了研究评估过程的定制,详细介绍RoB工具的使用情况,并评估证据体内的偏见风险。使用偏差风险工具评估实验和观察研究的几个例子附在文件中,以说明该方法的应用。该文件构成了一份草案,将在1年的试点阶段中应用于EFSA的评估中,并在必要时进行修订和补充。在文件定稿之前,将展开公众谘询。
    EFSA requested its Scientific Committee to prepare a guidance document on appraising and integrating evidence from epidemiological studies for use in EFSA\'s scientific assessments. The guidance document provides an introduction to epidemiological studies and illustrates the typical biases of the different epidemiological study designs. It describes key epidemiological concepts relevant for evidence appraisal. Regarding study reliability, measures of association, exposure assessment, statistical inferences, systematic error and effect modification are explained. Regarding study relevance, the guidance describes the concept of external validity. The principles of appraising epidemiological studies are illustrated, and an overview of Risk of Bias (RoB) tools is given. A decision tree is developed to assist in the selection of the appropriate Risk of Bias tool, depending on study question, population and design. The customisation of the study appraisal process is explained, detailing the use of RoB tools and assessing the risk of bias in the body of evidence. Several examples of appraising experimental and observational studies using a Risk of Bias tool are annexed to the document to illustrate the application of the approach. This document constitutes a draft that will be applied in EFSA\'s assessments during a 1-year pilot phase and be revised and complemented as necessary. Before finalisation of the document, a public consultation will be launched.
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  • 文章类型: Journal Article
    Physical inactivity in children and youth in India is a major public health problem. The 2016 Indian Report Card on Physical Activity for Children and Youth has been conceptualized to highlight this epidemic by appraising behaviors, contexts, strategies, and investments related to physical activity of Indian children and youth.
    An international research collaboration resulted in the formation of a Research Working Group (RWG). RWG determined key indicators; identified, synthesized, and analyzed existing evidence; developed criteria for assigning grades; and, finally, assigned grades to indicators based on consensus.
    Overall Physical Activity Levels were assigned a grade of C-. Active Transportation and Sedentary Behaviors were both assigned a grade of C. Government Strategies and Investments was assigned a grade of D. Six other indicators, including the country-specific indicator Physical Fitness, were graded as INC (incomplete) due to the lack of nationally representative evidence.
    Based on existing evidence, it appears that most Indian children do not achieve recommended levels of physical activity and spend most of their day in sedentary pursuits. The report card identifies gaps in both investments and research that need to be addressed before understanding the complete picture of active living in children and youth in India.
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  • 文章类型: Journal Article
    AORN perioperative practice specialists responsible for authoring the Guidelines for Perioperative Practice have spent several years using evidence-based practice tools adapted from other organizations. AORN now has its own evidence appraisal tools and model for evidence-based practice that can be used by nurses and students to appraise research and nonresearch articles and assign an evidence rating to help inform perioperative practice decisions. The new and revised tools include a new evidence rating model, hierarchy of evidence, and expanded appraisal tools.
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  • 文章类型: Journal Article
    Evidence-based practice (EBP) is an approach used in numerous professions that focuses attention on evidence quality in decision making and action. We review research on EBP implementation, identifying critical underlying psychological factors facilitating and impeding its use. In describing EBP and the forms of evidence it employs, we highlight the challenges individuals face in appraising evidence quality, particularly that of their personal experience. We next describe critical EBP competencies and the challenges underlying their acquisition: foundational competencies of critical thinking and domain knowledge, and functional competencies such as question formulation, evidence search and appraisal, and outcome evaluation. We then review research on EBP implementation across diverse fields from medicine to management and organize findings around three key contributors to EBP: practitioner ability, motivation, and opportunity to practice (AMO). Throughout, important links between psychology and EBP are highlighted, along with the contributions psychological research can make to further EBP development and implementation.
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