Write an evidence-based clinical literature review – Pubrica

1. HowdoyouWritean Evidence-Based Clinical Literature Review? AnAcademicpresentationby Dr.NancyAgnes,Head,TechnicalOperations,Pubrica Group: www.pubrica.com Email:sales@pubrica.com

2. 02 TODAY'SDISCUSSION Inbrief Introduction TopicSelection SearchingtheLiterature Patient-Oriented vs Disease-Oriented Evidence Levelsof Evidence FormatoftheReview Conclusion AboutPubrica

3. INBRIEF Systematic reviews and meta-analyses are not the same astraditionalclinicalreviewpapers,usuallyknownas updates. Updates evaluate the medical literature selectively while covering a broad topic for Physician Writing. Nonquantitativesystematicreviewsanalyzethemedical literature indepth,attempting tofindandsynthesizeall relevantdata toestablishtheoptimaldiagnosticor treatmentstrategy. Meta-analyses(systematicquantitativereviews)utilize sophisticated statistical analysis of pooled research papers to address a specific clinical question. The guidelines for authoringanevidence-basedclinicalreviewarticlefor physiciansare presented in this article.

4. INTRODUCTION The most acceptable clinical review articles base their discussions on current systematic reviewsand meta-analyses, and they include allrelevantresearchresultsonhowtotreataspecificcondition. These evidence-based updates give readers concise summaries aswell assolid therapeutic advice. Criteriaforproducinganevidence-basedclinicalreviewarticle, particularly one intended for continuing medical education (CME) andincludeCMEobjectivesinits structure. The article's bias, a lack of adequate supporting evidence, or other considerationstoconductastudyoftheLiteraturereview methodologiesand,whenpossible,assignascoretoessential pieces of evidence. This method helps to accentuate the article's mainthemes.

6. TOPICSELECTION Choose a prevalent clinical condition and themes that are rare or uncommon avoid illness presentationsorthataremerelyinterestingforthe sakeof curiosity. Choosecommonissuesforwhichthereisnew knowledgeondiagnosisortherapywherever possible. Recentdataindicatingspironolactonemedication increases survival in patients with severe congestive heartfailure,forexample,mightdriveaclinical practicechange ifit isvalid. Contd...

7. Similarly,newevidenceindicatingthatanarrativeliteraturereviewof conventional treatment is no longer effective and may even be hazardous should bereported. Patchingmostacutecornealabrasions,forexample,mayexacerbatesymptoms anddelay healing.

8. SEARCHINGTHELITERATURE Look for relevant recommendations on the condition beingdiscussed'sdiagnosis,treatment,orprevention. Include any high-quality suggestions that are related tothe issue. Look for all suggestions primary Clinical Literature review concerning diagnosis and, especially, therapyintheinitialdraught. Attempt to ensure that all suggestions are based on themost up-to-dateevidence.

9. PATIENT-ORIENTEDVS DISEASE-ORIENTEDEVIDENCE Patient-OrientedEvidencethatMatters(POEM)is concerned with patient-relevant outcomes such as changes inmorbidity, mortality,or qualityof life. POEM-typeevidencediffersfromdisease-oriented evidence(DOE),whichSystematicliteraturereview focuses on surrogate endpoints such as test results or other responseindicators. Indicate that foremost clinical advice lacks the backing of outcomesevidencewhenDOEistheonlyguideline provided.

10. LEVELSOFEVIDENCE Thequalityoftheevidencesupportingtheessentialclinical recommendations on diagnosis and therapy is critical information for readers. In the medical literature, several different grading systemsofvaryingcomplexityandclinicalusefulnessare reported. Takes all significant outcomes Comprehensive search tactics were used to conduct a high-quality meta-analysis (systematic quantitativereview). Acomprehensivenonquantitativereviewwitheffective searchtactics and well-supported findings. Contd...

11. A well-designed, nonrandomized clinical study is considered Level B (other evidence). Lower-qualityRCTs,clinical cohort studies, and case-controlled studies with non-biasedparticipantselectionand consistentfindingsareincluded. Otherdata,suchaswell-designedepidemiologicstudieswithcompellingfindings orhigh-quality, historical, uncontrolledinvestigations, is also included. LevelC(consensus/expertopinion):Expertopinionorconsensusposition.

12. FORMATOFTHEREVIEW INTRODUCTION The review's topic and objective should be defined in theintroductionanditsrelevancetofamilypractice. The natural way of achieving this is to talk about the disease'sepidemiology, whichincludeshowmany individualshaveitatanyparticularmoment (prevalence) and what percentage of the population is projectedtoget itovertime (incidence). Contd...

13. A more exciting approach to accomplish this is to show how many times a regularfamilyphysicianmeetthisprobleminaweek,month,year,orcareer. Emphasizeandsummarisethereview'sprimaryCMEobjectivesinaseparate tablelabelled "CME Objectives." Contd...

14. METHODS The methodology section should briefly describe how the literature searchwas carried out and the primary evidence sources. Indicate which studies were included or excluded based on predefined criteria(e.g.,studieshadtobeindependentlyratedashighqualityby anestablishedevaluationprocess,suchastheCochrane Collaboration). Make a thorougheffort to locateall significantrelevant research. Avoidusingsolelythematerialthatsupportsyourfindingsas a reference. If an issue is controversial, discuss the entire extent of the argument. Contd...

15. DISCUSSIONS After then, the discussion might take on the shape of aclinical reviewarticle. It should cover aetiology, clinical presentation (signs andsymptoms),pathophysiology,diagnostic evaluation(history,physicalexamination,diagnostic imaging,laboratoryevaluation,and),differential diagnosis, treatment (goals, medical/surgical therapy, laboratory testing, patient education, and follow-up), prognosis,prevention,andfuturedirections). Contd...

16. REFERENCES Thereferencesshouldcontainthemostcurrentand essentialsourcesofsupport(i.e.,studiesreferredto, controversialmaterial,newinformation,specific quantitativedata, andinformationthatwouldnot usuallybefoundinmostgeneralreferencetextbooks). Theseusuallyaresignificantevidence-based recommendations,meta-analyses, orSystematic literature reviews, seminal studies. While other journals publishlengthylistsofreferencecitations,AFPprefers toprovideaconciselistofrelevant references. Contd...

17. CONCLUSION Evidence-basedevaluationsmayhelpselecthowto deployhealth-careservices,particularlypreventative programmes,in someinstances. Somehigh-qualitycost-effectivenessstudieswere appropriate to assist understand the costs and health benefits of various strategies for achieving a particular healthresult. Inthediscussion,highlightsignificantaspects concerning diagnosisandtherapy.Thesepointsare notalwaysthesameasthesignificant recommendations, which are ranked according to their degreeof evidence.

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