ORCID Profile
0000-0001-8544-7386
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Publisher: Springer Science and Business Media LLC
Date: 10-10-2013
Publisher: Cold Spring Harbor Laboratory
Date: 09-12-2019
DOI: 10.1101/19013912
Abstract: From 2006 to 2019, Cochrane reviews could be designated “stable” if they were not being updated but highly likely to be current. This provides an opportunity to observe practice in ending systematic reviewing and what is regarded as enough evidence. We identified Cochrane reviews designated stable in 2013 and 2019 and reasons for this designation. For those with conclusions stated to be so firm that new evidence is unlikely to change them, we assessed conclusions, strength of evidence ratings, and recommendations for further research. We assessed the fate of the 2013 stable reviews. We also estimated usage of formal analytic methods to determine when there is enough evidence in protocols for Cochrane reviews. Cochrane reviews were rarely designated stable. In 2019, there were 507 stable Cochrane reviews (6.6% of 7,645 non-withdrawn reviews). The most common reasons related to no, little, or infrequent research activity expected (331 of 505 65.5%). Only 39 reviews were stable because of firm conclusions unlikely to be changed by new evidence (7.7%), but that declaration was mostly not supported by judgments made in the review about strength of evidence and implications for research. Among the 180 reviews stable in 2013, 16 reverted to normal status (8.9%), with 2 of those changing conclusions because of new studies. Few Cochrane protocols specified an analytic method for determining when there was enough evidence to stop updating the review (116 of 2,415 4.8%). Cochrane reviews were more likely to end because important future primary research activity was believed to be unlikely, than because there was enough evidence. Judgments about the strength of evidence and need for research were often inconsistent with the declaration that conclusions were unlikely to change. The inconsistencies underscore the need for reliable analytic methods to support decision-making about the conclusiveness of evidence.
Publisher: BMJ
Date: 29-04-2020
Publisher: Springer Science and Business Media LLC
Date: 13-07-2019
Publisher: Cambridge University Press (CUP)
Date: 10-2011
DOI: 10.1017/S0266462311000547
Abstract: Background: The Institute for Quality and Efficiency in Health Care (IQWiG) was established in 2003 by the German parliament. Its legislative responsibilities are health technology assessment, mostly to support policy making and reimbursement decisions. It also has a mandate to serve patients’ interests directly, by assessing and communicating evidence for the general public. Objectives: To develop a priority-setting framework based on the interests of patients and the general public. Methods: A theoretical framework for priority setting from a patient/consumer perspective was developed. The process of development began with a poll to determine level of lay and health professional interest in the conclusions of 124 systematic reviews (194 responses). Data sources to identify patients’ and consumers’ information needs and interests were identified. Results: IQWiG's theoretical framework encompasses criteria for quality of evidence and interest, as well as being explicit about editorial considerations, including potential for harm. Dimensions of “patient interest” were identified, such as patients’ concerns, information seeking, and use. Rather than being a single item capable of measurement by one means, the concept of “patients’ interests” requires consideration of data and opinions from various sources. Conclusions: The best evidence to communicate to patients/consumers is right, relevant and likely to be considered interesting and/or important to the people affected. What is likely to be interesting for the community generally is sufficient evidence for a concrete conclusion, in a common condition. More research is needed on characteristics of information that interest patients and consumers, methods of evaluating the effectiveness of priority setting, and methods to determine priorities for disinvestment.
Publisher: Oxford University Press (OUP)
Date: 1996
Abstract: Clinical practice guidelines are increasingly affecting the quality of health care, and have the potential to affect the availability of health care options for consumers. Deciding what guidelines will cover, how they will be developed and what they will say are, therefore, issues in which consumers have a considerable stake. While there is a growing acknowledgement of the need to involve consumers in guideline development, the reality can fall far short of the rhetoric. This article advocates the use of three types of strategies in combination to enable better consideration of consumers' views in the guideline development process: the involvement of accountable consumer representatives in group decision making, community consultation and the use of research literature describing people's experiences. A framework for assessing the level of consumer participation in an activity is suggested. It is argued that if consumer involvement is to successfully raise the standard of health care guidelines, then the standard of consumer participation itself needs to be raised.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2013
DOI: 10.1002/CHP.21197
Publisher: Cambridge University Press (CUP)
Date: 10-2011
DOI: 10.1017/S0266462311000523
Abstract: Background: Patient involvement is widely acknowledged to be a valuable component in health technology assessment (HTA) and healthcare decision making. However, quantitative approaches to ascertain patients' preferences for treatment endpoints are not yet established. The objective of this study is to introduce the analytic hierarchy process (AHP) as a preference elicitation method in HTA. Based on a systematic literature review on the use of AHP in health care in 2009, the German Institute for Quality and Efficiency in Health Care (IQWiG) initiated an AHP study related to its HTA work in 2010. Methods: The AHP study included two AHP workshops, one with twelve patients and one with seven healthcare professionals. In these workshops, both patients and professionals rated their preferences with respect to the importance of different endpoints of antidepressant treatment by a pairwise comparison of in idual endpoints. These comparisons were performed and evaluated by the AHP method and relative weights were generated for each endpoint. Results: The AHP study indicates that AHP is a well-structured technique whose cognitive demands were well handled by patients and professionals. The two groups rated some of the included endpoints of antidepressant treatment differently. For both groups, however, the same six of the eleven endpoints analyzed accounted for more than 80 percent of the total weight. Conclusions: AHP can be used in HTA to give a quantitative dimension to patients' preferences for treatment endpoints. Preference elicitation could provide important information at various stages of HTA and challenge opinions on the importance of endpoints.
Publisher: SAGE Publications
Date: 02-2005
Publisher: Informa UK Limited
Date: 03-04-2014
Publisher: Public Library of Science (PLoS)
Date: 31-05-2016
Publisher: Georg Thieme Verlag KG
Date: 18-11-2011
Abstract: The German Institute for Quality and Efficiency in Health Care (IQWiG) began publishing free bi-lingual (German/English) evidence-based health information in February 2006 on the website, www.gesundheitsinformation.de www.informedhealthonline.org . The Institute aims to be a patient-centred and non-directive provider of health information to the public and patients. The point of view and information needs of the public are a central element in the development of health information. People can be involved implicitly or explicitly. People can participate directly or explicitly in health information, for ex le, by suggesting a topic, by helping shape the content and during the development process. We do this in several ways, including surveys, consultation with consumer representatives as well as through user-testing and reader online rating. In addition, implicit involvement of patients occurs indirectly through consideration of the experiences and information needs of patients via an analysis of qualitative research. A challenge here is the generalisability of information derived from research in other cultures. The Institute monitors methodological developments in the area of patient and health information, to keep its methods up-to-date. In addition, the colleagues involved in this work participate in an in-house training program on patient-centred health information.
Publisher: Cambridge University Press (CUP)
Date: 1998
DOI: 10.1017/S0266462300010485
Abstract: Forces from communities and from health care are pushing toward more consumer involvement in health care internationally. This article addresses the philosophies and rationales behind this trend and traces the history and development of consumer advocacy in health care.
Publisher: American Thoracic Society
Date: 15-12-2012
Publisher: Public Library of Science (PLoS)
Date: 21-09-2010
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.ZEFQ.2010.03.030
Abstract: There is some evidence that involving patients in the development of health information can increase the relevance and understandability of this information. The German Institute for Quality and Efficiency in Health Care (IQWiG) publishes easy-to-understand and freely accessible evidence-based health information on its bilingual website gesundheitsinformation.de / informedhealthonline.org. The aim of the Institute is to determine the information needs of the general public and patients, and to take those needs into account when producing its health information. One way in which this is done is by carrying out online surveys before the information is produced, asking the users of the website about their level of interest in various aspects of a topic. In this article we present two ex les of such surveys - on the topics of "endometriosis" and "skin cancer screening and prevention" - as well as the results of these surveys and how the results influenced the contents of the health information produced. Our experience with a total of seven surveys suggests that online surveys can be a helpful additional tool to identify information gaps and determine information needs and areas of special interest. In addition, surveys provide a way to interact with the users of the website. In their current form, however, online surveys also have methodological limitations that need to be considered when developing these surveys and interpreting their results.
Publisher: Public Library of Science (PLoS)
Date: 09-04-2013
Publisher: Public Library of Science (PLoS)
Date: 30-12-2014
Publisher: Walter de Gruyter GmbH
Date: 10-2010
DOI: 10.1016/J.PHF.2010.06.007
Abstract: Evidenzbasierte Gesundheitsinformationen veröffentlicht das Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) seit 2006 auf der Website Gesundheitsinformation.de. Allerdings ist wenig bekannt, wie und wonach im Internet nach Gesundheitsinformationen gesucht wird. Es fehlt an Daten und allgemein anerkannten Methoden. Daher liegt ein Schwerpunkt darauf, Informationsbedürfnisse von Bürgern in Erfahrung zu bringen. Lesen Sie, wie das Institut dabei methodisch vorgeht.
Publisher: American Diabetes Association
Date: 20-05-2011
DOI: 10.2337/DC11-0188
Publisher: Cold Spring Harbor Laboratory
Date: 11-12-2019
DOI: 10.1101/19014134
Abstract: The Cochrane Collaboration has been publishing systematic reviews in the Cochrane Database of Systematic Reviews ( CDSR ) since 1995, with the intention that these be updated periodically. To chart the long-term updating history of a cohort of Cochrane reviews and the impact on the number of included studies. The status of a cohort of Cochrane reviews updated in 2003 was assessed at three time points: 2003, 2011, and 2018. We assessed their subject scope, compiled their publication history using PubMed and CDSR , and compared them to all Cochrane reviews available in 2002 and 2017/18. Of the 1,532 Cochrane reviews available in 2002, 11.3% were updated in 2003, with 16.6% not updated between 2003 and 2011. The reviews updated in 2003 were not markedly different to other reviews available in 2002, but more were retracted or declared stable by 2011 (13.3% versus 6.3%). The 2003 update led to a major change of the conclusions of 2.8% of updated reviews (n = 177). The cohort had a median time since publication of the first full version of the review of 18 years and a median of three updates by 2018 (range 1–11). The median time to update was three years (range 0–14 years). By the end of 2018, the median time since the last update was seven years (range 0–15). The median number of included studies rose from eight in the version of the review before the 2003 update, to 10 in that update and 14 in 2018 (range 0–347). Most Cochrane reviews get updated, however they are becoming more out-of-date over time. Updates have resulted in an overall rise in the number of included studies, although they only rarely lead to major changes in conclusion.
Publisher: American Medical Association (AMA)
Date: 02-2014
Publisher: Informa UK Limited
Date: 2000
DOI: 10.1016/S0968-8080(00)90012-0
Abstract: For a consumer advocate, entering the world of the disability-adjusted life years (DALYs) calculations was a surreal experience. What began with the noble aim of working out how to overcome the tyranny of death as the only way of 'measuring' health, has led to an exercise where people weigh the relative value of health conditions without death as a feature. However, life-threatening diseases, if they no longer carry the threat of death, are no longer themselves. These valuations of 'altered health states' then, can become absurd. While data often fail to measure real life very well, and distort as well as illuminate, the ranking of disease in this way is particularly problematic. It has been said to disadvantage the poor, the very young and very old, and women. It privileges short-term interventions over prevention and long-term strategies. Can this really improve decision-making about resource allocation in health?
Publisher: Wiley
Date: 20-07-2015
Publisher: Cold Spring Harbor Laboratory
Date: 27-02-2017
DOI: 10.1101/106757
Abstract: An editorial expression of concern (EEoC) is issued by editors or publishers to draw attention to potential problems in a publication, without itself constituting a retraction or correction. We searched PubMed, PubMed Central (PMC), and Google Scholar to identify EEoCs issued for publications in PubMed and PMC up to 22 August 2016. We also searched the archives of the Retraction Watch blog, some journal and publisher websites, and studies of EEoCs. In addition, we searched for retractions of EEoCs and affected articles in PubMed up to 8 December 2016. We analyzed overall historical trends, as well as reported reasons and subsequent editorial actions related to EEoCs issued between August 2014 and August 2016. After screening 5,076 records, we identified 230 EEoCs that affect 300 publications indexed in PubMed, the earliest issued in 1985. Half of the primary EEoCs were issued between 2014 and 2016 (52%). We found evidence of some EEoCs that had been removed by the publisher without leaving a record and some were not submitted for PubMed or PMC indexing. A minority of publications affected by EEoCs had been retracted by early December 2016 (25%). For the subset of 92 EEoCs issued between August 2014 and August 2016, affecting 99 publications, the rate of retraction was similar (29%). The majority of EEoCs were issued because of concerns with validity of data, methods, or interpretation of the publication (68%), and 31% of cases remained open. Issues with images were raised in 40% of affected publications. Ongoing monitoring after the study identified another 17 EEoCs to year’s end in 2016, increasing the number of EEoCs to 247 and publications in PubMed known to be affected by EEoCs to 320 at the end of 2016. EEoCs have been rare publishing events in the biomedical literature, but their use has been increasing. Most have not led to retractions, and many remain unresolved. Lack of prominence and inconsistencies in management of EEoCs reduce the ability of these notices to alert the scientific community to potentially serious problems in publications. EEoCs will be made identifiable in PubMed in 2017.
Publisher: Elsevier BV
Date: 06-1992
Publisher: John Wiley & Sons, Ltd
Date: 17-10-2007
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.PEC.2008.08.020
Abstract: To define evidence-based health information and the conceptual framework and methodology of Germany's national health information website. Description of the political and methodological processes in the development of the website Gesundheitsinformation.de/Informed Health Online developed by the Institute of Quality and Efficiency in Health Care (IQWiG). Autonomy, empowerment and health literacy were useful theoretical concepts to guide the definition of evidence-based health information and the objectives and methodologies used for developing this website. These choices had direct practical consequences for the patient information. Evidence-based patient information involves the use of evidence and systematic methodologies in several facets of information provision. These include a process of information development that minimises bias, evidence as the information basis for the content, and the use of evidence-based communication techniques. To be empowering and support patient autonomy, information should be patient-centred and non-directive. Health websites are communication interventions which can have very different objectives and methods. A conceptual framework can help guide these choices and provide a basis for subsequent evaluation.
Publisher: Oxford University Press (OUP)
Date: 02-2017
Publisher: BMJ
Date: 04-2010
DOI: 10.1136/BMJ.C1395
Publisher: VS Verlag für Sozialwissenschaften
Date: 2009
Publisher: Cambridge University Press (CUP)
Date: 1996
DOI: 10.1017/S0266462300009600
Abstract: The ethical principles of beneficence (doing the best for one's patients and clients), nonmaleficence (doing no harm), autonomy, justice, and equity, are positively associated with the quality of a trial rather than being opposed to it. Ethical considerations involve such important questions as appropriate design and documentation, participation rates, withdrawals or losses to follow-up, careful monitoring of safety and efficacy, timely completion, generalizability, and publication and dissemination of findings. When conflicts between ethical considerations and the trial's scientific quality do occur, the ethical considerations must be paramount.
Publisher: Springer Science and Business Media LLC
Date: 28-02-2020
Publisher: Walter de Gruyter GmbH
Date: 04-2011
DOI: 10.1016/J.PHF.2010.12.004
Abstract: Patienteninformationen sind traditionell paternalistisch und verfolgen mit wenig Erfolg das Ziel, das Verhalten von Patienten zu steuern. Patientenzentrierte Informationen erkennen die Kompetenzen von Patienten an und verfolgen das Ziel, die Ressourcen von Patienten zu stärken und sie dazu zu befähigen, einen größeren Einfluss auf ihre persönlichen Gesundheits- und Lebensziele zu nehmen. Dieser Artikel stellt die verschiedenen Gegensätze gegenüber.
Publisher: Wiley
Date: 02-1992
Publisher: BMJ
Date: 13-08-2010
DOI: 10.1136/BMJ.C3852
Publisher: Elsevier
Date: 2008
Publisher: Wiley
Date: 12-1993
DOI: 10.1111/J.1523-536X.1993.TB00225.X
Abstract: In Australia, planning to give birth at home was unusual in the middle to late 1980s, a choice made by only about 0.5 percent of women. This study investigated the personal beliefs and circumstances of 552 women who planned to give birth at home. Results showed that these women came from erse backgrounds and beliefs, although in general they were of higher than average educational and occupational status, and less likely to hold Christian beliefs relative to the Australian community in general. Their lives and experiences reflected both unconventional and more traditional choices, and the view that women who give birth at home characteristically belong to the counterculture could not be justified. The findings of this study suggest that stereotypes of women who give birth at home do not apply to the circumstances of substantial numbers of women.
Publisher: Springer Science and Business Media LLC
Date: 02-07-2019
No related grants have been discovered for Hilda Bastian.