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How to Write an evidence-based clinical literature review – Pubrica
Introduction
The most acceptable
clinical review articles base their discussions on current systematic
reviews and meta-analyses,
and they include all relevant research results on how to treat a specific
condition. These evidence-based updates give readers concise summaries as well
as solid therapeutic advice. Criteria for producing an evidence-based
clinical review article, particularly one intended for
continuing medical education (CME) and include CME objectives in its structure.
The article’s bias, a lack of adequate supporting evidence, or other
considerations to conduct a study of the Literature review methodologies and,
when possible, assign a score to essential pieces of evidence. This method
helps to accentuate the article’s main themes.
Topic
Selection
Choose a prevalent clinical condition and avoid themes that are
rare or uncommon illness presentations or that are merely interesting for the
sake of curiosity. Choose common issues for which there is new knowledge on
diagnosis or therapy wherever possible. Recent data indicating spironolactone
medication increases survival in patients with severe congestive heart failure,
for example, might drive a clinical practice change if it is valid. Similarly,
new evidence indicating that a narrative literature review of
conventional treatment is no longer effective and may even be hazardous should
be reported. Patching most acute corneal abrasions, for example, may exacerbate
symptoms and delay healing.
Searching the Literature
Look
for relevant recommendations on the condition being discussed’s diagnosis,
treatment, or prevention. Include any high-quality suggestions that are related
to the issue.
Patient-Oriented vs Disease-Oriented
Evidence
Patient-Oriented Evidence that Matters (POEM)
is concerned with patient-relevant outcomes such as changes in morbidity,
mortality, or quality of life. POEM-type evidence differs from disease-oriented
evidence (DOE), which Systematic literature review focuses on surrogate
endpoints such as test results or other response indicators. Indicate that
foremost clinical advice lacks the backing of outcomes evidence when DOE is the
only guideline provided.
Levels of Evidence
The quality of the
evidence supporting the essential clinical recommendations on diagnosis and
therapy is critical information for readers. In the medical literature, several different grading systems of
varying complexity and clinical usefulness are reported.
·
Takes all significant outcomes Comprehensive search tactics were
used to conduct a high-quality meta-analysis (systematic quantitative review).
·
A comprehensive nonquantitative review with effective search
tactics and well-supported findings. A well-designed, nonrandomized clinical
study is considered Level B (other evidence). Lower-quality RCTs, clinical
cohort studies, and case-controlled studies with non-biased participant
selection and consistent findings are included. Other data, such as
well-designed epidemiologic studies with compelling findings or high-quality,
historical, uncontrolled investigations, is also included.
Format of the Review
INTRODUCTION
The review’s topic and objective should be defined in the
introduction and its relevance to family practice. The natural way of achieving
this is to talk about the disease’s epidemiology, which includes how many
individuals have it at any particular moment (prevalence) and what percentage
of the population is projected to get it over time (incidence). A more exciting
approach to accomplish this is to show how many times a regular family
physician meet this problem in a week, month, year, or career. Emphasize and
summarise the review’s primary CME objectives in a separate table labelled “CME
Objectives.”
METHODS
The methodology section should briefly describe how the
literature search was carried out and the primary evidence sources. Indicate
which studies were included or excluded based on predefined criteria (e.g.,
studies had to be independently rated as high quality by an established
evaluation process, such as the Cochrane Collaboration). Make a thorough effort
to locate all significant relevant research. Avoid using solely the material
that supports your findings as a reference. If an issue is controversial,
discuss the entire extent of the argument.
DISCUSSION
After then, the discussion might take on the shape of a clinical
review article. It should cover aetiology, clinical presentation (signs and
symptoms), pathophysiology, diagnostic evaluation (history, physical
examination, diagnostic imaging, laboratory evaluation, and), differential
diagnosis, treatment (goals, medical/surgical therapy, laboratory testing,
patient education, and follow-up), prognosis, prevention, and future
directions).
REFERENCES
The references should contain
the most current and essential sources of support (i.e., studies referred to,
controversial material, new information, specific quantitative data, and
information that would not usually be found in most general reference
textbooks). These usually are significant evidence-based recommendations,
meta-analyses, or Systematic literature reviews,
seminal studies. While other journals publish lengthy lists of reference
citations, AFP prefers to provide a concise list of relevant references.
Conclusion
Evidence-based evaluations may help select how to deploy
health-care services, particularly preventative programmes, in some instances.
Some high-quality cost-effectiveness studies were appropriate to assist
understand the costs and health benefits of various strategies for achieving a
particular health result. In the discussion, highlight significant aspects
concerning diagnosis and therapy.
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