#RandomizedTrials in individual patients – #Nof1 #RCTs – provide the highest certainty evidence of treatment impact in an individual. The epitome of best clinical practice. This article gives a step by step for setting up and running an N of 1 trial. pubmed.ncbi.nlm.nih.gov/3409138/

Core #GRADE, 7 articles in #BMJ this spring, one-stop-shopping for those who want to get GRADE right with the essentials. Now also frequently asked question – latest post considers a priori hypotheses to explain #heterogeneity. All questions welcome, send to [email protected] t.co/hh6owWxn5O

This #SystematicReview and #MetaAnalysis shook up the surgical world when results suggested that #antibiotics rather than #surgery may, for many patients, be the best management for their #appendicitis. pubmed.ncbi.nlm.nih.gov/26990957/

#BradfordHill’s iconic criteria for addressing #causation still resonates with many. How do those criteria relate to #GRADE’s certainty of evidence for causation? This paper explains. pubmed.ncbi.nlm.nih.gov/20947872/

Just back from a trip to #Chengdu, the birthplace of #EBM, where applying EBM to #TraditionalChineseMedicine and thus advance #TCM on the global stage is all the rage. With my first Chinese Phd student Xin Sun, now number 1 in EBM in China, and his colleagues.

In this one minute video I explain how a person who takes an #Evidence based approach to life responds when asked a question for which they don’t know the evidence. @leticiakawano.bsky.social www.linkedin.com/feed/update/...

Addressing costs in #SystematicReviews is challenging and applying #GRADE to rate certainty of evidence particularly so. This paper shows you how. pubmed.ncbi.nlm.nih.gov/22863410/

Biking with my friend and former mentee Mohit Bhandari, now leading clinical trialist in orthopedic trauma, leader in intimate partner violence research and Chair of Surgery at #McMaster.

This #JAMA Users’ guide to the medical literature explains how to use an article that addresses how to understand and interpret articles about patients’ #QualityofLife usually measured using #PatientReportedOutcomes (PRO). pubmed.ncbi.nlm.nih.gov/9103349/

#JAMA editor Drummond Rennie who died recently acted as the champion of the JAMA Users’ Guides to the Medical Literature. Without his advocacy the series would never have happened and the #EBM movement might never have got off the ground. jamanetwork.com/journals/jam...

When to give #RBCtransfusion for hospitalized patients with #anemia: Definitive updated trustworthy #guidelines, #JAMA publication. pubmed.ncbi.nlm.nih.gov/37824153/

In this one minute tutorial, I explain the meaning and significance of a weak or conditional #GRADE recommendation. www.linkedin.com/feed/update/...

Anyone interested in determining the effect of a drug in a single patient by conducting a #RandomizedTrial in a that patient – an N of 1 trial – will find this step-by-step guide enormously useful. www.cmaj.ca/content/139/...

If you are using #GRADE to rate #CertaintyofEvidence for diagnostic tests this article that deals with study design, #RiskofBias, and #indirectness provides crucial guidance. pubmed.ncbi.nlm.nih.gov/32060007/

Just published #MetaAnalysis of #AdverseEffects of short-course #steroids in #children and #adolescents in many diseases can provide high certainty evidence for their use in #RareDisease. Generally applicable approach for harms of common drugs in rare diseases. pubmed.ncbi.nlm.nih.gov/41026484/

Forming #EvidenceBased plans of #EBM care that respond to each patient’s situation demands #SharedDecisionMaking. JP Brito, Iris Hargraves, and Marleen Kunneman are doing leading work to advance the practice of making care fit using shared decision making. ebm.bmj.com/content/28/4...

This video presents a answer to the question of how evidence-based medicine - #EBM - protects us against inflated, misleading claims of treatment effect. I’ll be posting a number of such snippets and you’ll enjoy my charming interlocutor, @leticiakawano.bsky.social www.linkedin.com/feed/update/...

The ground-breaking #NEJM #randomizedTrial suggests that every #surgery patient at substantial #bleeding risk should receive #tranexamicAcid: 24% #RelativeRisk reduction in serious bleeding. www.nejm.org/doi/full/10....

15 minute #JAMA podcast in which I interview world authority @thomasagoritsas.bsky.social on how to Use a Patient Management #Recommendations: #ClinicalPracticeGuidelines and #DecisionAnalyses edhub.ama-assn.org/jn-learning/...

This #BMJ article demonstrates that plausible assumptions regarding outcomes of patients lost to follow-up could often change the interpretation of results of #RandomisedControlledTrials published in top medical journals. pubmed.ncbi.nlm.nih.gov/22611167/

Are #RelativeRisks overwhelmingly similar across risk groups? And if so, can we personalize care by applying relative risk to individual patients’ risk profiles? This key #EBM study demonstrates that the answer to both questions is an unquestionable YES. pubmed.ncbi.nlm.nih.gov/11914297/

A survey addresses #guidelines trustworthiness evolution 2010 to 2022. Glass half empty - modest improvement, long way to go; and half full - almost 20% high trustworthiness. Thousands published yearly, astute clinicians will find quality guidelines relevant to them pubmed.ncbi.nlm.nih.gov/40889618/

Studies being published checking whether #LLMs and other #generativeAI models provide good health advice. #Clinicians, #Researchers, #Reviewers, #Editors, #Publishers can check and optimize studies through the #CHART checklist, abstract checklist, and methodological diagram. chartguideline.org

When applying plausible assumptions to the outcomes of participants with definite missing data to 100 #SystematicReviews, the average change in pooled relative effect estimate was substantive. #BMJ #EBM #Medicine pubmed.ncbi.nlm.nih.gov/32847800/

My research of #GenderAffirming care following #EBM principles have engendered attacks by trans activists, anti-trans activists, and journalists advocating denial of gender-affirming care. Fortunately, some journalists present a balanced account. Here is one. www.statnews.com/2025/09/22/e...

Recently completed biking vacation with Maureen in Portugal. It’s a wonderful country!

Pooling health-related #QualityofLife outcomes in #MetaAnalysis in ways that enhance #interpretability provides a big challenge. This tutorial shows you the statistical methods for achieving the goal. pubmed.ncbi.nlm.nih.gov/26061786/

#GRADE’s primary focus in #SystematicReviews has been on rating certainty in evidence on interventions. But in this article GRADE also provides guidance for #CertaintyofEvidence in #prognosis in which #ObservationalStudies start as high certainty evidence. pubmed.ncbi.nlm.nih.gov/31982539/

At the recent #GuidelinesInternationalNetwork (GIN) meeting in Geneva I paid the price for my notoriety as folks cornered me, including this group lining up to have their photo taken with me.

At recent #GuidelinesInternationalNetwork (GIN) meeting with Thomas Agoritsas, Chair of the #MAGICEcosytemFoundation and international #GRADE methodology leader and our researcher Prashanti Eachempati, creator of the JUDGE instrument that will revolutionize GRADE education and practice.

The #ChronicRespiratoryQuestionnaire (CRQ) is the most responsive and valid #HealthStatusMeasurement instrument for disease-specific #QualityOfLife in patients with #COPD and other chronic respiratory conditions. This paper presents a self-report version. pubmed.ncbi.nlm.nih.gov/11713359/

Clinicians increasingly rely on #chatbots for advice in managing patients. But is this advice helpful or misleading? Researchers are trying to find out. A survey of 137 studies of bot performance demonstrates their methods leave a great deal to be desired. pubmed.ncbi.nlm.nih.gov/39903463/

I am keen that the Core #GRADE series - 7 articles in @bmj.com this spring - gets optimal use. I will therefore be available to address queries anyone has about using Core GRADE. Don’t hesitate to ask at [email protected]. pubmed.ncbi.nlm.nih.gov/40233981/

#TransActivists suggest our #SystematicReviews showing low certainty evidence for outcomes of #GenderAffirming care are “pseudoscientce”. The right attacks because we suggest that banning trans care is unconscionable. This newspaper article provides a balanced perspective. archive.ph/WsBIN

#GRADE provides guidance for rating #CertaintyofEvidence regarding accuracy of diagnostic tests. This informative paper provides details on assessing #inconsistency, #imprecision, #PublicationBias and other domains and for creating #SummaryofFindings tables. pubmed.ncbi.nlm.nih.gov/32058069/

Most #GRADE users are familiar with GRADE’s #EvidenceToDecision frameworks for interventions. Less so with EtD for tests. This excellent exposition provides guidance when creating or using a #DiagnosticTests and other tests (such as #screening) EtDs. pubmed.ncbi.nlm.nih.gov/26931285/

Our group posted: using our #GRADE #SR of #GenderAffirming care to justify denial of care is unconscionable. A #NationalPost piece decried our position. The author had been suspended by the BC College of Nursing for comments derogatory towards transgender people! nationalpost.com/opinion/fath...

As winner of the 2024 Canadian #Friesen prize, I toured 8 Canadian universities delivering Friesen lectures on the past and future of #EvidenceBasedMedicine. A booklet summarizing the lecture is now available. fchr.ca/books

This classic article looking at #DiagnosticTests for iron deficiency #anemia (showed #ferritin by far the best) remains the best example to teach students how to use #LikelihoodRatios in their clinical practice. pubmed.ncbi.nlm.nih.gov/2178409/

How the world has changed, how quickly we take for granted technological miracles that not so long ago would have been the stuff of #ScienceFiction. Only few years ago, a colleague called his research fellow over to view the miracle of his computer screen that showed six talking faces. And now…

#TransitionRatings (are you better; if so how much) is the most-used strategy for establishing #MinimalImportantDifferences in #PatientReportedOutcomeMeasures. But transition ratings must be valid. This seminal, essential paper shows how to test their validity. pubmed.ncbi.nlm.nih.gov/12393078/

Hanlon's Razor is a principle stating, "Never attribute to malice that which is adequately explained by incompetence". I’ve recently had an experience that put me in mind of these wise words – I suspected malevolence; explanation proved otherwise. fs.blog/mental-model...

We chose the term #MinimalClinicallyImportantDifference in an era of medical paternalism. We subsequently realized that we are considering patient-important outcomes and our language should align. This article presents the transition to #MinimallyImportantDifference pubmed.ncbi.nlm.nih.gov/15762909/

Legislators have unconscionably misused our #SystematicReviews of #GenderTransition interventions to deny #PatientsCare. Formerly, I thought my job ended with conducting and reporting high quality research. I now realize I have an additional responsibility to address how my work is used.

The #GRADE evidence to decision (EtD) framework provides invaluable guidance in moving from evidence to recommendations. There are a number of variations for specific areas. This article explains EtD frameworks for #HealthSystem and policy decisions. pubmed.ncbi.nlm.nih.gov/29843743/

Recent BMJ: strong rapid recommendation against lucrative interventional #pain intervention. Practitioners pushed back, but this enlightened exception acknowledges industry influence, catchy branding ignoring science, hidden COI, low quality research. pmc.ncbi.nlm.nih.gov/articles/PMC...

As this article demonstrates, when one is creating a health status measurement #instrument for use in #Clinicaltrials, factor analysis has major limitations. Far preferable to pick items patients think are important than to choose on the basis of factor structure. pubmed.ncbi.nlm.nih.gov/9120521/

Explanatory or mechanistic #RCTs of physical or psychological interventions requires “placebo,” or “sham” comparators. This @bmj.com article presents recommendations for designing, and reporting comparator interventions as well as a reporting checklist. pubmed.ncbi.nlm.nih.gov/37230508/

Over-reliance on #SurrogateOutcomes remains a big problem in expert-driven recommendations. This #JAMA users guide shows how most surrogates are not valid: in #RCTs they fail to predict impact of interventions on patient-important outcomes pubmed.ncbi.nlm.nih.gov/10463714/

Introducing #CHART - reporting guidelines for studies evaluating evidence summaries and health advice from #genAI models like #ChatGPT. Authors may apply the CHART checklist ✅and methodological diagram 📈 when reporting their studies. Published in @bmj.com: pubmed.ncbi.nlm.nih.gov/40750271/