French academic physicians had a poor knowledge of terms used in clinical epidemiology

Estellat, Candice; Faisy, Christophe; Colombet, Isabelle; Châtellier, Gilles; Burnand, Bernard; Durieux, Pierre

doi:10.1016/j.jclinepi.2006.03.005

Cited by 24 publications

(25 citation statements)

References 22 publications

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“…[9,10] but is not meaningful for everyone [11]. Presenting results as a percentage of responders after defining a threshold of improvement (MCID) or the threshold of acceptable pain (PASS) at the individual level enhances the relevance of the results [12].…”

Section: What Is New?mentioning

confidence: 99%

Systematic review reveals heterogeneity in definition of a clinically relevant difference in pain

Ruyssen‐Witrand¹,

Tubach²,

Ravaud³

2011

Journal of Clinical Epidemiology

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Objective: To describe the pain decrease considered as clinically relevant when designing a trial and reporting its results. Methods: A systematic review of the literature in MEDLINE was conducted to select randomized controlled trials (RCTs) with pain as a primary outcome. Data extracted included the definition (terms and values) of a clinically relevant difference in pain, the type of pain studied (acute or chronic), the level of application (group or individual) of the clinically relevant difference, and the reference justifying the choice of value for clinically relevant difference.Study Design and Setting: Seventy-four trials were included, and only 16 articles justified the choice of a value for clinically relevant difference with a reference citation. The values chosen for the clinically relevant relative decrease in pain varied from 4 to 40 mm or from 15% to 55% at the group level and from 20 to 50 mm at the individual level. In seven articles, the authors confused the application of the reference value at the individual or group level.Conclusion: Our review revealed a great heterogeneity in definition, format, and values of what is considered a clinically relevant difference in pain in RCTs of analgesics, and standardizations are advisable. Ó

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Section: What Is New?mentioning

confidence: 99%

Systematic review reveals heterogeneity in definition of a clinically relevant difference in pain

Ruyssen‐Witrand¹,

Tubach²,

Ravaud³

2011

Journal of Clinical Epidemiology

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“…At the end of the trial, they allow to report the proportion of patients benefiting from treatment (difference in proportion of improved patients or patients in an acceptable state between treatment arms). These concepts have been recognized as useful [6e8], in addition to the conventional way of reporting results of trials (e.g., difference in mean change), known to be usually a more powerful approach [9e11], but not meaningful to everyone [12]. MCID and PASS values have been estimated in different studies, in different diseases, and in different countries [1e5,13e20].…”

Section: Introductionmentioning

confidence: 99%

The variability in minimal clinically important difference and patient acceptable symptomatic state values did not have an impact on treatment effect estimates

Tubach

Giraudeau

Ravaud

2009

Journal of Clinical Epidemiology

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“…Conceivably, subjects who are more versed in statistical understanding also are more exposed to the concept of uncertainty. However, even among subjects who are more cognizant of uncertainty, the overall level of statistical understanding was low, a finding commonly noted in other studies [2,6,27]. Physicians' lack of understanding of health statistics is thought by some to be one of the major impediments to healthcare efficiency [10].…”

Section: Discussionmentioning

confidence: 96%

Do Orthopaedic Surgeons Acknowledge Uncertainty?

Teunis

Janssen

Guitton

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decisionmaking. Questions/purposes We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? Methods We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents One of the authors (DR) certifies that he, or a member of his immediate family, has or may receive payments or benefits, an amount of less than USD 10,000 during the study period from Wright Medical (Memphis, TN, USA); an amount less than USD 10,000 from Skeletal Dynamics (Miami, FL, USA); an amount less than USD 10,000 from Biomet (Warsaw, IN, USA); an amount less than USD 10,000 from AO North America (Paoli, PA, USA); and an amount less than USD 10,000 from AO International (Dubendorf, Switzerland Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years of experience. Two hundred forty-two (34%) members completed the survey. We found no differences between responders and nonresponders. Each survey item measured its own trait better than any of the other traits. Recognition of uncertainty (0.70) and confidence bias (0.75) had relatively high Cronbach alpha levels, meaning that the questions making up these traits are closely related and probably measure the ...

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French academic physicians had a poor knowledge of terms used in clinical epidemiology

Cited by 24 publications

References 22 publications

Systematic review reveals heterogeneity in definition of a clinically relevant difference in pain

Systematic review reveals heterogeneity in definition of a clinically relevant difference in pain

The variability in minimal clinically important difference and patient acceptable symptomatic state values did not have an impact on treatment effect estimates

Do Orthopaedic Surgeons Acknowledge Uncertainty?

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