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Results for “methodological review”

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PubMed2000

Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions.

AIMS: The methodology of studies that reported data on individuals who recovered from an alcohol or other drug problem (cigarette smokers were excluded) without formal help or treatment were reviewed. DESIGN/MEASUREMENTS: Potential studies were identified (a) through computerized literature searches, (b) by reviewing references from key publications and (c) by correspondence with researchers in the field. Studies had to (a) be in English, (b) be published, in press, or presented before the end of 1997, (c) report original results or be part of an original survey and (d) separately report respondents whose recoveries were and were not attributable to treatment. No case studies were included. Eligible studies were evaluated with respect to meeting criteria for (a) natural recovery, (b) methodological rigor and (c) reporting demographic and substance abuse history variables. FINDINGS: Until 1997 only 38 articles (40 different respondent samples) met the inclusion criteria for this review. This small number of studies is not surprising, as natural recovery from substance abuse is a relatively new area of study. Moreover, the majority of the 38 articles were published in the past 8 years. For most studies, descriptions of the respondent samples at pre- and post-recovery were seriously deficient. Alcohol was the most studied drug, with heroin a distant second. Low-risk drinking (78.6%) and limited drug use (46.2%) were commonly reported outcomes in natural recovery studies. CONCLUSIONS: Based on this review, future natural recovery studies should: (a) report respondents' demographic characteristics at the time of their recovery; (b) describe respondents' pre-recovery problem severity; (c) explore in some depth what factors, events or processes are associated with the self-change process; (d) provide corroboration of respondents' self-reports; (e) examine factors related to the maintenance of recoveries; (f) conduct interviews with individuals who have naturally recovered from cocaine, marijuana and polydrug abuse; (g) include a second interview at a later time to examine stability of natural recoveries; and (h) require a minimum 5-year recovery time frame.

Female↗

PubMed2002

Economic evaluation of antiepileptic drug therapy: a methodologic review.

PURPOSE: The increasing number of antiepileptic drugs (AEDs) fostered the development of economic studies in epilepsy. We reviewed this literature to identify and discuss methodologic issues. METHODS: We included all studies devoted to cost-based evaluation in epilepsy, published in English from 1989 to 2001, and identified via a Medline search. RESULTS: We identified a series of methodologic problems. First, we reconsidered heterogeneity of concepts and estimating methods, often cited as the most critical problem, as they do not necessarily result from a failure to apply standard methods. One must distinguish "natural" sources of heterogeneity arising from the many unconstrained choices left open in the implementation of economic evaluation on the one hand, and imperfect information and observation-based sources of heterogeneity leading to constrained choices on the other hand. By their very nature, cost-of-illness studies are subject to this variety of choices and were used to illustrate our purpose. Second, cost-minimization studies were reviewed, as they raise additional problems related to study design and choice of an outcome measure. Finally, deficiencies were also identified in cost-effectiveness and cost-utility studies concerning attempts to incorporate patient's point of view in outcome measurement. CONCLUSIONS: We agreed with previous reviews on the difficulty of compare results from economic studies in epilepsy due to heterogeneity in methods and concepts used. This is partly due to imperfect information and limits in observation as sources for data collection, as well as to unavailability of refined outcome measures. Therefore, improvements are possible in this field.

Anticonvulsants↗

PubMed1990

Editorial peer review: methodology and data collection.

This study reports on the editorial peer review practices of two categories of U.S. medical journals indexed in Index Medicus. Journals in group 1 were included on each of three lists of recommended journals, had a circulation of 10,000, and were cited at least 5,000 times per year. Group 2 journals, also indexed in Index Medicus, met none of the criteria. After being pretested, data were collected through a series of interviews and questionnaires. A summary of the methodology and an analysis of the differences between data collected through questionnaires and interviews is reported. The study concluded that initial interviews are very helpful in designing a questionnaire; a high percentage of editors agreed to be interviewed (100% for sixteen group 1 editors and 93.8% for sixteen group 2 editors); a 69.4% response rate to the mailed questionnaire indicates either sufficient follow-up or a high rate of interest in the subject matter; no trends identified by the questionnaire were reversed by changes in answers given during the interviews; approximately 11% to 15% of the answers differed between the questionnaire and interview methodology; and for some sensitive issues, editors were more likely to give answers on the questionnaire according to what was perceived as the most appropriate answer, rather than the actual practices of the journal.

Data Collection↗

PubMed1992

A methodological review of "method skeptic" reports.

The literature purporting to demonstrate that clinical neuropsychology is of limited validity in the forensic setting is reviewed critically and alternative interpretations are discussed. The methodological, procedural, conceptual, data analytical and survey/research design limitations are evaluated.

Female↗

PubMed1993

Vasectomy and prostate cancer risk: methodological review of the evidence.

Two recent studies have reported a significantly elevated risk of prostate cancer among vasectomized men. To assess whether the new results conflict with earlier studies that found no significant overall association, and, if so, whether such a conflict could have a methodological basis, we reviewed the six major epidemiological studies of this topic. Statistical analysis revealed significant (p < 0.01) heterogeneity among the associations in the six studies, attributable to one of the recent studies. Scrutiny of the studies for fulfillment of eight methodological standards for scientific validity revealed that no study completely fulfilled more than four standards, and that all studies were deficient in avoiding detection bias and obtaining accurate vasectomy histories. Our review indicates that the evidence on this topic is indeed conflicting, that the quality of the evidence does not resolve the conflict, and that future studies of this topic, designed to ensure scientific credibility of results, are needed.

Adult↗

PubMed2000

Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.

In the literature concerning the sacroiliac joint (SIJ) there are numerous specific tests used to detect joint mobility or pain provocation. In this article the authors have reviewed 11 studies which investigated the reliability of these tests. The methodological quality of the studies was tested by a list of criteria developed by the authors. This list consisted of three categories: (1) study population, (2) test procedures and (3) test results. To each criterion a weighting was attached. The methodological score for nine out of the 11 studies was found to be acceptable. The results of this review, however, could not demonstrate reliable outcomes and therefore no evidence on which to base acceptance of mobility tests of the SIJ into daily clinical practice. There are no indications that 'upgrading' of methodological quality would have improved the final conclusions. With respect to pain provocation tests, the findings did not show the same trend. Two studies demonstrated reliable results using the Gaenslen test and the Thigh thrust test. One study showed acceptable reliability for five other pain provocation tests; however, since other authors have described contradictory results, there is a necessity for further research in this area with an emphasis on multiple test scores and pain provocation tests of the SIJ.

Humans↗

PubMed1999

The prevalence of low back pain in adults: a methodological review of the literature.

The prevalence of low back pain (LBP) has been reported in the literature for different populations. Methodological differences among studies and lack of methodological rigor have made it difficult to draw conclusions from these studies. A systematic review was done for adult community prevalence studies of LBP published from 1981 to 1998. The technique of capture-recapture was performed to estimate the completeness of the search strategy used. Established guidelines and a methodological scoring system were used to critically appraise the studies. Thirteen studies were deemed methodologically acceptable. Differences in the duration of LBP used in the studies appeared to affect the prevalence rates reported and explain much of the variation seen. It was estimated that the point prevalence rate in North America is 5.6%. Further studies using superior methods are needed, however, before this estimate can be used with confidence to make health care policies and decisions relating to physical therapy.

Adult↗

PubMed1995

Methodological review and meta-analysis of sexuality and menopause research.

A selection of empirical studies from 1972-1992 that assessed sexuality and the peri/post menopausal women were collected and reviewed. Using a blind procedure, two Ph. D. experimental psychologists rated methodology sections of all studies. For comparison, variables that were related to peri/postmenopausal sexuality were converted to a standard effect size and correlation. Significantly higher effects sizes were found in studies that were rated as having an adequate measure of hormone status or adequate hormone manipulation, included appropriate controls, and had less confounding variables. Larger effect sizes tended to be found for studies that had an adequate measure of sexuality. Ratings of representativeness of the population, number of subjects, age of the subjects, adequacy of the menopause measure or statistical analysis were not related to effect sizes. Multiple regression analysis showed that overall ratings accounted for 31% of the variance of effect sizes. For studies in which an effect size could be calculated a mean D of 0.67 +/- 1.23 (SD) was found indicating that hormones, both exogenous and endogenous, have some importance to peri/postmenopausal sexuality. Difficulties encountered in attempting a meta-analysis in this area and the meaning of the findings are discussed, as is the importance of such an analysis to the area of sexuality and menopause research.

Adult↗

PubMedDate not supplied

Does the goose really lay golden eggs? A methodological review of Workmen's Compensation studies.

OBJECTIVE: To assess the value of workmen's compensation (WC) studies to determine the effectiveness of chiropractic. Therefore, the results of the available WC studies are summarized and the methodological quality of WC studies is discussed. DATA SOURCES: All studies were eligible without time restriction. Studies were identified by a Medline search from 1966 to 1990 (key words: chiropractic, and manipulation-orthopedic in combination with comparative studies, follow-up studies, evaluation studies) by manual examination of the most important chiropractic reference systems (CRAC and Index to Chiropractic Literature), by tracking the reference lists of identified (reviews of) WC studies and by correspondence with researchers. STUDY SELECTION: Studies were regarded as WC studies if by means of databases of WC boards, a comparison was made between claimants treated by chiropractors and those treated by other health care professionals. At least one of the following outcomes should be reported: compensated days, compensation paid or treatment costs. DATA EXTRACTION: Relevant data (authors, year, state, study population, number of patients, days compensated, compensation paid, number of treatments, consultation costs, additional treatment costs and total cost per case) were extracted by one nonblinded observer. The methodological value was reviewed narratively. DATA SYNTHESIS: The retrospective character of WC studies and the use of large WC databases harbor severe methodological problems like incomparability of study groups, absence of information on prognostic indicators, insufficient outcome measures and missing data. The results of older WC studies (before 1980) and the more recent WC studies, which were of better methodological quality, are presented separately. The older studies are in favor of chiropractic. Two of the six more recent WC studies challenge chiropractic effectiveness. CONCLUSIONS: WC studies in general report positive results for chiropractic. Recent results are more ambiguous. Because of the methodological drawbacks identified, WC studies are insufficient to enable a valid study made of chiropractic effectiveness. Therefore, chiropractic (cost-) effectiveness is not yet convincingly proven. More effort should be directed at establishing randomized clinical trials including the question of (cost-) effectiveness.

Accidents, Occupational↗

PubMed1993

Direct versus indirect suggestions: a conceptual and methodological review.

The article reviews the literature on the effects of direct versus indirect hypnotic suggestions. A conceptual and methodological analysis of direct versus indirect suggestions is also provided. Three conclusions follow from the review: (a) Contrary to views of Ericksonian hypnotists, suggestion style has little effect on objective responding to hypnotic test items; (b) studies of clinical- and laboratory-induced pain and other measures of subjective experience have yielded contradictory results--however, the best controlled studies have not indicated that indirect suggestions are superior to direct suggestions; and (c) there is insufficient evidence to conclude that hypnotizability level and suggestion wording interact, such that low hypnotizable subjects are particularly responsive to indirect suggestions. Methodological and conceptual problems in defining and studying hypnotic communications, the lack of rigorous experimental controls, and research issues and directions are highlighted.

Arousal↗

PubMedDate not supplied

Health interview surveys in developing countries: a methodological review.

This review covers cross-sectional health interview surveys in which respondents were asked about their recent illness and their use of preventive and curative health services. Country survey results differed widely, for both morbidity prevalence estimates and health services utilization, reflecting major methodological differences as well as any true differences that may exist between the population groups studied. Comparison of morbidity and utilization rates is thus thwarted by the absence of standardization in survey methodology, methods of analysis, and the classification of results. A lack of theoretical studies upon which to base methodology choices combined with a general lack of rigor in applying the methodologies chosen has limited the interpretation of many surveys carried out to date. The review concludes with a series of specific recommendations for improving the survey methodology of future health interview surveys in less developed countries.

Cross-Sectional Studies↗

PubMed2004

The Menopause Rating Scale (MRS) scale: a methodological review.

BACKGROUND: This paper compiles data from different sources to get a first comprehensive picture of psychometric and other methodological characteristics of the Menopause Rating Scale (MRS) scale. The scale was designed and standardized as a self-administered scale to (a) to assess symptoms/complaints of aging women under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and postmenopause replacement therapy. The scale became widespread used (available in 10 languages). METHOD: A large multinational survey (9 countries in 4 continents) from 2001/ 2002 is the basis for in depth analyses on reliability and validity of the MRS. Additional small convenience samples were used to get first impressions about test-retest reliability. The data were centrally analyzed. Data from a postmarketing HRT study were used to estimate discriminative validity. RESULTS: Reliability measures (consistency and test-retest stability) were found to be good across countries, although the sample size for test-retest reliability was small. VALIDITY: The internal structure of the MRS across countries was astonishingly similar to conclude that the scale really measures the same phenomenon in symptomatic women. The sub-scores and total score correlations were high (0.7-0.9) but lower among the sub-scales (0.5-0.7). This however suggests that the subscales are not fully independent. Norm values from different populations were presented showing that a direct comparison between Europe and North America is possible, but caution recommended with comparisons of data from Latin America and Indonesia. But this will not affect intra-individual comparisons within clinical trials. The comparison with the Kupperman Index showed sufficiently good correlations, illustrating an adept criterion-oriented validity. The same is true for the comparison with the generic quality-of-life scale SF-36 where also a sufficiently close association has been shown. CONCLUSION: The currently available methodological evidence points towards a high quality of the MRS scale to measure and to compare HRQoL of aging women in different regions and over time, it suggests a high reliability and high validity as far as the process of construct validation could be completed yet.

Adult↗

PubMed2000

Economic evaluation studies in nuclear medicine: a methodological review of the literature.

BACKGROUND: The growing need for evaluation of the utility of new nuclear medicine technologies has spawned a few economic studies ranging from preliminary indications of cost savings to complete decision analysis models incorporating costs and quality of life. The objective of the current study was to evaluate the methodological quality of economic analyses of nuclear medicine procedures which targeted cost-effectiveness or cost-utility issues published in the medical literature during the years 1985-1999. METHODS: A computerized literature search was used to identify original investigations from the medical literature which included an economic analysis of a nuclear medicine procedure. Each economic analysis article was evaluated by two independent reviewers for adherence to ten accepted methodological criteria. RESULTS: Of the 29 articles meeting the search criteria, only six (21%) conformed to all ten methodological criteria. CONCLUSIONS: Published economic analyses of nuclear medicine procedures usually do not meet accepted methodological standards and could be significantly improved to achieve overall better quality relative to similar analyses in the literature from other medical fields. Continued improvement in the number and quality of economic studies is critically needed for the future competitiveness of nuclear medicine studies.

Cost-Benefit Analysis↗

PubMed1984

Paradoxical procedures and single-case methodology: review and recommendations.

Recently, paradoxical techniques have been increasingly employed by behavior therapists. The present paper: summarizes case study paradoxical investigations, reviews paradoxical procedures evaluated via intrasubject replication designs, and offers suggestions for continued use of single-case methodology in paradoxical research. Five major design strategies (reversal, time-series, multiple-baseline, simultaneous treatment and changing criterion) are discussed and examples provided within each area. Specific recommendations are made for a further merging of single-case experimental designs and paradoxical therapies.

Agoraphobia↗

PubMed1982

Group treatment of sexual dysfunctions: a methodological review of the outcome literature.

This paper reviewed 36 studies which examined the effects of the group format in the treatment of sexual dysfunctions. The methodological evaluation was conducted within the following sections: subjects, therapists, treatment goals, group composition, time format, treatment, outcome measures and assessment times. Numerous methodological deficiencies were found, most notably the inadequate definitions of dysfunction and treatment success, the failure to control for therapist or expectancy factors, the failure to isolate the specific effects of different treatments, and an absence of control or comparison groups. The data tentatively suggest that a group format is effective in the treatment of female orgasmic dysfunction and secondary erectile dysfunction. Same-sex only groups and couples' groups promote comparable improvements. It is premature to make any conclusive statements regarding the relative efficacy of group and individual treatment formats. Future investigators should examine the specific and relative effects of the various treatment components and explore the potential therapeutic advantages of the group in the treatment of sexual dysfunction.

Adult↗

PubMed1995

Adolescent schizophrenia: a methodologic review of the current neuroimaging and neuropsychologic literature.

This paper reviews all relevant articles that reported structural neuroimaging or neuropsychological data in adolescent patients with schizophrenia. These papers were subsequently examined from a methodological perspective. Few papers have been written that have examined whether adolescent schizophrenia is associated with structural neuroimaging abnormalities or cognitive dysfunction. In these studies, major methodologic issues exist. Therefore, at present, firm conclusions cannot be made regarding the presence or absence of neuropsychologic dysfunction or structural neuroimaging abnormalities in this population. Attention to certain methodologic issues may improve future studies of this topic.

Adolescent↗

PubMed2002

Acne therapy: a methodologic review.

BACKGROUND: Acne is a very common problem with significant physical and psychological morbidity. The evidence basis for its treatment had not been systematically reviewed. Therefore, we performed an evidence review to provide researchers a basis for further studies, and to provide clinicians the background needed to interpret current and future clinical studies. OBJECTIVE: We summarize the methodologic state of the acne literature in patients with acne who do not have complicating co-morbidities. METHODS: This was an expert-advised literature synthesis. We used a structured literature search for English-language controlled trials in Cochrane CENTRAL, MEDLINE, OLDMEDLINE, HSTAT, CINAHL, and PsychInfo. Results underwent a structured data abstraction process, with review by at least 2 reviewers. RESULTS: Out of 1588 unique articles, 250 articles (274 controlled trials) over the past 50 years were reviewed: 57 (21%) trials had at least one major weakness and no strengths; 125 (47%) trials had at least one major strength and at least one major weakness; 48 (18%) trials had at least one major strength, and no major weaknesses. The remaining 16 (6%) were of intermediate quality or did not provide enough information to make a determination. One fourth of studies did not report patient age; one fourth did not report on patient gender. Only 8% mentioned patient race; only 2% mentioned skin type; 0.4% mentioned diet; none scored sexual maturity or insurance status. There were 1237 outcomes. There were more than 25 methods of assessing acne severity and more than 19 methods for counting lesions. There were only two trials that formally assessed psychological outcomes. More than 140 treatments were tested in 251 comparisons. CONCLUSION: Ranging over 50 years of research, the acne literature evidences great heterogeneity at all levels: patient characteristics, acne severity, outcome assessments, treatments, and comparisons. A list of methodologic recommendations is provided.

Acne Vulgaris↗

PubMed2005

Children in reviews: methodological issues in child-relevant evidence syntheses.

BACKGROUND: The delivery of optimal medical care to children is dependent on the availability of child relevant research. Our objectives were to: i) systematically review and describe how children are handled in reviews of drug interventions published in the Cochrane Database of Systematic Reviews (CDSR); and ii) determine when effect sizes for the same drug interventions differ between children and adults. METHODS: We systematically identified all of the reviews relevant to child health in the CDSR 2002, Issue 4. Reviews were included if they investigated the efficacy or effectiveness of a drug intervention for a condition that occurs in both children and adults. Information was extracted on review characteristics including study methods, results, and conclusions. RESULTS: From 1496 systematic reviews, 408 (27%) were identified as relevant to both adult and child health; 52% (213) of these included data from children. No significant differences were found in effect sizes between adults and children for any of the drug interventions or conditions investigated. However, all of the comparisons lacked the power to detect a clinically significant difference and wide confidence intervals suggest important differences cannot be excluded. A large amount of data was unavailable due to inadequate reporting at the trial and systematic review level. CONCLUSION: Overall, the findings of this study indicate there is a paucity of child-relevant and specific evidence generated from evidence syntheses of drug interventions. The results indicate a need for a higher standard of reporting for participant populations in studies of drug interventions.

Adolescent↗