Misuse and misinterpretation of subgroup analysis

Originally posted on EC EBM:

Misuse and misinterpretation of subgroup analysis Misuse and misinterpretation of subgroup analysis

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Ethics and equity in research priority-setting: stakeholder engagement and the needs of disadvantaged groups

A transparent and evidence-based priority-setting process promotes the optimal use of resources to improve health outcomes. Decision-makers and funders have begun to increasingly engage representatives of patients and healthcare consumers to ensure that research becomes more relevant. However, disadvantaged groups and their needs may not be integrated into the priority-setting process since they do not have a “political voice” or are unable to organise into interest groups. Equitable priority-setting methods need to balance patient needs, values, experiences with population-level issues and issues related to the health system.
Read the full paper published by Dr. Soumyadeep B et al at Indian Journal of Medical Ethics here (Click: Open Access)

Child and Adolescent Psychiatry in India Part 4: Attachment Theory in the slums of Kolkata

Originally posted on Child Psychiatry OOPE at Calcutta Rescue:

In the not so distant past, academics and clinicians alike debated the relative influence of the environment on the developing mind. At one extreme were those that saw the mind as a ‘tabula rasa’ stating the mind was completely shaped by the environment and experience. At the other were those who believed the child’s innate way of being was the deciding factor. We now know a child’s mind develops through a complex interaction between their environment and genes, with both playing a crucial role. So for example, the presence of a certain gene responsible for reduced levels of an enzyme monoamine oxidase A (MAOA) in the brain places you at greater risk of developing aggressive and antisocial personality traits as an adult. However, that risk is only realised when that child grows up in an abusive or traumatic environment.

One area of child development that is predominately effected by environmental…

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Cost-effectiveness of interventions to control cardiovascular diseases and type 2 diabetes mellitus in South Asia:

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) together contribute to the largest burden of morbidity (14% of disability-adjusted life years) and mortality (over 30% of all deaths) in South Asia.T2DM doubles the risk of developing CVD, and approximately half of patients with T2DM are known to be hypertensive.By 2030, it is projected that there will be 120.9 million people with diabetes in South Asia (90–95% of these will have T2DM), more than double the number affected in North America or Europe.

South Asians experience higher case fatality rates and rates of premature death due to CVD (deaths occurring at least 10–15 years younger) than the rest of the Western world.A report in 2010 suggested that the total annual income loss to households affected by CVDs in India was 144–158 billion INR. The WHO estimates that India will lose US$237 billion due to heart disease, stroke and diabetes, which will slow the growth in India’s GDP (gross domestic product) by 1% over the next 10 years, thereby contributing to poverty. The mortality and morbidity due to CVD/T2DM thus impose a huge economic burden on individuals, families and society, the health system, and the economy as a whole.

CVD and T2DM share various common risk factors (unhealthy diet, physical inactivity, tobacco use, high blood pressure, dyslipidaemia and stress), and hence there is considerable overlap in strategies used to control these diseases.

While the efficacy and safety of various interventions have been tested by several randomised controlled clinical trials and subsequent systematic reviews and meta-analyses, little is known about the cost-effectiveness of these interventions from the perspective of either the patient or the healthcare system.

Full Systematic Review Protocol on the issue was published by Singh K , Sekaran AMC , Bhaumik S et al  recently in BMJ Open and is available here (Click) (Open Access )

So-Called “Special” Issues of Journals: Big Money for Gold OA Publishers

Originally posted on Scholarly Open Access:

journal special issues Vicious cycle

Special issues of journals mean big money for gold (author-pays) OA publishers. It’s a type of affinity marketing. The special issue guest editor typically invites his contacts and colleagues to contribute papers for a special issue on a topic, and they all have to pay author fees to the publisher. 

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Too much medical research may be unnecessary, unethical, unscientific, and wasteful, warns new international research network

Researchers, research funders, regulators, sponsors and publishers of research fail to use earlier research when preparing to start, fund or publish the results of new studies. To embark on research without systematically reviewing evidence of what is already known, particularly when the research involves people or animals, is unethical, unscientific, and wasteful.

To address this problem a group of Norwegian and Danish researchers have initiated an international network, the ‘Evidence-Based Research Network’ (EBRNetwork). The EBRNetwork brings together initial partners from Australia, Canada, Denmark, the Netherlands, Norway, the UK, and USA was established in Bergen, Norway in December 2014. It also has members from low and middle income nations like India, South Africa and Brazil.

At the ‘Bergen meeting’ partners agreed the aim of the EBRNetwork is to reduce waste in research by promoting:

No new studies without prior systematic review of existing evidence

Efficient production, updating and dissemination of systematic reviews

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Logo of the new Evidence Based Research Network

My take : In real terms this signifies a tactical shift of the way medical research is conducted and funded globally and bring in more objectivity into funding decisions . The current system of research funding is flawed and decisions are often not on the scientific need of the research to be conducted but on peer-perceptions. It will also prevent policy makers to be mis-guided by scientist who are prone to hype their own agenda for causes of career progression.

Note : The information provided here is adapted from the press release by network together with some personal opinions.  Dr. Soumyadeep Bhaumik is one of the members of the network.

To tweet or not to tweet…at conferences

Originally posted on The Contemplative Mammoth:

Live-tweeting, whether a department seminar or a conference talk, is one of the most powerful aspects of academic Twitter I’ve witnessed. It’s not an easy skill, but it’s worth cultivating, because it has tremendous value in bringing exciting research to a broad audience. Instead of the twenty to two hundred people in the room, you have the potential to reach thousands, and generate exciting conversations — what I often refer to as the “meeting within the meeting” that only takes place in the ether.

Live-tweeting also helps me focus more — I personally get more out of talks I tweet than ones I don’t. I sometimes refer to it as my superpower, because I have a special knack for distilling a talk into 140-character sound bites, and a high WPM to match. Live-tweeting usually gets me a handful of new followers, too, which is a good indication that folks are finding the…

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