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Objectives: To develop a methodology for evaluating the impact of research on health care, and to characterise the papers cited on clinical guidelines. Design: The bibliographic details of the papers cited in 15 clinical guidelines, developed in and for the United Kingdom, were collated and analysed with applied bibliometric techniques. Results: The median age of papers cited in clinical guidelines was eight years; most papers were published by authors living in either the United States (36%) or the United Kingdom (25%)—this is two and a half times more than expected as about 10% of all biomedical outputs are published in the United Kingdom; and clinical guidelines do not cite basic research papers. Conclusion: Analysis of the evidence base of clinical guidelines may be one way of tracking the flow of knowledge from the laboratory to the clinic. Moreover, such analysis provides a useful, clinically relevant method for evaluating research outcomes and different strategies in research and development.

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Pragmatic trials offer the opportunity to obtain real-life data on the relative effectiveness and safety of a treatment before or after market authorisation. This is the penultimate paper in a series of eight, describing the impact of design choices on the practical implementation of pragmatic trials. This paper focuses on the practical challenges of collecting and reporting safety data and of monitoring trial conduct while maintaining routine clinical care practice. Current ICH guidance recommends that, all serious adverse events (SAEs) and all drug-related events must be reported in an interventional trial. In line with current guidance, we propose a risk based approach to the collection of non-drug related non-serious AEs, and even serious events not related to treatment based on the risk profile of the medicine/class in the patient population of interest. Different options available to support the collection and reporting of safety data whilst minimizing study-related follow-up visits are discussed. A risk-based approach to monitoring trial conduct is also discussed, highlighting the difference in the balance of risks likely to occur in a pragmatic trial compared to traditional clinical trials, and the careful consideration that must be given to the mitigation and management of these risks in order to maintain routine care.

If you prescribe drugs, the pharmaceutical industry is interested in you and is investing a staggering sum of money trying to influence you. The most effective way of changing the prescribing habits of a clinician is through personal representatives (known in Britain as “drug reps” and in North America as “detailers”), who travel round with a briefcase full of “evidence” in support of their wares.1 Pharmaceutical “reps” do not tell nearly as many lies as they used to (drug marketing has become an altogether more sophisticated science), but they have been known to cultivate a shocking ignorance of basic epidemiology and clinical trial design when it suits them.2 It often helps their case, for example, to present the results of uncontrolled trials and express them in terms of before and after differences in a particular outcome measure.3 The recent correspondence in the Lancet and BMJ on placebo effects should remind you why uncontrolled before and after studies are the stuff of teenage magazines, not hard science.4 5 6 7 8 9 10 11 12 Sackett and colleagues have argued that before giving a drug to a patient the doctor should: #### Summary points Pharmaceutical “reps” are now much more informative than they used to be, but they may show ignorance of basic epidemiology and clinical trial design The value of a drug should be expressed in terms of safety, tolerability, efficacy, and price The efficacy of a drug should ideally be measured in terms of clinical end points that are relevant to patients; if surrogate end points are used they should be valid Promotional literature of low scientific validity (such as uncontrolled before and after trials) should not be allowed to influence practice

It has long been assumed by the medical–scientific fraternitythat the intended end-point of research is publication of resultsin a respected journal, there to be read and examined in perpe-tuity. This has been challenged by a distinguished ex-editor ofthis journal, who concluded that the primary aim of manyauthors was not to have their paper accepted for publication[1]. He outlined numerous creative opportunities in the pres-entation of the manuscript to antagonize the reviewer andeditor. We contend that there are simpler, more compellingand less demanding means of antagonizing the statisticalreviewer, thus ensuring certain rejection of the paper. We haveoutlined some of the possibilities available to the novice andexperienced researcher alike, recognizing that it is never toolate to learn and, indeed, Continuing Professional Developmentrequires you to do so.

Purpose: To supply further references by analyzing the status of research on mild cognitive impairment nursing in China. Methods: Papers on mild cognitive impairment nursing published between 2005 and 2014 were collected from China National Knowledge Infrastructure, Wanfang Data, and China Biological Medicine database, while their publication dates, journals, and types were subjected to a bibliometric analysis using NoteExpress and Excel. Results: A total of 68 papers were collected from the selected databases. The number of papers on mild cognitive impairment nursing increased annually. The selected papers were published in 44 journals, 55.88% of them were published in core journals, 35.29% received funding support, 35.29% were published by hospitals affiliated to colleges, 47.06% were published by other local hospitals, author collaboration is 2.66, and 66.18% showed co-authorship. These papers covered a wide range of topics, but were only conducted based on clinical interventions. Around 29.41% of these papers had a citation frequency of over 5, the highest citation frequency was 29, and the highest h-index was 23. Conclusion: Beijing and Shanghai established core author groups for mild cognitive impairment nursing research. These studies should focus on the community and psychological nursing of such impairment. Targeted nursing interventions on different types of mild cognitive impairment should be adopted, new avenues for research should be opened, and various research methods should be introduced. Keywords: Mild cognitive impairment, Nursing, Bibliometric

The study is aimed at presenting new diagnostic and therapeutic proposals for patients with alcohol use disorders. The revised ICD-11 which is currently being updated is coming closer to American standards in disease classification. The latest update of the American DSM-5 has been a notable step forward as it integrates alcohol abuse and alcohol dependence into a single disorder called alcohol use disorder. Recent developments in research into diagnostic tools have brought changes in the approach to therapy. According to most international guidelines, the form of treatment should be customised to the individual patient, with consideration given to his/her mental and physical condition, personality and natural setting. A significant change is the recommendation of a harm reduction strategy as a useful alternative to total abstinence in alcohol dependence treatment for some patients.

The Research Paper of the Year, awarded by the Royal College of General Practitioners, highlights the best research published in the previous year across six clinical categories, with one overall winner. One theme that was evident this year was the importance of partnership with patients. The overall winner of the Research Paper of the Year 2014 was a fascinating study by Jon Banks and colleagues.1 They presented 3469 people with vignettes describing different sets of symptoms, giving them information about the risk that these symptoms represented cancer, along with details of likely treatment and prognosis if cancer was identified. This is very topical, given the recently published National Institute for Health and Care Excellence guidelines on investigation of suspected cancer, which are based on a general principle of recommending investigation for …

Summary The Green Paper Working together for a healthier Scotland is a landmark in the drive to improve health, with a vital emphasis on reducing inequalities. It paves the way for a considered approach to building a health promoting society, with a critical reappraisal of the traditional pre-eminence of disease and behavioural topics. Its three action levels - life circumstances, lifestyle topics and health topics - provide a framework for putting an end to unhelpful quarrels over approaches to health promotion and for doing what is best done at each of the three levels. Against the background of the Green Paper, this paper seeks to facilitate a common understanding among all concerned as a basis for the necessary united effort to promote health, calls for a wider recognition of the full scope of health - including well-being, and identifies implications and opportunities in the areas of research and evidence-based action.

Purpose Over 20 years ago the term non-specific low back pain became popular to convey the limitations of our knowledge of the pathological source of most people's low back pain. Knowledge of underlying pathology has advanced little since then, despite limited improvements in outcomes for patients with low back pain. Methods This paper discusses potential misunderstandings related to diagnostic studies in the field of low back pain and argues that future diagnostic studies should include and investigate pathological sources of low back pain. Results Six potential misunderstandings are discussed. (1) Until diagnosis is shown to improve outcomes it is not worth investigating; (2) without a gold standard it is not possible to investigate diagnosis of low back pain; (3) the presence of pathology in some people without low back pain means it is not important; (4) dismissal of the ability to diagnose low back pain in clinical guidelines is supported by the same level of evidence as recommendations for therapy; (5) suggesting use of a diagnostic test in research is misinterpreted as endorsing its use in current clinical practice; (6) we seem to have forgotten the 'bio' in biopsychosocial low back pain. Conclusions We believe the misunderstandings presented in this paper partly explain the lack of investigation into pathology as an important component of the low back pain experience. A better understanding of the biological component of low back pain in relation, and in addition, to psychosocial factors is important for a more rational approach to management of low back pain.

The scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. This study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiologic and pathological conditions, such as metabolic disease, antibiotic-associated and Clostridium difficile-associated diarrhea, IBS, constipation, IBD, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associated pneumonia, NAFLD, liver encephalopathy, periodontitis, depression, vaginosis, urinary tract infections, pancreatitis, incidence of ventilator-associated pneumonia, hospital infection and stay in ICU, mortality of post-trauma patients, necrotising enterocolitis in premature infants. Only for antibiotic- and Clostridium difficile-associated diarrhea, and respiratory tract infections the effects of probiotics are considered "evidence-based." Concerning other fields, meta-analyses lacks to define type and biologic effect of probiotic strains, as well as the outcome in a disease state. Therefore, the results presented should be a stimulus for further studies which will provide clinical recommendations.

OBJECTIVES: There is an important need to evaluate therapeutic approaches for osteoarthritis (OA) in terms of cost-effectiveness as well as efficacy. METHODS: The ESCEO expert working group met to discuss the epidemiological and economic evidence that justifies the increasing concern of the impact of this disease and reviewed the current state-of-the-art in health economic studies in this field. RESULTS: OA is a debilitating disease; it is increasing in frequency and is associated with a substantial and growing burden on society, in terms of both burden of illness and cost of illness. Economic evaluations in this field are relatively rare, and those that do exist, show considerable heterogeneity of methodological approach (such as indicated population, comparator, decision context and perspective, time horizon, modeling and outcome measures used). This heterogeneity makes comparisons between studies problematic. CONCLUSIONS: Better adherence to guidelines for economic evaluations is needed. There was strong support for the definition of a reference case and for what might constitute "standard optimal care" in terms of best clinical practice, for the control arms of interventional studies.

Background In 2007, the European Society of Physical and Rehabilitation Medicine (ESPRM) established the European Physical and Rehabilitation Medicine Journal Network (EPRMJN) with a view to increase scientific knowledge among physical and rehabilitation medicine (PRM) specialists and to foster collaboration among the national, regional (multinational) and European PRM journals. In this connection, this paper gives the readers of national and regional, and European PRM journals a complete overview of the European Journal of Physical and Rehabilitation Medicine (EJPRM), the official ESPRM journal, and a review of the papers published in 2008. Methods The evolution of the EJPRM in the last five years was analyzed, and the papers published in 2008 were systematically reviewed and classified by content and discussed. Results The EJPRM is listed in PubMed and Current Contents; at now the unofficial 2008 Impact Factor is 1.14, like the Impact Factor, also the independent SCImago Journal Rate and Cites per Doc (two years) have increased steadily since 2005. The EJPRM published 72 papers in 2008, with a well balanced coverage of different rehabilitation topics. The rejection rate is around 40%; the review and publication times are 1.2 and 10.0 months, respectively. The published papers are presented here by topic, highlighting multi-journal initiatives (such as the EPRMJN and the Euro-American Focus with the American Journal of PRM), monographic Special Sections, systematic Cochrane PRM reviews, original papers and case reports, and other contents including the Internet Bookshelf. Conclusion This paper represents the start of the EPRMJN collaborative efforts to increase scientific knowledge among PRM specialists in Europe, independently of the language in which papers are published.

Background: Literature on the health-related quality of life (HRQoL) for men with localized prostate cancer (PCa) on active surveillance (AS) shows a need for methodological guidance regarding HRQoL issues and how to address them. Objective: The European School of Oncology Task Force (ESO TF) aimed to identify a core set of research questions and related measures to include in AS HRQoL studies. Design, setting, and participants: A modified Delphi study was used to reach consensus on AS HRQoL research topics and tools between 2014 and 2015. Data were collected by engaging a multidisciplinary team of 15 experts. Outcome measurements and statistical analysis: An open-ended questionnaire was used to collect information from ESO TF members regarding issues in AS HRQoL research. Then a structured questionnaire was used to collect ratings on the usefulness/importance of different AS HRQoL aspects. Items that ≥80% of ESO TF members rated as useful/important were retained. Items with a 50-80% rating were discussed to reach final agreement. Results and limitations: Six main research questions concerning the selection of outcome measures, measurement tools, and comparison groups were identified as relevant. The core set of measures identified were related to individual characteristics, psychological dimensions; decision-making-related issues, and physical functioning. The multidisciplinary expertise of ESO TF members was a significant asset, even if bringing different backgrounds to the discussion table represented a challenge. Conclusions: HRQoL measures have to be sensitive to the specific needs of men on AS. The definition of HRQoL outcomes will enhance a broader understanding of the HRQoL of men on AS and sustain patient-centered medicine. Patient summary: An international panel agreed on a set of health-related quality-of-life aspects to be assessed among men on active surveillance for prostate cancer. Valid relevant questionnaires were identified. The experts' indications lay a foundation for future research and clinical practice. A multidisciplinary team of experts on active surveillance for prostate cancer defined a set of health-related quality-of-life outcomes and measures to be used to design future studies. Such studies will eventually provide information to guide treatment decision-making and more closely address patient well being.

Trainees seeking membership of the Royal College of Psychiatrists must, through Paper B examinations, demonstrate understanding of critical review, statistical methods and evidence-based practice. This ensures that no psychiatrist progresses through training without an appreciation of how the

BACKGROUND: Sponsors that seek to commercialize new drugs apply to the Food and Drug Administration (FDA) which independently analyzes the raw data and reports the results on its website.OBJECTIVES: This study sought to determine if there are differences between the FDA assessments and journal reports on biologic agents developed for the treatment of rheumatoid arthritis.METHODS: Available data on FDA-approved drugs were extracted from the website, and a systematic literature search was conducted to identify matching studies in peer-reviewed medical journals. Outcome measures were the American College of Rheumatology response criteria ACR20 (efficacy) and withdrawal due to adverse events (safety). As effect size odds ratios were estimated for each active trial arm vs. control arm (i.e. for both sources: FDA and journal report), followed by calculation of the ratios of the FDA and journal report odds ratios. A ratio of odds ratios not equal to 1 was categorized as a discrepancy.RESULTS: FDA reports were available for 8 of 9 FDA-approved biologic agents for rheumatoid arthritis; all identified trials (34) except one were published in peer-reviewed journals. Overall, discrepancies were noted for 20 of the 33 evaluated trials. Differences in the apparent benefit reporting were found in 39% (24/61) pairwise comparisons and in 11 cases these were statistically significant; the FDA report showed greater benefit than the journal publication in 15 comparisons and lesser benefit in 9. Differences in the reported harms were found in 51% (28/55) pairwise comparisons and were statistically significant in 5. The "signal" in FDA reports showed a less harmful effect than the journal publication in 17 comparisons whereas a more harmful effect in 11. The differences were attributed to differences in analytic approach, patient inclusion, rounding effect, and counting discrepancies. However, no differences were categorized as critical.CONCLUSION: There was no empirical evidence to suggest biased estimates between the two sources. Increased and detailed transparency in publications would improve the understanding and credibility of published results. Further, the FDA report was found to be a useful source when data are missing in the published report (i.e. reporting bias).

Clinical guidelines, defined as ‘systematically developed statements to assist both practitioner and patient decisions in specific circumstances, have become an increasingly familiar part of clinical care. A central challenge in Primary Care is the question of how do we act in the field of atypical courses of diseases or clinical symptoms beside the spectrum of EBM and how could this gap be measured in scientific literature. Main purpose of this paper is a brief analysis of the actual role and evidence of clinical case reports and case series in primary care as a basis for a scientific discussion. According to the scientific-accepted Oxford levels of evidence case reports and case series belong to the level 4 of evidence. At present a significant majority of published case reports deal with descriptions of physician’s care following their clinical intuition beside the pathways of randomized controlled trials (RCT) or guidelines. Clinical symptoms of many cases will add up to what we would recognize as a ‘medical’ condition, but in up to 19% they are vague, non-specific and/or contradictory and the management of patients with such undefined symptoms can pose a daunting challenge. Even randomized controlled trials are the gold standard in clinical research and systematic reviews and meta-analysis have the highest level of evidence, there is still a need for well-prepared case reports; for instance to describe rare adverse drug effects.

More than 500 journals have adopted the uniform requirements of the International Committee of Medical Journal Editors, which stipulate that authors should “indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation.”1 One major purpose of institutional review is to ensure that informed consent is obtained when possible. We investigated how often research publications about child health report ethics committee approval or informed consent. We reviewed all research reports related to child health (involving patients

The purpose of this paper is to review the importance of malaria research in global health care settings and the lack of contribution from Japan. A report from the Wellcome Trust in 1996 discussed the pressing need for research in the field of malaria. The report concluded that the global investment on malaria research was very low compared with other diseases areas. Though, Japan has become the second largest country after USA in terms of the number of scientific papers, Japan's contribution on malaria research is quite weak. Japan had only 1 percent of world's output of malaria research indexed in PubMed/Medline. By analyzing two databases of grants-in-aids from Japanese Government, the share of expenditure on malaria research in Japan was very small. As malaria has to be recognized as a major threat to world health, Japan's contribution on malaria research is now required.

The year 2011 was very interesting regarding new studies, trials and guidelines in the field of lipidology, hypertensiology and nephrology. Suffice it to mention the new European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines on the management of dyslipidaemias, American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) guidelines on hypertension in the elderly, and many important trials presented among others during the American Society of Nephrology (ASN) Annual Congress in Philadelphia and the AHA Annual Congress in Orlando. The paper is an attempt to summarize the most important events and reports in the mentioned areas in the passing year.

Osteoporosis is a systemic disease of the bone that affects millions of people and causes burden for both the affected individual and health systems and societies worldwide. Since the 1970s much research has been done in the field of osteoporosis. The number of citations of a paper reflects its influence and importance to the field. Thomson ISI Web of Science database was searched to retrieve a list of the fifty most cited articles related to osteoporosis and its research. The fifty most cited articles in absolute numbers in the field of osteoporosis were cited from 877 to 3056 times (mean1141±537). Most papers were published in the basic science category(n=23). 395 authors contributed; a single paper had between one and 62 authors (mean:10.02±9.9authors). 12 authors (3.04%) contributed between 7 and 4 papers; 340 authors (86.1%) were at least named once. Corresponding authors were from eight countries with most contributions from the United States (n=34, 68%). The majority of papers were published in the 1990s(n=29). The list of 50 most cited papers presents citation classics in the field of osteoporosis and related research.

Health secretary Alan Milburn this week published proposals for a reform of the Mental Health Act 1983, as part of his plans to modernise the NHS in England and Wales. Patients discharged from psychiatric hospitals will be given orders specifying where they will live and what treatment they will have. If they break the terms of the order, they will be returned to hospital for compulsory treatment. Meanwhile the government's recent proposals for the permanent detention of people with personality disorder were heavily criticised by psychiatrists at a joint conference held by the Royal Society of Medicine and Royal College of …

BACKGROUND: The Canadian Clinical Practice Guidelines (CPGs) for the management of asthmatic patients were last published in 1999, with updates in 2001 and June 2004. Large disparities exist in the implementation of these guidelines into clinical practice.OBJECTIVE: The present study evaluated the knowlege of Quebec-based primary care physicians regarding the CPGs, as well as patient outcomes before and after introducing physicians to a new clinical tool – a memory aid in the form of a self-inking paper stamp checklist summarizing CPG criteria and guidelines for assessing asthmatic patient control and therapy. The primary objective of the present study was to assess whether the stamp would improve physicians’ knowledge of the CPGs, and as a secondary objective, to assess whether it would decrease patient emergency room visits and hospitalizations.METHODS: A prospective, randomized, controlled study of 104 primary care physicians located in four Quebec regions was conducted. Each physician initially responded to questions on their knowledge of the CPGs, and was then randomly assigned to one of four groups that received information about the CPGs while implementing an intervention (the stamp tool) aimed at supporting their decision-making process at the point of care. Six months later, the physicians were retested, and patient outcomes for approximately one year were obtained from the Régie de l’assurance maladie du Québec.RESULTS: The stamp significantly improved physicians’ knowledge of the CPGs in all Quebec regions tested, and reduced emergency room visits and hospitalizations in patients who were followed for at least one year.CONCLUSION: A paper stamp summarizing CPGs for asthma can be used effectively to increase the knowledge of physicians and to positively affect patient outcomes.

Journal clubs have traditionally been important means by which clinicians, academics and trainees appraise research that relates to their field. In recent years the evidence-based style has become more prevalent, allowing knowledge gleaned from research to be applied to clinical situations. Currently, the main approach of evidence-based journal clubs is quantitative. This paper describes the evaluation of a modified journal club format, developed in an academic department of a medical school and combining the appraisal of both qualitative and quantitative papers.

The recent study by Taft and colleagues, which explores communication differences in paper versus electronic health records (EHRs), was both interesting and timely.1 EHRs are becoming a focal point for healthcare delivery in the US, yet the impact of EHRs on the patient-provider relationship remains poorly understood. Communication is at the heart of this relationship, and providers are concerned about the potential for EHRs to reduce the quality of their communications with patients.2,3 We would like to provide additional thoughts on Taft et al .’s reported findings and put them into a broader context. First, it is interesting to note that the authors found that EHRs fostered better communications with patients across nearly all measures. However, we wonder what might explain why a physician would greet a patient more warmly when walking into an exam room with a laptop computer vs. a paper chart. This …

The Royal College of General Practitioners Research Paper of the Year Award showcases the excellence of research in primary health care conducted in the UK or Republic of Ireland. This year, prizes for the best papers published in 2013 were awarded in six categories aligned to the NIHR Clinical Research Network divisions with one overall winner. The winning papers include large, hugely ambitious studies using a range of sophisticated research methods. Notably this includes three randomised-controlled trials of complex interventions that are challenging to both implement and evaluate. The 2013 Research Paper of the Year was awarded to Mark Ledwidge and colleagues for the STOP-HF trial of a screening programme using brain-type natriuretic peptide to identify asymptomatic patients at high risk of heart failure, followed by collaborative care to optimise their treatment.1 …

Do probiotic preparations for humans really have efficacy? by Marika Mikkelsaar et al. is the result of hard work throughout almost two years. The 4 authors are/have been distinguished members of the board or in the inner circle of SOMED. Ever since the Rome Workshop on Probiotics February 25-27, 2010 they have worked on the answer to the difficult question they had been given, reflected in the title above. Everyone working in the probiotic field knows the many difficulties when evaluating experimental and clinical reports. The experienced authors were of course aware of that, and they have handled the data in a very balanced way, making the report a very valuable Position Paper. It is a pleasure for me recommending readers of MEHD to carefully go through this paper as well as the relevant references given. I am sure they will find a lot of valuable information for their own research as well as for their clinical practice. It goes without saying that if anyone has comments or questions, please feel free to address them to MEHD. I can promise a rapid publishing. Tore Midtvedt Editor-in-Chief (Published: 6 December 2011) Citation: Microbial Ecology in Health & Disease 2011, 22 : 11620 - DOI: 10.3402/mehd.v22i0.11620

Journal publication of material presented at medical conferences is vital in propagating research to the global community. The peer review process provides a rigorous assessment and critique of scientific methodology and helps ensure research remains relevant. Therefore, journal publication rates of material presented at meetings is a significant marker of the research quality of the meetings and their participants (1). Impact factors (IF) of journals are determined by dividing the number of citations articles receive by the number of citable articles over a period of time and is considered a marker of the scientific quality of a journal (2). The IF of the journal in which an article is published is therefore a partial marker of the scientific quality of that study.

Medical journals, unlike their basic science cousins, are the link between medical science and practice. Not only do they seek to disseminate new knowledge, but they also intend to influence outcomes - the application of new knowledge to the treatment of patients. But this laudable goal creates a dilemma: who are medical journals actually for? The scientists or the doctors? Or perhaps the small group of specialists who are both?

We have concerns about the editorial process involved in the publication of Sharma and colleagues’ article.1 The article is fundamentally flawed in presentation and logic, and the results were further misrepresented by The BMJ press release. The BMJ is highly regarded and anything it publishes will probably be taken as fact by journalists and the public. It is therefore crucial that The BMJ operates with the highest levels of peer review scrutiny and editorial comment. Depression in young people is underdiagnosed and undertreated.2 Parents often feel conflicted or guilty. Suicide is a highly emotional topic and the claim that antidepressants increase suicide in young people is likely to …

AIMS: To examine how countries differ in attitudes to adverse drug reactions by examining published scientific papers. METHODS: We searched Ovid EMBASE for publications indexed by the category "therapeutic agents", and the subcategory "adverse effects", by country for 43 countries. RESULTS: We counted 1 810 202 papers world-wide regarding therapeutic agents during 14 years, of which 195 154 (10.8%) were included in the adverse effects subcategory. There were substantial differences between countries, not explained by population, economic variation, overall publication rate on therapeutic agents, or the presence of large indigenous pharmaceutical companies. CONCLUSIONS: Many local cultural factors influence the ratio of papers on adverse reactions to all drug effects, so it may be difficult to improve their recognition and reporting by international efforts.

In recognition of the high standard of papers submitted to the Scandinavian Journal of Primary Health Care, the editorial board in collaboration with the Nordic Federation of General Practice and the Nordic Congress of General Practice proudly announce the Paper of the Year Award 2013 and 2014. Candidates will be selected among all first authors of papers published in the Scandinavian Journal of Primary Health Care in 2013 and 2014.

The quality of published research is highly variable and it is critically important for the busy clinicians to be able to appraise published papers and make up their own mind about the evidence that is presented in the papers read. To be able to do this reader does not necessarily need to be an expert in research methodology or a statistician. We in this article present some basic information and a list of questions which when asked systematically would help the readers appraise a scientific paper.

Education and health are two of the most valued goods of human existence. The wellbeing of society is largely determined by the content and quality of health and education passed from one generation to the next. Upon the education of present and future osteopaths the fate of osteopathy and osteopathic medicine depends. We are asking you to share your ideas about education in the pages of the International Journal of Osteopathic Medicine. Osteopathy exists in its practitioners. The culture that we have and outwardly express publicly defines us. Osteopathic education and the institutions are where that dynamic culture exists and are at the heart of the osteopathic profession. These institutions have a fundamental

In this series we address key topics for clinicians who conduct research as part of their work in the ED. Analysis of research data does not represent the completion of a project as the findings need to be communicated to clinicians and other researchers in the field. In this section, we describe how to write up clinical research data for publication in a peer-reviewed journal. We also describe the editorial and peer-review process.

Adaptive clinical trials attract great attention from academia, industry and regulatory authorities. Both the European Medicines Agency and the US FDA have clarified their positions in recently issued (final or draft) guidance documents. With this background, current trends and issues were analyzed in a panel discussion at the International Society for Biopharmaceutical Statistics (ISBS) meeting in March 2011. In this article, members of the panel summarize their thoughts based on this discussion.

Academics need to beware of the dangers of flattery, says Per Aspenberg In February 2015, I was invited to join an academic working group to analyse procedures for increasing bone mass, structure, and strength through “intraosseous interventions.” The group, which included some of the world’s most prominent osteoporosis researchers, was meeting at a luxury hotel in Switzerland as part of the preparations for the world congress on osteoporosis. I was asked to give a presentation on “currently available orthopaedic procedures for bone enhancement.” The subject puzzled me, because there are no such procedures. But I was flattered by the invitation so rather than decline I spent several days preparing a presentation in which I concluded that prophylactic surgery in osteoporosis was not a good idea. One week before the meeting I received an email from a professional medical writer, attaching a synopsis for the meeting in which I …