AIM To determine the efficacy of probiotic supplementation on intestinal transit time (ITT) and to identify factors that influence these outcomes. METHODS A systematic review of randomized controlled trials (RCTs) of probiotic supplementation that measured ITT in adults was conducted by searching MEDLINE and EMBASE using relevant key word combinations. Main search limits included RCTs of prob...

BACKGROUND As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study method rather than also appraising the key elements of study design. A long-standing debate regarding findings of randomized...

BACKGROUND Publication of clinical research findings in prominent journals influences health beliefs and medical practice, in part by engendering news coverage. Randomized controlled trials (RCTs) should be most influential in guiding clinical practice. We determined whether study design of clinical research published in high-impact journals influences media coverage. METHODS AND FINDINGS We ...

OBJECTIVE The aim of the study was to investigate how doctors considered and experienced the concept of equipoise while recruiting patients to randomized controlled trials (RCTs). STUDY DESIGN AND SETTING In-depth interviews with 32 doctors in six publicly funded pragmatic RCTs explored their perceptions of equipoise as they undertook RCT recruitment. The RCTs varied in size, duration, type o...

CONTEXT Previous studies indicate that the interpretation of trial results can be distorted by authors of published reports. OBJECTIVE To identify the nature and frequency of distorted presentation or "spin" (ie, specific reporting strategies, whatever their motive, to highlight that the experimental treatment is beneficial, despite a statistically nonsignificant difference for the primary ou...

Using detailed data on gifts, loans, and asset sales, this paper investigates how rural Filipino households deal with income and expenditure shocks. We find that shocks have a strong effect on gifts and informal loans, but little effect on sales of livestock and grain. Mutual insurance does not appear to take place at the village level; rather, households receive help primarily through networks...

BACKGROUND JAMA introduced a requirement for independent statistical analysis for industry-funded trials in July 2005. We wanted to see whether this policy affected the number of industry-funded trials published by JAMA. METHODS AND FINDINGS We undertook a retrospective, before-and-after study of published papers. Two investigators independently extracted data from all issues of JAMA publishe...

Ecological evidence has suggested that health systems with a strong orientation towards primary care achieve lower overall costs, better satisfaction of their populations, and better health. Relevant research is essential to informing best practice in primary care settings, as this may be different to best practice in secondary or tertiary settings. However, several barriers have been described...

BACKGROUND Some studies have indicated the efficacy of quetiapine in the treatment of bipolar depression in adult patients. However, its efficacy has been not shown in child and adolescent patients. OBJECTIVE This systematic review purposefully determined the efficacy and acceptability of quetiapine in the treatment of children and adolescents with bipolar depression. DATA SOURCES A databas...

OBJECTIVE In clinical trials of RA, it is common to assess effectiveness using end points based upon dichotomized continuous measures of disease activity, which classify patients as responders or non-responders. Although dichotomization generally loses statistical power, there are good clinical reasons to use these end points; for example, to allow for patients receiving rescue therapy to be as...