Search

This study established the clinical conclusiveness of Cochrane reviews (CRs) in family nursing. We extracted relevant characteristics of CRs to determine the methods of obtaining high-level evidence for family nursing. We performed a systematic search of all CRs on family nursing published in the Cochrane Library between January 2014 and April 2023. After screening 1212 titles and abstracts, we identified seven potentially relevant articles. Upon reviewing their full texts, we included six CRs with a total of 34 interventions. Of these, 22 (64.7%) interventions were conclusive and 12 (55%) were inconclusive. Thus, the number and percentage of conclusive CRs is lower in family nursing versus other fields. [ABSTRACT FROM AUTHOR]

Abstract Background One of the most important formats to disseminate the evidence in health to different populations are Cochrane Plain Language Summaries (PLSs). PLSs should be written in a simplified language, easily understandable and providing clear message for the consumer. The aim of this study was to examine the extent to which PLSs are customized for lay persons, specifically by providing conclusive, comprehensible, and readable messages. Methods The study analyzed Cochrane PLSs of interventional studies (N = 4360) in the English language published from 1995 to 2019. We categorized the conclusiveness into one of the following categories: “positive”, “positive inconclusive”, “no evidence”, “no opinion”, “negative”, “negative inconclusive”, “unclear”, “equal”, “equal inconclusive”. Language characteristics were analyzed using Linguistic Inquiry and Word Count (LIWC) software. The level of readability was measured by SMOG (Simple Measure of Gobbledygook) index, indicating the number of years of education required to read the text. For each PLS, we also collected the following data: Cochrane Review Network, year of publication and number of authors. Results Most of the PLSs (80%) did not have a conclusive message. In 53% PLSs there was no concluding opinion about the studied intervention or the conclusion was unclear. The most frequent conclusiveness category was “no opinion” (30%), and its frequency increased over time. The conclusiveness categories were similarly dispersed across Cochrane Networks. PLSs were written in an objective style, with high levels of analytical tone and clout above neutral, but a lower relation to authenticity and tone. The median number of years of non-specific education needed to read the PLSs was 14.9 (IQR 13.8 to 16.1), indicating that the person needs almost 15 years of general education to read the content with ease. Conclusion Most of the Cochrane PLSs provided no concluding opinion or unclear conclusion regarding the effects of analyzed intervention. Analysis of readability indicated that they may be difficult to read for the lay population without medical education. Our results indicate that PLSs may not be so plain, and that the writing of Cochrane PLSs requires more effort. Tools used in this study could improve PLSs and make them better suited for lay audiences.

Background: One of the most important formats to disseminate the evidence in health to different populations are Cochrane Plain Language Summaries (PLSs). PLSs should be written in a simplified language, easily understandable and providing clear message for the consumer. The aim of this study was to examine the extent to which PLSs are customized for lay persons, specifically by providing conclusive, comprehensible, and readable messages.Methods: The study analyzed Cochrane PLSs of interventional studies (N = 4360) in the English language published from 1995 to 2019. We categorized the conclusiveness into one of the following categories: "positive", "positive inconclusive", "no evidence", "no opinion", "negative", "negative inconclusive", "unclear", "equal", "equal inconclusive". Language characteristics were analyzed using Linguistic Inquiry and Word Count (LIWC) software. The level of readability was measured by SMOG (Simple Measure of Gobbledygook) index, indicating the number of years of education required to read the text. For each PLS, we also collected the following data: Cochrane Review Network, year of publication and number of authors.Results: Most of the PLSs (80%) did not have a conclusive message. In 53% PLSs there was no concluding opinion about the studied intervention or the conclusion was unclear. The most frequent conclusiveness category was "no opinion" (30%), and its frequency increased over time. The conclusiveness categories were similarly dispersed across Cochrane Networks. PLSs were written in an objective style, with high levels of analytical tone and clout above neutral, but a lower relation to authenticity and tone. The median number of years of non-specific education needed to read the PLSs was 14.9 (IQR 13.8 to 16.1), indicating that the person needs almost 15 years of general education to read the content with ease.Conclusion: Most of the Cochrane PLSs provided no concluding opinion or unclear conclusion regarding the effects of analyzed intervention. Analysis of readability indicated that they may be difficult to read for the lay population without medical education. Our results indicate that PLSs may not be so plain, and that the writing of Cochrane PLSs requires more effort. Tools used in this study could improve PLSs and make them better suited for lay audiences. [ABSTRACT FROM AUTHOR]

Foodborne diseases, especially those caused by zoonotic agents, pose a significant threat to human health. Food business operators are therefore responsible for producing safe food. To do this, they must regularly carry out appropriate sample investigations to detect zoonotic agents in their food before it leaves the factory. Depending on the issue investigated, there may be legal requirements for food business operators, usually specifying minimum sample sizes, such as Commission Regulation (EU) No 2073/2005. However, in most cases, there is no information on the precision, and therefore, on the significance of the results for these sample sizes. Regulatory veterinary authorities have a control function and, as a result, they are required to regularly evaluate the available investigations and their results. In addition, in certain crisis situations (e.g., foodborne outbreaks or suspected food contamination), authorities may guide food business operators in their investigations and conduct their own investigations to assess food safety measures. In such cases, as there are no legally defined sample sizes to be taken, the appropriate sample sizes must be determined by the authorities. This can lead to a conflict between the need for feasibility and the need for conclusiveness of the investigation potentially being a challenge for the regulatory authority in charge. This paper highlights the importance of thoughtful study design and the critical communication of available results by veterinary authorities on the background of a use case involving Listeria monocytogenes findings in a crisis situation. Using the minimum sample size, n = 5, required by Commission Regulation (EU) No 2073/2005 for the pathogen Listeria monocytogenes as a guide, the uncertainties associated with small sample sizes are highlighted. It also aims to facilitate the evaluation of studies performed and the assessment of further sample sizes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Some Cochrane reviews were declared stable or closed, that is, not in need of updating. For some of them, it has been declared that conclusions will not (or it is unlikely they will) change with further studies. We explored whether there is a discernable decision‐making pattern for decisions about the conclusiveness and stabilization of these reviews. We analyzed Cochrane reviews published until April 2020 labeled as stable or closed. We extracted the rationale leading to the decision declaring that the conclusion is not expected to change with further studies. Furthermore, we assessed whether the reviews used GRADE analysis. We extracted data from summary of findings (SoF) tables on the direction of effect, statistical significance, and I2 values for the first and primary outcomes in SoFs, conclusions in the abstract and review, and implications for practice and future research. We included 40 stable/closed Cochrane reviews. Rationales for their stabilization did not enable any insight into the Cochrane's decision‐making algorithm for considering the evidence as conclusive. Among 191 outcomes presented in the SoFs, 70% were rated with either low or very low certainty evidence. None of the reviews mentioned in the text that the review should be stabilized or closed, or that there is sufficient evidence on the subject. Reasons for stabilizing/closing Cochrane reviews were unclear, and we could not discern any pattern of "conclusive review" traits. Definition of systematic review conclusiveness is still lacking, which may contribute to research waste. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the conclusiveness of Cochrane Reviews (CRs) in oncology nursing., Methods: We searched systematically for all CRs published in the Cochrane Library in the oncology nursing field between January 2014 and April 2023. We analyzed the difference between conclusive and inconclusive outcomes using the χ 2 and Mann-Whitney U -tests and identified 430 articles. However, we excluded 385 articles after reviewing their titles and abstracts. We assessed 45 full-text articles for eligibility and identified 32 articles. Of the 32 articles, we extracted 19 interventions., Results: The overall outcomes were 182 cases, with 51.6% (n = 94) and 48.4% (n = 88) demonstrating conclusiveness and inconclusiveness, respectively. Regarding conclusiveness, 28.0% (n = 51) and 23.6% (n = 43) reported that the studied interventions were effective and ineffective, respectively. We found that studies on interventions related to physical activity and yoga had significantly high rates of conclusive. Compared with inconclusiveness outcomes, conclusive outcomes involved significantly more studies ( p < 0.001) and patients ( p < 0.001)., Conclusions: Ultimately, these findings reveal that in the oncology nursing field, only 51% of the main outcomes of each nursing intervention in CRs were conclusive., Competing Interests: None, (Copyright © Japan Medical Association.)

In recent years, traditiones were often characterised as "party-neutral authentications" with legal power. But there are arguments against this view, since noblemen tended to register legal acts only occasionally within monastic traditiones. Apparently, they didn't assign them any official credibility. There is also no proof that traditiones were recognised as legal evidence in court. More likely, they were considered as memory aid in oral contracts, even when the notoriousness could guarantee the legal continuity in excess of the witnesses proof.

Background: It is challenging to keep systematic reviews (SR) current and updated. Cochrane designated some of its SRs as "stable," that is, not in need of updating. The issue of stabilizing an SR is an important in research synthesis, because it could help reduce research waste. The aim of this study was to analyze publicly available justifications for stabilizing a Cochrane review, with the ultimate goal of helping to make decisions about whether the update of any SR is warranted. Methods: We analyzed Cochrane reviews labeled as stable in Archie, Cochrane's system for managing the editorial/publishing process. From the "What's new" section of the reviews in the Cochrane Library, we extracted justification for stabilization. Results: We included 545 Cochrane reviews labeled in Archie as stable on October 28, 2019. The most common of the five reasons for stabilization was that "last search did not identify any potentially relevant studies likely to change conclusions" (N = 99; 18%), followed by "research area no longer active" (N = 86; 16%), "review is or will be superseded" (N = 41; 7.5%), "evidence is conclusive" (N=35; 6.4%), and "intervention no longer in general use" (N = 34; 6.2%). For the 269 (49%) Cochrane reviews, we considered that the justification for stabilization was not clearly described, that is, sufficiently informative. Conclusions: Cochrane reviews would benefit from more transparency and consistency in publicly available justifications for stabilizing reviews. Further work in this field will help make decisions about the futility of further research and deciding on enough evidence in the field of research synthesis. [ABSTRACT FROM AUTHOR]

In recent years, traditiones were often characterised as "party-neutral authentications" with legal power. But there are arguments against this view, since noblemen tended to register legal acts only occasionally within monastic traditiones. Apparently, they didn't assign them any official credibility. There is also no proof that traditiones were recognised as legal evidence in court. More likely, they were considered as memory aid in oral contracts, even when the notoriousness could guarantee the legal continuity in excess of the witnesses proof. [ABSTRACT FROM AUTHOR]

To assess the conclusiveness of the Cochrane reviews (CRs) in the field of palliative and supportive care for cancer. We searched the CRs on Pain, Palliative, and Supportive Care Group available in the Cochrane library on February 01, 2015, to analyze whether a CR could reach a clinical decision. Each CR was analyzed for conclusiveness, number of randomized controlled trials (RCTs) enrolled, number of participants enrolled, the need for further studies, and the reasons. Only 45% (30 of 66) of the CRs reached definitive clinical recommendations. The number of RCTs and participants enrolled in conclusive CRs were significantly higher than those in inconclusive CRs. Nearly all CRs recognized the need for further studies. The conclusiveness was not affected by the year of publication. We concluded that a large number of clinical trials were not carried out well in the palliative and supportive oncology. [ABSTRACT FROM AUTHOR]

According to Article 172 (12) of the Criminal Procedure Code „After the finalisation of the fact-finding report, whenever the judicial body considers necessary the opinion of an expert or whenever the conclusions of the fact-finding report are contested, an expertise shall be ordered to be made". This legal text is not correlated with the rest of the provisions of the Criminal Procedure Code in force, nor with the other provisions of the previous codes, therefore, in the author's opinion, this fact is likely to give rise to controversies. In a different line of ideas, the author argues that the legislator imposes as processual remedy that upon the finalization of the fact-finding report, in case its conclusions are only contested, to order an expertise to be conducted. This hypothesis is even more questionable as there is the possibility that the judicial body appreciates that the opinion of such an expert is not necessary. Thus, the legislator acts instead of the place of the judicial body in deciding on the admissibility of such means of evidence. Starting from such an inadvertence, in a given case, although the judicial body has concluded on the lack of utility and conclusiveness of an expertise, taking into account that one of the subjects to the trial, a defendant in this case, has contested the conclusions of some previous technical-scientific reports and even of an initial expertise report, both the prosecutor, during the phase of criminal prosecution, and the judge, during the phase of trial, had to admit, according to the text ot the law, the contestation or the application of that subject to the trial respectively and thus to order an expertise to be conducted. The author believes that the mentioned text provision is also contrary to the contents of several normative acts that provide the independence of the judge and of the prosecutor in the activity of criminal investigation and in the phase of trial, as well as their exclusive competence to decide on the processual acts and measures, as the case is undergoing the phase of criminal prosecution, of preliminary chamber or of trial. Moreover, in support of the opinions which the author has expressed in this article, he also brings arguments of comparative law, showing that the analysis made has not identified legislations or points of view from other countries, convergent with the text of Article 172 (12) of the Criminal Procedure Code. In conclusion, for the reasons shown within this article, the author appreciates that it is required a reconsideration and reformulation of the text of Article 172 (12) of the Criminal Procedure Code from the legislator. [ABSTRACT FROM AUTHOR]

The research literature suggests that open-ended or two-sided ads may work better in U.S. culture while close-ended or one-sided ads may fit Chinese culture better. Therefore, this study was designed to test the influence of sidedness and conclusiveness of a climate-change ad among Chinese (N = 161) and U.S. (N = 154) college students. The results show that U.S. students overall have higher knowledge, more positive attitude, and stronger behavioral intention about the issue. The pattern of the results, although not statistically significant, still implies that open-ended or two-sided ads have stronger effects in increasing U.S. students' knowledge, attitude, and behavioral intention, while close-ended or one-sided ads work better with Chinese students. [ABSTRACT FROM AUTHOR]

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Abstract: We aimed to retrospectively assess (1) the conclusiveness of breast fine needle aspiration (FNA) in a histologically confirmed population and (2) the clinical and radiologic determinants of a conclusive diagnosis. Aspirates were diagnosed as inadequate, benign, atypical, suspicious or malignant. We defined a conclusive FNA diagnosis as ‘benign’ in histologically benign lesions and as ‘malignant’ in histologically malignant lesions. In 2419 breast lesions, the proportion of conclusive diagnoses was 46.1% (95% confidence interval, 42.0–50.2%) in histologically benign lesions (n = 571) and 81.6% (95% confidence interval, 79.8%–83.4%) in histologically malignant lesions (n = 1848). On multivariate analysis, factors associated with a conclusive preoperative diagnosis included tumour diameter of 2–2.9 cm (P < 0.001), malignant histology (P < 0.001) and the pathologist examining the aspirate (P = 0.02). Breast FNA has to be utilised selectively in the routine work-up of breast lesions. In suspicious lesions of large size, FNA may still be used to obtain a quick confirmation of malignancy. [Copyright &y& Elsevier]

Abstract Background The ultrasonic industry has recently produced echocardiographic Hand Held Devices (miniaturized, compact and battery-equipped echocardiographic systems). Their potential usefulness has been successfully assessed in a wide range of clinical conditions. The aim of the study was to verify if the routine use of a basic model of echocardiographic Hand Held Device (HHD) could be an important diagnostic tool during outpatient cardiologic consulting or in non-cardiologic hospital sections. Methods 87 consecutive patients were included in this study; they underwent routine physical examination, resting ECG and echocardiographic evaluation using a basic model of HHD performed by trained echocardiographists; the cardiologist, whenever possible, formulated a diagnosis. The percentage of subjects in whom the findings were judged reasonably adequate for final diagnostic and therapeutic conclusions was used to quantify the "conclusiveness" of HHD evaluation. Successively, all patients underwent a second echocardiographic evaluation, by an examiner with similar echocardiographic experience, performed using a Standard Echo Device (SED). The agreement between the first and the second echocardiographic exam was also assessed. Results Mean examination time was 6.7 ± 1.5 min. using HHD vs. 13.6 ± 2.4 min. using SED. The echocardiographic examination performed using HHD was considered satisfactory in 74/87 patients (85.1% conclusiveness). Among the 74 patients for whom the examination was conclusive, the diagnosis was concordant with that obtained with the SED examination in 62 cases (83.8% agreement). Conclusion HHD may generally allow a reliable cardiologic basic evaluation of outpatient or subjects admitted to non-cardiologic sections, more specifically in particular subgroups of patients, with a gain in terms of time, shortening patient waiting lists and reducing healthy costs.

Aim: Systematic reviews (SRs) are frequently inconclusive. The aim of this study was to analyze factors associated with conclusiveness of SRs about efficacy and safety of interventions for neuropathic pain (NeuP). Materials & methods: The study protocol was registered in the PROSPERO database (No. CRD42015025831). Five electronic databases (Medical Literature Analysis and Retrieval System Online, Cochrane Database of Systematic Reviews, Cumulative Index for Nursing and Allied Health Literature, Database of Abstracts of Reviews of Effects and Psychological Information Database) were searched until July 2018 for SRs about NeuP management. Conclusion statements for efficacy and safety, and characteristics of SRs were analyzed. Conclusiveness was defined as explicit statement by the SR authors that one intervention is better/similar to the other in terms of efficacy and safety. Methodological quality of SRs was assessed with the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) tool. Results: Of 160 SRs, 37 (23%) were conclusive for efficacy and/or safety. In the SRs, conclusions about safety were missing in half of the analyzed abstracts, and a third of the full texts. Conclusive SRs included significantly more trials and participants, searched more databases, had more authors, conducted meta-analysis, analyzed quality of evidence, and had lower methodological quality than inconclusive SRs. The most common reasons for the lack of conclusiveness indicated by the SR authors were the small number of participants and trials, and the high heterogeneity of included studies. Conclusion: Most SRs about NeuP treatment were inconclusive. Sources of inconclusiveness of NeuP reviews need to be further studied, and SR authors need to provide conclusions about both safety and efficacy of interventions.

To assess the conclusiveness of the Cochrane reviews (CRs) in the field of palliative and supportive care for cancer. We searched the CRs on Pain, Palliative, and Supportive Care Group available in the Cochrane library on February 01, 2015, to analyze whether a CR could reach a clinical decision. Each CR was analyzed for conclusiveness, number of randomized controlled trials (RCTs) enrolled, number of participants enrolled, the need for further studies, and the reasons. Only 45% (30 of 66) of the CRs reached definitive clinical recommendations. The number of RCTs and participants enrolled in conclusive CRs were significantly higher than those in inconclusive CRs. Nearly all CRs recognized the need for further studies. The conclusiveness was not affected by the year of publication. We concluded that a large number of clinical trials were not carried out well in the palliative and supportive oncology.

Objectives: The objective of our article is to show how "quality of evidence" and "imprecision," as they are defined in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) articles, may lead to confusion. We focus only on the context of systematic reviews., Study Design and Setting: We analyze, with the aid of standard probabilistic and statistical concepts, the concepts of quality of evidence and imprecision as used in the GRADE framework. This enables us to point out some weaknesses in the relation between "quality of evidence" and "imprecision.", Results: The GRADE framework contains terms familiar from classical statistics, but these terms are used in nonstandard ways. Notably, "imprecision" does not have the meaning in the GRADE framework that it has in statistics, and the well-known table of "evidence levels" wrongly suggests that "quality of evidence" and "accuracy" express the same concept-they do not., Conclusion: We believe that "conclusiveness" rather than "imprecision" would be a suitable term to use when the question whether the CI excludes or includes certain critical margins is being addressed. Conclusiveness could also replace quality of evidence as the final step for a systematic reviewer., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)