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Recent advances in machine learning techniques have created opportunities to improve medical diagnostics, but implementing these advances in the clinic will not be without challenge. Examination of the vaccine strategies and technical platforms used for the COVID pandemic in the context of those used for previous emerging and reemerging infectious diseases and pandemics can offer critical lessons to prepare for future public health emergencies.
As the emergence of viral diseases is expected to accelerate, proactive programs to develop broadly active family-specific and cross-family antiviral therapeutics will be key to prepare for future disease outbreaks.
The many levels of heterogeneity within tumors dictate their response to therapy and should be considered in future therapeutic regimes. Increased understanding of the biology of metastases allows improved targeting and outcomes for patients with both micro- and macrometastases. The COVID pandemic has resulted in an accelerated development of applications for digital health, including symptom monitoring and contact tracing.
Their potential is wide ranging and must be integrated into conventional approaches to public health for best effect. Recent clinical observations have prompted clinicians to think of COVID as being more than a respiratory disease. Health data are being generated and collected at an unprecedented scale, but whether big data will truly revolutionize healthcare is still a matter of much debate.
Sex differences in the prevalence, risk factors and symptoms of cardiometabolic disorders are being elucidated and should be taken into account in diagnosis and treatment. The rise of cardiometabolic diseases in low- and middle-income countries is tied to a multitude of environmental, social and commercial determinants, which are discussed in this Review along with a strategy to counteract those factors.
This Review examines the promise, progress and challenges for developing personal T cell—based immunotherapies for cancer. Clinical application of CAR T cells to cancer therapy has met with much success, but future trials must build on current understanding to overcome therapy resistance.
Advances in cellular regeneration and technical approaches to spinal cord repair are on the verge of being translated into clinical trials. Broadly neutralizing antibodies have the potential to clear HIV and prevent further infection, as shown in emerging clinical studies.
The microbiome influences response to cancer therapy, including cancer immunotherapy, and also plays a role in therapeutic toxicity. Targeting epigenetic modifications is an effective cancer therapeutic approach and can be combined with other therapeutics for maximal effect. Advanced search. Skip to main content Thank you for visiting nature.
Review Articles. Year All. Review Article 15 Jul Biomarkers for neurodegenerative diseases As the development of biomarkers for neurodegenerative diseases advances, new opportunities arise for their implementation in clinical practice and trials. Review Article 03 Jun Health systems resilience in managing the COVID pandemic: lessons from 28 countries A review of COVID responses in 28 selected countries identifies elements of highly effective public health responses and offers recommendations toward strengthening health systems resilience.
Review Article 17 May Deep learning in histopathology: the path to the clinic Recent advances in machine learning techniques have created opportunities to improve medical diagnostics, but implementing these advances in the clinic will not be without challenge.
Review Article 14 May Vaccine development for emerging infectious diseases Examination of the vaccine strategies and technical platforms used for the COVID pandemic in the context of those used for previous emerging and reemerging infectious diseases and pandemics can offer critical lessons to prepare for future public health emergencies.
Review Article 12 Apr
In this case we should think about synonyms of P, and I elements, and combine them with a conjunction AND. A good example of this method can be found in PubMed interface of Medline. The Clinical Queries tool offers empirically developed filters for five different inquiries as guidelines for etiology, diagnosis, treatment, prognosis or clinical prediction.
As an indispensable component of the review process is to discriminate good, and bad quality researches from each other, and the outcomes should be based on better qualified researches, as far as possible. A hierarchy of evidence for different research questions is presented in Table 4.
However this hierarchy is only a first step. Rarely all researches arrive at the same conclusion. In this case a solution should be found. However it is risky to make a decision based on the votes of absolute majority. Indeed, a well-performed large scale study, and a weakly designed one are weighed on the same scale. Therefore, ideally a meta-analysis should be performed to solve apparent differences.
Ideally, first of all, one should be focused on the largest, and higher quality study, then other studies should be compared with this basic study. In conclusion, during writing process of a review article, the procedures to be achieved can be indicated as follows: 1 Get rid of fixed ideas, and obsessions from your head, and view the subject from a large perspective.
National Center for Biotechnology Information , U. Journal List Turk J Urol v. Turk J Urol. Author information Article notes Copyright and License information Disclaimer. Received Mar 6; Accepted May This article has been cited by other articles in PMC.
Abstract In the medical sciences, the importance of review articles is rising. Keywords: How to write, review, writing. This simple definition of a review article contains the following key elements: The question s to be dealt with Methods used to find out, and select the best quality researches so as to respond to these questions. To synthetize available, but quite different researches For the specification of important questions to be answered, number of literature references to be consulted should be more or less determined.
Table 1. Additional analyses 16 Describe methods of additional analyses such as sensitivity or subgroup analyses, meta-regression , if done, indicating which were pre-specified. Results Study selection 17 Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram. Study characteristics 18 For each study, present characteristics for which data were extracted such as study size, PICOS, follow-up period and provide the citation.
Risk of bias within studies 19 Present data on risk of bias of each study and, if available, any outcome-level assessment see item 12 Results of individual studies 20 For all outcomes considered benefits and harms , present, for each study, simple summary data for each intervention group and effect estimates and confidence intervals, ideally with a forest plot a type of graph used in meta-analyses which demonstrates relat, ve success rates of treatment outcomes of multiple scientific studies analyzing the same topic Syntheses of resxults 21 Present the results of each meta-analyses including confidence intervals and measures of consistency Risk of bias across studies 22 Present results of any assessment of risk of bias across studies see item Additional analyses 23 Give results of additional analyses, if done such as sensitivity or subgroup analyses, meta-regression see item 16 Discussion Summary of evidence 24 Summarize the main findings, including the strength of evidence for each main outcome; consider their relevance to key groups such as healthcare providers, users, and policy makers Limitations 25 Discuss limitations at study and outcome level such as risk of bias , and at review level such as incomplete retrieval of identified research, reporting bias Conclusions 26 Provide a general interpretation of the results in the context of other evidence, and implications for future research Funding Funding 27 Indicate sources of funding or other support such as supply of data for the systematic review, and the role of funders for the systematic review.
Open in a separate window. Contents and format Important differences exist between systematic, and non-systematic reviews which especially arise from methodologies used in the description of the literature sources. Table 2. Structure of a systematic review. Section Contents Introduction Presents the problem and certain issues dealt in the review article Methods Describes research, and evaluation process Specifies the number of studies evaluated orselected Results Describes the quality, and outcomes of the selected studies Discussion Summarizes results, limitations, and outcomes of the procedure and research.
Preparation of the review article Steps, and targets of constructing a good review article are listed in Table 3. Steps of a systematic review. Step Processes Formulation of researchable questions Select answerable questions Disclosure of studies Databases, and key words Evaluation of its quality Quality criteria during selection of studies Synthesis Methods interpretation, and synthesis of outcomes. The research question It might be helpful to divide the research question into components.
Finding Studies In a systematic review on a focused question, methods of investigation used should be clearly specified. Evaluation of the Quality of the Study As an indispensable component of the review process is to discriminate good, and bad quality researches from each other, and the outcomes should be based on better qualified researches, as far as possible.
Determination of levels of evidence based on the type of the research question. Formulating a Synthesis Rarely all researches arrive at the same conclusion. Conclusions In conclusion, during writing process of a review article, the procedures to be achieved can be indicated as follows: 1 Get rid of fixed ideas, and obsessions from your head, and view the subject from a large perspective.
References 1. How to use an overview. Evidence-Based Medicine Working Group. Number of published systematic 2 reviews and global burden of disease: database analysis. Canadian Institutes of Health Research. Mulrow CD. The medical review article: state of the science. Ann Intern Med. Quality of Reporting of Meta-analyses. Collins JA, Fauser B. Balancing the strengths of systematicand narrative reviews. Hum Reprod Update. Writing narrative literaturereviews for peer-reviewed journals: secrets of the trade.
J SportsChiropract Rehabil. Chicago: The Universty of Chicago Press; The craft of research. The medical review article revisited: has the science improved? Systematic reviews in health care: a practical guide. Cambridge University Press; Systematic reviews to support evidence based medicine How to review and apply finding of health care research.
London: RSM Press; Mulrow C, Cook D, editors. Systematic reviews: synthesis of best evidence for health care decisions. Philadelphia: American Collage of Phtsicians; These points are not necessarily the same as the key recommendations, whose level of evidence is rated, although some of them will be.
Use tables, figures, and illustrations to highlight key points, and present a step-wise, algorithmic approach to diagnosis or treatment when possible. Rate the evidence for key statements, especially treatment recommendations. We expect that most articles will have at most two to four key statements; some will have none. Rate only those statements that have corresponding references and base the rating on the quality and level of evidence presented in the supporting citations.
Use primary sources original research, RCTs, meta-analyses, and systematic reviews as the basis for determining the level of evidence. In other words, the supporting citation should be a primary research source of the information, not a secondary source such as a nonsystematic review article or a textbook that simply cites the original source.
Systematic reviews that analyze multiple RCTs are good sources for determining ratings of evidence. The references should include the most current and important sources of support for key statements i. Generally, these references will be key evidence-based recommendations, meta-analyses, or landmark articles.
Although some journals publish exhaustive lists of reference citations, AFP prefers to include a succinct list of key references. We will make more extensive reference lists available on our Web site or provide links to your personal reference list. You may use the following checklist to ensure the completeness of your evidence-based review article; use the source list of reviews to identify important sources of evidence-based medicine materials.
The topic is common in family practice, especially topics in which there is new, important information about diagnosis or treatment. The introduction defines the topic and the purpose of the review, and describes its relevance to family practice.
The review states how you did your literature search and indicates what sources you checked to ensure a comprehensive assessment of relevant studies e. Several sources of evidence-based reviews on the topic are evaluated Table 1. Where possible, POEM dealing with changes in morbidity, mortality, or quality of life rather than DOE dealing with mechanistic explanations or surrogate end points, such as changes in laboratory tests is used to support key clinical recommendations Table 2.
Studies of patients likely to be representative of those in primary care practices, rather than subspecialty referral centers, are emphasized. Studies that are not only statistically significant but also clinically significant are emphasized; e. Acknowledge controversies, recent developments, other viewpoints, and any apparent conflicts of interest or instances of bias that might affect the strength of the evidence presented. Highlight key points about diagnosis and treatment in the discussion and include a summary table of key take-home points.
Use tables, figures, and illustrations to highlight key points and present a step-wise, algorithmic approach to diagnosis or treatment when possible. Emphasize evidence-based guidelines and primary research studies, rather than other review articles, unless they are systematic reviews. The essential elements of this checklist are summarized in Table 3. Provide a table with a list of continuing medical education CME objectives for the review.
Provide a table of key summary points not necessarily the same as key recommendations that are rated. Already a member or subscriber? Log in. He is also editor of American Family Physician. Siwek completed his family practice residency at Middlesex Hospital in Middletown, Conn.
Lewis Barnett, Jr. He completed his doctorate and fellowship training at the Medical University of South Carolina, Charleston. Address correspondence to Jay Siwek, M. NW, Washington DC e-mail: afp family. Reprints are not available from the authors.
The authors thank Ted Ganiats, M. The authors indicate that they do not have any conflicts of interest. Sources of funding: none reported. Siwek J. Reading and evaluating clinical review articles. Am Fam Physician. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med.
Should we patch corneal abrasions? A meta-analysis. J Fam Pract. Becoming a medical information master: feeling good about not knowing everything. Becoming an information master: a guidebook to the medical information jungle. Becoming an information master: using POEMs to change practice with confidence.
Patient-oriented evidence that matters. Methods Work Group, Third U. Current methods of the U. A review of the process. Am J Prev Med. CATbank topics: levels of evidence and grades of recommendations. The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services. Evidence-based medicine glossary. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.
This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Emergencies and Common Abnormalities Involving the Abdomen. Pelvis, Extremities, Genitalia, and Spine. Jan 15, Issue. Patient-Oriented vs.
State how the literature search and reference selection were done. Use several sources of evidence-based reviews on the topic. Rate the level of evidence for key recommendations in the text. Read the full article. Get immediate access, anytime, anywhere. Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue. Purchase Access: See My Options close.
Best Value! To see the full article, log in or purchase access. More in Pubmed Citation Related Articles. Email Alerts Don't miss a single issue. Sign up for the free AFP email table of contents. Navigate this Article. Primary Care Clinical Practice Guidelines. Antiarrhythmic therapy. Antiarrhythmic drug X is associated with an increase in mortality.
Antihypertensive therapy. Antihypertensive drug treatment lowers blood pressure. Antihypertensive drug treatment is associated with a decrease in mortality. Screening for prostate cancer. PSA screening detects prostate cancer at an early stage. Choose a common, important topic in family practice.