Literature DB >> 34720166

A Focus on Evaluating Major Study Limitations in Order to Apply Clinical Trials to Patient Care: Implications for the Healthcare Team.

Mary J Ferrill1, Alireza FakhriRavari2, Lisa Hong2, Jody Jacobson Wedret3.   

Abstract

Background: With more than a million new biomedical articles published annually, healthcare providers must stay up to date in order to provide optimal evidence-based patient care. The concise ROOTs (relevance, observe validity, obtain clinically significant results, and translate results to clinical practice) format is a valuable tool to assist with literature evaluation. Purpose: To illustrate how major study limitations found in clinical trials might inhibit the ability to adopt the findings of such studies to patient care.
Methods: Examples from published clinical trials that contain major study flaws were used to illustrate, if taken at face value, would lead to erroneous assumptions, and if adopted, could potentiallly harm patients.
Conclusion: When evaluating the literature, it is crucial to identify limitations in the published literature that might reduce the internal validity, affect the results, or limit the external validity of clinical trials, hence affecting the usability of literature for patient care. This article provides examples of clinical trials that contain major study limitations with potentially erroneous assumptions. These illustrations are meant to show how important it is to delve deeper into an article before conclusions are drawn.
© The Author(s) 2020.

Entities:  

Keywords:  clinical services; drug information; drug/medical use evaluation

Year:  2020        PMID: 34720166      PMCID: PMC8554602          DOI: 10.1177/0018578720931750

Source DB:  PubMed          Journal:  Hosp Pharm        ISSN: 0018-5787


  30 in total

1.  Changes in weight during a 1-year trial of fluoxetine.

Authors:  D Michelson; J D Amsterdam; F M Quitkin; F W Reimherr; J F Rosenbaum; J Zajecka; K L Sundell; Y Kim; C M Beasley
Journal:  Am J Psychiatry       Date:  1999-08       Impact factor: 18.112

Review 2.  Clinical versus statistical significance: interpreting P values and confidence intervals related to measures of association to guide decision making.

Authors:  Mary J Ferrill; Dana A Brown; Jeffrey A Kyle
Journal:  J Pharm Pract       Date:  2010-04-13

3.  Impact of loading doses on the time to adequate predicted beta-lactam concentrations in prolonged and continuous infusion dosing schemes.

Authors:  Nathaniel J Rhodes; Shawn H MacVane; Joseph L Kuti; Marc H Scheetz
Journal:  Clin Infect Dis       Date:  2014-05-27       Impact factor: 9.079

4.  Interpretation of Clinical Trials That Stopped Early.

Authors:  Kert Viele; Anna McGlothlin; Kristine Broglio
Journal:  JAMA       Date:  2016-04-19       Impact factor: 56.272

5.  Adjusted value of thromboprophylaxis in hospitalized obese patients: A comparative study of two regimens of enoxaparin: The ITOHENOX study.

Authors:  Sébastien Miranda; Véronique Le Cam-Duchez; Jacques Benichou; Nathalie Donnadieu; Virginie Barbay; Maelle Le Besnerais; François-Xavier Delmas; Antoine Cuvelier; Hervé Lévesque; Ygal Benhamou; Guillaume Armengol
Journal:  Thromb Res       Date:  2017-04-12       Impact factor: 3.944

6.  Fluoxetine: a randomized clinical trial in the treatment of obesity.

Authors:  D J Goldstein; A H Rampey; G G Enas; J H Potvin; L A Fludzinski; L R Levine
Journal:  Int J Obes Relat Metab Disord       Date:  1994-03

7.  Prospective comparison of three enoxaparin dosing regimens to achieve target anti-factor Xa levels in hospitalized, medically ill patients with extreme obesity.

Authors:  Andrew Freeman; Tuesdy Horner; Robert C Pendleton; Matthew T Rondina
Journal:  Am J Hematol       Date:  2012-05-06       Impact factor: 10.047

8.  A review of multicenter controlled studies of fluoxetine vs. imipramine and placebo in outpatients with major depressive disorder.

Authors:  P Stark; C D Hardison
Journal:  J Clin Psychiatry       Date:  1985-03       Impact factor: 4.384

Review 9.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.

Authors:  Klaus F Rabe; Suzanne Hurd; Antonio Anzueto; Peter J Barnes; Sonia A Buist; Peter Calverley; Yoshinosuke Fukuchi; Christine Jenkins; Roberto Rodriguez-Roisin; Chris van Weel; Jan Zielinski
Journal:  Am J Respir Crit Care Med       Date:  2007-05-16       Impact factor: 21.405

10.  A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia.

Authors:  Marin H Kollef; Jean Chastre; Marc Clavel; Marcos I Restrepo; Bart Michiels; Koné Kaniga; Iolanda Cirillo; Holly Kimko; Rebecca Redman
Journal:  Crit Care       Date:  2012-11-13       Impact factor: 9.097

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