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Critical appraisal (or quality assessment) in evidence based medicine, is the use of explicit, transparent methods to assess the data in published research, applying the rules of evidence to factors such as internal validity, adherence to reporting standards, conclusions, generalizability and risk-of-bias.
The Jadad scale independently assesses the methodological quality of a clinical trial judging the effectiveness of blinding. Alejandro "Alex" Jadad Bechara, a Colombian physician who worked as a Research Fellow at the Oxford Pain Relief Unit, Nuffield Department of Anaesthetics, at the University of Oxford described the allocating trials a score of between zero (very poor) and five (rigorous ...
Detection bias occurs when a phenomenon is more likely to be observed for a particular set of study subjects. For instance, the syndemic involving obesity and diabetes may mean doctors are more likely to look for diabetes in obese patients than in thinner patients, leading to an inflation in diabetes among obese patients because of skewed detection efforts.
An asymmetric funnel indicates a relationship between treatment effect estimate and study precision. This suggests the possibility of either publication bias or a systematic difference between studies of higher and lower precision (typically ‘small study effects’). Asymmetry can also arise from use of an inappropriate effect measure.
Groupshift, the tendency for decisions to be more risk-seeking or risk-averse than the group as a whole, if the group is already biased in that direction; Social desirability bias, the tendency to over-report socially desirable characteristics or behaviours in oneself and under-report socially undesirable characteristics or behaviours. [137]
Thus, concealment up to the point of allocation of treatment and blinding after that point address different sources of bias and differ in their practicability. In light of those considerations, we refer to the former as 'allocation concealment' and reserve the term 'blinding' for measures taken to conceal group identity after allocation” [ 5 ]
Data extraction and risk of bias assessment Translation of reviews into other languages A recent systematic review of how people were involved in systematic reviews aimed to document the evidence-base relating to stakeholder involvement in systematic reviews and to use this evidence to describe how stakeholders have been involved in systematic ...
In clinical practice, verification bias is more likely to occur when a preliminary diagnostic test is negative. Because many gold standard tests can be invasive, expensive, and carry a higher risk (e.g. angiography, biopsy, surgery), patients and physicians may be more reluctant to undergo further work-up if a preliminary test is negative.