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      Towards understanding the de-adoption of low-value clinical practices: a scoping review.

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          Abstract

          Low-value clinical practices are common in healthcare, yet the optimal approach to de-adopting these practices is unknown. The objective of this study was to systematically review the literature on de-adoption, document current terminology and frameworks, map the literature to a proposed framework, identify gaps in our understanding of de-adoption, and identify opportunities for additional research.

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          Most cited references100

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          An evidence-based practice guideline for the peer review of electronic search strategies.

          Complex and highly sensitive electronic literature search strategies are required for systematic reviews; however, no guidelines exist for their peer review. Poor searches may fail to identify existing evidence because of inadequate recall (sensitivity) or increase the resource requirements of reviews as a result of inadequate precision. Our objective was to create an annotated checklist for electronic search strategy peer review. A systematic review of the library and information retrieval literature for important elements in electronic search strategies was conducted, along with a survey of individuals experienced in systematic review searching. Six elements with a strong consensus as to their importance in peer review were accurate translation of the research question into search concepts, correct choice of Boolean operators and of line numbers, adequate translation of the search strategy for each database, inclusion of relevant subject headings, and absence of spelling errors. Seven additional elements had partial support and are included in this guideline. This evidence-based guideline facilitates the improvement of search quality through peer review, and thus the improvement in quality of systematic reviews. It is relevant for librarians/information specialists, journal editors, developers of knowledge translation tools, research organizations, and funding bodies.
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            A decade of reversal: an analysis of 146 contradicted medical practices.

            To identify medical practices that offer no net benefits. We reviewed all original articles published in 10 years (2001-2010) in one high-impact journal. Articles were classified on the basis of whether they addressed a medical practice, whether they tested a new or existing therapy, and whether results were positive or negative. Articles were then classified as 1 of 4 types: replacement, when a new practice surpasses standard of care; back to the drawing board, when a new practice is no better than current practice; reaffirmation, when an existing practice is found to be better than a lesser standard; and reversal, when an existing practice is found to be no better than a lesser therapy. This study was conducted from August 1, 2011, through October 31, 2012. We reviewed 2044 original articles, 1344 of which concerned a medical practice. Of these, 981 articles (73.0%) examined a new medical practice, whereas 363 (27.0%) tested an established practice. A total of 947 studies (70.5%) had positive findings, whereas 397 (29.5%) reached a negative conclusion. A total of 756 articles addressing a medical practice constituted replacement, 165 were back to the drawing board, 146 were medical reversals, 138 were reaffirmations, and 139 were inconclusive. Of the 363 articles testing standard of care, 146 (40.2%) reversed that practice, whereas 138 (38.0%) reaffirmed it. The reversal of established medical practice is common and occurs across all classes of medical practice. This investigation sheds light on low-value practices and patterns of medical research. Published by Elsevier Inc.
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              RANDOMISED TRIAL OF INTRAVENOUS STREPTOKINASE, ORAL ASPIRIN, BOTH, OR NEITHER AMONG 17 187 CASES OF SUSPECTED ACUTE MYOCARDIAL INFARCTION: ISIS-2

              (1988)
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                Author and article information

                Journal
                BMC Med
                BMC medicine
                Springer Science and Business Media LLC
                1741-7015
                1741-7015
                Oct 06 2015
                : 13
                Affiliations
                [1 ] Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, T1Y 6J4, Canada. Daniel.niven@albertahealthservices.ca.
                [2 ] Department of Community Health Sciences, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada. Daniel.niven@albertahealthservices.ca.
                [3 ] Department of Community Health Sciences, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada. Kelly.mrklas@albertahealthservices.ca.
                [4 ] Department of Community Health Sciences, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada. jkholodi@ucalgary.ca.
                [5 ] Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, M5B 1T8, Canada. Sharon.straus@utoronto.ca.
                [6 ] Department of Community Health Sciences, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada. Brenda.hemmelgarn@albertahealthservices.ca.
                [7 ] Department of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada. Brenda.hemmelgarn@albertahealthservices.ca.
                [8 ] Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, M5B 1T8, Canada. jeffsl@smh.ca.
                [9 ] Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, T1Y 6J4, Canada. tstelfox@ucalgary.ca.
                [10 ] Department of Community Health Sciences, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada. tstelfox@ucalgary.ca.
                [11 ] Department of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada. tstelfox@ucalgary.ca.
                Article
                10.1186/s12916-015-0488-z
                10.1186/s12916-015-0488-z
                4596285
                26444862
                141e42cc-7ba5-486c-8723-c300595c4a4d
                History

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