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Article ; Online: The Global Evidence Commission's report provided a wake-up call for the evidence community.

Stewart, Ruth / Boutron, Isabelle / Akl, Elie A

2022 Volume 154, Page(s) 212–215

Language	English
Publishing date	2022-10-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	639306-8
ISSN	1878-5921 ; 0895-4356
ISSN (online)	1878-5921
ISSN	0895-4356
DOI	10.1016/j.jclinepi.2022.10.002
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Article ; Online: The Role of CT-Guided Optimal Fluoroscopic Viewing Angle to Guide Right Endomyocardial Biopsy.

Zgheib, Ali / Akl, Elie / Spaziano, Marco / Martucci, Giuseppe / Piazza, Nicolo

JACC. Case reports

2023 Volume 26, Page(s) 102060

Abstract: We report the case of a 64-year-old man with a history of chemotherapy-induced cardiomyopathy requiring heart transplant in 2022 who underwent successful endomyocardial biopsy using patient-specific computed tomographic fluoroscopic projections. ( ...

Abstract	We report the case of a 64-year-old man with a history of chemotherapy-induced cardiomyopathy requiring heart transplant in 2022 who underwent successful endomyocardial biopsy using patient-specific computed tomographic fluoroscopic projections. (
Language	English
Publishing date	2023-11-15
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2023.102060
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Article ; Online: Choosing and accessing COVID-19 treatment options: a qualitative study with patients, caregivers, and health care providers in Lebanon.

Hoteit, Reem / Hassoun, Aya / Bou Sanayeh, Elie / Saade, Marie Christelle / Honein-AbouHaidar, Gladys / Akl, Elie A

Health research policy and systems

2024 Volume 22, Issue 1, Page(s) 38

Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic has strained healthcare systems globally, particularly in terms of access to medicines. Lebanon has been greatly affected by the pandemic, having faced concomitant financial and economic ... ...

Abstract	Background: The coronavirus disease 2019 (COVID-19) pandemic has strained healthcare systems globally, particularly in terms of access to medicines. Lebanon has been greatly affected by the pandemic, having faced concomitant financial and economic crises. The objective of the study was to understand the experiences of patients with COVID-19 in Lebanon, as well as those of their families, and healthcare providers, with regards to their treatment decisions and accessibility to COVID-19 medicines. Methods: For this qualitative study, we conducted 28 semi-structured interviews. We used purposive sampling to recruit participants with a diverse range of perspectives. The data collection phase spanned from August to November 2021 and was conducted virtually. After transcribing and translating the interviews, we employed thematic analysis to identify recurring themes and patterns. Results: In total, 28 individuals participated in this study. Participants highlighted challenges owing to the COVID-19 pandemic and economic crisis. Accessing COVID-19 medicines posed major hurdles for physicians and patients, given limited availability, global shortages, local circumstances, community hoarding and stockpiling by pharmacies. Providers based treatment decisions on research, local and international practice guidelines, experiences and expert feedback. Patients sought information from social media, community members and physicians, as well as through word of mouth. Accessing medicines involved navigating the healthcare system, the black market, charities, personal networks and political parties and sourcing from abroad. The medicines were either free, subsidized or at inflated costs. Conclusions: This study highlights the diversity and complexity of factors influencing decision-making and accessing medicines during the COVID-19 pandemic in Lebanon. Future research should explore strategies for ensuring medicine access during crises, drawing insights from comparative studies across different countries.
MeSH term(s)	Humans ; Caregivers ; Lebanon ; COVID-19 Drug Treatment ; Pandemics ; COVID-19 ; Health Personnel ; Qualitative Research
Language	English
Publishing date	2024-03-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2101196-5
ISSN	1478-4505 ; 1478-4505
ISSN (online)	1478-4505
ISSN	1478-4505
DOI	10.1186/s12961-024-01131-9
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Article ; Online: Meta-Analysis of Randomized Trials: Efficacy and Safety of Colchicine for Secondary Prevention of Cardiovascular Disease.

Akl, Elie / Sahami, Nazanin / Labos, Christopher / Genest, Jacques / Zgheib, Ali / Piazza, Nicolo / Jolly, Sanjit

Journal of interventional cardiology

2024 Volume 2024, Page(s) 8646351

Abstract: Background: Colchicine has shown potential cardioprotective effects owing to its broad anti-inflammatory properties. We performed a meta-analysis to assess its safety and efficacy in secondary prevention in patients with established coronary artery ... ...

Abstract	Background: Colchicine has shown potential cardioprotective effects owing to its broad anti-inflammatory properties. We performed a meta-analysis to assess its safety and efficacy in secondary prevention in patients with established coronary artery disease (CAD). Methods: We searched Ovid Healthstar, MEDLINE, and Embase (inception to May 2022) for randomized controlled trials (RCTs) evaluating the cardiovascular effects of colchicine compared with placebo or usual care in patients with CAD. Study-level data on efficacy and safety outcomes were pooled using the Peto method. The primary outcome was the composite of cardiovascular (CV) death, myocardial infarction (MI), or stroke. Results: A total of 8 RCTs were included with a follow-up duration of ≥1 month, comprising a total of 12,151 patients. Compared with placebo or usual care, colchicine was associated with a significant risk reduction in the primary outcome (odds ratio (OR) 0.70, 95% CI 0.60 to 0.83, Conclusions: Colchicine therapy may reduce the risk of future cardiovascular events in patients with established CAD; however, there remains a concern about non-CV mortality. Further trials are underway that will shed light on non-CV mortality and colchicine NCT03048825, and NCT02898610.
MeSH term(s)	Humans ; Cardiovascular Diseases/prevention & control ; Colchicine/adverse effects ; Secondary Prevention ; Randomized Controlled Trials as Topic ; Myocardial Infarction/epidemiology ; Stroke/prevention & control ; Stroke/epidemiology ; Coronary Artery Disease/drug therapy
Chemical Substances	Colchicine (SML2Y3J35T)
Language	English
Publishing date	2024-03-12
Publishing country	United States
Document type	Meta-Analysis ; Journal Article
ZDB-ID	1036325-7
ISSN	1540-8183 ; 0896-4327
ISSN (online)	1540-8183
ISSN	0896-4327
DOI	10.1155/2024/8646351
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Article ; Online: Prospective collaborative recommendation development: a novel model for more timely and trustworthy guidelines.

Akl, Elie A / Cuker, Adam / Mustafa, Reem A / Nieuwlaat, Robby / Stevens, Adrienne / Schünemann, Holger J

Journal of clinical epidemiology

2023 Volume 162, Page(s) 156–159

MeSH term(s)	Humans ; Prospective Studies ; Evidence-Based Medicine
Language	English
Publishing date	2023-08-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	639306-8
ISSN	1878-5921 ; 0895-4356
ISSN (online)	1878-5921
ISSN	0895-4356
DOI	10.1016/j.jclinepi.2023.08.015
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Article ; Online: Summary of WHO infection prevention and control guideline for Ebola and Marburg disease: a call for evidence based practice.

Willet, Victoria / Dixit, Devika / Fisher, Dale / Bausch, Daniel G / Ogunsola, Folasade / Khabsa, Joanne / Akl, Elie A / Baller, April

BMJ (Clinical research ed.)

2024 Volume 384, Page(s) 2811

MeSH term(s)	Animals ; Humans ; Hemorrhagic Fever, Ebola/epidemiology ; Hemorrhagic Fever, Ebola/prevention & control ; Marburg Virus Disease/prevention & control ; Ebolavirus ; Evidence-Based Practice ; World Health Organization
Language	English
Publishing date	2024-02-26
Publishing country	England
Document type	Journal Article
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.p2811
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Article ; Online: Rapid reviews methods series: Guidance on assessing the certainty of evidence.

Gartlehner, Gerald / Nussbaumer-Streit, Barbara / Devane, Declan / Kahwati, Leila / Viswanathan, Meera / King, Valerie J / Qaseem, Amir / Akl, Elie / Schuenemann, Holger J

BMJ evidence-based medicine

2024 Volume 29, Issue 1, Page(s) 50–54

Abstract: This paper is part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group. Rapid reviews (RRs) use modified systematic review methods to accelerate the review process while maintaining systematic, transparent and ... ...

Abstract	This paper is part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group. Rapid reviews (RRs) use modified systematic review methods to accelerate the review process while maintaining systematic, transparent and reproducible methods. This paper addresses considerations for rating the certainty of evidence (COE) in RRs. We recommend the full implementation of GRADE (Grading of Recommendations, Assessment, Development and Evaluation) for Cochrane RRs if time and resources allow.If time or other resources do not permit the full implementation of GRADE, the following recommendations can be considered: (1) limit rating COE to the main intervention and comparator and limit the number of outcomes to critical benefits and harms; (2) if a literature review or a Delphi approach to rate the importance of outcomes is not feasible, rely on informal judgements of knowledge users, topic experts or team members; (3) replace independent rating of the COE by two reviewers with single-reviewer rating and verification by a second reviewer and (4) if effect estimates of a well-conducted systematic review are incorporated into an RR, use existing COE grades from such a review. We advise against changing the definition of COE or the domains considered part of the GRADE approach for RRs.
Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Journal Article
ISSN	2515-4478
ISSN (online)	2515-4478
DOI	10.1136/bmjebm-2022-112111
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Article ; Online: Methodology for the adolopment of recommendations for the treatment of rheumatoid arthritis in the Kingdom of Saudi Arabia.

Khabsa, Joanne / Yaacoub, Sally / Omair, Mohammed A / Al Rayes, Hanan / Akl, Elie A

BMC medical research methodology

2023 Volume 23, Issue 1, Page(s) 224

Abstract: Background: Currently, there are no guidelines for the treatment of rheumatoid arthritis (RA) tailored to the context of the Kingdom of Saudi Arabia (KSA). Adaptation of guidelines accounts for contextual factors and becomes more efficient than de novo ... ...

Abstract	Background: Currently, there are no guidelines for the treatment of rheumatoid arthritis (RA) tailored to the context of the Kingdom of Saudi Arabia (KSA). Adaptation of guidelines accounts for contextual factors and becomes more efficient than de novo guideline development when relevant, good quality, and up-to-date guidelines are available. The objective of this study is to describe the methodology used for the adolopment of the 2021 American College of Rheumatology (ACR) guidelines for the treatment of RA in the KSA. Methods: We followed the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE)-ADOLOPMENT methodology. The adolopment KSA panel included relevant stakeholders and leading contributors to the original guidelines. We developed a list of five adaptation-relevant prioritization criteria that the panelists applied to the original recommendations. We updated the original evidence profiles with newly published studies identified by the panelists. We constructed Evidence to Decision (EtD) tables including contextual information from the KSA setting. We used the PanelVoice function of GRADEPro Guideline Development Tool (GDT) to obtain the panel's judgments on the EtD criteria ahead of the panel meeting. Following the meeting, we used the PANELVIEW instrument to obtain the panel's evaluation of the process. Results: The KSA panel prioritized five recommendations, for which one evidence profile required updating. Out of five adoloped recommendations, two were modified in terms of direction, and one was modified in terms of certainty of the evidence. Criteria driving the modifications in direction were valuation of outcomes, balance of effects, cost, and acceptability. The mean score on the 7-point scale items of the PANELVIEW instrument had an average of 6.47 (SD = 0.18) across all items. Conclusion: The GRADE-ADOLOPMENT methodology proved to be efficient. The panel assessed the process and outcome positively. Engagement of stakeholders proved to be important for the success of this project.
MeSH term(s)	Humans ; United States ; Saudi Arabia ; Arthritis, Rheumatoid/diagnosis ; Arthritis, Rheumatoid/drug therapy ; Rheumatology ; Judgment
Language	English
Publishing date	2023-10-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041362-2
ISSN	1471-2288 ; 1471-2288
ISSN (online)	1471-2288
ISSN	1471-2288
DOI	10.1186/s12874-023-02031-2
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Article ; Online: Exploring the concordance of recommendations across guidelines on chest imaging for the diagnosis and management of COVID-19: A proposed methodological approach based on a case study.

Yaacoub, Sally / Chamseddine, Fatimah / Jaber, Farah / Blazic, Ivana / Frija, Guy / Akl, Elie A

PloS one

2023 Volume 18, Issue 7, Page(s) e0288359

Abstract: Objective: To describe a methodological approach to explore the concordance of recommendations across guidelines and its application to the case of the WHO recommendations on chest imaging for the diagnosis and management of COVID-19.: Study design ... ...

Abstract	Objective: To describe a methodological approach to explore the concordance of recommendations across guidelines and its application to the case of the WHO recommendations on chest imaging for the diagnosis and management of COVID-19. Study design and setting: We followed a methodological approach applied to a case study that included: defining the 'reference guideline' (i.e., the WHO guidance) and the 'reference recommendations'; searching for 'related guidelines' and identifying 'related recommendations'; constructing the PICO for the recommendations; assessing the matching of the PICO of each related recommendation to the PICO corresponding reference recommendation; and assessing the concordance between the PICO-matching recommendations. Results: We identified a total of 89 related recommendations from 22 related guidelines. Out of the 89 related recommendations, 43 partly matched and 1 entirely matched one of the reference recommendations, and out of these, 8 were concordant with one of the reference recommendations. When considering the seven reference recommendations, they had a median of 12 related recommendations (range 3-17), a median of 7 PICO-matching recommendations (range 0-13), and a median of 1 concordant recommendation (range 0-4). Conclusion: Following a detailed methodological approach, we were able to explore the concordance between our reference recommendations and related recommendations from other guidelines. A relatively low percentage of recommendations was concordant.
MeSH term(s)	Humans ; COVID-19/diagnostic imaging ; Diagnostic Imaging ; COVID-19 Testing
Language	English
Publishing date	2023-07-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0288359
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Article ; Online: Evidence synthesis to policy: development and implementation of an impact-oriented approach from the Eastern Mediterranean Region.

El-Jardali, Fadi / Fadlallah, Racha / Bou Karroum, Lama / Akl, Elie A

Health research policy and systems

2023 Volume 21, Issue 1, Page(s) 40

Abstract: Background: Despite the importance of evidence syntheses in informing policymaking, their production and use remain limited in the Eastern Mediterranean region (EMR). There is a lack of empirical research on approaches to promote and use policy-relevant ...

Abstract	Background: Despite the importance of evidence syntheses in informing policymaking, their production and use remain limited in the Eastern Mediterranean region (EMR). There is a lack of empirical research on approaches to promote and use policy-relevant evidence syntheses to inform policymaking processes in the EMR. Objective: This study sought to describe the development of an impact-oriented approach to link evidence synthesis to policy, and its implementation through selected case studies in Lebanon, a middle-income country in the EMR. Methods: This study followed a multifaceted and iterative process that included (i) a review of the literature, (ii) input from international experts in evidence synthesis and evidence-informed health policymaking, and (iii) application in a real-world setting (implementation). We describe four selected case studies of implementation. Surveys were used to assess policy briefs, deliberative dialogues, and post-dialogue activities. Additionally, Kingdon's stream theory was adopted to further explain how and why the selected policy issues rose to the decision agenda. Results: The approach incorporates three interrelated phases: (1) priority setting, (2) evidence synthesis, and (3) uptake. Policy-relevant priorities are generated through formal priority setting exercises, direct requests by policymakers and stakeholders, or a focusing event. Identified priorities are translated into focused questions that can be addressed via evidence synthesis (phase 1). Next, a scoping of the literature is conducted to identify existing evidence syntheses addressing the question of interest. Unless the team identifies relevant, up-to-date and high-quality evidence syntheses, it proceeds to conducting SRs addressing the priority questions of interest (phase 2). Next, the team prepares knowledge translation products (e.g., policy briefs) for undertaking knowledge uptake activities, followed by monitoring and evaluation (phase 3). There are two prerequisites to the application of the approach: enhancing contextual awareness and capacity strengthening. The four case studies illustrate how evidence produced from the suites of activities was used to inform health policies and practices. Conclusions: To our knowledge, this is the first study to describe both the development and implementation of an approach to link evidence synthesis to policy in the EMR. We believe the approach will be useful for researchers, knowledge translation platforms, governments, and funders seeking to promote evidence-informed policymaking and practice.
MeSH term(s)	Humans ; Policy Making ; Health Policy ; Surveys and Questionnaires ; Mediterranean Region ; Qualitative Research
Language	English
Publishing date	2023-06-01
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2101196-5
ISSN	1478-4505 ; 1478-4505
ISSN (online)	1478-4505
ISSN	1478-4505
DOI	10.1186/s12961-023-00989-5
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