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Iain Chalmers

Publications and source records attributed to Iain Chalmers.

46 records · Page 3Linked to original sources
PubMed2002

A brief history of research synthesis.

Science is supposed to be cumulative, but scientists only rarely cumulate evidence scientifically. This means that users of research evidence have to cope with a plethora of reports of individual studies with no systematic attempt made to present new results in the context of similar studies. Although the need to synthesize research evidence has been recognized for well over two centuries, explicit methods for this form of research were not developed until the 20th century. The development of methods to reduce statistical imprecision using quantitative synthesis (meta-analysis) preceded the development of methods to reduce biases, the latter only beginning to receive proper attention during the last quarter of the 20th century. In this article, the authors identify some of the trends and highlights in this history, to which researchers in the physical, natural, and social sciences have all contributed, and speculate briefly about the "future history" of research synthesis.

Bias↗
PubMed2002

Why we need to know whether prophylactic antibiotics can reduce measles-related morbidity.

In some parts of the world, measles vaccination has resulted in very substantial reductions in measles-related morbidity and mortality. Even so, it has been estimated that 30 million people still contract the disease every year, that nearly 1 million of these die, and that measles-related deaths account for about 10% of all deaths in children under the age of 5 in developing countries. Existing evidence from controlled trials suggests that antibiotic prophylaxis in measles can result in important reductions in measles-related morbidity, and, at a World Health Organization meeting convened in 1993 to decide on research priorities for the treatment of measles, highest priority was accorded to additional controlled trials of prophylactic antibiotics. As controlled trials of vitamin A in measles have made clear, such trials are feasible. Continued acquiescence in uncertainties about the effects of prophylactic antibiotics in a disease that continues to afflict so many children worldwide is unacceptable.

Anti-Bacterial Agents↗
PubMed2000

Current Controlled Trials: an opportunity to help improve the quality of clinical research.

Some problems with the quality of controlled clinical trials can be addressed by following these procedures: registering all trials at inception; using systematic reviews to inform the design of new studies; posting and obtaining feedback on preprints; reporting all well conducted trials, regardless of their results; reducing biased and inefficient assessment of reports submitted for publication; publishing sufficiently detailed reports; linking trial reports to relevant external information; providing readier access to reports; and reviewing and amending reports after initial publication. The launch of a new range of electronic journals by Current Controlled Trials offers an opportunity to contribute to progress in these ways.

Journal Article↗
PubMedDate not supplied

Is the NHS willing to help clinicians and patients reduce uncertainties about the effects of treatments?

Uncertainty is an inevitable component of clinical practice. Clinicians have a responsibility to minimise it by keeping up-to-date with current knowledge: but what is the responsibility of individual clinicians in reducing collective uncertainty? In all fields of medicine there are important questions relevant to both patients and clinicians, which can be answered only by clinical research. Unfortunately, much of the clinical research that attracts funding does not address the questions that both patients and clinicians regard as important. Furthermore, although the NHS has a proud record of innovation and clinical research, recent changes are jeopardising the ability and willingness of NHS clinicians to continue undertaking such work. A combination of increased bureaucracy in obtaining research ethics and local research and development (R&D) governance approval and the pressures on management to deliver service targets threaten to strangle research by NHS clinicians. Policy makers argue for informed patient choice, modernisation and improved quality. It is not in the interest of patients when research designed to address important therapeutic uncertainties is seen as an optional extra, rather than an intrinsic element of a health service interested in improving quality. The NHS needs to listen to its users, ie the patients, and to its clinical staff, and to encourage them to engage in research to help reduce those uncertainties.

Clinical Competence↗