Search PubMed⌕ Search

Biomedical subjects

William J Gillespie

Publications and source records attributed to William J Gillespie.

6 recordsLinked to original sources
PubMed2006

Adjustment of meta-analyses on the basis of quality scores should be abandoned.

OBJECTIVE: To find if a particular quality score was better than others at validly scoring the quality of randomized controlled trials, both by examining the consistency of dividing studies into high and low quality and using a large study as a reference standard. STUDY DESIGN AND SETTING: Observational study of meta-analyses from the Cochrane Library. These had to have binary outcomes that included more than 10 studies, one or more of which randomized more than 500 people into each group. RESULTS: Eighteen systematic reviews, with 65 meta-analyses using binary outcomes, were included and the included trials were scored for 43 different quality scores. None of these scores was better at dividing the studies in to low and high quality, and none of the scores was better over the 65 meta-analyses in making the result closer to the reference standard. CONCLUSION: None of the quality scores found appeared to measure quality validly. It is a mistake to assign meaning to the result of a quality score.

Bias↗
PubMed2006

Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review.

OBJECTIVES: To present the updated results of systematic review of the current evidence for the effectiveness of hip protectors from reports of completed randomised trials, and to explore the evolution of that evidence. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Cochrane Bone, Joint, and Muscle Trauma Group trials register (January 2005), Cochrane central register of controlled trials (Cochrane Library Issue 1, 2005), Medline (1966 to January 2005), Embase (1988 to January 2005), and CINAHL (1982 to December 2004). Other databases and reference lists of relevant articles were searched and some trialists were contacted. REVIEW METHODS: Randomised or quasirandomised controlled trials reporting the incidence of hip fractures, pelvic fractures, and other fractures in elderly people offered hip protectors compared with a control group that was not. RESULTS: Outcomes for fracture were available from 14 randomised and quasirandomised trials. Pooling of data from 11 trials carried out in nursing or residential care settings, including six cluster randomised studies, showed evidence of a marginally statistically significant reduction in incidence of hip fracture (relative risk 0.77, 95% confidence interval 0.62 to 0.97). Pooling of data from three individually randomised trials of 5135 community dwelling participants showed no reduction in hip fracture incidence with provision of hip protectors (1.16, 0.85 to 1.59). No evidence was found of any significant effect of hip protectors on incidence of pelvic or other fractures. No important adverse effects of hip protectors were reported, but compliance, particularly in the long term, was poor. CONCLUSIONS: On the basis of early reports of randomised trials, hip protectors were advocated. Accumulating evidence indicates that hip protectors are an ineffective intervention for those living at home and that their effectiveness in an institutional setting is uncertain.

Aged↗