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1.  Miss Polly had a dolly 
doi:10.3399/bjgp13X670598
PMCID: PMC3722807
2.  Exception reporting as a quality marker 
doi:10.3399/bjgp13X668276
PMCID: PMC3662439  PMID: 23735393
3.  Exposing the evidence gap for complementary and alternative medicine to be integrated into science-based medicine 
When people who advocate integrating conventional science-based medicine with complementary and alternative medicine (CAM) are confronted with the lack of evidence to support CAM they counter by calling for more research, diverting attention to the ‘package of care’ and its non-specific effects, and recommending unblinded ‘pragmatic trials’. We explain why these responses cannot close the evidence gap, and focus on the risk of biased results from open (unblinded) pragmatic trials. These are clinical trials which compare a treatment with ‘usual care’ or no additional care. Their risk of bias has been overlooked because the components of outcome measurements have not been taken into account. The components of an outcome measure are the specific effect of the intervention and non-specific effects such as true placebo effects, cognitive measurement biases, and other effects (which tend to cancel out when similar groups are compared). Negative true placebo effects (‘frustrebo effects’) in the comparison group, and cognitive measurement biases in the comparison group and the experimental group make the non-specific effect look like a benefit for the intervention group. However, the clinical importance of these effects is often dismissed or ignored without justification. The bottom line is that, for results from open pragmatic trials to be trusted, research is required to measure the clinical importance of true placebo effects, cognitive bias effects, and specific effects of treatments.
doi:10.1258/jrsm.2011.100271
PMCID: PMC3078611  PMID: 21502214
5.  The clinical features of the piriformis syndrome: a systematic review 
European Spine Journal  2010;19(12):2095-2109.
Piriformis syndrome, sciatica caused by compression of the sciatic nerve by the piriformis muscle, has been described for over 70 years; yet, it remains controversial. The literature consists mainly of case series and narrative reviews. The objectives of the study were: first, to make the best use of existing evidence to estimate the frequencies of clinical features in patients reported to have PS; second, to identify future research questions. A systematic review was conducted of any study type that reported extractable data relevant to diagnosis. The search included all studies up to 1 March 2008 in four databases: AMED, CINAHL, Embase and Medline. Screening, data extraction and analysis were all performed independently by two reviewers. A total of 55 studies were included: 51 individual and 3 aggregated data studies, and 1 combined study. The most common features found were: buttock pain, external tenderness over the greater sciatic notch, aggravation of the pain through sitting and augmentation of the pain with manoeuvres that increase piriformis muscle tension. Future research could start with comparing the frequencies of these features in sciatica patients with and without disc herniation or spinal stenosis.
doi:10.1007/s00586-010-1504-9
PMCID: PMC2997212  PMID: 20596735
Piriformis; Sciatica; Diagnosis; Systematic review
10.  Sicily statement on evidence-based practice 
Background
A variety of definitions of evidence-based practice (EBP) exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP) means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC").
Discussion
Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources.
Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available.
Summary
All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'.
doi:10.1186/1472-6920-5-1
PMCID: PMC544887  PMID: 15634359

Results 1-14 (14)