Institut für Evidenz in der Medizin

This project will shed new light on the controversial field of nutrition research by comparing the consistency of effect estimates across the endpoint-specific bodies of evidence from randomized controlled trials and cohort studies, thereby helping us understand the reasons for these discrepancies.

In this project, the IfEM is supporting the Institute of Nursing Science in conducting a comprehensive literature review (scoping review) to explore and analyze the existing evidence on self-management following solid organ transplantation.

The goal is to develop and test a program to support and promote self-management among people following organ transplantation. Experts and affected individuals will be involved in this process. The research project is funded by the Federal Ministry of Education and Research (BMBF)

Link to the Institute of Nursing Science’s SMART project page

Back pain is widespread and causes a significant degree of disability and high costs worldwide. The workplace offers an important starting point for interventions aimed at preventing back pain. The available interventions are diverse and often include various components, such as exercise combined with education and ergonomic adjustments to the workplace.

The aim of this systematic review is to identify various workplace-based interventions for the prevention of nonspecific back pain and to compare their effects using a network meta-analysis. Where possible, the effects of individual intervention components will also be determined and compared with one another in a component network meta-analysis. Based on the analyses, the interventions will be ranked according to their effectiveness. This should enable the identification of the most promising interventions for the prevention of back pain in workplace settings.

This HTA examines the effectiveness of eye exercises for children and adolescents with visual impairments.

The aim of this project is to use a network meta-analysis (NMA) to compare various dietary intervention strategies that have been evaluated in randomized controlled trials (RCTs) and, based on this, to rank the most effective dietary intervention strategies for the primary prevention of overweight and obesity in school settings.

Background

The traditional systematic review is not ideal for quickly providing up-to-date and reliable decision-making foundations during a pandemic characterized by rapidly evolving research. The CEOsys collaborative project aims to ensure the quality of medical care, support policy decisions, and focus research activities on pandemic response by addressing the most urgent questions through dynamic evidence syntheses and the resulting recommendations for action.

Methods

The CEOsys collaborative project, involving 21 universities and four additional partners, is funded by the BMBF as part of the University Medicine Network. CEOsys is establishing a national evidence ecosystem of human studies on COVID-19. Registered, ongoing, or completed studies on COVID-19 are systematically recorded, and their results are evaluated using standardized criteria. This work provides the foundation for “living,” i.e., regularly updated, evidence syntheses.

CEOsys covers the following COVID-19 topic areas:

1. Testing and Diagnostics
2. Outpatient and inpatient care
3. Intensive care and palliative care
4. Hospital hygiene
5. Public health
6. Mental health

In collaboration with the AWMF-IMWI and the COVID-19 Task Force, recommendations for action are developed based on the findings and communicated to specific target groups. From this, the interdisciplinary CEOsys collaborative project generates recommendations for action for:

1. clinical practice
2. public health
3. the most urgent next steps in research

CEOsys establishes a quality-assured information platform for the scientific community, the healthcare system, the public, and policymakers.

Health Technology Assessment (HTA)

Health Technology Assessment (HTA)

In this project, the IfEM is supporting the development of an IUNS position paper on dietary fat and the quality of various fats in the prevention of chronic diseases. In this context, the IfEM is conducting scoping reviews that synthesize the evidence from systematic reviews and guidelines on the topic of dietary fat and fat quality.

The overall project aims to improve health literacy regarding childhood vaccinations, thereby supporting informed and self-determined decisions. Through various work packages, the information needs of parents are identified, existing evidence for various childhood vaccinations is reviewed, vaccination decision aids are developed and tested, and finally evaluated.
As a project partner, IfEM is responsible for systematic research and evidence synthesis. Evidence-based dossiers on the efficacy and safety of the rotavirus vaccine, the pneumococcal vaccine, and the hexavalent vaccine are being created. This information forms the basis for the vaccination decision aids.

PEN examines the content, implementation, and effectiveness of policy measures designed to promote healthy eating and physical activity among the population.

Noncommunicable diseases such as type 2 diabetes, cardiovascular diseases, cancer, and respiratory diseases account for more than 70% of global deaths. Unhealthy diets and lack of physical activity are the primary risk factors for the development of these diseases. In many European countries, policy measures are being implemented to bring about sustainable changes in dietary and physical activity habits. However, the effects of such measures have not yet been systematically recorded and evaluated.

The European Network on the Effectiveness of Policy Measures for Lifestyle Interventions, or PEN (Policy Evaluation Network), consists of 28 research institutions from 7 European countries and New Zealand. The primary goal is to develop tools for Europe that can be used to evaluate and assess policy measures aimed at promoting healthy eating and physical activity and reducing sedentary behavior.

Risk Perception and Risk Attitudes in Long-Term Opioid Therapy for Outpatients with Chronic, Non-Cancer-Related Pain.

The increasing inappropriate prescribing of opioids in Germany as long-term therapy for patients with chronic, non-cancer-related pain (CNTS) in outpatient settings and the resulting threat to patient safety calls for a systematic understanding of the reasons behind the sometimes inappropriate prescribing and the associated increased risk of adverse drug events (ADEs). The “ERONA” project aims to close this knowledge gap regarding long-term opioid therapy for CNTS patients in outpatient settings through systematic, experimental research into the risk assessment and risk decisions made by physicians and patients, taking into account how they learn about the risks of drug therapy (description versus experience). Based on this, the project aims to develop intervention strategies designed to reduce identified causes of inadequate medication safety in the context of inappropriate opioid prescribing through facility-independent, online-based educational formats.

GELL-ALTER is creating an evidence map of studies that examine treatment preferences among older patients with multiple chronic conditions.

Physician-patient consultations are often complex in older patients with multiple comorbidities due to interactions between diseases and treatments, as well as multifaceted treatment and care needs. To avoid inappropriate care and its consequences, a patient-centered approach that takes patient preferences into account is recommended. However, it is unclear how older patients with multiple chronic conditions prioritize diseases and treatment options and how their preferences are incorporated into the treatment process. The aim of the project is to (1) identify all studies that examined the patient preferences of older patients with multiple chronic conditions in order to map them in an “Evidence Map” (EM) and thereby illustrate evidence clusters (and gaps); (2) conduct a comprehensive systematic review (SR) on one of the evidence clusters. The results will be shared with patient organizations and institutions for general practice advanced training.

Publications:

Registration: Open Science Framework (OSF): DOI 10.17605/OSF.IO/MCRWQ.

This systematic review examines studies on the treatment of rotator cuff tears.

The aim of this systematic review is to evaluate the efficacy and safety of surgical interventions compared to no surgical treatment in patients with rotator cuff tears. 

Publications

Christine Schmucker, Viktoria Titscher, Cordula Braun, Irma Klerings, Barbara Nussbaumer-Streit, Gerald Gartlehner, Joerg J Meerpohl. Efficacy and safety of surgical interventions for full-thickness rotator cuff tears. PROSPERO 2018 CRD42018100343

Christine Schmucker, Viktoria Titscher, Cordula Braun, Barbara Nussbaumer-Streit, Gerald Gartlehner, Jörg Meerpohl, Surgical and Non-Surgical Interventions in Complete Rotator Cuff Tears, https://pubmed.ncbi.nlm.nih.gov/33263527/

The quasi-experimental IIT-IMPACT study compares the extent to which the results of research-initiated versus industry-initiated primary studies are (1) published, (2) cited in systematic reviews, and (3) included in clinical guidelines, and are thus available for use in medical care and the planning of further clinical trials.

The DFG and BMBF fund high-quality clinical research projects from the academic sector. These investigator-initiated trials (IITs) cover all areas of medical research and often go beyond the scope of industry-sponsored trials (ISTs). IITs are of great importance because they evaluate the efficacy and safety of already approved drugs as well as their use outside the approved indication (off-label use); for example, drugs for the treatment of rare diseases.

To date, however, little is known about the impact of investigator-initiated clinical trials on medical practice. The aim of this research project is therefore to track a predefined number of IITs (including all studies funded by the DFG and BMBF) as well as a corresponding number of ISTs that were completed between 2005 and 2012 in a quasi-experimental study, and to investigate whether their results (1) were published, (2) were cited, particularly in systematic reviews and meta-analyses, and (3) whether they have been incorporated into clinical treatment guidelines and thus into medical practice.

Publications

Initial results were presented as a talk at the 2018 Cochrane Colloquium in Edinburgh: Transparency and completeness of reporting in study registries - a comparative study

MEDIATE aims to improve media and public discourse on diagnostic tests through evidence-based, ethically grounded science communication.

The collaborative project is funded by the BMBF program “Discourse Projects on Ethical, Legal, and Social Issues in the Modern Life Sciences.” Using selected diagnostic tests as examples, the project aims to discuss and establish, through dialogue with both young and experienced science journalists and physicians, the necessary content quality criteria for educational information about diagnostic tests, as well as quality criteria for communicating this information to users.

Through a multi-stage process (review of the evidence, quality assessment of reporting, seminars, workshops, and symposia), recommendations regarding quality requirements for educational information for the care process as well as for media reporting will be developed and published. 

Publications

Labonté V, Alsaid D, Lang B, Meerpohl JJ. Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review. BMC Pregnancy Childbirth. 2019;19(1):385.

Labonté V, Alsaid D, Meerpohl JJ. Psychosocial Consequences of Communicating Results from Non-Invasive Prenatal Testing (NIPT) to Parents: A Scoping Review. Poster. The 26th Cochrane Colloquium; October 16, 2018, Edinburgh, Scotland.

Labonté V, Alsaid D, Meerpohl JJ. Overview of reviews of diagnostic test accuracy for 3 types of non-invasive prenatal diagnostics to detect fetal aneuploidies – protocol. PROSPERO 2018 CRD42018102401.

Reports

Labonté V, Gauch J, Alsaid D, Meerpohl JJ. 2019. Overview of reviews: Diagnostic test accuracy of non-invasive prenatal tests (NIPT) to detect fetal aneuploidies.

Labonté V, Gauch J, Meerpohl JJ. 2019. Rapid overview of reviews: Diagnostic test accuracy of HIV self-tests.

Labonté V, Gauch J, Meerpohl JJ. 2019. How can education about diagnostic tests be improved in the physician-patient consultation? – A summary of four expert opinions.

Zähringer J, Labonté V, Meerpohl JJ. 2019. How does media discourse, from the perspective of physicians and medical ethicists, influence the use of diagnostic tests, and is this influence viewed as positive or negative?

Popular science articles

Gauch, Labonté, Rüschemeyer 2019. Relieved, anxious, full of regret? The psychological consequences of a non-invasive prenatal diagnostic test (NIPT) for pregnant women. WissenWasWirkt – Cochrane blogs in German.

The cluster-randomized GAP study is evaluating, in Bavarian primary care practices, whether the use of digitally formatted, evidence-based health information during consultations improves the level of knowledge and healthcare-seeking behavior among patients with back pain.

Medical treatment that is jointly managed by the patient and physician and tailored to the individual can positively influence the course of the disease. In particular, patients must be empowered to make such decisions with full knowledge of the facts. However, citizens and patients are increasingly seeking information about diseases and treatment options on their own and are overwhelmed by the sheer volume and quality of information available, particularly online. Furthermore, self-research is controversial among the medical community, as self-information can confuse patients and unreliable health information is often not easily recognizable.

The GAP project builds on established European information systems such as NHS Choices and provides patients and physicians with a platform offering evidence-based information on back pain during and after the consultation. The study examines how the level of information among physicians and patients, the assessment of physician-patient communication, and the perceived level of patient involvement differ between groups with and without platform use. Other endpoints being examined include days of work disability caused by back pain and utilization of the healthcare system.

Publications

Brief project description for the Innovation Committee

Lang B, Kunzweiler K, Voigt-Radloff S. Well-informed communication between physician and patient in the digital age—The GAP Project. In: Knieps F, Pfaff H (eds.). BKK Health Report 2017: Digital Work—Digital Health: MWV Medizinisch Wissenschaftliche Verlagsgesellschaft and BKK Dachverband e.V. 2017.

Voigt-Radloff S, Schöpf AC, Boeker M, Frank L, Farin E, Kaier K, Körner M, Wollmann K, Lang B, Meerpohl JJ, Möhler R, Niebling W, Serong J, Lange R, van der Keylen P, Maun A. Well-informed physician-patient communication in consultations on back pain—study protocol of the cluster-randomized GAP trial.

CEBHA+ is a research network dedicated to expanding evidence-based healthcare and public health in Africa.

The overarching goal of the CEBHA+ project is to build sustainable capacities and an infrastructure for evidence-based healthcare in sub-Saharan African countries. This includes primary research, the development of evidence syntheses, as well as evidence-based health policy and its practical implementation. CEBHA+ takes a population-based approach that encompasses both disease prevention and the provision of care.

Publications

Rehfuess EA, Durão S, Kyamanywa P, Meerpohl JJ, Young T, Rohwer A; CEBHA+ consortium. An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries. Bull World Health Organ. 2016 Apr 1;94(4):297-3

Schmidt BM, Durao S, Toews I, Bavuma CM, Meerpohl JJ, Kredo T: Screening strategies for hypertension: a systematic review protocol. BMJ Open. 2019;9(1):e025043.

Nicol JU, Rohwer A, Young T, Bavuma CM, Meerpohl JJ: Correction to: Integrated models of care for diabetes and hypertension in low- and middle-income countries (LMICs): Protocol for a systematic review. Syst Rev. 2019;8(1):36.

Schmidt BM, Durao S, Toews I, Bavuma CM, Meerpohl JJ, Kredo T. Screening strategies for hypertension (Protocol). Cochrane Database of Systematic Reviews, 2018; Issue 11. Art. No.: CD013212.