Institut für Evidenz in der Medizin

This project will provide new insights into the controversial field of nutrition research by comparing the concordance of effect estimates of outcome-specific bodies of evidence from randomized controlled trials and cohort studies, and help us understand the reasons for these discrepancies.

In this project, 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 after solid organ transplantation.

The aim is to develop and test a program to support and promote the self-management of people after organ transplantation. Experts and those affected will be involved. The research project is funded by the Federal Ministry of Education and Research (BMBF)

Link to the SMART project page of the Institute of Nursing Sciences

Back pain is widespread and causes a considerable amount of disability and high costs worldwide. The workplace offers an important starting point for interventions to prevent back pain. The available interventions are diverse and often include different components, such as exercise in combination with education and ergonomic adjustments of the workplace.

The aim of this systematic review is to identify different workplace-based interventions for the prevention of non-specific back pain and to compare their effects using a network meta-analysis. If possible, the effects of individual intervention components will also be determined and compared in a component network meta-analysis. Based on the analyses, the interventions will be ranked according to their effectiveness. This should make it possible to identify the most promising interventions for the prevention of back pain in workplace-related settings.

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

The aim of the project is to compare different nutritional intervention strategies that have been evaluated in randomized controlled trials (RCTs) with a network meta-analysis (NMA) and to derive a ranking of the most effective nutritional intervention strategies in the primary prevention of overweight and obesity in the school setting.

Background

The classic systematic review is not ideal for quickly providing up-to-date and reliable bases for decision-making in a pandemic with a high level of research momentum. The CEOsys joint project aims to use living evidence syntheses and the recommendations for action derived from them to ensure the quality of medical care, support political decisions and focus research activities for pandemic management on the most urgent issues.

Methods

The joint project CEOsys with 21 universities and four other partners is funded by the BMBF as part of the University Medicine Network. CEOsys is building a national evidence ecosystem of human studies on COVID-19. Registered, ongoing or completed studies on COVID-19 will be systematically recorded and their results evaluated in a standardized manner. This work provides the basis for "living", i.e. regularly updated evidence syntheses.

CEOsys covers the following COVID-19 topics:

1. Testing and diagnostics
2. Outpatient and inpatient treatment
3. Intensive and palliative medical 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 will be developed on the basis of the findings and communicated to specific target groups. From this, the interdisciplinary joint project CEOsys generates recommendations for action for

1. healthcare practice
2. the health of the population
3. the most urgent further research steps

CEOsys establishes a quality-assured information platform for science, the healthcare system, the population and political decision-makers.

Health Technology Assessment (HTA)

Health Technology Assessment (HTA)

In the project, IfEM supports the preparation of an IUNS position paper on dietary fat and quality of different fats in the prevention of chronic diseases. In this context, the IfEM is preparing scoping reviews in which the evidence from systematic reviews and guidelines on the topic of dietary fat and fat quality is analyzed.

The overall project aims to improve health literacy with regard to childhood vaccinations and thus support informed and self-determined decisions. In various work packages, the information needs of parents are recorded, the existing evidence for various childhood vaccinations is processed, vaccination decision aids are developed and tested, and finally evaluated.
As a project partner, IfEM is responsible for the systematic research and evidence synthesis. Evidence-based dossiers on the efficacy and safety of the rotavirus vaccine, the pneumococcal vaccine and the six-way vaccine are being compiled. This information forms the basis for the vaccination decision aids.

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

Non-communicable diseases such as type 2 diabetes, cardiovascular diseases, cancer and respiratory diseases are responsible for more than 70% of global deaths. Unhealthy diets and a lack of physical activity are the main risk factors for the development of these diseases. In many European countries, political measures are being implemented to bring about a lasting change in diet and exercise habits. However, the effects of such measures have not yet been systematically recorded and evaluated.

The European Policy Evaluation Network (PEN) consists of 28 research institutions from 7 European countries and New Zealand. The primary aim is to develop tools for Europe that can be used to evaluate and assess policy measures to promote healthy eating and physical activity or to reduce sedentary behavior.

Risk perception and risk attitude in long-term opioid therapy in outpatients with chronic, non-tumor-related pain.

The increasing inappropriate prescription of opioids as long-term therapy in patients with chronic non-tumor-related pain (CNTS) in the outpatient setting in Germany and the resulting threat to patient safety calls for a systematic understanding of the reasons for the sometimes inappropriate prescription and the associated increase in the risk of adverse drug-related events (ADEs). The "ERONA" project aims to close this knowledge gap in the area of long-term opioid therapy for CNTS patients in the outpatient setting through systematic, experimental research into risk assessment and risk decisions by physicians and patients, taking into account the way in which they learn about the risks of drug therapy (description versus experience). Based on this, the project aims to develop solutions for interventions that are suitable for reducing identified reasons for inadequate drug therapy safety in the area of inappropriate opioid prescribing through facility-independent, online-based educational formats.

GELL-ALTER creates an evidence map of studies investigating treatment preferences of older patients with multiple diseases.

Physician-patient consultations are often complex in older patients with multiple conditions due to interactions between conditions and treatments, as well as multiple 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 conditions prioritize illnesses 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 investigated patient preferences of older patients with multiple conditions in order to map them in an evidence map (EM) and thus represent evidence clusters (and gaps); (2) conduct a full systematic review (SR) on one of the evidence clusters. The results will be communicated to patient organizations and GP advanced training institutions.

Publications:

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

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

The aim of the systematic review is to evaluate the effectiveness 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 science-initiated versus industry-initiated primary studies are (1) published, (2) cited in systematic reviews and (3) included in guidelines and thus available for 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 as they test the efficacy and safety of already approved drugs as well as their use outside the approved indication area (off-label use), e.g. drugs for the treatment of rare diseases.

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

Publications

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

MEDIATE aims to improve the media and social discourse on diagnostic tests through evidence-based, ethically reflected scientific communication.

The joint project is funded by the BMBF program "Discourse projects on ethical, legal and social issues in the modern life sciences". Using the example of selected test procedures, the necessary content-related quality criteria for educational information on diagnostic tests as well as quality criteria for the communication of this information to users will be discussed and agreed upon in discourse with both young and experienced science journalists and physicians.

In a multi-stage process (review of evidence, quality assessment of reporting, seminars, workshops and symposia), recommendations on quality requirements for educational information for the care process as well as for reporting in the media are to 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; 16.10.2018, 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 information 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 the media discourse influence the use of diagnostic tests from the perspective of physicians and medical ethicists and is this influence seen positively or negatively?

Popular science articles

Gauch, Labonté, Rüschemeyer 2019 Relieved, anxious, full of remorse? The consequences of a non-invasive prenatal diagnostic test (NIPT) on the psyche of pregnant women. WissenWasWirkt - Cochrane blogs in German.

The cluster-randomized GAP study evaluates in Bavarian GP practices whether the use of digitally prepared and evidence-based health information during the consultation improves the informedness and utilization behavior of back pain patients.

Individually appropriate medical treatment for which the patient and physician share responsibility can have a positive influence on the course of the disease. Patients in particular must be put in a position to make well-informed decisions. However, citizens and patients are increasingly informing themselves about illnesses and treatment options and are overwhelmed by the amount and quality of information found on the Internet. Doing one's own research is also controversial in the medical profession, as self-information can confuse patients and dubious health information is often not easy to recognize.

The GAP project builds on established European information systems such as NHS Choices and provides patients and GPs with a platform of evidence-based information on back pain during and after consultations. The study examines how physicians' and patients' informedness, assessment of physician-patient communication and perceived patient involvement differ in the groups with and without platform use. Other endpoints examined are the days of incapacity for work caused by back pain and the utilization of the healthcare system.

Publications

Brief project description at the Innovation Committee

Lang B, Kunzweiler K, Voigt-Radloff S. Well-informed communication between physicians and patients 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, Woll-mann 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 that aims to expand evidence-based healthcare and public health in Africa.

The overall objective of the CEBHA+ project is to build sustainable capacities and infrastructure for evidence-based health care 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+ has a population-based approach that includes both prevention of disease and 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.