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Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS)
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  • Published on:
    Access to the AXIS tool in full is available here

    Access to the AXIS tool in full is available at this website www.epinet.net

    Conflict of Interest:
    None declared.
  • Published on:
    Publication bias "baked into" conventional systematic review methods
    • Erick H Turner, physician-researcher Oregon Health & Science University

    The method proposed here follows the conventional systematic review approach, which is to begin with a search of the published literature. Unfortunately, it is becoming increasingly apparent that clinical trials are published selectively. Thus the notion that the published literature will provide an accurate and unbiased view of a drug's risk-benefit ratio is no longer tenable. In order to circumnavigate this problem, one must look "upstream" by seeking and working with an inception cohort of clinical trials. (As one example, one sees a quite different estimate of the efficacy of antidepressants medications, depending on whether the cohort is from the published literature or from a regulatory agency (e.g. FDA).*) The term "systematic review" could, and in my opinion should, apply to the "systematic" use of an inception cohort, not an approach based on a selective subset of that cohort.

    * Turner EH, Matthews AM, Linardatos E, et al. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med 2008;358:252–60. doi:10.1056/NEJMsa065779

    Conflict of Interest:
    None declared.