Evidence map›Paper›PMID 31429718›Full record

SynthesisBMC medical research methodology2019

Hierarchies of evidence applied to lifestyle Medicine (HEALM): introduction of a strength-of-evidence approach based on a methodological systematic review.

D L Katz, M C Karlsen, M Chung, M M Shams-White, L W Green, J Fielding, A Saito, W Willett

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medical research methodology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  20. Grading nutrition evidence: where to go from here?The American journal of clinical nutrition · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

D L KatzAmerican College of Lifestyle Medicine, PO Box 6432, Chesterfield, MO, 63006, USA.
M C KarlsenAmerican College of Lifestyle Medicine, PO Box 6432, Chesterfield, MO, 63006, USA. mkarlsen@lifestylemedicine.org.ORCID 0000-0002-9365-151X
M ChungDepartment of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.
M M Shams-WhiteRisk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 4E204, Bethesda, MD, 20850, USA.
L W GreenDepartment of Epidemiology and Biostatistics, University of California at San Francisco School of Medicine, 550 16th Street, Second Floor, San Francisco, CA, 94158, USA.
J FieldingUniversity of California Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
A SaitoBrown University School of Public Health, 121 S Main St, Providence, RI, 02903, USA.
W WillettHarvard University T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA.

Funding

ACL HHS U48DP005023NCCDPHP CDC HHS U48 DP005023
6 · The paper itself

Abstract

backgroundCurrent methods for assessing strength of evidence prioritize the contributions of randomized controlled trials (RCTs). The objective of this study was to characterize strength of evidence (SOE) tools in recent use, identify their application to lifestyle interventions for improved longevity, vitality, or successful aging, and to assess implications of the findings.

methodsThe search strategy was created in PubMed and modified as needed for four additional databases: Embase, AnthropologyPlus, PsycINFO, and Ageline, supplemented by manual searching. Systematic reviews and meta-analyses of intervention trials or observational studies relevant to lifestyle intervention were included if they used a specified SOE tool. Data was collected for each SOE tool. Conditions necessary for assigning the highest SOE grading and treatment of prospective cohort studies within each SOE rating framework were summarized. The expert panel convened to discuss the implications of findings for assessing evidence in the domain of lifestyle medicine. RESULTS AND

conclusionsA total of 15 unique tools were identified. Ten were tools developed and used by governmental agencies or other equivalent professional bodies and were applicable in a variety of settings. Of these 10, four require consistent results from RCTs of high quality to award the highest rating of evidence. Most SOE tools include prospective cohort studies only to note their secondary contribution to overall SOE as compared to RCTs. We developed a new construct, Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM), to illustrate the feasibility of a tool based on the specific contributions of diverse research methods to understanding lifetime effects of health behaviors. Assessment of evidence relevant to lifestyle medicine requires a potential adaptation of SOE approaches when outcomes and/or exposures obviate exclusive or preferential reliance on RCTs. This systematic review was registered with the International Prospective Register of Systematic Reviews, PROSPERO [CRD42018082148].

Indexed as

Health BehaviorLife StyleResearch DesignAgedAgingBiomedical ResearchEvidence-Based MedicineHumansRandomized Controlled Trials as TopicHEALMLifestyle medicineLifetime effectsSOEStrength of evidenceSystematic review

Identifiers

PMID31429718
PMCPMC6701153

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.