Evidence map›Paper›PMID 26504102›Full record

Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2016

Do clinicians understand the size of treatment effects? A randomized survey across 8 countries.

Bradley C Johnston, Pablo Alonso-Coello, Jan O Friedrich, Reem A Mustafa, Kari A O Tikkinen, Ignacio Neumann, Per O Vandvik, Elie A Akl, Bruno R da Costa, Neill K Adhikari and 6 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 12 pooled it
5.1field-weighted citation impact, top 3% of its field
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

50 citing papers in PubMed, 12 syntheses or guidelines pooled it, 108 citations in OpenAlex.

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  8. Citicoline for treating people with acute ischemic stroke.The Cochrane database of systematic reviews · 2020
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  11. Prevalence Of Review Studies Published In Rehabilitation Journals During The Last Decade.Journal of rehabilitation medicine. Clinical communications · 2018
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 2 institutions in 2 countries.

Bradley C JohnstonDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont. bradley.johnston@sickkids.ca.
Pablo Alonso-CoelloDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Jan O FriedrichDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Reem A MustafaDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Kari A O TikkinenDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Ignacio NeumannDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Per O VandvikDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Elie A AklDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Bruno R da CostaDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Neill K AdhikariDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Gemma Mas DalmauDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Elise KosunenDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Jukka MustonenDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Mark W CrawfordDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Lehana ThabaneDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Gordon H GuyattDepartment of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael's Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri-Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Tampere University · FIPublic Health Ontario · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMeta-analyses of continuous outcomes typically provide enough information for decision-makers to evaluate the extent to which chance can explain apparent differences between interventions. The interpretation of the magnitude of these differences - from trivial to large - can, however, be challenging. We investigated clinicians' understanding and perceptions of usefulness of 6 statistical formats for presenting continuous outcomes from meta-analyses (standardized mean difference, minimal important difference units, mean difference in natural units, ratio of means, relative risk and risk difference).

methodsWe invited 610 staff and trainees in internal medicine and family medicine programs in 8 countries to participate. Paper-based, self-administered questionnaires presented summary estimates of hypothetical interventions versus placebo for chronic pain. The estimates showed either a small or a large effect for each of the 6 statistical formats for presenting continuous outcomes. Questions addressed participants' understanding of the magnitude of treatment effects and their perception of the usefulness of the presentation format. We randomly assigned participants 1 of 4 versions of the questionnaire, each with a different effect size (large or small) and presentation order for the 6 formats (1 to 6, or 6 to 1).

resultsOverall, 531 (87.0%) of the clinicians responded. Respondents best understood risk difference, followed by relative risk and ratio of means. Similarly, they perceived the dichotomous presentation of continuous outcomes (relative risk and risk difference) to be most useful. Presenting results as a standardized mean difference, the longest standing and most widely used approach, was poorly understood and perceived as least useful.

interpretationNone of the presentation formats were well understood or perceived as extremely useful. Clinicians best understood the dichotomous presentations of continuous outcomes and perceived them to be the most useful. Further initiatives to help clinicians better grasp the magnitude of the treatment effect are needed.

Indexed as

ComprehensionSurveys and QuestionnairesTreatment OutcomeFemaleHumansInternationalityMaleRiskStatistics as Topic

Identifiers

PMID26504102
PMCPMC4695351
OpenAlexW2213253325

What OpenQuestion holds

Textmetadata
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 OpenQuestion graph.