http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 A graphic framework for teaching critical appraisal of randomised controlled trials http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:9926 Students of evidence-based medicine often try unsuccessfully to commit to memory a particular critical appraisal framework (often lengthy), or they have to depend on pocket cards and are lost without them. We have described a pedagogic aid: a flow diagram of an RCT, which has been developed over years of teaching residents. This diagram focuses on the steps in an RCT, and by drawing arrows, it highlights the biases possible at each step. This diagram serves as a framework on which the list of critical appraisal questions can be hung and is easy to remember. 2012-02-08T22:10:10.870Z ]]> Effectiveness of strategies to encourage general practitioners to accept an offer of free access to online evidence-based information: a randomised controlled trial http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7839 Background: This study examined the effectiveness of seven different interventions designed to increase the proportion of general practitioners (GPs) accepting an offer of free access to an online evidence-based resource. Methods: Australian GPs (n = 14,000) were randomly selected and assigned to seven intervention groups, with each receiving a different letter. Seven different strategies were used to encourage GPs to accept an offer of two years free access to an online evidence-based resource (BMJ Clinical Evidence). The first group received a standard letter of offer with no experimental demands. Groups two to seven received a standard letter of offer outlining the requirements of the study. They were asked to complete an initial online questionnaire, agree to complete a 12-month follow-up questionnaire, and agree to having data about their usage of the online evidence-based resource provided to researchers. Groups three to seven also had additional interventions included in the letter of offer: access to an online tutorial in use of the resource (group three); provision of a pamphlet with statements from influential opinion leaders endorsing the resource (group four); offer of eligibility to receive professional development points (group five); offer of eligibility for a prize of $500 for registration at a medical conference of their choice (group six); and a combination of some of the above interventions (group seven). Results: In the group with no research demands, 27% accepted the offer. Average acceptance across all other groups was 10%. There was no advantage in using additional strategies such as financial incentives, opinion leader support, offer of professional development points, or an educational aid over a standard letter of offer to increase acceptance rates. Conclusion: This study showed low acceptance rates of the offer of access to the online resource when there was an associated requirement of response to a short online questionnaire and non-obtrusive monitoring of GP behaviour in terms of accessing the resource. If we are to improve care and encourage evidence-based practice, we need to find effective ways of motivating doctors and other health professionals to take part in research that can inform our implementation efforts. 2012-01-30T05:13:16.973Z ]]> The effects of a reduced-sodium, high-potassium salt substitute on food taste and acceptability in rural northern China http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:6990 A potassium chloride-containing salt substitute lowers blood pressure levels, but its overall acceptability has been of concern due to its potential adverse effects on food taste. In a large-scale, blinded randomised trial evaluating the comparative effects of a salt substitute (65% sodium chlofide, 25% potassium chloride and 10% magnesium sulphate) and a normal salt (100% sodium chloride) on blood pressure, we collected data on the saltiness, flavour and overall acceptability of food. We performed this at baseline, 1, 6 and 12 months post-randomisation using 100 mm visual analogue scales for assessments of both home-cooked foods and a standard salty soup. The mean age of the 608 participants from rural northern China was 60 years and 56% of them were females. In the primary analyses, the changes in the saltiness, flavour and overall acceptability of both home-cooked foods and a standard salty soup were not different between the randomised groups (all P>0.08). In the secondary analyses, weighting each of the data points according to the lengths of the respective follow-up intervals, the flavour of both home-cooked foods (mean difference = -1.8 mm, P=0.045) and a standard salty soup (mean difference = -1.9mm, P=0.03) was slightly weaker in the salt substitute group. We conclude that salt substitution is both an effective and an acceptable means of blood pressure control. Possible small differences in flavour did not importantly deter the use of the salt substitute in this study group, although the acceptability of the salt substitute by a more general population group would need to be confirmed. 2012-01-30T05:04:13.420Z ]]> Smoking and pregnancy http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:1052 2011-02-08T23:00:01.500Z ]]>