Deans' stroke musings: Wasted research when systematic reviews fail to provide a complete and up-to-date evidence synthesis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, January 26, 2016

Wasted research when systematic reviews fail to provide a complete and up-to-date evidence synthesis

This is completely true in stroke. So much so that I wonder if our researchers even read other research in the field.
http://www.mdlinx.com/internal-medicine/medical-news-article/2016/01/26/lung-cancer/6505672/?newsdt=012616&subspec_id=0&utm_source=DailyNL&utm_medium=newsletter&utm_content=general-article&utm_campaign=article-section&category=daily-digest&page_id=1
Multiple treatments are frequently available for a given condition, and clinicians and patients need a comprehensive, up–to–date synthesis of evidence for all competing treatments. Authors aimed to quantify the waste of research related to the failure of systematic reviews to provide a complete and up–to–date evidence synthesis over time. They illustrate how systematic reviews of a given condition provide a fragmented, out–of–date panorama of the evidence for all treatments. This waste of research might be reduced by the development of live cumulative network meta–analyses.

Methods

Authors performed a series of systematic overviews and networks of randomized trials assessing the gap between evidence covered by systematic reviews and available trials of second–line treatments for advanced non–small cell lung cancer.
They searched the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, EMBASE, and other resources sequentially by year from 2009 to March 2, 2015.
They sequentially compared the amount of evidence missing from systematic reviews to the randomized evidence available for inclusion each year.
They constructed cumulative networks of randomized evidence over time and evaluated the proportion of trials, patients, treatments, and treatment comparisons not covered by systematic reviews on December 31 each year from 2009 to 2015.

Results

They identified 77 trials (28,636 patients) assessing 47 treatments with 54 comparisons and 29 systematic reviews (13 published after 2013).
From 2009 to 2015, the evidence covered by existing systematic reviews was consistently incomplete: 45 % to 70 % of trials; 30 % to 58 % of patients; 40 % to 66 % of treatments; and 38 % to 71 % of comparisons were missing.
In the cumulative networks of randomized evidence, 10 % to 17 % of treatment comparisons were partially covered by systematic reviews and 55 % to 85 % were partially or not covered.