Tips for Trusting Evidence

Echoing some of the themes from the previous night’s keynote, a morning breakout session at the 13^th annual Association of VA Hematology/Oncology (AVAHO) meeting focused on helping researchers interpret statistics and determine the usefulness of clinical studies or guidelines. Three presentations comprised the session, titled, “Making Sense of the Evidence: Useful Strategies to Appraise Clinical Trials and Guidelines”

The session opened with a discussion of critical appraisal. According to Melissa V. Taylor, PhD, RN, associate chief nurse for research at VA Pittsburgh Healthcare System, critical appraisal involves the systematic examination of research to accomplish an assessment of validity, results, and relevance to inform clinical practice. This, according to Taylor, involves 2 steps: appraise an individual piece of research, then appraise all the research studies that collectively examine the same clinical issue or question.

“While critical appraisal won’t necessarily give us the right answer about that research study,” said Taylor, “it will give us some insight into whether a piece of research is good enough to use in clinical decision making.”

Beverly Priefer, PhD, RN, focused her presentation on the usefulness of clinical guidelines and whether or not they should be followed. Preifer defined clinical practice guidelines as statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. She stressed that these are not mandates and health care providers can focus an appraisal of guidelines on the following metrics found in the Appraisal of Guidelines for Research & Evaluation II:

• Scope and purpose;
• Stakeholder involvement;
• Rigor of development;
• Clarity of presentation;
• Applicability;
• Editorial independence; and
• Overall assessment.

The final presentation of the session, “Beyond the P Value: What is the Evidence Telling Us,” examined the usefulness of P values in research studies. Although ubiquitous in the literature, “a p value is just one tool in your tool box…there are other models that might be just as valid and not incompatible with the data,” according to Paula K. Roberson, PhD, professor and chair of the department of biostatistics at the University of Arkansas for Medical Sciences. Roberson dove into the 6 principals of the American Statistical Association’s statement that address misconceptions and misuse of the P value. She also suggested that other measures, such as confidence intervals or odds ratios, may provide insight that P values cannot.

Echoing some of the themes from the previous night’s keynote, a morning breakout session at the 13^th annual Association of VA Hematology/Oncology (AVAHO) meeting focused on helping researchers interpret statistics and determine the usefulness of clinical studies or guidelines. Three presentations comprised the session, titled, “Making Sense of the Evidence: Useful Strategies to Appraise Clinical Trials and Guidelines”

The session opened with a discussion of critical appraisal. According to Melissa V. Taylor, PhD, RN, associate chief nurse for research at VA Pittsburgh Healthcare System, critical appraisal involves the systematic examination of research to accomplish an assessment of validity, results, and relevance to inform clinical practice. This, according to Taylor, involves 2 steps: appraise an individual piece of research, then appraise all the research studies that collectively examine the same clinical issue or question.

“While critical appraisal won’t necessarily give us the right answer about that research study,” said Taylor, “it will give us some insight into whether a piece of research is good enough to use in clinical decision making.”

Beverly Priefer, PhD, RN, focused her presentation on the usefulness of clinical guidelines and whether or not they should be followed. Preifer defined clinical practice guidelines as statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. She stressed that these are not mandates and health care providers can focus an appraisal of guidelines on the following metrics found in the Appraisal of Guidelines for Research & Evaluation II:

• Scope and purpose;
• Stakeholder involvement;
• Rigor of development;
• Clarity of presentation;
• Applicability;
• Editorial independence; and
• Overall assessment.

The final presentation of the session, “Beyond the P Value: What is the Evidence Telling Us,” examined the usefulness of P values in research studies. Although ubiquitous in the literature, “a p value is just one tool in your tool box…there are other models that might be just as valid and not incompatible with the data,” according to Paula K. Roberson, PhD, professor and chair of the department of biostatistics at the University of Arkansas for Medical Sciences. Roberson dove into the 6 principals of the American Statistical Association’s statement that address misconceptions and misuse of the P value. She also suggested that other measures, such as confidence intervals or odds ratios, may provide insight that P values cannot.

Echoing some of the themes from the previous night’s keynote, a morning breakout session at the 13^th annual Association of VA Hematology/Oncology (AVAHO) meeting focused on helping researchers interpret statistics and determine the usefulness of clinical studies or guidelines. Three presentations comprised the session, titled, “Making Sense of the Evidence: Useful Strategies to Appraise Clinical Trials and Guidelines”

The session opened with a discussion of critical appraisal. According to Melissa V. Taylor, PhD, RN, associate chief nurse for research at VA Pittsburgh Healthcare System, critical appraisal involves the systematic examination of research to accomplish an assessment of validity, results, and relevance to inform clinical practice. This, according to Taylor, involves 2 steps: appraise an individual piece of research, then appraise all the research studies that collectively examine the same clinical issue or question.

“While critical appraisal won’t necessarily give us the right answer about that research study,” said Taylor, “it will give us some insight into whether a piece of research is good enough to use in clinical decision making.”

Beverly Priefer, PhD, RN, focused her presentation on the usefulness of clinical guidelines and whether or not they should be followed. Preifer defined clinical practice guidelines as statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. She stressed that these are not mandates and health care providers can focus an appraisal of guidelines on the following metrics found in the Appraisal of Guidelines for Research & Evaluation II:

• Scope and purpose;
• Stakeholder involvement;
• Rigor of development;
• Clarity of presentation;
• Applicability;
• Editorial independence; and
• Overall assessment.

The final presentation of the session, “Beyond the P Value: What is the Evidence Telling Us,” examined the usefulness of P values in research studies. Although ubiquitous in the literature, “a p value is just one tool in your tool box…there are other models that might be just as valid and not incompatible with the data,” according to Paula K. Roberson, PhD, professor and chair of the department of biostatistics at the University of Arkansas for Medical Sciences. Roberson dove into the 6 principals of the American Statistical Association’s statement that address misconceptions and misuse of the P value. She also suggested that other measures, such as confidence intervals or odds ratios, may provide insight that P values cannot.