CoChat
Sign Up
Cited by 90Meta-analysis and systematic reviewsAdvanced Causal Inference TechniquesStatistical Methods in Epidemiology

Observational studies often make clinical practice recommendations: an empirical evaluation of authors' attitudes

Prasad, Vinay, Jorgenson, Joel, Ioannidis, John P.A., Cifu, Adam·2013·Journal of Clinical Epidemiology
DOI 10.1016/j.jclinepi.2012.11.005
Open this paper in CoChat — free account

Abstract

Objectives Although observational studies provide useful descriptive and correlative information, their role in the evaluation of medical interventions remains contentious. There has been no systematic evaluation of authors' attitudes toward their own nonrandomized studies and how often they recommend specific medical practices.Study design and setting We reviewed all original articles of nonrandomized studies published in 2010 in New England Journal of Medicine, Lancet, Journal of the American Medical Association, and Annals of Internal Medicine. We classified articles based on whether authors recommend a medical practice and whether they state that a randomized trial is needed to support their recommendation. We also examined the types of logical extrapolations used by authors who did advance recommendations.Results Of the 631 original articles published in 2010, 298 (47%) articles were eligible observational studies. In 167 (56%) of 298 studies, authors recommended a medical practice based on their results. Only 24 (14%) of 167 studies stated that a randomized controlled trial (RCT) should be done to validate the recommendation, whereas the other 143 articles made a total of 149 logical extrapolations to recommend specific medical practices. Recommendations without a call for a randomized trial were most common in studies of modifiable factors (59%), but they were also common in studies reporting incidence or prevalence (51%), studies examining novel tests (41%), and association studies of nonmodifiable factors (32%).Conclusion The authors of observational studies often extrapolate their results to make recommendations concerning a medical practice, typically without first calling for a RCT.

Integrity signals

Registry

Crossref · 10.1016/j.jclinepi.2012.11.005

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Implication of a causal relationship even after stating that the evidence is insufficient to reach causal conclusions may introduce error into bodies of published literature.

    “Publication bias [20, 21], lack of replicability and replication [22], implication of a causal relationship even after stating that the evidence is insufficient to reach causal conclusions [23–25], and related phenomena may also introduce error into bodies of published literature.”

    From Causal language and strength of inference in academic and media articles shared in social media (CLAIMS): A systematic review (2018) · cites this paper as [24]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Prasad, V., Jorgenson, J., Ioannidis, J. P. A., & Cifu, A.
Affiliations
  • National Institutes of Health (US)
  • Northwestern University (US)
  • Stanford Medicine (US)
  • University of Chicago Medical Center (US)
Corresponding author
Cifu, Adam
ORCID
Venue
Journal of Clinical Epidemiology
Publisher
Elsevier BV
Published
2013-04
Volume
66
Issue
4
Pages
361-366.e4
ISSN
0895-4356 (ISSN-L)
DOI
10.1016/j.jclinepi.2012.11.005
OpenAlex
W1980717696
Semantic Scholar
5c30d113922fec89305d584409a7aefcebfcf16a
Cited by
90
References
40
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 25 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 7 · 2015: 8 · 2014: 8 · 2013: 8
FWCI
2.09
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Clinical Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Keywords
observational studies, clinical guidelines, author attitudes, non-randomized studies, randomized controlled trials, evidence-based medicine, medical journal articles, modifiable risk factors
MeSH terms
Attitude, Authorship, Humans, Epidemiologic Research Design, Observation, Empirical Research, Research Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review