Joerg J Meerpohl

• Professor
• Director at University Medical Center Freiburg

To make healthcare decisions, patients, clinicians, clinical practice guideline developers, researchers, policy-makers and health system managers need a comprehensive, critical, accessible, actionable and up-to-date synthesis of all available evidence in a given condition. Systematic reviews and meta-analyses are a cornerstone of healthcare decisio...

The “one-off” approach of systematic reviews is no longer sustainable; we need to move toward producing “living” evidence syntheses (i.e., comprehensive, based on rigorous methods, and up-to-date). This implies rethinking the evidence synthesis ecosystem, its infrastructure and management. The three distinct production systems — primary research, e...

Background: Nutrition and physical activity policies have the potential to influence lifestyle patterns and reduce the burden of non-communicable diseases. In the world of health-related guidelines, GRADE (Grading of Recommendations, Assessment, Development and Evaluation) is the most widely used approach for assessing the certainty of evidence an...

Objectives: The public, policy makers, and science communities are subject to many false, uninformed, overly optimistic, premature, or simply ridiculous health claims. The coronavirus disease 2019 (COVID-19) pandemic and its context is a paramount example for such claims. In this article, we describe why expressing the certainty in evidence to sup...

To become user-driven and more useful for decision-making, the current evidence synthesis ecosystem requires significant changes (Paper 1.Future of evidence ecosystem series). Reviewers have access to new sources of data (clinical trial registries, protocols, clinical study reports from regulatory agencies or pharmaceutical companies) for more info...

Systematic reviews are essential for evidence-based health care, but conducting them is time- and resource-consuming. To date, efforts have been made to accelerate and (semi-)automate various steps of systematic reviews through the use of artificial intelligence (AI) and the emergence of large language models (LLMs) promises further opportunities....

Background: Balancing the risk of thromboembolism and bleeding after transcatheter aortic valve replacement (TAVR) remains clinically challenging. Questions regarding the efficacy and safety of non-vitamin K oral anticoagulants (NOACs) after TAVR still need to be definitively answered. Objectives: To evaluate the efficacy and safety of NOACs aft...

We performed an update (last search: 24 July 2023) of a systematic review on relative efficacy/effectiveness (rVE) and safety of newer/enhanced seasonal influenza vaccines in comparison with standard influenza vaccine or in head‐to‐head comparison. Eligible studies investigated adults aged ≥ 18 years, analysed the MF59‐adjuvanted or high‐dose or ce...

Background: Machine learning (ML) promises versatile help in the creation of systematic reviews (SRs). Recently, further developments in the form of large language models (LLMs) and their application in SR conduct attracted attention. Objective: To provide an overview of ML and specifically LLM applications in SR conduct in health research. Study d...

Zusammenfassung In akuten Krisen wie der COVID-19-Pandemie müssen wissenschaftliche Fragestellungen schnell bearbeitet werden, um die Gesundheit der Bevölkerung zu schützen und die Funktion des Gesundheitssystems aufrechtzuerhalten. Die vorherrschende Dringlichkeit und die Vielzahl zu bearbeitender Fragestellungen bei gleichzeitiger Limitation von...

Background Suboptimal diet quality is a key risk factor for premature death. Assuming relatively stable energy intake among individuals, changes in nutrient intakes occur by exchanging different nutrients. Therefore we aimed to examine the association of isocaloric substitution of dietary (macro)nutrients with all-cause mortality using network meta...

Systematic reviews are essential for evidence based healthcare, but conducting them is time and resource consuming. To date, efforts have been made to accelerate and (semi-) automate various steps of systematic reviews through the use of artificial intelligence and the emergence of large language models (LLMs) promises further opportunities. One cr...

During a pandemic, resilience must be considered not only as an attribute of the health care system, but also of the surrounding research environment. To provide reliable evidence-based advice from university medicine to health policy and decision makers, scientific evidence must be generated, synthesized and communicated in a rapid, integrative an...

Objectives To assess the efficacy and safety of pharmacological interventions for preventing upper gastrointestinal (GI) bleeding in people admitted to intensive care units (ICUs). Design and setting Systematic review and frequentist network meta-analysis using standard methodological procedures as recommended by Cochrane for screening of records,...

Allgemeinverständliche Zusammenfassungen wissenschaftlicher Fachpublikationen (Plain Language Summaries; PLS) haben das Potenzial, die interessierte Öffentlichkeit hochwertig und zugänglich über wissenschaftliche Erkenntnisse zu informieren. Die American Psychological Association (APA) empfiehlt daher seit einigen Jahren, psychologische Fachartikel...

Background: Systematic reviews are performed manually despite the exponential growth of scientific literature. Objective: To investigate the sensitivity and specificity of GPT-3.5 Turbo, from OpenAI, as a single reviewer, for title and abstract screening in systematic reviews. Design: Diagnostic test accuracy study. Setting: Unannotated bibl...

Introduction Large language model (LLM)-linked chatbots are being increasingly applied in healthcare due to their impressive functionality and public availability. Studies have assessed the ability of LLM-linked chatbots to provide accurate clinical advice. However, the methods applied in these Chatbot Assessment Studies are inconsistent due to the...

Importance For the design of a randomized clinical trial (RCT), estimation of the expected event rate and effect size of an intervention is needed to calculate the sample size. Overestimation may lead to an underpowered trial. Objective To evaluate the accuracy of published estimates of event rate and effect size in contemporary cardiovascular RCT...

Background Observational epidemiologic studies provide critical data for the evaluation of the potential effects of environmental, occupational and behavioural exposures on human health. Systematic reviews of these studies play a key role in informing policy and practice. Systematic reviews should incorporate assessments of the risk of bias in resu...

Das übergeordnete Ziel von PREPARED ist die Entwicklung eines Konzepts für eine umfassend realisierbare, kooperative, adaptierbare und nachhaltige Infrastruktur für das Pandemie-Management und die Pandemie-Vorbereitung im Rahmen des NUM. Im Resultat des Projektes entsteht ein ganzheitliches Konzept zur Pandemic Preparedness, einschließlich einer...

Background Implications for research (IfR) sections are an important part of systematic reviews (SRs) to inform health care researchers and policy makers. PRISMA 2020 recommends reporting IfR, while Cochrane Reviews require a separate chapter on IfR. However, it is unclear to what extent SRs discuss IfR. We aimed i) to assess whether SRs include an...

Importance: Systematic reviews are time-consuming and are still performed predominately manually by researchers despite the exponential growth of scientific literature. Objective: To investigate the sensitivity, specificity and estimate the avoidable workload when using an AI-based large language model (LLM) (Generative Pre-trained Transformer [GPT...

The quality of reporting practice guidelines is often poor, and there is no widely accepted ­guidance or standards for such reporting in health care. The international RIGHT (Reporting Items for practice Guidelines in HealThcare) Working Group was established to address this gap. The group followed an existing framework for developing guidelines fo...

Background: In this systematic review, we address the question whether children and adolescents with developmental visual disorders benefit from computer-assisted visual training. Methods: Systematic literature searches were carried out in three bibliographic databases (initial search in October 2021) and trial registries. Included were randomiz...

Background Early in the COVID-19 pandemic, many experts pointed to potential adverse mental health effects for older adults. By contrast, many studies in young to middle-aged adults found older age to be associated with reduced mental burden. However, a systematic review on older adults is missing. Objectives To comprehensively assess the pandemic’...

Background: Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systemati...

Background The prevalence of multi-morbidity is increasing globally. Integrated models of care present a potential intervention to improve patient and health system outcomes. However, the intervention components and concepts within different models of care vary widely and their effectiveness remains unclear. We aimed to describe and map the definit...

Diese Ausgabe des Versorgungs-Reports widmet sich schwerpunktmäßig der Bedeutung von medizinischen Leitlinien in der Gesundheitsversorgung. Leitlinien geben den Behandelnden diagnostische und therapeutische Empfehlungen an die Hand. Sie werden nach systematischen und evidenzbasierten Kriterien entwickelt und zielen darauf ab, die Versorgungsqualitä...

https://www.thieme-connect.de/products/ejournals/html/10.1055/s-0043-1769218

Background: It has been reported that people with COVID-19 and pre-existing autoantibodies against type I interferons are likely to develop an inflammatory cytokine storm responsible for severe respiratory symptoms. Since interleukin 6 (IL-6) is one of the cytokines released during this inflammatory process, IL-6 blocking agents have been used for...

One of the aims of the GRADE Working Group has been to develop a single system that would reduce confusion arising from a legion of multiple conflicting systems for grading evidence and recommendations and serve as unifying lingua franca. Although GRADE has been widely endorsed, the way it is being used is not infrequently inconsistent with GRADE g...

Background: This is the second update of the original Cochrane review published in 2013 (issue 6), which was updated in 2016 (issue 11). Pruritus occurs in patients with disparate underlying diseases and is caused by different pathologic mechanisms. In palliative care patients, pruritus is not the most prevalent but is a burdening symptom. It can c...

Background Implications for research (IfR) sections are an important part of systematic reviews (SRs) in healthcare. The PRISMA 2020 statement recommends discussion of the implications of the results for practice, while Cochrane Reviews require an IfR section. However, it is unclear to what extent systematic reviews discuss IfR and if this section...

Background: To date, more than 761 million confirmed SARS-CoV-2 infections have been recorded globally, and more than half of all children are estimated to be seropositive. Despite high SARS-CoV-2 infection incidences, the rate of severe COVID-19 in children is low. We aimed to assess the safety and efficacy or effectiveness of COVID-19 vaccines a...

Background: Clinical practice guidelines are systematically developed statements intended to optimize patient care. However, a gap-less implementation of guideline recommendations requires health care personnel not only to be aware of the recommendations and to support their content, but also to recognize every situation in which they are applicab...

Objective: Our aim was to investigate if and how Cochrane nutrition reviews assess dietary adherence to a specific dietary regimen. Study design and setting: Cochrane nutrition reviews fulfilling the following criteria were included: systematic review of randomized controlled trials including adults and investigating the effect of caloric restri...

Background Right from the beginning of the SARS-CoV-2 pandemic the general public faced the challenge to find reliable and understandable information in the overwhelming flood of information. To enhance informed decision-making, evidence-based information should be provided. Aim was to explore the general public’s information needs and preferences...

Background: The success of elective colorectal surgery is mainly influenced by the surgical procedure and postoperative complications. The most serious complications include anastomotic leakages and surgical site infections (SSI)s, which can lead to prolonged recovery with impaired long-term health. Compared with other abdominal procedures, colore...

Background: Various formalisms have been developed to represent clinical practice guideline recommendations in a computer-interpretable way. However, none of the existing formalisms leverage the structured and computable information that emerge from the evidence-based guideline development process. Thus, we here propose a FHIR-based format that us...

Ziel des Manuals ist es, in grundlegende Aspekte der Bewertung der Qualität von systematischen Reviews zu therapeutischen Interventionen einzuführen. Das Manual richtet sich primär an alle wissenschaftlich tätigen Personen und Gruppen, die sich mit der kritischen Bewertung von systematischen Reviews befassen bzw. sich für diese interessieren. Das M...

Systematic reviews (SRs) have become a central tool for evidence-based health care over the last 30 years. The number of SRs being published has increased steadily. However, concerns have been raised regarding the duplication of work, methodological flaws and the currency of many systematic reviews, also in the context of the COVID-19 pandemic. Liv...

Objective To examine the effects of different nutritional intervention strategies in the school setting on anthropometric and quality of diet outcomes by comparing and ranking outcomes in a network meta-analysis. Design Systematic review and network meta-analysis. Data sources PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web...

Objective The Collaboration for Evidence-Based Healthcare and Public Health in sub-Saharan Africa (CEBHA+), a research network, aims to build capacities for evidence-based healthcare. Hypertension (HTN) and diabetes mellitus (DM) are two priority areas of the network, both are major causes of burden of disease in this region. This review aimed to:...

Background: Different forms of vaccines have been developed to prevent the SARS-CoV-2 virus and subsequent COVID-19 disease. Several are in widespread use globally. OBJECTIVES: To assess the efficacy and safety of COVID-19 vaccines (as a full primary vaccination series or a booster dose) against SARS-CoV-2. Search methods: We searched the Cochra...

https://www.iqwig.de/download/ht21-03_sehtraining-bei-kindern-und-jugendlichen_hta-bericht_v1-0.pdf, Health Technology Assessment im Auftrag des IQWiG, ThemenCheck Medizin, HT21-03

Background: Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Evidence to Decision (EtD) frameworks are well-known tools that enable guideline panels to structure the process of developing recommendations and making decisions in healthcare and public health. To date, they have not regularly been used for health policy-maki...

Objective: Back pain is common in the working population. This systematic review with network meta-analysis (NMA) aimed to compare the effects of interventions for preventing back pain among office workers. Methods: We searched eight databases and additional sources up to March 2021. We included randomized controlled trials (RCT) and cluster RCT...

Background Randomized controlled trials (RCTs) and cohort studies are the most common study design types used to assess treatment effects of medical interventions. We aimed to hypothetically pool bodies of evidence (BoE) from RCTs with matched BoE from cohort studies included in the same systematic review. Methods BoE derived from systematic revie...

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess in hospitalised older people with (risk of) malnutrition the effects of different nutrition interventions (e.g. supportive interventions, nutritional counselling, food modifications, oral nutritional supplements, comprehensive individualise...

Background During the design of a randomized controlled trial (RCT), the estimation of the expected event rate (ER) and effect size (ES) of an intervention is an essential step to calculate the sample size, which determines the scope of the trial. Overestimation of ER and ES might lead to an underpowered trial design. Objective To evaluate the acc...

Background: Acute graft-versus-host disease (aGvHD) is a major cause of morbidity and mortality after haematopoietic stem cell transplantation (HSCT), occurring in 8% to 85% of paediatric recipients. Currently, the therapeutic mainstay for aGvHD is treatment with corticosteroids. However, there is no established standard treatment for steroid-refr...

Objective To describe (i) registered and (ii) published systematic reviews (SRs) on COVID-19 treatments, and to analyze (iii) the proportion of publications among registered SRs and (iv) the proportion of registrations among published SRs. Study design and setting This meta-research study (CRD42021240423) is part of CEOsys, http://www.covid-eviden...

Background Post-entry studies are a key element in managed entry agreements and aim at generating evidence about the additional benefit of new medical interventions before reimbursement decisions are made. This study evaluates the willingness of different stakeholder groups to engage post-entry in studies for benefit assessment and to assess differ...

Objective To provide insights into women’s attitudes towards a human papillomavirus (HPV)-based cervical cancer screening strategy. Data sources Medline, Web of Science Core Collection, Cochrane Library, PsycINFO, CINAHL and ClinicalTrials.gov were systematically searched for published and ongoing studies (last search conducted in August 2021). M...

Background: Vaccines are effective in preventing severe COVID-19, a disease for which few treatments are available and which can lead to disability or death. Widespread vaccination against COVID-19 may help protect those not yet able to get vaccinated. In addition, new and vaccine-resistant mutations of SARS-CoV-2 may be less likely to develop if...

Background Clinical practice guidelines are systematically developed statements intended to optimize patient care. However, a gap-less implementation of guideline recommendations requires health care personnel not only to be aware of the recommendations and to support their content, but also to recognize every situation in which they are applicable...

BACKGROUND Clinical practice guidelines are systematically developed statements intended to optimize patient care. However, a gapless implementation of guideline recommendations requires health care personnel not only to be aware of the recommendations and to support their content but also to recognize every situation in which they are applicable....

Background: Chronic graft-versus-host disease (cGvHD) is a major cause of morbidity and mortality after haematopoietic stem cell transplantation, occurring in 6% to 65% of the paediatric recipients. Currently, the therapeutic mainstay for cGvHD is treatment with corticosteroids, frequently combined with other immunosuppressive agents in people wit...

Public health and social measures (PHSM) have been central to the COVID-19 response. Consequently, there has been much pressure on decision-makers to make evidence-informed decisions and on researchers to synthesize the evidence regarding these measures. This article describes our experiences, responses and lessons learnt regarding key challenges w...

Background Various formalisms have been developed to represent clinical practice guideline recommendations in a computer-interpretable way. However, none of the existing formalisms leverage the structured and computable information that emerge from the evidence-based guideline development process. Thus, we here propose a FHIR-based guideline repres...

Background Randomized controlled trials (RCTs) and cohort studies are the most common study design types used to assess the treatment effects of medical interventions. To evaluate the agreement of effect estimates between bodies of evidence (BoE) from randomized controlled trials (RCTs) and cohort studies and to identify factors associated with dis...

Objective: We investigated characteristics of systematic reviews (SRs) assessing measures to prevent COVID-19 by (1) identifying SR registrations in Prospective Register of Systematic Reviews (PROSPERO), (2) identifying published SRs in COVID-19 Living Overview of the Evidence (L-OVE) and (3) estimating the proportion of PROSPERO registrations pub...

Objectives Comprehensive protocols are key for the planning and conduct of randomised clinical trials (RCTs). Evidence of low reporting quality of RCT protocols led to the publication of the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) checklist in 2013. We aimed to examine the quality of reporting of RCT protocols fr...

(1) Background: Health care workers (HCWs) play a key role in increasing anti-COVID vaccination rates. Fear of potential side effects is one of the main reasons for vaccine hesitancy. We investigated which side effects are of concern to HCWs and how these are associated with vaccine hesitancy. (2) Methods: Data were collected in an online survey in...

Background We previously found that 25% of 1,017 randomized clinical trials (RCTs) approved between 2000 and 2003 were discontinued prematurely, and 44% remained unpublished at a median of 12 years follow-up. We aimed to assess a decade later (1) whether rates of completion and publication have increased; (2) the extent to which nonpublished RCTs c...

https://www.iqwig.de/download/ht19-01_nicht-medikamentoese-verfahren-bei-lymphoedem_hta-bericht_v1-0.pdf Health Technology Assessment im Auftrag des IQWiG ThemenCheck Medizin HT19-01

Objectives To evaluate the development and quality of actionable statements that qualify as good practice statements (GPS) reported in COVID-19 guidelines. Design and setting Systematic review . We searched MEDLINE, MedSci, China National Knowledge Infrastructure (CNKI), databases of Grading of Recommendations Assessment, Development and Evaluatio...

An evidence-based approach is considered the gold standard for health decision-making. Sometimes, a guideline panel might judge the certainty that the desirable effects of an intervention clearly outweigh its undesirable effects as high, but the body of supportive evidence is indirect. In such cases, the application of the Grading of Recommendation...

Only very few Cochrane nutrition reviews include cohort studies (CSs), but most evidence in nutrition research comes from CSs. We aimed to pool bodies of evidence (BoE) from randomized controlled trials (RCTs) derived from Cochrane reviews with matched BoE from CSs. The Cochrane Database of Systematic Reviews, and MEDLINE were searched for systemat...

Objective There is little empirical evidence of the impact of pooling randomized controlled trials (RCTs) and cohort studies (CSs) on the certainty-of-evidence. To evaluate the hypothetical-scenario of pooling bodies-of-evidence from RCTs with matched bodies-of-evidence from CSs on the certainty-of-evidence. Study design and setting We extracted G...

Objective Our objective was to develop an extension of the widely used GIN-McMaster Guideline Development Checklist and Tool for the integration of quality assurance and improvement (QAI) schemes with guideline development. Study Design and Setting We used a mixed-methods approach incorporating evidence from a systematic review, an expert workshop...

Purpose Food-derived bioactive peptides may influence important physiological functions. An important example is beta-casomorphins, which are opioid peptides derived from A1 beta-casein in bovine milk and have been associated to be risk factors for non-communicable diseases in humans. A1 and A2 beta-casein are different with respect to the release...

Background: Cardiovascular diseases (CVD) are a major cause of disability and the leading cause of death worldwide. To reduce mortality and morbidity, prevention strategies such as following an optimal diet are crucial. In recent years, low-gluten and gluten-free diets have gained strong popularity in the general population. However, study results...

Objective To identify and describe the use of the GRADE dose-response-gradient domain to upgrade the certainty-of-evidence (CoE) in nutrition systematic-reviews (SRs). Study design and setting We searched for SRs of observational studies of nutrition topics that used GRADE and upgraded the CoE of at least one outcome for a dose-response-gradient,...

Background: Interleukin-1 (IL-1) blocking agents have been used for treating severe coronavirus disease 2019 (COVID-19), on the premise that their immunomodulatory effect might be beneficial in people with COVID-19. Objectives: To assess the effects of IL-1 blocking agents compared with standard care alone or with placebo on effectiveness and sa...

Introduction: The development process for clinical guidelines is influenced by factors that are relevant to the validity of a guideline but often are not captured sufficiently in the final guideline documents. PANELVIEW is an English-language tool that can be used to explore the guideline development process from the perspective of guideline group...

Background: When the SARS-CoV-2 pandemic began, no uniform treatment and care strategies for critically ill COVID-19 patients were yet available. National and international treatment recommendations were formulated under time pressure, initially on the basis of indirect evidence from the treatment of similar diseases. In this article, we give an o...