All trials identified byhand search by the Unit of Evaluation of Technologies in Health, were ass... more All trials identified byhand search by the Unit of Evaluation of Technologies in Health, were assessed for quality ofrandomization, blinding, analysis of results and other characteristics of trial design, along withthe application of Jadad’s Score, that assesses the methodological quality of clinical trials in ascale that ranges from 0 to 5.
Background Systematic reviews allow health decisions to be informed by the best available researc... more Background Systematic reviews allow health decisions to be informed by the best available research evidence. However, their number is proliferating quickly, and many skills are required to identify all the relevant reviews for a specific question. Methods and findings We screen 10 bibliographic databases on a daily or weekly basis, to identify systematic reviews relevant for health decision-making. Using a machine-based approach developed for this project we select reviews, which are then validated by a network of more than 1000 collaborators. After screening over 1,400,000 records we have identified more than 300,000 systematic reviews, which are now stored in a single place and accessible through an easy-to-use search engine. This makes Epistemonikos the largest database of its kind. Conclusions Using a systematic approach, recruiting a broad network of collaborators and implementing automated methods, we developed a one-stop shop for systematic reviews relevant for health decisio...
Background Symptom management in rheumatoid arthritis (RA) remains a complex challenge. Widesprea... more Background Symptom management in rheumatoid arthritis (RA) remains a complex challenge. Widespread use of cannabis-based medicines for a myriad of symptoms has fostered rheumatology patients' interest. However, their safety and efficacy in RA remain unclear. Objective The aim of this study was to perform a structured summary of the body of evidence in order to determine whether cannabis, cannabis-derived products, and synthetic cannabinoids are an effective treatment for rheumatoid arthritis. Methods An electronic search in Epistemonikos database was performed to identify systematic reviews and their primary studies that addressed our clinical question. The body of evidence was collected in a pivot table in Epistemonikos. Information and data from the primary studies were extracted from the identified reviews. Finally, extracted data were reanalyzed, and a summary of findings table was generated using the Grading of Recommendations Assessment, Development and Evaluation approach. Results Twenty-six systematic reviews were identified which included in total only 1 randomized trial assessing our clinical question. Conclusions Cannabis, cannabis-derived products and synthetic cannabinoids may slightly reduce disease activity in patients with RA. Its use may result in little to no difference in pain reduction and may slightly increase nervous system adverse events. The evidence is very uncertain about the effect of cannabis, cannabis-derived products, and synthetic cannabinoids on serious adverse events risk.
International Journal of Environmental Research and Public Health, 2021
The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observa... more The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into ac...
Objective This living, systematic review aims to provide a timely, rigorous, and continuously upd... more Objective This living, systematic review aims to provide a timely, rigorous, and continuously updated summary of the evidence available on the role of macrolides for treating patients with COVID-19. Design A living, systematic review. Database We conducted searches in the centralized repository L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from the Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customized to group all COVID-19 evidence in one place. Today it is maintained through regular searches in 39 databases. Methods We included randomized trials evaluating the effect of macrolides — as monotherapy or in combination with other drugs — versus placebo or no treatment in patients with COVID-19. Randomized trials evaluating macrolides in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomized studies in COVID-19 were sear...
ABSTRACTOBJECTIVETo assess the therapeutic effects of cannabis, cannabis-derived products and syn... more ABSTRACTOBJECTIVETo assess the therapeutic effects of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis.DESIGNThis is the protocol of a systematic review. DATA SOURCES: Searches will be conducted in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), trial registries, grey literature and in a centralized repository in L-OVE (Living OVerview of Evidence). L-OVE is a platform that maps PICO questions to evidence from Epistemonikos database.ELIGIBILITY CRITERIA FOR SELECTING STUDIES AND METHODSWe will include randomized controlled trials evaluating therapeutic use of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis. Our primary interest will be in trials comparing the intervention with placebo or no treatment (intervention plus optimal treatment vs placebo plus optimal treatment or optimal treatment alone) in patients receiving optimal treatment for rheumatoid arthritis. Optimal t...
The efficacy of using gloves by the general population to prevent COVID-19 is unknown. Despite no... more The efficacy of using gloves by the general population to prevent COVID-19 is unknown. Despite not having evidence to support its use, a large number of people have decided to use them, and governments and media don’t have a clear message about using gloves by the general population. If we also consider the shortage of medical supplies, it’s crucial to determine the efficacy of routine glove use by the general population in preventing COVID-19. Using innovative and agile processes, taking advantage of technological tools, and resorting to the collective effort of several research groups, this living systematic review aims to provide a timely, rigorous and continuously updated summary of the evidence available on the the efficacy of the use of gloves in the prevention of COVID-19 disease in healthy population.
Aiming to prevent thromboembolic events, bed rest was historically considered in the management o... more Aiming to prevent thromboembolic events, bed rest was historically considered in the management of patient with deep vein thrombosis. Nevertheless early ambulation could have beneficial effects. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified seven systematic reviews including 10 randomized trials answering this question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded early ambulation is probably effective in reducing deep vein thrombosis progression and improving limb pain, and might not increase the risk of thromboembolism.
Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available heal... more Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available health evidence. This paper describes the design, development and implementation of the Epistemonikos project. Using several web technologies to store systematic reviews, their included articles, overviews of reviews and structured summaries, Epistemonikos is able to provide a simple and powerful search tool to access health evidence for sound decision making. Currently, Epistemonikos stores more than 115,000 unique documents and more than 100,000 relationships between documents. In addition, since its database is translated into 9 different languages, Epistemonikos ensures that non-English speaking decision-makers can access the best available evidence without language barriers.
All trials identified byhand search by the Unit of Evaluation of Technologies in Health, were ass... more All trials identified byhand search by the Unit of Evaluation of Technologies in Health, were assessed for quality ofrandomization, blinding, analysis of results and other characteristics of trial design, along withthe application of Jadad’s Score, that assesses the methodological quality of clinical trials in ascale that ranges from 0 to 5.
Background Systematic reviews allow health decisions to be informed by the best available researc... more Background Systematic reviews allow health decisions to be informed by the best available research evidence. However, their number is proliferating quickly, and many skills are required to identify all the relevant reviews for a specific question. Methods and findings We screen 10 bibliographic databases on a daily or weekly basis, to identify systematic reviews relevant for health decision-making. Using a machine-based approach developed for this project we select reviews, which are then validated by a network of more than 1000 collaborators. After screening over 1,400,000 records we have identified more than 300,000 systematic reviews, which are now stored in a single place and accessible through an easy-to-use search engine. This makes Epistemonikos the largest database of its kind. Conclusions Using a systematic approach, recruiting a broad network of collaborators and implementing automated methods, we developed a one-stop shop for systematic reviews relevant for health decisio...
Background Symptom management in rheumatoid arthritis (RA) remains a complex challenge. Widesprea... more Background Symptom management in rheumatoid arthritis (RA) remains a complex challenge. Widespread use of cannabis-based medicines for a myriad of symptoms has fostered rheumatology patients' interest. However, their safety and efficacy in RA remain unclear. Objective The aim of this study was to perform a structured summary of the body of evidence in order to determine whether cannabis, cannabis-derived products, and synthetic cannabinoids are an effective treatment for rheumatoid arthritis. Methods An electronic search in Epistemonikos database was performed to identify systematic reviews and their primary studies that addressed our clinical question. The body of evidence was collected in a pivot table in Epistemonikos. Information and data from the primary studies were extracted from the identified reviews. Finally, extracted data were reanalyzed, and a summary of findings table was generated using the Grading of Recommendations Assessment, Development and Evaluation approach. Results Twenty-six systematic reviews were identified which included in total only 1 randomized trial assessing our clinical question. Conclusions Cannabis, cannabis-derived products and synthetic cannabinoids may slightly reduce disease activity in patients with RA. Its use may result in little to no difference in pain reduction and may slightly increase nervous system adverse events. The evidence is very uncertain about the effect of cannabis, cannabis-derived products, and synthetic cannabinoids on serious adverse events risk.
International Journal of Environmental Research and Public Health, 2021
The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observa... more The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into ac...
Objective This living, systematic review aims to provide a timely, rigorous, and continuously upd... more Objective This living, systematic review aims to provide a timely, rigorous, and continuously updated summary of the evidence available on the role of macrolides for treating patients with COVID-19. Design A living, systematic review. Database We conducted searches in the centralized repository L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from the Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customized to group all COVID-19 evidence in one place. Today it is maintained through regular searches in 39 databases. Methods We included randomized trials evaluating the effect of macrolides — as monotherapy or in combination with other drugs — versus placebo or no treatment in patients with COVID-19. Randomized trials evaluating macrolides in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomized studies in COVID-19 were sear...
ABSTRACTOBJECTIVETo assess the therapeutic effects of cannabis, cannabis-derived products and syn... more ABSTRACTOBJECTIVETo assess the therapeutic effects of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis.DESIGNThis is the protocol of a systematic review. DATA SOURCES: Searches will be conducted in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), trial registries, grey literature and in a centralized repository in L-OVE (Living OVerview of Evidence). L-OVE is a platform that maps PICO questions to evidence from Epistemonikos database.ELIGIBILITY CRITERIA FOR SELECTING STUDIES AND METHODSWe will include randomized controlled trials evaluating therapeutic use of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis. Our primary interest will be in trials comparing the intervention with placebo or no treatment (intervention plus optimal treatment vs placebo plus optimal treatment or optimal treatment alone) in patients receiving optimal treatment for rheumatoid arthritis. Optimal t...
The efficacy of using gloves by the general population to prevent COVID-19 is unknown. Despite no... more The efficacy of using gloves by the general population to prevent COVID-19 is unknown. Despite not having evidence to support its use, a large number of people have decided to use them, and governments and media don’t have a clear message about using gloves by the general population. If we also consider the shortage of medical supplies, it’s crucial to determine the efficacy of routine glove use by the general population in preventing COVID-19. Using innovative and agile processes, taking advantage of technological tools, and resorting to the collective effort of several research groups, this living systematic review aims to provide a timely, rigorous and continuously updated summary of the evidence available on the the efficacy of the use of gloves in the prevention of COVID-19 disease in healthy population.
Aiming to prevent thromboembolic events, bed rest was historically considered in the management o... more Aiming to prevent thromboembolic events, bed rest was historically considered in the management of patient with deep vein thrombosis. Nevertheless early ambulation could have beneficial effects. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified seven systematic reviews including 10 randomized trials answering this question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded early ambulation is probably effective in reducing deep vein thrombosis progression and improving limb pain, and might not increase the risk of thromboembolism.
Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available heal... more Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available health evidence. This paper describes the design, development and implementation of the Epistemonikos project. Using several web technologies to store systematic reviews, their included articles, overviews of reviews and structured summaries, Epistemonikos is able to provide a simple and powerful search tool to access health evidence for sound decision making. Currently, Epistemonikos stores more than 115,000 unique documents and more than 100,000 relationships between documents. In addition, since its database is translated into 9 different languages, Epistemonikos ensures that non-English speaking decision-makers can access the best available evidence without language barriers.
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Papers by Gabriel Rada