Effect of population screening for type 2 diabetes

Effect of population screening for type 2 diabetes
by Medical Xpress August 24, 2017
"Three large trials published today in Diabetologia (the journal of the European Association for the Study of Diabetes) show that screening for type 2 diabetes and cardiovascular risk factors may not reduce mortality and cardiovascular disease in the general population. However, for individuals diagnosed with diabetes, screening is associated with a reduction in mortality and cardiovascular disease risk. " full text

Articles mentioned in this news:

• Simmons (2017). Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults
• Simmons (2017). Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009
• Feldman (2017). Screening for type 2 diabetes: do screen-detected cases fare better?
• Simmons (2017). Should we screen for type 2 diabetes among asymptomatic individuals? Yes
• Shaw (2017). Does the evidence support population-wide screening for type 2 diabetes? No

continuing professional education

Continuing Professional Education & Glossary by JECH


2008

• Hruschka (2008/11). A glossary of culture in epidemiology
• Gunasekara (2008/10). Glossary for econometrics and epidemiology
• Freeman (2008/9).Gone viral? Heard the buzz? A guide for public health practitioners and researchers on how Web 2.0
• Millar (2008/8). Glossary of terms relating to capture–recapture methods
• Starfield (2008/7). The concept of prevention: a good idea gone astray?
• Bambra (2008/1). The welfare state: a glossary for public health

2007

• Bambra (2007/12). The psychosocial and health effects of workplace reorganisation. 2. A systematic review of task restructuring interventions
• De Mario (2007/10). Income inequality measures
• Laurent (2007/08). Effect of socioeconomic status on the relationship between atmospheric pollution and mortality
• Rutherford (2007/08). Violence: a glossary, and Violence: a priority for public health? (part 2)
• Bambra (2007/07). A politics of health glossary
• Whitehead (2007/06). A typology of actions to tackle social inequalities in health
• Deary (2007/05). Cognitive epidemiology
• Moore (2007/04). Public health preparedness: a systems-level approach
• Decullier (2007/03). Oral presentation bias: a retrospective cohort study
• Burger (2007/03). A glossary on psychiatric epidemiology
• Rezaeian (2007/02).Geographical epidemiology, spatial analysis and geographical information systems: a multidisciplinary glossary
• Tite (2007/01). Why do peer reviewers decline to review? A survey

2006

• A glossary for the social epidemiology of work organisation
• Benach (2006/11). Part 1, Terms from social psychology
• Muntaner (2006/12). Part 2 Terms from the sociology of work and organisations
• Hadden (2007/01). Part 3, Terms from the sociology of labour markets
• Bray (2006/10). Advanced paternal age: How old is too old?
• Baum (2006/10). Participatory action research
• Whittaker (2006/10). Pragmatic randomised controlled trials in parenting research: the issue of intention to treat
• Alvarez-Dardet (2006/08). Democratisation and health after the fall of the Wall
• Susser (2006/08). A personal history: social medicine in a South African setting, 1952–5. Part 2: Social medicine as a calling: ups, downs, and politics in Alexandra Township
• Labonte (2006/08). Glossary of the World Trade Organisation and public health: part 1    
• Labonte (2006/09). Glossary on the World Trade Organisation and public health: part 2   
• Carpiano (2006/07). A guide and glossary on postpositivist theory building for population health
• Popay (2006/07). Whose theory is it anyway?
• Dunn (2006/07). Speaking theoretically about population health
• Vagero (2006/07). Where does new theory come from?
• Carpiano (2006/07). Theory building on the high seas of population health: Love Boat, Mutiny on the Bounty, or Poseidon Adventure
• Hernan (2006/07). Estimating causal effects from epidemiological data
• Loue (2006/06). Community health advocacy
• Eriksson (2006/05). Antonovsky’s sense of coherence scale and the relation with health: a systematic review
• Waters (2006/04). Evaluating the effectiveness of public health interventions: the role and activities of the Cochrane Collaboration
• Barreto (2006/03). Infectious diseases epidemiology
• King (2006/03). What same sex civil partnerships may mean for health
• Galobardes (2006/01). Indicators of socioeconomic position (part 1), and (part 2)

2005

• Agyemang (2005/12). Labelling African origin populations in the health arena in the 21st       
• Nguyen (2005/11). Terms in reproductive and perinatal epidemiology: I. Reproductive terms
• Nguyen (2005/12). Terms in reproductive and perinatal epidemiology: 2. Perinatal terms
• Krantz (2005/10). Violence against women
• Merlo. A brief conceptual tutorial on multilevel analysis in social epidemiology:
• 2005/09. Investigating contextual phenomena in different groups of people
• 2005/12. Interpreting neighbourhood differences and the effect of neighborhood characteristics on individual health
• 2006/04. Using measures of clustering in multilevel logistic regression to investigate contextual phenomena
• De Silva (2005/08). Social capital and mental illness: a systematic review
• McKee (2005/08). International cooperation and health. Part I: issues and concepts and Part 2: making a difference
• Baum (2005/07). Wealth and health: the need for more strategic public health research
• Neutra (2005/07). Glossary of terms used when discussing exposure to electric and magnetic fields
• Lindstrom (2005/06). Salutogenesis
• Merlo (2005/06). A brief conceptual tutorial of multilevel analysis in social epidemiology
• Krieger (2005/04). Embodiment: a conceptual glossary for epidemiology
• Khawaja (2005/04). Poverty
• Pless (2005/03). Injury prevention: a glossary of terms
• Spencer (2005/02). Social paediatrics
• Barnett (2005/02). Excess in cardiovascular events on Mondays: a meta-analysis and prospective study
• McLaren (2005/01). Ecological perspectives in health research

2004

• Hawe (2004/12). A glossary of terms for navigating the field of social network analysis
• Halliday (2004/11). Genetics and public health—evolution, or revolution?
• Regidor (2004/10). Measures of health inequalities: part 1 and part 2
• Mackenbach (2004/09). Streets of Paris, sunflower seeds, and Nobel prizes. Reflections on the quantitative paradigm of public health
• Kawachi (2004/09). Five American authors on wealth, poverty, and inequality
• Almeida-Filho (2004/09). Saramago’s All the Names and the epidemiological dream
• Berridge (2004/09). History of addictions
• Delgado-Rodriguez (2004/08). Bias
• Rychetnik (2004/07). A glossary for evidence based public health
• Bhopal (2004/06). Glossary of terms relating to ethnicity and race: for reflection and debate
• Chapman (2004/05). Advocacy for public health: a primer
• Hernan (2004/04). A definition of causal effect for epidemiological research
• Jefferson (2004/04). Peer review
• Howden-Chapman (2004/03). Housing standards: a glossary of housing and health
• Barker (2004/02). Developmental origins of adult health and disease
• Rodriguez-Artalejo (2004/02). Cardiovascular epidemiology and prevention
• Tunstall (2004/01). Places and health

2003

• Illich (2003/12). Medical nemesis
• Kuh (2003/10). Life course epidemiology
• Mindell (2003/09). A glossary for health impact assessment
• Malats (2003/06). Basic molecular genetics for epidemiologists
• Malats (2003/07). Basic glossary on genetic epidemiology
• Malats (2003/08). Advanced glossary on genetic epidemiology
• Baum (2003/05). Social capital
• Berridge (2003/03). Public health history
• Garcia (2003/01). A glossary for research in occupational health 

Syndemics: health in context

Syndemics: health in context
A syndemic, coined by Merrill Singer in mid-1990s, is a conceptual framework for understanding diseases or health conditions that arise in populations and that are exacerbated by the social, economic, environmental, and political milieu in which a population is immersed. The today's issue of Lancet published a series related the syndemic... full text ...

Information about the Global Burden of Diseases, Injuries, and Risk Factors Study

Information about the Global Burden of Diseases, Injuries, and Risk Factors Study

• WHO: the Global Burden of Disease (GBD) project
• Lancet Global Burden of Disease
• UW website directed Christopher Murray
• Wikipedia: History of GDB
• List of causes and ICD9 and ICD10 of these causes in eTable 2 of supplement
• Search title with "Global Burden of Disease Study" on the PubMed

All-cause mortality was increasing among US middle age whites

All-cause mortality was increasing among US middle age Whites


Title: Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century
Authors: Anne Case and Angus Deaton
Abstract: This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, thosewith less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration. Full text: PNAS

Related articles:

• Epimonitor: All Cause mortality rate takes surprising upward turn for middle age Whites in the US
• The Washington Post: Prestigious medical journals rejected stunning study on deaths among middle-aged whites
• The New York Times: Death rates rising for middle-aged White Americans, study finds
• Vox: A big study found spiking death rates for middle-aged white Americans. Critics say it's more complicated
• New York: Anne Case, Co-author of the White Mortality Paper, Responds to a New Critique of Its Approach to Gender (Updated)

Ecological fallacy & atomistic fallacy

Ecological fallacy & atomistic fallacy

As epidemiologists, usually we are told to avoid ecological fallacy, which is making a incorrect inference at lower level (individual) using the information at higher level (group); However, we may think little about the opposite fallacy, atomistic fallacy, which is making a incorrect inference at higher level (group) using the information at lower level (individual). Even worse, some may think the individual level information are only gold standard for policy making.

References

• Ecological fallacy - Wikipedia
• A Glossary for Multilevel Analysis - Epidemiologic Bulletin, PAHO. This article by A V Diez Roux also is on the J Epidemiol Community Health (2002)
• The fallacy of the ecological fallacy: the potential misuse of a concept and the consequences. - S Schwartz (1994)

Odds Ratio, Risk Ratio, and Prevalence Ratio

Odds Ratio, Risk Ratio, and Prevalence Ratio

Deddens (2008). Approaches for estimating prevalence ratios.

Petersen (2008). A comparison of two methods for estimating prevalence ratios.
Lumley (2006). Relative Risk Regression in Medical Research: Models, Contrasts,Estimators, and Algorithms.

Spiegelman (2005). Easy SAS calculations for risk or prevalence ratios and differences.
Santos (2008). Estimating adjusted prevalence ratio in clustered cross-sectional epidemiological data.
Savu (2009). Estimation of relative risk and prevalence ratio (pdf).
Barros (2003). Alternatives for logistic regression in cross-sectional studies. (using Stata)
Lee (1993). Estimation of prevalence rate ratios for cross sectional data: an example in occupational epidemiology, and (1994) Use of the prevalence ratio v the prevalence odds ratio as a measure of risk in cross sectional studies.
Thompson (1998). Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done?

How can I estimate relative risk using glm for common outcomes in cohort studies using Stata or SAS? Source: UCLA Statistical Computing.

Understanding RR Ratios in Multinomial Logistic Regression. Source: UCLA Statistical Computing.

FW: A Firm Diagnosis of Frailty - NYTimes.com

A Firm Diagnosis of Frailty
Source: NYTimes.com


... After years of observing and working with older patients, Dr. Fried recognized objective hallmarks of frailty, and in the 1990s developed a definition of frailty in people 65 and older that called for the diagnosis when three or more of the following five criteria were present: unintentional weight loss of 10 pounds or more in the past year, self-reported exhaustion, weakness as measured by grip strength, slow walking speed and low physical activity. The presence of one or two of those criteria would identify a person as "pre-frail."

In pursuit of scientific excellence: sex matters

In pursuit of scientific excellence: sex matters
by Virginia M. Miller
The comments of this article is from the perspective of biology, but may help us to understand existed sex/gender arguments from the perspective of public health.
"...
In the era of physiological genomics and individualized medicine, the presence of an XX or XY chromosomal complement is fundamental to the genome of an individual person, animal, tissue, or cell. Every cell has a sex.
Therefore, based on existing knowledge, it is inappropriate to assume that results from studies conducted on only one sex apply to the other (13). For some studies of neonates and embryos, cells derived from males and females are mixed in a single culture and should be reported as such. The scientific community needs to determine whether this technique is valid by providing sufficient data to control and confirm survival, differentiation, and function of cells of each sex. Similarly, cell-based therapies need to validate survival and function of the cell graft in the same- and opposite-sexed recipients.
...
How then should the sex of experimental material be reported? Use of the terms "sex" and "gender" has evolved over the last decade. According to definitions proposed by the Institute of Medicine (23), "sex" is a biological construct dictated by the presence of sex chromosomes and in animals and humans the presence of functional reproductive organs. "Gender" is a cultural construct and refers to behaviors that might be directed by specific stimuli (visual, olfactory, etc.) or by psychosocial expectations that result from assigned or perceived sex. Gender, thus, can influence biological outcomes. In most studies conducted on isolated cells, tissues can be classified as male or female by the sex chromosomal complement and for experimental animals by the sex chromosomal complement and anatomical features. Similar information may be available for humans. However, humans may self-report their sex according to gender and some studies in animals can be designed to address influences of psychosocial (gender) constructs on physiological outcomes (12). The new editorial policy for all APS journals requires the reporting of sex for cells, tissues, and experimental animals and humans (i.e., male and female) or gender where appropriate. The investigator must decide based on the experimental design which terms are most appropriate for a given study.
..."
Full text of article

In defence of white rice | BMJ

In defence of white rice
by Kadoch
The finding of an increased risk of type 2 diabetes with higher consumption of white rice1 is not surprising because suboptimal results are to be expected whenever a whole plant food is refined. This is especially true with other poor lifestyle practices. Nevertheless, I worry that we are losing the forest among the trees.
White rice has been the staple of the Asian diet for thousands of years. For most of that time it produced some of the most slender people in history. Western diseases such as diabetes and coronary artery disease were almost unheard of in this region.2 Only after the comparatively recent adoption of high fat Western dietary habits, focused primarily on animal products and highly processed junk foods, have these illnesses become more prevalent in Asia.
Diets centred on white rice have, in fact, produced some of the most dramatic health benefits reported in the medical literature. The rice diet, as pioneered by Walter Kempner, has repeatedly been shown to drastically reduce hypertension, insulin resistance, and obesity.3 Low fat diets emphasising starch have reversed diabetes and coronary artery disease.4 5 These remarkable studies were all inspired by the traditional Asian cuisine.
Encouraging patients to choose intact whole grains such as brown rice is certainly warranted. However, to rescue the Asian population from a mounting epidemic of chronic lifestyle diseases, most effort should be focused on removing the cause-the toxic Western diet. This may even justify promoting a return to white rice, instead of condemning it outright.
Full text of article

Tools for Innovative Thinking in Epidemiology

Tools for Innovative Thinking in Epidemiology

By Roberta B. Ness

Source: American Journal of Epidemiology

“Innovation is the engine of scientific progress. Concern has been raised by the National Academies of Science about how well America is sustaining its ‘‘creative ecosystem.’’ In this commentary, the author argues that we can all improve our ability to think innovatively through instruction and practice. The author presents a series of tools that are currently being taught in a curriculum developed at the University of Texas, based on earlier evidence-based creativity training programs. The tools are these: 1) finding the right question; 2) enhancing observation; 3) using analogies; 4) juggling induction and deduction; 5) changing your point of view; 6) broadening the perspective; 7) dissecting the problem; 8) leveraging serendipity and reversal; 9) reorganization and combination of ideas; 10) getting the most out of groups; and 11) breaking out of habitual expectations and frames. Each tool is explained using examples from science and public health. It is likely that each of us will identify with and agree with the usefulness of one or two of the tools described. Broader mastery of many of these tools, particularly when used in combination, has provided our students with a powerful device for enhancing innovation.”

Read full text here

Study Says DNA’s Power to Predict Illness Is Limited - NYTimes.com

Study Says DNA's Power to Predict Illness Is Limited
By Gina Kolata of the New York Times
...
If every aspect of a person's DNA is known, would it be possible to predict the diseases in that person's future? And could that knowledge be used to forestall the otherwise inevitable?
The answer, according to a new study of twins, is, for the most part, "no."
...
Full Text: here
Original Research Article: The Predictive Capacity of Personal Genome Sequencing

BMJ Basic Concepts for Reading Health Articles

Basic Concepts for Reading Health Articles by BMJ

• How to read a paper
• Epidemiology for the uninitiated
• Academic medicine
• Statistics at square one
• Photographs of twentieth century doctors

Sex-Specific Reporting of Scientific Research A Workshop Sum...

Sex-Specific Reporting of Scientific Research: A Workshop Summary

Editors

Institute of Medicine (US) Board on Population Health and Public Health Practice.

Source

Washington (DC): National Academies Press (US); 2012.
The National Academies Collection: Reports funded by National Institutes of Health.

Excerpt

On August 30, 2011, the Institute of Medicine hosted a workshop, Sex-Specific Reporting of Scientific Research, sponsored by the Office of Research on Women's Health (ORWH) of the National Institutes of Health (NIH). The workshop explored the need for sex-specific reporting of scientific results; potential barriers and unintended consequences of sex-specific reporting of scientific results; experiences of journals that have implemented sex-specific requirements, including the challenges and benefits of such editorial policies; and steps to facilitate the reporting of sex-specific results. Presenters and participants included current and former editors of scientific journals, researchers, and scientists and policymakers from government, industry, and nonprofit organizations. Presentations and discussions highlighted the importance to both women and men of having sex-specific data, the problems with sample size and financial constraints for conducting the research, the appropriateness of sex-specific analyses, and the limitations of journal policies to change experimental designs. During closing remarks, the planning committee chair summarized some of the individual suggestions discussed for advancing sex-specific reporting as: identifying the sex of populations in journal populations, sharing of sex-identified raw data, giving extra credit in review to manuscripts that include sex-specific information, and requiring sex-stratified analyses where applicable.
Copyright © 2012, National Academy of Sciences.

Sections

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE ON SEX-SPECIFIC REPORTING OF SCIENTIFIC RESEARCH: A WORKSHOP
• Reviewers
• OVERVIEW
• INTRODUCTION
• INCLUSION OF WOMEN IN CLINICAL TRIALS FUNDED BY THE NATIONAL INSTITUTES OF HEALTH
• WHY SEX-SPECIFIC REPORTING IS IMPORTANT
• THE RESEARCHER PERSPECTIVE: COLLECTING, ANALYZING, AND REPORTING SEX-SPECIFIC DATA
• THE EDITOR PERSPECTIVE: IMPLEMENTING JOURNAL EDITORIAL POLICIES
• IMPLICATIONS FOR JOURNALS OF SEX-SPECIFIC REPORTING POLICIES OF JOURNALS
• LOOKING FORWARD
• CLOSING REMARKS
• REFERENCES
• APPENDIXES

PMID:22379657[PubMed]

Books & DocumentsFree full text

Sex-Specific Reporting of Scientific Research: A Workshop SummaryFree full text

Thoughts: Hazards of dependence on surrogate endpoints

Thoughts: Hazards of dependence on surrogate endpoints


HK: Professor Yudkin et al. (The idolatry of the surrogate (2011)) offer a very important insight into the use of surrogate endpoints in medical science.   They argue that this practice - so widespread, especially in diabetes care - is tantamount to losing sight of the patient's interest.   It's a very readable piece -- a challenge to much of our work in public health & chronic-disease epidemiology.   It adds to the growing chorus of criticisms directed at the "guidelines" we (used to) cherish.

YC:  I like to read this kind of article.We are fool only when we think surrogate is a real/only cause of the disease. I agree that the hard event is the most important for evaluation of a treatment. However, the authors seem ignoring the whole spectrum of development of science, which is from short range (quick surrogate) to long range (hard event). If a drug even cannot control the level of meaningful surrogate such as glucose and blood pressure, I don’t think that the drug is good for controlling of the hard event beyond the surrogate.


BTW, the example of rosiglitazone exactly demonstrates that the scientists or physicians (maybe I need say good scientists ^_^) didn’t forget the target beyond the glucose and stop digging up more evidences. Anyhow, this is a heads-up for someone.

Selected References of The idolatry of the surrogate (2011):

• ebook: Institute of Medicin (2010).Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease.
• Yudkin JS, Richter B, Gale EAM. Intensified glucose lowering in type 2 diabetes: time for a reappraisal (2010); Intensified glucose control in type 2 diabetes—whose agenda? Lancet (2011)
• Emerging Risk Factors Collaboration (2010). C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality.
• O’Connor PJ, Bodkin NL, Fradkin J, Glasgow RE, Greenfield S, Gregg E, et al (2011). Diabetes performance measures: current status and future directions.
• Lehman R, Yudkin JS and Krumholz HM (2010). Licensing drugs for diabetes.

Journal Article - Heart Disease and Stroke Statistics—2012 Update from the AHA

Journal Article - Heart Disease and Stroke Statistics—2012 Update from the AHA

"Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on disease morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document." … 

Full text: here (pdf)

GRADE guidelines (Grades of Recommendation, Assessment, Development, and Evaluation)

GRADE guidelines (Grades of Recommendation, Assessment, Development, and Evaluation)

From Journal of Clinical Epidemiology (JCE)

JCE published some systemic recommendations/guidance for rating quality of evidence and grading strength of recommendations in healthcare on two issues. I combined these related linkages below:

JCE Volume 64, Issue 4

Standards, guidelines, and norms

Challenges in guideline methodology

GRADE guidelines: A new series of articles in the Journal of Clinical Epidemiology

GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables

GRADE guidelines: 2. Framing the question and deciding on important outcomes

GRADE guidelines: 3. Rating the quality of evidence

GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias)

JCE Volume 64, Issue 12

Evidence, (un)certainty, and clinical practice

GRADE: complex decisions

Strength of evidence and handling uncertainty: practical considerations and general observations

GRADE guidelines: 5. Rating the quality of evidence—publication bias

GRADE guidelines 6. Rating the quality of evidence—imprecision

GRADE guidelines: 7. Rating the quality of evidence—inconsistency

GRADE guidelines: 8. Rating the quality of evidence—indirectness

GRADE guidelines: 9. Rating up the quality of evidence

 

Mixed Methods Research

NIH RELEASES BEST PRACTICES FOR COMBINING QUALITATIVE AND QUANTITATIVE RESEARCH 

The National Institutes of Health today released recommendations or best practices <http://obssr.od.nih.gov/scientific_areas/methodology/mixed_methods_research/index.aspx> for scientists conducting mixed methods health research. Mixed methods research combines the strengths of quantitative research and qualitative research. Despite the increased interest in mixed methods research in health fields and at NIH, prior to this report, there was limited guidance to help scientists developing applications for NIH funding that featured mixed methods designs, nor was there guidance for the reviewers at NIH who assess the quality of these applications. 

The CONSORT Statement Website

CONSORT, which stands for Consolidated Standards of Reporting Trials, encompasses various initiatives developed by the CONSORT Group to alleviate the problems arising from inadequate reporting of randomized controlled trials (RCTs).

The main product of CONSORT is the CONSORT Statement, which is an evidence-based, minimum set of recommendations for reporting RCTs. It offers a standard way for authors to prepare reports of trial findings, facilitating their complete and transparent reporting, and aiding their critical appraisal and interpretation.

The CONSORT Statement comprises a 25-item checklist and a flow diagram, along with some brief descriptive text. The checklist items focus on reporting how the trial was designed, analyzed, and interpreted; the flow diagram displays the progress of all participants through the trial.

Considered an evolving document, the CONSORT Statement is subject to periodic changes as new evidence emerges. This website contains the current definitive version of the CONSORT Statement and up-to-date information on extensions.

Guidelines for Reporting Observational & RCT Studies

• Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies
• The CONSORT 2010 Statement is intended to improve the reporting of a randomized controlled trial (RCT), also on Annals of Internal Medicine 
• The flow diagram is intended to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of a trial (enrollment, intervention allocation, follow-up, and analysis).