Research
Do clinicians understand the size of treatment effects? A randomized survey across 8 countries
Bradley C. Johnston, Pablo Alonso-Coello, Jan O. Friedrich, Reem A. Mustafa, Kari A.O. Tikkinen, Ignacio Neumann, Per O. Vandvik, Elie A. Akl, Bruno R. da Costa, Neill K. Adhikari, Gemma Mas Dalmau, Elise Kosunen, Jukka Mustonen, Mark W. Crawford, Lehana Thabane and Gordon H. Guyatt
CMAJ January 05, 2016 188 (1) 25-32; DOI: https://doi.org/10.1503/cmaj.150430
Bradley C. Johnston
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Pablo Alonso-Coello
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Jan O. Friedrich
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Reem A. Mustafa
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Kari A.O. Tikkinen
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Ignacio Neumann
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Per O. Vandvik
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Elie A. Akl
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Bruno R. da Costa
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Neill K. Adhikari
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Gemma Mas Dalmau
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Elise Kosunen
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Jukka Mustonen
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Mark W. Crawford
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Lehana Thabane
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Gordon H. Guyatt
Department of Anesthesia and Pain Medicine (Johnston, Crawford), The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Johnston), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Child Health Evaluative Sciences (Johnston), The Hospital for Sick Children Research Institute, Toronto, Ont.; Iberoamerican Cochrane Center (Alonso-Coello, Dalmau), Biomedical Research Institute Sant Pau, CIBER Epidemiologiay Salud Publica, Barcelona, Spain; Departments of Critical Care and Medicine (Friedrich), St. Michael’s Hospital, Toronto, Ont.; Department of Medicine and Interdepartmental Division of Critical Care (Friedrich), University of Toronto, Toronto, Ont.; Departments of Medicine and Biomedical and Health Informatics (Mustafa), University of Missouri–Kansas City, Kansas City, Mo.; Department of Clinical Epidemiology and Biostatistics (Mustafa, Tikkinen, Neumann, Akl, Thabane, Guyatt), McMaster University, Hamilton, Ont.; Departments of Urology and Public Health (Tikkinen), Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Internal Medicine (Neumann), Pontificia Universidad Catolica de Chile, Santiago, Chile; Institute of Health and Society (Vandvik), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine (Vandvik), Innlandet Hospital Trust, Division Gjövik, Norway; Clinical Epidemiology Unit (Akl), American University of Beirut, Beirut, Lebanon; Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari), Sunnybrook Health Sciences Centre, Toronto, Ont.; Interdepartmental Division of Critical Care (Adhikari), University of Toronto, Toronto, Ont.; School of Medicine and Centre for General Practice (Kosunen), University of Tampere and Pirkanmaa Hospital District, Tampere, Finland; School of Medicine and Department of Internal Medicine (Mustonen), University of Tampere and Tampere University Hospital, Tampere, Finland; Physiology and Experimental Medicine (Crawford), The Hospital for Sick Children Research Institute, Toronto, Ont.; Biostatistics Unit of the Centre for Evaluation of Medicines (Thabane), McMaster University, Hamilton, Ont.; Population Health Research Unit, Hamilton Health Sciences (Thabane), McMaster University, Hamilton, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.
Article Figures & Tables
Figures
- Figure 1:
Respondents’ understanding of the magnitude of the treatment effect for each of 6 statistical formats used to present continuous outcomes from meta-analyses. Higher percentages represent greater understanding; error bars = 95% confidence intervals. Mean difference = mean difference in natural units, MID = minimal important difference, SMD = standardized mean difference.
- Figure 2:
Perceived usefulness of each statistical format for clinical decision-making. Higher scores represent higher perceived usefulness; error bars = 95% confidence intervals. Mean difference = mean difference in natural units, MID = minimal important difference, SMD = standardized mean difference.
- Figure 3:
Factors associated with respondents’ understanding of the statistical formats. An odds ratio below 1.0 indicates a worse understanding than the reference category. CI = confidence interval, mean difference = mean difference in natural units, MID = minimal important difference, SMD = standardized mean difference.
Tables
Characteristic No. (%) of respondents Sex Female 302 (56.9) Male 228 (42.9) Not specified 1 (0.2) Country Canada 179 (33.7) Chile 27 (5.1) Finland 57 (10.7) Lebanon 26 (4.9) Norway 27 (5.1) Spain 129 (24.3) Switzerland 23 (4.3) United States 63 (11.9) Specialty Internal medicine 259 (48.8) Family medicine 225 (42.4) Other 47 (8.8) Professional status Resident 343 (64.6) Attending/staff 110 (20.7) Clinical fellow 20 (3.8) Medical student 19 (3.6) Other 39 (7.3) Year of graduation or expected graduation from medical school Before 1990 50 (9.4) 1990–1999 41 (7.7) 2000–2009 205 (38.6) 2010 or later 229 (43.1) Not specified 6 (1.1) Training in health research methodology Never completed a formal course 293 (55.2) Completed formal courses, but no masters or doctorate in health research methodology 219 (41.2) Has masters or doctorate in health research methodology 16 (3.0) Not specified 3 (0.6)
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Do clinicians understand the size of treatment effects? A randomized survey across 8 countries
Bradley C. Johnston, Pablo Alonso-Coello, Jan O. Friedrich, Reem A. Mustafa, Kari A.O. Tikkinen, Ignacio Neumann, Per O. Vandvik, Elie A. Akl, Bruno R. da Costa, Neill K. Adhikari, Gemma Mas Dalmau, Elise Kosunen, Jukka Mustonen, Mark W. Crawford, Lehana Thabane, Gordon H. Guyatt
CMAJ Jan 2016, 188 (1) 25-32; DOI: 10.1503/cmaj.150430
Do clinicians understand the size of treatment effects? A randomized survey across 8 countries
Bradley C. Johnston, Pablo Alonso-Coello, Jan O. Friedrich, Reem A. Mustafa, Kari A.O. Tikkinen, Ignacio Neumann, Per O. Vandvik, Elie A. Akl, Bruno R. da Costa, Neill K. Adhikari, Gemma Mas Dalmau, Elise Kosunen, Jukka Mustonen, Mark W. Crawford, Lehana Thabane, Gordon H. Guyatt
CMAJ Jan 2016, 188 (1) 25-32; DOI: 10.1503/cmaj.150430
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