Alfonso Iorio

Use of thresholds for rating certainty of evidence with the GRADE framework: a systematic survey of systematic reviews

Hamed Movahed, Reza Mirza, Romina Brignardello-Petersen, Alfonso Iorio et autres

OBJECTIVES: Current guidance regarding applying the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework mandates establishing thresholds to assess certainty of evidence. These thresholds include the null, the minimally important difference (MID), and moderate and large effect thresholds. GRADE experts offer …

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Familiarity With Generative Artificial Intelligence Chatbot Prompt Engineering for Academic Research: A Large-Scale, International Cross-Sectional Survey of Medical Researchers

Cecile Woo, Wael Abdelkader, L.M. Bouter, Isabelle Boutron et autres

Generative artificial intelligence chatbots (AICs), such as ChatGPT, Gemini, Meta AI, Claude AI, and Microsoft Co-Pilot, are increasingly used in academic research. Prompt engineering, the practice of crafting effective inputs to elicit high-quality chatbot responses, has emerged as a critical skill. Although …

Long-term experience with emicizumab in people with hemophilia A in the Canadian Bleeding Disorders Registry

Alfonso Iorio, Federico Germini, Q. Ibrahim, Arun Keepanasseril et autres

Emicizumab prophylaxis has been approved in Canada for the prevention or reduction of bleeding episodes in people with congenital hemophilia A (PwHA). Using routinely collected health data from the Canadian Bleeding Disorders Registry (CBDR), this observational cohort study aimed to evaluate the …

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Understanding Transformer-Based Classifications of Medical Text Using a Large Language Model for the Attribution of Feature Importance: Proof-of-Concept Algorithm Development and Validation Study

Fangwen Zhou, Ashirbani Saha, Muhammad Afzal, Rick Parrish et autres

Background: Deep learning, particularly encoder-only transformer architectures, has demonstrated excellent performance in biomedical literature classification, facilitating evidence-based medicine, and knowledge synthesis. However, the opacity of these models' decision-making processes limits their clinical interpretability, trustworthiness, and widespread adoption. Traditional explainable artificial intelligence methods, …

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Selective Serotonin Reuptake Inhibitors for Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

Elisabetta Trinari, Noella Noronha, Davide Papola, Tahira Devji et autres

Abstract Background Effects of Selective Serotonin Reuptake Inhibitors (SSRI) for symptoms of autism spectrum disorder (ASD) or comorbid conditions are uncertain. We conducted a systematic review and meta-analyses to determine the efficacy and safety of SSRIs in children with ASD on restricted …

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What You May Have Missed in 2025

Alfonso Iorio, Christine Laine

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Development of risk prediction model for chronic pain after knee replacement surgery: protocol for an individual patient data meta-analysis

Behnam Sadeghirad, Malahat Khalili, Jason W. Busse, Wael Abdelkader et autres

BACKGROUND: Chronic post-surgical pain (CPSP) impacts approximately one in four patients following total knee arthroplasty (TKA) and is associated with reduced function and quality of life. We will conduct a systematic review of prospective studies to identify eligible data and establish an …

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Zero-shot interpretable biomedical literature appraisal with generative large language models

Fangwen Zhou, Muhammad Afzal, Ashirbani Saha, Rick Parrish et autres

Objective: This study aims to apply 2 decoder-based Generative Pre-trained Transformer (GPT) models (GPT-4o and GPT-o3-mini) in automating the methodological appraisal of randomized controlled trials (RCTs), under a variety of prompt designs, and to compare their performance to a fine-tuned encoder-only BioLinkBERT …

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GRADE Guidance: Update on Developing Good Practice Statements in Guidelines

Omar Dewidar, Elie A Akl, Gian Paolo Morgano, Elena Parmelli et autres

Despite published guidance by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group on the use of good practice statements (GPSs), their appropriate development remains challenging. This article provides updated guidance with nuanced operationalization. The updated guidance was developed on …

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A decision algorithm for assessing indirectness in core GRADE

Gordon Guyatt, Prashanti Eachempati, Monica Hultcrantz, Víctor M. Montori et autres

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Comparative safety of drug therapies used in hemophilia A and B in Canada: a multi-center, retrospective study

Omotola O Olasupo, Emma Iserman, Arun Keepanasseril, Quazi Ibrahim et autres

Background: Comparative safety data on hemophilia therapies are scarce. Objectives: To compare the risk of adverse drug reactions (ADRs) associated with extended-half-life (EHL) and standard-half-life (SHL) clotting factor therapies, bypassing agents, and emicizumab. Methods and Analysis: We analyzed Canadian Bleeding Disorders Registry …

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Core GRADE unpacked: a summary of recent innovations in complementary GRADE methodology

Luis Enrique Colunga‐Lozano, Ying Wang, Thomas Agoritsas, Monica Hultcrantz et autres

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