Research Topics
| Holger SchunemannSummaryAffiliation: McMaster University Country: Canada Publications
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Publications
[Integrative assessment of evidence in healthcare: the GRADE system]Holger Schunemann
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
Z Evid Fortbild Qual Gesundhwes 103:261-8. 2009..The international collaboration and acceptance by many organisations is an indicator of GRADE's innovative nature and advances in the assessment of evidence and development of recommendations in the context of healthcare...
Editorial: can China master the guideline challenge?Kehu Yang
Departments of Clinical Epidemiology and Biostatistics and of Medicine, McMaster University Health Sciences Centre, Room 2C16, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
Health Res Policy Syst 11:1. 2013..China can build on what is known and work with the international community to develop methods to meet the challenges of evidence-based guideline development...
[Diagnostic accuracy and linked evidence--testing the chain]Holger J Schunemann
Department of Clinical Epidemiology and Biostatistics, WHO Collaborating Center for Evidence informed Policy, Cochrane Applicability and Recommendations Methods Group, McMaster University Health Sciences Centre, Hamilton, ON, Canada
Z Evid Fortbild Qual Gesundhwes 106:153-60. 2012....- The GRADE approach for assessing new technologies as applied to apheresis devices in ulcerative colitisNora Ibargoyen-Roteta
Basque Office for Health Technology Assessment OSTEBA, Department of Health and Consumer Affairs of the Basque Country, Vitoria Gasteiz, Spain
Implement Sci 5:48. 2010..The aim of the present study is to describe the use of this approach in the development of recommendations for a new health technology, and to analyse the strengths, weaknesses, opportunities, and threats found when doing so... - Improving the interpretation of quality of life evidence in meta-analyses: the application of minimal important difference unitsBradley C Johnston
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Health Qual Life Outcomes 8:116. 2010..This approach provides a potential solution to both the statistical and interpretational problems of existing methods... 
How a well-grounded minimal important difference can enhance transparency of labelling claims and improve interpretation of a patient reported outcome measureJan L Brozek
Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland
Health Qual Life Outcomes 4:69. 2006....- Systems medicine and integrated care to combat chronic noncommunicable diseasesJean Bousquet
Department of Respiratory Diseases, Arnaud de Villeneuve Hospital, CHU Montpellier, INSERM CESP U1018, Villejuif, France
Genome Med 3:43. 2011..This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems... - Association between anemia and quality of life in a population sample of individuals with chronic obstructive pulmonary diseaseGokul Krishnan
Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
BMC Pulm Med 6:23. 2006..However, there is little evidence regarding the association of anemia with HRQL in patients with chronic obstructive pulmonary disease (COPD)... - Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a surveyElie A Akl
Department of Medicine, State University of New York at Buffalo, Buffalo, NY, USA
BMC Med Educ 10:26. 2010..The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States... - Values and preferences in oral anticoagulation in patients with atrial fibrillation, physicians' and patients' perspectives: protocol for a two-phase studyPablo Alonso-Coello
Iberoamerican Cochrane Center, Hospital Sant Pau, Sant Antoni Maria Claret 171, Barcelona, Spain
BMC Health Serv Res 8:221. 2008..The literature postulates that patient and clinician preferences may explain this low utilization... - Educational games in geriatric medicine education: a systematic reviewZiad Alfarah
Geriatrics Section, Department of Medicine, Boston University, Boston, MA, USA
BMC Geriatr 10:19. 2010..To systematically review the medical literature to assess the effect of geriatric educational games on the satisfaction, knowledge, beliefs, attitudes and behaviors of health care professionals... - The impact of illness in patients with moderate to severe gastro-esophageal reflux diseaseSamer El-Dika
Division of Gastroenterology, Veterans Affairs Medical Center, Salem, Virginia, USA
BMC Gastroenterol 5:23. 2005..Gastro-esophageal reflux disease (GERD) is a common disease. It impairs health related quality of life (HRQL). However, the impact on utility scores and work productivity in patients with moderate to severe GERD is not well known... - Application of generalizability theory confirmed lower reliability of the standard gamble than the feeling thermometerHolger J Schunemann
Department of Epidemiology, INFORMA Unit CLARITY Research Group, Italian National Cancer Institute Regina Elena, Via Elio Chianesi 53, 00144 Rome, Italy
J Clin Epidemiol 60:1256-62. 2007..Further, lack of interrater reliability may compromise the use of CMS in interpreting health state ratings. The aim of this study was to assess the reliability of CMS ratings for the SG and the FT... - Guidelines 2.0: do no net harm-the future of practice guideline development in asthma and other diseasesHolger J Schunemann
Department of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Centre, Hamilton, ON, Canada
Curr Allergy Asthma Rep 11:261-8. 2011.... - The GRADE approach and Bradford Hill's criteria for causationHolger Schunemann
Department of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Centre, 1200 Main Street West, Hamilton, Ontario, Canada
J Epidemiol Community Health 65:392-5. 2011..This article describes how causation may relate to developing recommendations and how the Bradford Hill criteria are considered in GRADE, using examples from the public health literature with a focus on immunisation... - Grading quality of evidence and strength of recommendations for diagnostic tests and strategiesHolger J Schunemann
Department of Epidemiology, Italian National Cancer Institute Regina Elena, 00144 Rome, Italy
BMJ 336:1106-10. 2008 - An instrument to assess quality of life in relation to nutrition: item generation, item reduction and initial validationHolger J Schunemann
Department of Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA
Health Qual Life Outcomes 8:26. 2010..Therefore, the aim of this project was to develop an instrument for measuring QoL related to nutrition in the general population... - Transparent development of the WHO rapid advice guidelinesHolger J Schunemann
Italian National Cancer Institute Regina Elena, Department of Epidemiology, Rome, Italy
PLoS Med 4:e119. 2007..The process could be improved by shortening the time required to commission evidence profiles. Further development is needed to facilitate stakeholder involvement, and evaluate and ensure the guideline's usefulness... - Measurement properties and interpretability of the Chronic respiratory disease questionnaire (CRQ)Holger J Schunemann
Departments of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State of New York, Buffalo, New York, USA
COPD 2:81-9. 2005..These objectives include the exploration of presentation of quality of life information and prospective anchor-based approaches... - Evaluation of the minimal important difference for the feeling thermometer and the St. George's Respiratory Questionnaire in patients with chronic airflow obstructionHolger J Schunemann
Department of Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 462 Grider Street, Buffalo, NY 14215, USA
J Clin Epidemiol 56:1170-6. 2003..The objective of our study is to explore the interpretation of the SGRQ and FT... - A comparison of narrative and table formats for presenting hypothetical health states to patients with gastrointestinal or pulmonary diseaseHolger J Schunemann
McMaster University Health Sciences Centre, Room 2C12, Hamilton, Ontario, L8N 3Z5, Canada
Med Decis Making 24:53-60. 2004..Investigators should consider using the table presentation for describing health states to subjects who are not familiar with these states of health... - A randomized multicenter trial to evaluate simple utility elicitation techniques in patients with gastroesophageal reflux diseaseHolger J Schunemann
Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
Med Care 42:1132-42. 2004..We evaluated whether the administration of marker states improves measurement properties of the FT and SG... - A randomised trial to evaluate the self-administered standardised chronic respiratory questionnaireH J Schünemann
Department of Medicine, University Health Sciences Centre, Room 2C12, Hamilton, Ontario L8N 3Z5, Canada
Eur Respir J 25:31-40. 2005..These results challenge the assumption that interviewer-administered questionnaires are superior to self-administered questionnaires in older patients with chronic respiratory disease... - [GRADE: from grading the evidence to developing recommendations. A description of the system and a proposal regarding the transferability of the results of clinical research to clinical practice]Holger J Schunemann
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
Z Evid Fortbild Qual Gesundhwes 103:391-400. 2009..In addition to providing an overview of the GRADE system, this article focuses on the approach to assessing directness or generalizability... - Do clinical marker states improve responsiveness and construct validity of the standard gamble and feeling thermometer: a randomized multi-center trial in patients with chronic respiratory diseaseHolger J Schunemann
Division of Clinical Research Development and INFORMAtion Translation INFROMA, Italian National Cancer Institute Regina Elena, Rome, Italy
Qual Life Res 15:1-14. 2006..We evaluated the impact of clinical marker state (CMS) rating prior to patients' rating their own health on two utility instruments (feeling thermometer (FT) and standard gamble (SG)) in patients with chronic respiratory disease (CRD)... - Interpreting the results of patient reported outcome measures in clinical trials: the clinician's perspectiveHolger J Schunemann
Division of Clinical Research Development and INFORMAtion Translation, Department of Epidemiology, Istituto Regina Elena Italian National Cancer Institute Rome, Rome, Italy
Health Qual Life Outcomes 4:62. 2006..Thus, there are several steps investigators can take to facilitate this process to help bringing HRQL information closer to the bedside... - WHO Rapid Advice Guidelines for pharmacological management of sporadic human infection with avian influenza A (H5N1) virusHolger J Schunemann
Italian National Cancer Institute Regina Elena, INFORMA Unit, Department of Epidemiology, Istituto Regina Elena, Rome, Italy
Lancet Infect Dis 7:21-31. 2007..Emergence of other novel influenza A viral subtypes with pandemic potential, or changes in the pathogenicity of H5N1 virus strains, will require an update of these guidelines and WHO will be monitoring this closely... - Application of GRADE: Making evidence-based recommendations about diagnostic tests in clinical practice guidelinesJonathan Hsu
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Implement Sci 6:62. 2011..Therefore, we evaluated the factors that guideline developers and users need to consider for the development of implementable recommendations about diagnostic tests... - The diagnosis of myocardial infarction in critically ill patients: an agreement studyWendy Lim
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
J Crit Care 24:447-52. 2009..The aim of the study was to assess agreement among 4 intensivists in diagnosing myocardial infarction (MI) in critically ill patients based on screening electrocardiograms (ECGs) and cardiac troponin (cTn) levels... - Parenteral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulationElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 4:CD006652. 2011..Anticoagulation may improve survival in patients with cancer through an antitumor effect in addition to the perceived antithrombotic effect... - [Patient reported outcomes: general principles of development and interpretability]Dianne Bryant
Faculty of Health Sciences, Elborn College, Room 1438, University of Western Ontario, London, ON, Canada
Pol Arch Med Wewn 117:5-11. 2007.... - The vexing problem of guidelines and conflict of interest: a potential solutionGordon Guyatt
McMaster University Health Sciences Centre, Henderson General Hospital, Hamilton, Ontario, Canada
Ann Intern Med 152:738-41. 2010..These strategies may help to achieve the benefits of expert input without conflicts of interest influencing recommendations... - Framing of health information messagesElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 12:CD006777. 2011.... - Anticoagulation for the initial treatment of venous thromboembolism in patients with cancerElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 4:CD006649. 2011..Compared to patients without cancer, patients with cancer who receive anticoagulant treatment for venous thromboembolism are more likely to develop recurrent venous thromboembolism (VTE)... - Orthopaedic surgeons prefer to participate in expertise-based randomized trialsElzbieta Bednarska
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
Clin Orthop Relat Res 466:1734-44. 2008..The expertise-based randomized clinical trial design may overcome some of the barriers to conducting clinical trials in orthopaedic surgery and improve the validity of their conclusions... - Anticoagulation for patients with cancer and central venous cathetersElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 2:CD006468. 2011..Central venous catheter (CVC) placement increases the risk of thrombosis in cancer patients. Thrombosis often necessitates the removal of the CVC, resulting in treatment delays and thrombosis related morbidity and mortality... - Anticoagulation for patients with cancer and central venous cathetersElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 4:CD006468. 2011..Central venous catheter (CVC) placement increases the risk of thrombosis in cancer patients. Thrombosis often necessitates the removal of the CVC, resulting in treatment delays and thrombosis related morbidity and mortality... - Anticoagulation for the initial treatment of venous thromboembolism in patients with cancerElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 2:CD006649. 2011..Compared to patients without cancer, patients with cancer who receive anticoagulant treatment for venous thromboembolism are more likely to develop recurrent venous thromboembolism (VTE)... - Oral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulationElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 6:CD006466. 2011..A number of basic research and clinical studies have led to the hypothesis that oral anticoagulants may improve the survival of patients with cancer through an antitumor effect in addition to their antithrombotic effect... - Low molecular weight heparin versus unfractionated heparin for perioperative thromboprophylaxis in patients with cancerElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 11:CD009447. 2011..The choice of the appropriate perioperative thromboprophylaxis in patients with cancer depends on the relative benefits and harms of low molecular weight heparin (LMWH) and unfractionated heparin (UFH)... - Stopping randomized trials early for benefit and estimation of treatment effects: systematic review and meta-regression analysisDirk Bassler
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
JAMA 303:1180-7. 2010..Theory and simulation suggest that randomized controlled trials (RCTs) stopped early for benefit (truncated RCTs) systematically overestimate treatment effects for the outcome that precipitated early stopping... - Anticoagulation for the initial treatment of venous thromboembolism in patients with cancerElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 6:CD006649. 2011..Compared to patients without cancer, patients with cancer who receive anticoagulant treatment for venous thromboembolism are more likely to develop recurrent venous thromboembolism (VTE)... - An international prospective cohort study evaluating major vascular complications among patients undergoing noncardiac surgery: the VISION Pilot StudyP J Devereaux
Population Health Research Institute, David Braley Cardiac, Vascular, and Stroke Research Institute, RoomC1 116, Perioperative Medicine and Surgical Research Unit, c o Hamilton General Hospital, 237 Barton Street East, Hamilton, ON, Canada, L8L2X2
Open Med 5:e193-200. 2011.... - An emerging consensus on grading recommendations?Gordon Guyatt
McMaster University, Hamilton, Ontario, Canada
Evid Based Med 11:2-4. 2006 - A new 'mechanistic-practical" framework for designing and interpreting randomized trialsPaul J Karanicolas
Department of Clinical Epidemiology and Biostatistics, McMaster University, Ontario, Canada
J Clin Epidemiol 62:479-84. 2009..e., the conventional pragmatic trial. Instead we will design, implement, and apply the results of practical trials to our patients... - Grading strength of recommendations and quality of evidence in clinical guidelines: report from an american college of chest physicians task forceGordon Guyatt
Department of Medicine, HSC 2C12, McMaster University, 1200 Main St West, Hamilton, ON, Canada L8N 3Z5
Chest 129:174-81. 2006..The trend toward uniformity of approaches to grading will enhance the usefulness of practice guidelines for clinicians... - Effect of bisphosphonates on periprosthetic bone mineral density after total joint arthroplasty. A meta-analysisMohit Bhandari
Department of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Center, Room 2C9, 1200 Main Street West, Hamilton, ON L8N 3Z5, Canada
J Bone Joint Surg Am 87:293-301. 2005.... - How can quality of life researchers make their work more useful to health workers and their patients?Gordon Guyatt
CLARITY Research Group, Department of Clinical Epidemiology and Biostatistics, Health Sciences Centre, McMaster University, 1200 Main Street West, Rm HSC 2C12, Hamilton, ON, Canada, L8N 3Z5
Qual Life Res 16:1097-105. 2007..These reporting approaches, as well as ensuring access to data from individual items, will also help those developing decision aids to use quality of life data... - Prognostic value of troponin and creatine kinase muscle and brain isoenzyme measurement after noncardiac surgery: a systematic review and meta-analysisMichael Levy
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Anesthesiology 114:796-806. 2011..There is uncertainty regarding the prognostic value of troponin and creatine kinase muscle and brain isoenzyme measurements after noncardiac surgery... - Anticoagulation for the long-term treatment of venous thromboembolism in patients with cancerElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 6:CD006650. 2011..Cancer increases the risk of thromboembolic events even while on anticoagulation... - Stopping randomized trials early for benefit: a protocol of the Study Of Trial Policy Of Interim Truncation-2 (STOPIT-2)Matthias Briel
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
Trials 10:49. 2009..The aim of STOPIT-2 is to determine the magnitude and determinants of possible bias introduced by stopping RCTs early for benefit... - Oral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulationElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 12:CD006466. 2010..A number of basic research and clinical studies have led to the hypothesis that oral anticoagulants may improve the survival of patients with cancer through an antitumor effect in addition to their antithrombotic effect... - Using alternative statistical formats for presenting risks and risk reductionsElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 3:CD006776. 2011..The success of evidence-based practice depends on the clear and effective communication of statistical information... - Parenteral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulationElie A Akl
Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider Street, Buffalo, NY, USA, 14215
Cochrane Database Syst Rev 1:CD006652. 2011..Anticoagulation may improve survival in patients with cancer through an antitumor effect in addition to the perceived antithrombotic effect... - GRADE guidelines: 2. Framing the question and deciding on important outcomesGordon H Guyatt
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
J Clin Epidemiol 64:395-400. 2011.... - GRADE guidelines: a new series of articles in the Journal of Clinical EpidemiologyGordon H Guyatt
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
J Clin Epidemiol 64:380-2. 2011..gradeworkinggroup.org/), attests to the importance of this work. This article introduces a 20-part series providing guidance for the use of GRADE methodology that will appear in the Journal of Clinical Epidemiology... - GRADE guidelines: 4. Rating the quality of evidence--study limitations (risk of bias)Gordon H Guyatt
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
J Clin Epidemiol 64:407-15. 2011..Rather, for any individual outcome, when there are some studies with a high risk, and some with a low risk of bias, they should consider including only the studies with a lower risk of bias... - GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tablesGordon Guyatt
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
J Clin Epidemiol 64:383-94. 2011..Subsequent articles in this series will address GRADE's approach to formulating questions, assessing quality of evidence, and developing recommendations... - GRADE: an emerging consensus on rating quality of evidence and strength of recommendationsGordon H Guyatt
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada L8N 3Z5
BMJ 336:924-6. 2008 - Addressing resource allocation issues in recommendations from clinical practice guideline panels: suggestions from an American College of Chest Physicians task forceGordon Guyatt
Department of Medicine, HSC 2C12, McMaster University, 1200 Main St West, Hamilton, ON, Canada L8N 3Z5
Chest 129:182-7. 2006.... - Is blinding the endoscopists to bowel preparations in randomized-controlled trials a reality?Samer El-Dika
Department of Medicine, Veterans Affairs Medical Center, Salem, VA 24153, USA
Cancer Detect Prev 30:552-9. 2006..The primary aim of this study was to explore whether endoscopists can be effectively blinded to the type of bowel preparation... - An emerging consensus on grading recommendations?Gordon Guyatt
McMaster University, Hamilton, Ontario, Canada
ACP J Club 144:A8-9. 2006 - World Health Organization Guidelines: Use of cryotherapy for cervical intraepithelial neoplasiaNancy Santesso
Department of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Centre, Hamilton, Canada
Int J Gynaecol Obstet 118:97-102. 2012..In 2009, the World Health Organization (WHO) committed to updating recommendations for use of cryotherapy for cervical intraepithelial neoplasia (CIN)... - Association between industry funding and statistically significant pro-industry findings in medical and surgical randomized trialsMohit Bhandari
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
CMAJ 170:477-80. 2004..In this study, we examine the association between industry funding and the statistical significance of results in recently published medical and surgical trials... - Detecting myocardial infarction in critical illness using screening troponin measurements and ECG recordingsWendy Lim
Department of Medicine, McMaster University, Canada
Crit Care 12:R36. 2008..This is a prospective screening study... - A plant food-based diet modifies the serum beta-sitosterol concentration in hyperandrogenic postmenopausal womenPaola Muti
Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY, USA
J Nutr 133:4252-5. 2003..These findings indicate that phytosterols, in particular beta-sitosterol, can be used as biomarkers of exposure in observational studies or as compliance indicators in dietary intervention studies of cancer prevention... - Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusiveRoman Jaeschke
Department of Medicine, McMaster University, Hamilton, ON, Canada L8P 3B6
BMJ 337:a744. 2008