How reviews covered the unfolding scientific story of gabapentin for bipolar disorder.

Background: Despite the lack of randomized controlled trials (RCTs), gabapentin use increased rapidly in the 1990s for mental health conditions. Subsequent RCTs did not demonstrate efficacy for bipolar disorder (BD). We examined the characteristics of review articles to determine their potential role in the growth of gabapentin for BD.

Gabapentin in the treatment of mental illness: the echo chamber of the case series.

Background: Bipolar disorder is a common and debilitating psychiatric illness. Several antiepileptic drugs (AEDs) have been approved for the treatment of bipolar disorder. Gabapentin gained a large market share of AED use in the late 1990s in spite of a lack of randomized clinical trial (RCT) evidence and no labeled indication from the U.

Strategies in assessing the need for updating evidence-based guidelines for six clinical topics: an exploration of two search methodologies.

Background: Because of the expense of updating practice guidelines, recent attention has focused on approaches that can reliably assess any updating required. Shekelle et al. (Journal of the American Medical Association 2001, 286, 1461-7) proposed using limited literature searches with expert involvement to reduce resources used in assessing whether a guideline needs updating.

The insufficiency of evidence to establish the business case for quality.

Purpose: To determine whether a positive financial return on investment for quality-enhancing interventions is more likely for particular health conditions, in specific organizational settings, or with the use of particular interventions.

Data Sources: Electronic search of MEDLINE.

Data Extraction: Search keywords included: business case, cost-effectiveness, cost-benefit, return on investment, costs, cost savings, quality, quality improvement, and program evaluation.

Health services research tools for public health professionals.

Although the fields of public health and health services research have much in common, public health practitioners--in their daily encounters with practical, frontline challenges--may not be aware of the quantity and the quality of information generated by health services research that is directly related to public health activities. We describe a number of health services research resources that public health practitioners may find useful, including an overview of these resources and several in-depth examples.

Assessing the need to update prevention guidelines: a comparison of two methods.

Background: An important concern for developers of clinical practice guidelines is how best to determine when guidelines require updating to ensure they remain current and evidence based. Because of the high costs associated with updating guidelines, recent attention has focused on approaches that can reliably assess the extent of updating required. Recently, Shekelle and colleagues proposed a model of limited literature searches with modest expert involvement as a way to reduce the cost and time requirements for assessing whether a guideline needs updating.