Quality of observational studies of clinical interventions: a meta-epidemiological review

Associations of Group Size with Cohesion and Clinical Outcomes in Group Psychotherapy: A Systematic Review

Group size is a consideration for all psychotherapy groups, yet the topic has been subject to surprisingly few empirical investigations. This review explored the influence of group size within group psychotherapy by investigating its associations with cohesion and clinical outcomes. Significant group-size associations were found in seven of the 17 included individual and meta-analysis studies (combined N = 21,425), pointing to partial support for the influence of group size. Some interesting tentative trends were identified, such as potentially better outcomes in smaller groups and greater group-size influence in process-orientated groups. Considerably more research is needed, as psychotherapy group-size decisions should ideally be informed by empirical evidence rather than by relying on clinical opinion, conventional wisdom, and recommendations made by influential commentators.

Why is it important to implement meta-research in universities and institutes with medical research activities?

In recent years, there has been a growing concern over questionable practices and a lack of rigor in scientific activities, particularly in health and medical sciences. Universities and research institutes are key players in the development of science, technology, and innovation. Academic institutions, whose primary mission is to generate and disseminate knowledge, bear the responsibility in many parts of the world to act as consultants and guardians of scientific integrity in health research. Then, universities and research institutes must act as guardians of the research and technological development process, utilizing methodological and operational evaluation tools to validate the rigor and quality of medical research. Meta-research is defined as the research of research itself. Some of the most important specific objectives of meta-research include the assessment of research relevance, the evaluation of evidence validity, and the exploration of scientific integrity. A significant portion of evidence in the medical and health sciences literature has been found to be redundant, misleading, or inconsistent. Although this issue is of great importance in global health, discussions about practical and tangible solutions remain fragmented and limited. The aim of this manuscript is to highlight the significance of employing meta-research within universities and research institutes as a tool to monitor scientific rigor and promote responsible practices in medical research.

Evaluation of Parenteral Vitamin C's Effectiveness in Critically Ill Patients: A Systematic Review and Critical Appraisal

Vitamin C, a key nutrient with potent antioxidant and immunomodulatory properties, has been explored for its therapeutic potential in treating severe infections, particularly sepsis. This systematic review aims to evaluate the effectiveness of parenteral vitamin C in improving clinical outcomes in patients with severe infections. A comprehensive search of several databases, including PubMed, EMBASE, and the Cochrane Library, was conducted for studies published between January 2000 and June 2024. Included were randomized controlled trials, observational studies, and case reports that examined the use of parenteral vitamin C in adult patients with severe infections. Data extracted included study design, sample size, intervention specifics, and clinical outcomes. Quality was assessed using tools appropriate to each study design, such as the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. The review included nine studies with diverse methodologies. While individual studies reported benefits such as improved immune function and reduced oxidative stress, larger systematic reviews and meta-analyses did not demonstrate a significant reduction in mortality. The results indicate that while parenteral vitamin C may improve certain biochemical and physiological parameters, these improvements do not consistently translate into enhanced survival or substantial clinical benefits. Parenteral vitamin C shows potential in modulating immune response and reducing oxidative damage in severe infections. However, its impact on key clinical outcomes like mortality and long-term recovery remains uncertain. This review highlights the need for further high-quality, randomized controlled trials to clarify vitamin C's role in managing severe infections and define optimal therapeutic protocols.