Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 4 appraisals
BMC research notes
Survey to evaluate clinical benefits and acceptance in international tele-intensive care unit collaboration
OBJECTIVES: Tele-intensive care unit (TICU) networks have evolved quickly in recent years and have proved their value in providing care for the critically ill. Objective measures to assess performance and quantify success e.g. clinical and economic outcome parameters are desirable but not easily accessible in international collaboration with very diverse clinical settings and legal prerequisites. Therefore, we initiated a study to evaluate the performance in our tele-intensive care unit network. METHODS: We conducted an online survey addressing clinical staff at ten spoke sites in four countries connected to one TICU hub to assess subjective clinical benefit, acceptance and potential for improvement. RESULTS: The majority of the 30 participants felt well supported clinically and personally, with a high acceptance and trust as well as a positive working relationship in tele-medical collaboration. Ethical principles and data protection were discovered to be persistently of utmost significance in tele-intensive care unit networks. CONCLUSION: International telemedicine in critical care is perceived positively without major differences between diverse health care systems when crossing borders, showing potential for improvement to guide future clinical and research approaches. Clinical trial registiry: The study was registered on August 11th, 2023 with the German Clinical Trials Register (DRKS-IDDRKS00032246; https://www.drks.de/search/de/trial/DRKS00032246/details ).
24 May 2026
Read appraisal →PloS one
Investigating ChatGPT-mediated mind mapping to facilitate EFL learners' reading comprehension
Mastering Reading Comprehension (RC) is a significant challenge for English as a Foreign Language (EFL) learners. This quasi-experimental mixed-methods study examined the potential effectiveness of a ChatGPT-mediated mind mapping technique in enhancing RC among EFL students at a public university in Saudi Arabia. Sixty male preparatory-year students were assigned to two groups: an experimental group (n = 30), which took part in a 10-week intervention in ChatGPT-mediated mind mapping, and a control group (n = 30), which was taught mind mapping through conventional methods. Data were gathered through pre- and post-tests of RC together with semi-structured interviews. Post-test RC scores were significantly higher in the experimental group than in the control group (U = 180.00, p < .001), with a medium-to-large effect size (r = 0.52). The qualitative data showed that students found the technique useful for breaking down complex ideas and for making the relationships between concepts in the text visible. At the same time, they reported difficulties with the accuracy of the AI output, with comprehending dense content, and with technology access. Read through the lenses of Sociocultural Theory and Cognitive Load Theory, the findings suggest that ChatGPT-mediated mind mapping can serve as a useful pedagogical tool for supporting RC. Teachers are therefore encouraged to incorporate the technique into their instructional practice while offering the support needed to address the challenges identified here.
21 May 2026
Read appraisal →International health
Systematic narrative review on Menstrual health and hygiene (MHH) in Nigeria, Ghana, Liberia and The Gambia
Menstrual health and hygiene (MHH) are critical components of women's well-being, yet they continue to be overlooked in many low-resource settings. Addressing MHH issues in West Africa is crucial due to their widespread impact on education, health and gender equality, particularly among adolescent girls and women of reproductive age. This systematic narrative review consolidates the existing literature on MHH practices, knowledge, barriers and interventions in Nigeria, Ghana, Liberia and The Gambia. A comprehensive search was conducted across four databases (PubMed, Scopus, CINAHL Plus and Africa Journals Online) for studies published from 2000 to 2024. The search terms were related to menstruation, hygiene and the four West African countries. Both peer-reviewed articles and grey literature (Google Scholar, policy documents) were included to capture a broad spectrum of findings. Studies were selected based on their relevance to MHH in the target countries and data were extracted and analysed thematically. Of 345 articles identified, 26 studies met the inclusion criteria. Key findings highlighted the widespread lack of adequate MHM resources, such as sanitary products and functional sanitation facilities. Socio-economic disparities, cultural stigma and insufficient educational resources were major barriers to effective MHM. The review also found a strong link between inadequate MHM and adverse outcomes, including school absenteeism, psychological distress and increased vulnerability to infections. This review underscores the pressing need for comprehensive interventions to address MHH as a public health and human rights issue in Nigeria, Ghana, Liberia and The Gambia. Ensuring access to sanitary products, improved sanitation facilities and robust educational programs can help empower girls and women to manage menstruation with dignity, thereby improving their health, education and social participation.
12 May 2026
Read appraisal →Journal of global health
The effectiveness and cost-effectiveness of cash plus interventions to prevent acute malnutrition in Somalia: evidence from an adaptive cluster randomised control trial
BACKGROUND: Acute malnutrition affects millions of children aged <5 years, as well as pregnant and lactating women globally, especially in humanitarian settings. Although cash plus interventions - cash or food transfers combined with complementary components - are widely implemented, evidence remains limited on which combinations and durations are most effective at preventing acute malnutrition. METHODS: We conducted a three-arm cluster-randomised trial within the 'Save the Children's Cash Plus for Nutrition' programme in Somalia. Monthly support was provided as cash alone (arm 1), cash plus social and behaviour change communication (arm 2), or cash plus an additional cash top-up (arm 3). Further, we randomised 33 villages across arms, targeting approximately 1500 households. Primary outcomes included the prevalence and incidence of acute malnutrition in children aged 6-59 months and in mothers, assessed at baseline, midline (three months), and endline (six months). We also conducted market monitoring, qualitative data collection, and analysis. RESULTS: Child acute malnutrition prevalence was approximately 15.0% in each arm at baseline. After three months, prevalence declined by 2.0 percentage points in arm 1 to 13.0% (95% confidence interval (CI) = 10.3, 16.1), representing a relative reduction of 13.3%. In arm 2, prevalence declined by 5.9 percentage points to 9.1% (95% CI = 6.8, 11.8), a relative reduction of 39.3%. In contrast, prevalence in arm 3 remained essentially unchanged, increasing to 15.1% (95% CI = 12.1, 18.6). By endline, there was little change from midline in all arms. Maternal malnutrition improved most in arm 2, but differences were not statistically significant. All arms showed improvements in dietary diversity and food security, but only arm 2 achieved sustained nutrition gains. Household livelihood conditions appeared to improve overall, though monthly expenditures nearly doubled. Arm 2 was the most effective and cost-effective. CONCLUSIONS: Adding social and behaviour change communication to cash transfers significantly improved child nutrition compared to cash alone, highlighting that integrated approaches can enhance nutritional outcomes and at minimal additional cost in humanitarian settings. REGISTRATION: ClinicalTrials.gov: NCT06642012.
12 May 2026
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