1. James Lind Initiative Database of Uncertainties about the Effects of Treatments (DUETs) what gaps in the evidence matter to patients and doctors? Iain Chalmers NLH Eyes and Vision Specialist Library Birmingham, 14 March 2007

2. James Lind Initiative Consequences of maldistribution of resources for research

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4. Within treatment evaluation there are two important problems

5. James Lind Initiative First problem Researchers ignore patients’ & clinicians’ questions

6. James Lind Initiative Osteoarthritis of the knee Tallon D, Chard J, Dieppe P. Relation between agendas of the research community and the research consumer. Lancet 2000;355:2037-40.

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8. 1 st choices among research priorities in survey of 67 patients Knee replacement (35.8) Education and advice (20.9) Complementary therapy (6.0) Tablets (4.5) Injections in the knee (4.5) Physical therapy (3.0) No treatment at all (1.5) Miscellaneous other priorities (23.9)

9. James Lind Initiative Analysis of 460 randomised trials of treatments for osteoarthritis of the knee 380 trials of drugs 29 trials of complementary therapies 24 trials of physiotherapy/exercise 14 trials of education 13 trials of surgery

10. James Lind Initiative Second problem Researchers ignore treatment outcomes that are important to patients

11. James Lind Initiative Priority treatment outcome from a survey of patients with rheumatoid arthritis was not pain

12. James Lind Initiative Priority treatment outcome from a survey of patients with rheumatoid arthritis was not pain It was fatigue!

13. James Lind Initiative An initiative of the National Therapeutic Ignorance Service

14. James Lind Initiative DUETs’ working definition of uncertainty about the effects of treatments No up-to-date systematic reviews exist OR Up-to-date systematic reviews show that uncertainty exists

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19. The Specialist Libraries of the National Library for Health [NLH] are now assuming responsibility for developing and maintaining DUETs modules within their respective spheres of responsibility.

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21. The DUETs Core Team would be delighted if members of the NLH Eyes & Vision Specialist Library team and their colleagues would like to develop and manage a DUETs module within their sphere of responsibility.

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23. To visit DUETs go to: www.duets.nhs.uk