Discrepancies in Outcome Reporting Exist Between Protocols and Published Oral Health Cochrane Systematic Reviews

OBJECTIVES To assess discrepancies in the analyzed outcomes between protocols and published reviews within Cochrane oral health systematic reviews (COHG) on the Cochrane Database of Systematic Reviews (CDSR). STUDY DESIGN AND SETTING All COHG systematic reviews on the CDSR and the corresponding protocols were retrieved in November 2014 and information on the reported outcomes was recorded. Data was collected at the systematic review level by two reviewers independently. RESULTS One hundred and fifty two reviews were included. In relation to primary outcomes, 11.2% were downgraded to secondary outcomes, 9.9% were omitted altogether in the final publication and new primary outcomes were identified in 18.4% of publications. For secondary outcomes, 2% were upgraded to primary, 12.5% were omitted and 30.9% were newly introduced in the publication. Overall, 45.4% of reviews had at least one discrepancy when compared to the protocol; these were reported in 14.5% reviews. The number of review updates appears to be associated with discrepancies between final review and protocol (OR: 3.18, 95% CI: 1.77, 5.74, p<0.001). The risk of reporting significant results was lower for both downgraded outcomes [RR: 0.52, 95% CI: 0.17, 1.58, p = 0.24] and upgraded or newly introduced outcomes [RR: 0.77, 95% CI: 0.36, 1.64, p = 0.50] compared to outcomes with no discrepancies. The risk of reporting significant results was higher for upgraded or newly introduced outcomes compared to downgraded outcomes (RR = 1.19, 95% CI: 0.65, 2.16, p = 0.57). None of the comparisons reached statistical significance. CONCLUSION While no evidence of selective outcome reporting was found in this study, based on the present analysis of SRs published within COHG systematic reviews, discrepancies between outcomes in pre-published protocols and final reviews continue to be common. Solutions such as the use of standardized outcomes to reduce the prevalence of this issue may need to be explored.

The Quality of the Evidence According to GRADE Is Predominantly Low or Very Low in Oral Health Systematic Reviews

OBJECTIVES The main objective was to assess the credibility of the evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) in oral health systematic reviews on the Cochrane Database of Systematic Reviews (CDSR) and elsewhere. STUDY DESIGN AND SETTING Systematic Reviews or meta-analyses (January 2008-December 2013) from 14 high impact general dental and specialty dental journals and the Cochrane Database of Systematic Reviews were screened for meta-analyses. Data was collected at the systematic review, meta-analysis and trial level. Two reviewers applied and agreed on the GRADE rating for the selected meta-analyses. RESULTS From the 510 systematic reviews initially identified 91 reviews (41 Cochrane and 50 non-Cochrane) were eligible for inclusion. The quality of evidence was high in 2% and moderate in 18% of the included meta-analyses with no difference between Cochrane and non-Cochrane reviews, journal impact factor or year of publication. The most common domains prompting downgrading of the evidence were study limitations (risk of bias) and imprecision (risk of play of chance). CONCLUSION The quality of the evidence in oral health assessed using GRADE is predominantly low or very low suggesting a pressing need for more randomised clinical trials and other studies of higher quality in order to inform clinical decisions thereby reducing the risk of instituting potentially ineffective and/or harmful therapies.

Use of quality assessment tools in systematic reviews was varied and inconsistent

OBJECTIVES To assess the use of quality assessment tools among a cross-section of systematic reviews (SRs) and to further evaluate whether quality was used as a parameter in the decision to include primary studies within subsequent meta-analysis. STUDY DESIGN AND SETTING We searched PubMed for SRs (interventional, observational, and diagnostic) published in Core Clinical Journals between January 1 and March 31, 2014. RESULTS Three hundred nine SRs were identified. Quality assessment was undertaken in 222 (71.8%) with isolated use of the Cochrane risk of bias tool (26.1%, n = 58) and the Newcastle-Ottawa Scale (15.3%, n = 34) most common. A threshold level of primary study quality for subsequent meta-analysis was used in 12.9% (40 of 309) of reviews. Overall, fifty-four combinations of quality assessment tools were identified with a similar preponderance of tools used among observational and interventional reviews. Multiple tools were used in 11.7% (n = 36) of SRs overall. CONCLUSION We found that quality assessment tools were used in a majority of SRs; however, a threshold level of quality for meta-analysis was stipulated in just 12.9% (n = 40). This cross-sectional analysis provides further evidence of the need for more active or intuitive editorial processes to enhance the reporting of SRs.

Reporting and handling missing outcome data in mental health: a systematic review of Cochrane systematic reviews and meta-analyses

OBJECTIVES The purpose of the study was to provide empirical evidence about the reporting of methodology to address missing outcome data and the acknowledgement of their impact in Cochrane systematic reviews in the mental health field. METHODS Systematic reviews published in the Cochrane Database of Systematic Reviews after January 1, 2009 by three Cochrane Review Groups relating to mental health were included. RESULTS One hundred ninety systematic reviews were considered. Missing outcome data were present in at least one included study in 175 systematic reviews. Of these 175 systematic reviews, 147 (84%) accounted for missing outcome data by considering a relevant primary or secondary outcome (e.g., dropout). Missing outcome data implications were reported only in 61 (35%) systematic reviews and primarily in the discussion section by commenting on the amount of the missing outcome data. One hundred forty eligible meta-analyses with missing data were scrutinized. Seventy-nine (56%) of them had studies with total dropout rate between 10 and 30%. One hundred nine (78%) meta-analyses reported to have performed intention-to-treat analysis by including trials with imputed outcome data. Sensitivity analysis for incomplete outcome data was implemented in less than 20% of the meta-analyses. CONCLUSIONS Reporting of the techniques for handling missing outcome data and their implications in the findings of the systematic reviews are suboptimal.

The evidence from systematic reviews and meta-analyses published in orthodontic literature. Where do we stand?

AIM To analyse meta-analyses included in systematic reviews (SRs) published in leading orthodontic journals and the Cochrane Database of Systematic Reviews (CDSR) focusing on orthodontic literature and to assess the quality of the existing evidence. MATERIALS AND METHODS Electronic searching was undertaken to identify SRs published in five major orthodontic journals and the CDSR between January 2000 and June 2014. Quality assessment of the overall body of evidence from meta-analyses was conducted using the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE) tool. RESULTS One hundred and fifty-seven SRs were identified; meta-analysis was present in 43 of these (27.4 per cent). The highest proportion of SRs that included a meta-analysis was found in Orthodontics and Craniofacial Research (6/13; 46.1 per cent), followed by the CDSR (12/33; 36.4 per cent) and the American Journal of Orthodontics and Dentofacial Orthopaedics (15/44; 34.1 per cent). Class II treatment was the most commonly addressed topic within SRs in orthodontics (n = 18/157; 11.5 per cent). The number of trials combined to produce a summary estimate was small for most meta-analyses with a median of 4 (range: 2-52). Only 21 per cent (n = 9) of included meta-analyses were considered to have a high/moderate quality of evidence according to GRADE, while the majority were of low or very low quality (n = 34; 79.0 per cent). CONCLUSIONS Overall, approximately one quarter of orthodontic SRs included quantitative synthesis, with a median of four trials per meta-analysis. The overall quality of evidence from the selected orthodontic SRs was predominantly low to very low indicating the relative lack of high quality of evidence from SRs to inform clinical practice guidelines.

Die Bedeutung von Business Rules im Customer Relationship Management

Der Beitrag diskutiert Möglichkeiten zur Automatisierung von Kundenbeziehungsprozessen im Customer Relationship Management mit Hilfe von Business Rules. Anhand einer CRM-Architektur werden Anwendungsmöglichkeiten erörtert und am Beispiel einer Cross-Selling-Kampagne vertieft. Technische Aspekte werden dabei nicht im Detail betrachtet. Der Schwerpunkt liegt vielmehr in der Diskussion von Automatisierungs- und Integrationspotenzialen durch den Einsatz von Business Rules, wie sie in zunehmend individualisierten Kundenbeziehungen in Massenmärkten gegeben sind.

Do Information, Price, or Morals Influence Ethical Consumption? A Natural Field Experiment and Customer Survey on the Purchase of Fair Trade Coffee

We address ethical consumption using a natural field experiment on the actual purchase of Fair Trade (FT) coffee in three supermarkets in Germany. Based on a quasi-experimental before-and-after design the effects of three different treatments – information, 20% price reduction, and a moral appeal – are analyzed. Sales data cover actual ethical purchase behavior and avoid problems of social desirability. But they offer only limited insights into the motivations of individual consumers. We therefore complemented the field experiment with a customer survey that allows us to contrast observed (ethical) buying behavior with self-reported FT consumption. Results from the experiment suggest that only the price reduction had the expected positive and statistically significant effect on FT consumption.

Estrategia CRM (Customer Relationship Management)

Realizar una propuesta metodológica que permita analizar, diseñar e implementar una estrategia CRM en las empresas de servicios públicos de Mendoza.

Quantitative Determination of the Relationship between Internal Validity and Bias in Software Engineering Experiments: Consequences for Systematic Literature Reviews

Quality assessment is one of the activities performed as part of systematic literature reviews. It is commonly accepted that a good quality experiment is bias free. Bias is considered to be related to internal validity (e.g., how adequately the experiment is planned, executed and analysed). Quality assessment is usually conducted using checklists and quality scales. It has not yet been proven;however, that quality is related to experimental bias. Aim: Identify whether there is a relationship between internal validity and bias in software engineering experiments. Method: We built a quality scale to determine the quality of the studies, which we applied to 28 experiments included in two systematic literature reviews. We proposed an objective indicator of experimental bias, which we applied to the same 28 experiments. Finally, we analysed the correlations between the quality scores and the proposed measure of bias. Results: We failed to find a relationship between the global quality score (resulting from the quality scale) and bias; however, we did identify interesting correlations between bias and some particular aspects of internal validity measured by the instrument. Conclusions: There is an empirically provable relationship between internal validity and bias. It is feasible to apply quality assessment in systematic literature reviews, subject to limits on the internal validity aspects for consideration.

The determinants of the quality of Sales-Marketing Interface in a Multinational Customer Brand Focused Company: The Latin American Branches

Customer evolution and changes in consumers, determine the fact that the quality of the interface between marketing and sales may represent a true competitive advantage for the firm. Building on multidimensional theoretical and empirical models developed in Europe and on social network analysis, the organizational interface between the marketing and sales departments of a multinational high-growth company with operations in Argentina, Uruguay and Paraguay is studied. Both, attitudinal and social network measures of information exchange are used to make operational the nature and quality of the interface and its impact on performance. Results show the existence of a positive relationship of formalization, joint planning, teamwork, trust and information transfer on interface quality, as well as a positive relationship between interface quality and business performance. We conclude that efficient design and organizational management of the exchange network are essential for the successful performance of consumer goods companies that seek to develop distinctive capabilities to adapt to markets that experience vertiginous changes

Some insights for a relationship marketing model integrating SERVQUAL and customer loyalty in dental clinics

The demand of new services, the emergence of new business models, insufficient innovation, underestimation of customer loyalty and reluctance to adopt new management are evidence of the deficiencies and the lack of research about the relations between patients and dental clinics. In this article we propose the structure of a model of Relationship Marketing (RM) in the dental clinic that integrates information from SERVQUAL, Customer Loyalty (CL) and activities of RM and combines the vision of dentist and patient. The first pilot study on dentists showed that: they recognize the value of maintaining better patients however they don't perform RM actions to retain them. They have databases of patients but not sophisticated enough as compared to RM tools. They perceive that the patients value "Assurance" and "Empathy" (two dimensions of service quality). Finally, they indicate that a loyal patient not necessarily pays more by the service. The proposed model will be validated using Fuzzy Logic simulation and the ultimate goal of this research line is contributing a new definition of CL.

Customer training, oriented toward the customer in the spanish affiliate

On that date , the Spanish affiliate offered for the 1st. time to its customers courses oriented toward the user, not the product, within the area of programming, in the subarea of application programming

Customer loyalty plan at Residencia Gómez-Pardo, Universidad Politécnica de Madrid

Accommodation is a first need and one of the most important decisions that university students have to decide taking into account their limited budget. The satisfaction grade of these students is the relevant aspect for the administrators and managers of the university residences, because it allows assuring the viability and sustainability of this kind of accommodation. In a situation of decline in rate of retention of students into the residence, coupled with an environment of economic crisis. Hence, of disposable income reduction, it seems essential to get to know what factors affect the motivation to remain into the university residence more than others when it comes to the final choice. The offer?s increase of different kind of accommodation is another variable to be considered when taking the decision related to the management of this kind of accommodation. Thus, there is the need to know which are the key factors and to obtain information about these variables in order to go deep into the relevance grade with the aim to pursue the strategic objectives, that will allow to improve the relationship with the customer and to respond to his accommodation? needs. This article researches the motivation elements that lead the students to remain in a university residence or to abandon it in exchange or a different accommodation, as per example shared flats or individual apartments. This research work intends to be useful for the university residence?s managers in order to increase its incomes, to raise the satisfaction degree among its residents and to obtain better end results in the management of these properties. The fieldwork conducted in the Residencia Universitaria Gómez Pardo (RUGP), Universidad Politécnica de Madrid (UPM), for four semesters, which means students from 27 different grades (undergraduates) and 81 surveys finished, shows the following conclusions. Not only the relation with the residence?s personnel but also the quality and quantity of the feeding and the availability and quality of the internet service, constitute key factors when it comes to make the decision of remaining or of abandoning the residence when the semester comes to its end.

Implementación de un cambio de estrategia en un banco español para su optimización y ventaja competitiva

En la situación actual, en la que la inestabilidad económica es un hecho, se plantea analizar y estudiar el estado de las entidades financieras. El estudio a realizar se circunscribe únicamente al ámbito nacional, debido a la idiosincrasia de los bancos. Para conocer el entorno en el que se mueven los bancos nacionales, se analiza en primer lugar el estado financiero de los países más relevantes a nivel internacional, para posteriormente estudiar la situación económica de España, especialmente en el sector bancario. Se pretende establecer el marco en el que se mueve dicho sector, para poder tener toda la información necesaria para entender no sólo los problemas que afectan a estas entidades, sino también para ver que es necesario un cambio para que estas organizaciones puedan evolucionar y desarrollarse. Una vez detallado el entorno en el que se tienen que mover los bancos, se detallan los principales motivos por los que han perdido credibilidad de cara a los clientes y a los organismos internacionales responsables de velar por la correcta ejecución de las operaciones bancarias, conforme a unas normativas ya establecidas. Se han mencionado algunos ejemplos significativos y con gran repercusión social. No se entra a detallar cada uno de los casos, el objetivo es mostrar que este tipo de actuaciones no sólo perjudican a la propia entidad sino que repercuten en todo el ámbito financiero nacional. Al profundizar en los motivos que han llevado a los bancos a la situación que sufren actualmente, se ve que mantener el mismo método de trabajo no es sostenible a largo plazo; por ello, se plantea un cambio en su estrategia, en concreto un cambio en el modelo de cultura organizacional. Se toma como modelo el empleado en otras empresas, principalmente orientales, por su carácter innovador y por estar más alineadas con las nuevas necesidades y requerimientos de los clientes actualmente. La evolución de las tecnologías ha supuesto un cambio disruptivo en la forma de hacer negocios: algo que debe adoptar la banca para poder, no sólo competir, sino sobrevivir. El cambio de modelo estratégico ha de iniciarse en la Alta Dirección, para propagarse posteriormente al resto de la organización. Al tratarse de un cambio de gran envergadura, su completa implantación llevará años, por lo que es imprescindible realizar un seguimiento y una revisión continua del mismo. Finalmente se comentan las ventajas que el banco conseguirá con este cambio. Éstas abarcan la recuperación de la confianza de los clientes, pasando por una modernización (necesaria en cualquier caso), para completarse con un incremento de los beneficios económicos, que no deja de ser uno de los motores de los bancos. ---ABSTRACT---Nowadays, the economic instability is a fact, so in this project we have studied and analysed the status of financial institutions. This study is limited to the national environment, due to the idiosyncrasy of the banks. In order to understand the environment in which national banks moved, firstly it has been analysed the financial status of the most relevant countries internationally, to study later the economic status of Spain, especially in the banking sector. The aim is to establish a framework in which the sector moves, to have at the end all the necessary information to understand, not only the issues that are affecting to this entities, but also to realize that a change is necessary for their progress and develop. Once detailed the environment in which the banks have to move, it is detailed the main reasons that have lead them to lose credibility with customers, and with international agencies responsible for ensuring the correct execution of banking operations. These operations must be done under established regulations. It has been mentioned some significant examples of mistakes that have had a social impact. It has not been detailed each outrageous, the objective is to show that this kind of actions not only hurt the institution itself, but also affect the entire national financial sector. Into the reasons that have led banks to the actual situation, it can be seen that keeping the same method of working is not sustainable in the long term; therefore, a change of strategy is proposed, more specifically a change in the model of organizational culture. The reference model has been one used by other companies, mainly eastern companies, due to its innovation and its capability to be aligned with the changing needs and requirements of customers nowadays. The evolution of technology has been a disruptive change in the way of doing business: something to be taken by the bank, not only to compete but also to survive. The strategic model change must start with the compromise of CEO’s, and later must be spread to the rest of the organization. It is a major change, so its full implementation will take years, so, it is basic to carry out continuous reviews. Finally, the advantages that the bank will get with this change are discussed. These advantages include recovery of customer confidence, through modernization (something needed anyway), to be enriched by an increase in economic benefits, the engine of the banks.