this research is based on

Evidence-Based Research Series-Paper 1: What Evidence-Based Research is and why is it important?

Affiliations.

• 1 Johns Hopkins Evidence-based Practice Center, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
• 2 Digital Content Services, Operations, Elsevier Ltd., 125 London Wall, London, EC2Y 5AS, UK.
• 3 School of Nursing, McMaster University, Health Sciences Centre, Room 2J20, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4K1; Section for Evidence-Based Practice, Western Norway University of Applied Sciences, Inndalsveien 28, Bergen, P.O.Box 7030 N-5020 Bergen, Norway.
• 4 Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Department of Physiotherapy and Occupational Therapy, University Hospital of Copenhagen, Herlev & Gentofte, Kildegaardsvej 28, 2900, Hellerup, Denmark.
• 5 Musculoskeletal Statistics Unit, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Nordre Fasanvej 57, 2000, Copenhagen F, Denmark; Department of Clinical Research, Research Unit of Rheumatology, University of Southern Denmark, Odense University Hospital, Denmark.
• 6 Section for Evidence-Based Practice, Western Norway University of Applied Sciences, Inndalsveien 28, Bergen, P.O.Box 7030 N-5020 Bergen, Norway. Electronic address: [email protected].
• PMID: 32979491
• DOI: 10.1016/j.jclinepi.2020.07.020

Objectives: There is considerable actual and potential waste in research. Evidence-based research ensures worthwhile and valuable research. The aim of this series, which this article introduces, is to describe the evidence-based research approach.

Study design and setting: In this first article of a three-article series, we introduce the evidence-based research approach. Evidence-based research is the use of prior research in a systematic and transparent way to inform a new study so that it is answering questions that matter in a valid, efficient, and accessible manner.

Results: We describe evidence-based research and provide an overview of the approach of systematically and transparently using previous research before starting a new study to justify and design the new study (article #2 in series) and-on study completion-place its results in the context with what is already known (article #3 in series).

Conclusion: This series introduces evidence-based research as an approach to minimize unnecessary and irrelevant clinical health research that is unscientific, wasteful, and unethical.

Keywords: Clinical health research; Clinical trials; Evidence synthesis; Evidence-based research; Medical ethics; Research ethics; Systematic review.

Copyright © 2020 Elsevier Inc. All rights reserved.

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Science, health, and public trust.

September 8, 2021

Explaining How Research Works

We’ve heard “follow the science” a lot during the pandemic. But it seems science has taken us on a long and winding road filled with twists and turns, even changing directions at times. That’s led some people to feel they can’t trust science. But when what we know changes, it often means science is working.

Explaining the scientific process may be one way that science communicators can help maintain public trust in science. Placing research in the bigger context of its field and where it fits into the scientific process can help people better understand and interpret new findings as they emerge. A single study usually uncovers only a piece of a larger puzzle.

Questions about how the world works are often investigated on many different levels. For example, scientists can look at the different atoms in a molecule, cells in a tissue, or how different tissues or systems affect each other. Researchers often must choose one or a finite number of ways to investigate a question. It can take many different studies using different approaches to start piecing the whole picture together.

Sometimes it might seem like research results contradict each other. But often, studies are just looking at different aspects of the same problem. Researchers can also investigate a question using different techniques or timeframes. That may lead them to arrive at different conclusions from the same data.

Using the data available at the time of their study, scientists develop different explanations, or models. New information may mean that a novel model needs to be developed to account for it. The models that prevail are those that can withstand the test of time and incorporate new information. Science is a constantly evolving and self-correcting process.

Scientists gain more confidence about a model through the scientific process. They replicate each other’s work. They present at conferences. And papers undergo peer review, in which experts in the field review the work before it can be published in scientific journals. This helps ensure that the study is up to current scientific standards and maintains a level of integrity. Peer reviewers may find problems with the experiments or think different experiments are needed to justify the conclusions. They might even offer new ways to interpret the data.

It’s important for science communicators to consider which stage a study is at in the scientific process when deciding whether to cover it. Some studies are posted on preprint servers for other scientists to start weighing in on and haven’t yet been fully vetted. Results that haven't yet been subjected to scientific scrutiny should be reported on with care and context to avoid confusion or frustration from readers.

We’ve developed a one-page guide, "How Research Works: Understanding the Process of Science" to help communicators put the process of science into perspective. We hope it can serve as a useful resource to help explain why science changes—and why it’s important to expect that change. Please take a look and share your thoughts with us by sending an email to  [email protected].

Below are some additional resources:

• Discoveries in Basic Science: A Perfectly Imperfect Process
• When Clinical Research Is in the News
• What is Basic Science and Why is it Important?
• ​ What is a Research Organism?
• What Are Clinical Trials and Studies?
• Basic Research – Digital Media Kit
• Decoding Science: How Does Science Know What It Knows? (NAS)
• Can Science Help People Make Decisions ? (NAS)

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“Evidence-Based” vs. “Research-Based”: Understanding the Differences

Often, when reviewing resources, programs, or assessments, we might come across terms like “evidence-based” or “research-based.” These terms each tell us something about the resources that they describe and the evidence supporting them. Understanding each term’s meaning can help us make informed decisions when selecting and implementing resources.

So what do these terms mean, exactly?

Typically, the terms  Evidence-Based   Practices  or  Evidence-Based   Programs  refer to individual practices (for example, single lessons or in-class activities) or programs (for example, year-long curricula) that are considered effective based on scientific evidence. To deem a program or practice “evidence-based,” researchers will typically study the impact of the resource(s) in a controlled setting – for example, they may study differences in skill growth between students whose educators used the resources and students whose educators did not. If sufficient research suggests that the program or practice is effective, it may be deemed “evidence-based.”

Evidence-Informed  (or  Research-Based )  Practices  are practices that were developed based on the best research available in the field. This means that users can feel confident that the strategies and activities included in the program or practice have a strong scientific basis for their use. Unlike Evidence-Based Practices or Programs, Research-Based Practices have not been researched in a controlled setting.

What about assessment?

Terms like “evidence-based” and “research-based” are often used to describe  intervention activities,  like strategies or curricula designed to build skills in specific areas. But the process of measuring skills with assessment tools can be evidence-based as well. An assessment process can be considered  Evidence-Based Assessment  if:

• The choice of skills to be measured by the assessment was informed by research;
• The assessment method and measurement tools used are informed by scientific research and theory and meet the relevant standards for their intended uses; and
• The way that the assessment is implemented and interpreted is backed by research.

Using evidence-based assessment to guide or evaluate an intervention gives us confidence that the process is well-suited for our purpose, is grounded in scientific theory, and will be effective for our students.

What Standards Exist for Educational Assessments?

The process of Evidence-Based Assessment involves the use of a measurement tool that “meets the relevant standards for their intended uses.” What are the relevant standards, and how can we know if a tool meets them?

Some foundational standards for educational assessments, as compiled by experts in the educational, psychological, and assessment fields, include:

• Validity for an Intended Use:  the tool should have been researched to determine that it is valid, or appropriate, for the decisions we may make based on its results. Just like we wouldn’t use a math quiz to inform whether a student needs additional practice with reading comprehension, we shouldn’t use an assessment for purposes outside of those that research has deemed “valid.”
• Reliability:  the tool should have been researched to ensure that it meets expectations for reliability, or consistency. For example, researchers might explore whether the tool produces similar results if it is completed twice in a short period of time. Reliability can be explored via a variety of methods, depending on the measurement tool.
• Fairness:  the tool should have been researched to explore how fair, or unbiased, it is among different subgroups of students, such as subgroups based on race, ethnicity, or cultural background. Using a biased measurement tool can lead to biased decision-making and threaten our ability to provide equitable services.

Specific standards within each of these domains, and others, are compiled in the handbook, “Standards for Educational and Psychological Testing” (2014), written by the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education. This handbook can be a useful companion when reviewing the specific evidence behind measurement tools.

In Conclusion

Terms like “evidence-based” or “research-based” are useful indicators of the type of evidence behind programs, practices, or assessments – however, they can only tell us so much about the specific research behind each tool. For situations where more information on a resource’s evidence base would be beneficial, it may be helpful to request research summaries or articles from the resource’s publisher for further review.

Further Reading

• Hunsley, J., & Mash, E. J. (2007). Evidence-based assessment. Rev. Clin. Psychol., 3, 29-51 .
• Joint Committee on the Standards for Educational and Psychological Testing of the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education (2014). Standards for Educational and Psychological Testing. The American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education .
• S. Department of Education (2016). Using Evidence to Strengthen Education Investments .

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Evidence-Based? Research-Based? What does it all Mean?

Have you ever felt puzzled by trying to discern the difference between the terms, evidence-based and research-based ? Or have you ever found yourself feeling intimidated when someone asked you, “But is that program/practice evidence-based?” I know I have. To help me clarify my understanding, I reached out to my colleagues here at the Center and my old friend, Google. I’ve come to the following understandings and a bit of friendly advice – stay curious! Please keep reading if you’re feeling as perplexed as I am.

Clarifying the Difference between Research-Based and Evidence-Based

My current working definition of research-based instruction has come to mean those practices/programs that are based on well-supported and documented theories of learning. The instructional approach is based on research that supports the principles it incorporates, but there may not be specific research or its own evidence to directly demonstrate its effectiveness.

Defining evidence-based practice has been more headache-inducing as the term is frequently and widely used to mean a myriad of things. Currently, I have come to understand that evidence-based practices are those that have been researched with either experimental studies (think randomly assigned control groups), quasi-experimental studies (comparison groups that are not randomized), or studies that were well-designed and well-implemented correlational studies with statistical controls for selection bias. In brief, a specific study (or studies) has been done to test its effectiveness.

By no means are these definitions ready for Merriam-Webster, but they are helping me to make sense of the terms.

So what do you say or ask when “research” is thrown your way?

Recently, I met with a group of literacy coaches and we discussed how to respond when a fellow educator approaches them with “research” either supporting or refuting an instructional practice or program. My best advice to them probably sounded like a Viking River Cruise commercial – “Be curious!” Below are some examples of ways to respond to demonstrate that you are open to learning more.

• Thank you for bringing that information to my attention. Can you share your source of information or the article so I can read it too and we can talk about it together?
• Please talk more about what you have learned (or read or heard). I’m curious to learn more about: a. Whether the research was published in a peer-reviewed journal or if the research was sponsored by a publisher or other interested party. b. The sample size or the number of schools/students involved in the study. c. The demographics of the subjects involved in the study. d. The type of research conducted.

3. I’m wondering how many studies have been conducted that replicate those results. 4. That research sounds important. Can you share the source with me? Perhaps it will be helpful for our grade level team to read it and discuss the findings together.

As educators, we are always looking for the most effective ways to support our students. Stay open to new findings and be sure to slow the process down so you probe deeper to learn if there truly is current research to back what people are claiming. Then be sure to evaluate the credibility of the source of information, the methods or processes used to critique or research, and don’t forget to rely upon trusted sources like What Works Clearinghouse . You might also appreciate a lecture presented by Maren Aukerman that discusses comprehensive, research-informed literacy instruction . The more you dig, the more you may find that many practices and programs touted as evidence-based are either based on personal anecdotes and stories or the research base is flimsy at best.

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Research-Based Learning: Connecting Research and Instruction

• First Online: 01 January 2013

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• Dirk Ifenthaler 3 &
• Maree Gosper 4  

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Research-based learning (RBL) is a multifaceted approach for orchestrating a variety of learning and teaching strategies in order to connect research and instruction. This chapter presents a theoretical insight into RBL and teaching which integrates learning, teaching, and research. Further, a curriculum for descriptive and inferential statistics using the RBL and teaching approach is introduced. The chapter wraps up with reflections on further implementation of RBL and teaching, including the adoption of new technologies to assist this important approach of university education.

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Ifenthaler, D., Gosper, M. (2014). Research-Based Learning: Connecting Research and Instruction. In: Gosper, M., Ifenthaler, D. (eds) Curriculum Models for the 21st Century. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7366-4_5

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Original research

Evidence-based practice models and frameworks in the healthcare setting: a scoping review, jarrod dusin.

1 Department of Evidence Based Practice, Children’s Mercy Hospitals and Clinics, Kansas City, Missouri, USA

2 Therapeutic Science, The University of Kansas Medical Center, Kansas City, Kansas, USA

Andrea Melanson

Lisa mische-lawson, associated data.

bmjopen-2022-071188supp001.pdf

bmjopen-2022-071188supp002.pdf

No data are available.

The aim of this scoping review was to identify and review current evidence-based practice (EBP) models and frameworks. Specifically, how EBP models and frameworks used in healthcare settings align with the original model of (1) asking the question, (2) acquiring the best evidence, (3) appraising the evidence, (4) applying the findings to clinical practice and (5) evaluating the outcomes of change, along with patient values and preferences and clinical skills.

A Scoping review.

Included sources and articles

Published articles were identified through searches within electronic databases (MEDLINE, EMBASE, Scopus) from January 1990 to April 2022. The English language EBP models and frameworks included in the review all included the five main steps of EBP. Excluded were models and frameworks focused on one domain or strategy (eg, frameworks focused on applying findings).

Of the 20 097 articles found by our search, 19 models and frameworks met our inclusion criteria. The results showed a diverse collection of models and frameworks. Many models and frameworks were well developed and widely used, with supporting validation and updates. Some models and frameworks provided many tools and contextual instruction, while others provided only general process instruction. The models and frameworks reviewed demonstrated that the user must possess EBP expertise and knowledge for the step of assessing evidence. The models and frameworks varied greatly in the level of instruction to assess the evidence. Only seven models and frameworks integrated patient values and preferences into their processes.

Many EBP models and frameworks currently exist that provide diverse instructions on the best way to use EBP. However, the inclusion of patient values and preferences needs to be better integrated into EBP models and frameworks. Also, the issues of EBP expertise and knowledge to assess evidence must be considered when choosing a model or framework.

STRENGTHS AND LIMITATIONS OF THIS STUDY

• Currently, no comprehensive review exists of evidence-based practice (EBP) models and frameworks.
• Well-developed models and frameworks may have been excluded for not including all five steps of original model for EBP.
• This review did not measure the quality of the models and frameworks based on validated studies.

Introduction

Evidence-based practice (EBP) grew from evidence-based medicine (EBM) to provide a process to review, translate and implement research with practice to improve patient care, treatment and outcomes. Guyatt 1 coined the term EBM in the early 1990s. Over the last 25 years, the field of EBM has continued to evolve and is now a cornerstone of healthcare and a core competency for all medical professionals. 2 3 At first, the term EBM was used only in medicine. However, the term EBP now applies to the principles of other health professions. This expansion of the concept of EBM increases its complexity. 4 The term EBP is used for this paper because it is universal across professions.

Early in the development of EBP, Sackett 5 created an innovative five-step model. This foundational medical model provided a concise overview of the process of EBP. The five steps are (1) asking the question, (2) acquiring the best evidence, (3) appraising the evidence, (4) applying the findings to clinical practice and (5) evaluating the outcomes of change. Other critical components of Sackett’s model are considering patient value and preferences and clinical skills with the best available evidence. 5 The influence of this model has led to its integration and adaption into every field of healthcare. Historically, the foundation of EBP has focused on asking the question, acquiring the literature and appraising the evidence but has had difficulty integrating evidence into practice. 6 Although the five steps appear simple, each area includes a vast number of ways to review the literature (eg, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Newcastle-Ottawa Scale) and entire fields of study, such as implementation science, a field dedicated to implementing EBP. 7 8 Implementation science can be traced to the 1960s with Everett Rogers’ Diffusion of Innovation Theory and has grown alongside EBP over the last 25 years. 7 9

One way to manage the complexity of EBP in healthcare is by developing EBP models and frameworks that establish strategies to determine resource needs, identify barriers and facilitators, and guide processes. 10 EBP models and frameworks provide insight into the complexity of transforming evidence into clinical practice. 11 They also allow organisations to determine readiness, willingness and potential outcomes for a hospital system. 12 EBP can differ from implementation science, as EBP models include all five of Sackett’s steps of EBP, while the non-process models of implementation science typically focus on the final two steps. 5 10 There are published scoping reviews of implementation science, 13 however, no comprehensive review of EBP models and frameworks currently exists. Although there is overlap of EBP, implementation science and knowledge translation models and frameworks 10 14 the purpose of the scoping review was to explore how EBP models and frameworks used in healthcare settings align with the original EBP five-step model.

A scoping review synthesises findings across various study types and provides a broad overview of the selected topic. 15 The Arksey and O’Malley method and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) procedures guided this review (see online supplemental PRISMA-ScR checklist ). 15 16 The primary author established the research question and inclusion and exclusion criteria before conducting the review. An a priori protocol was not pre-registered. One research question guided the review: Which EBP models and frameworks align with Sackett’s original model?

Supplementary data

Eligibility criteria.

To be included in the review, English language published EBP models and frameworks needed to include the five main steps of EBP (asking the question, acquiring the best evidence, appraising the evidence, applying the findings to clinical practice and assessing the outcomes of change) based on Sackett’s model. 5 If the models or frameworks involved identifying problems or measured readiness for change, the criteria of ‘asking the question’ was met. Exclusions included models or frameworks focused on one domain or strategy (eg, frameworks focused on applying findings). Also, non-peer-reviewed abstracts, letters, editorials, opinion articles, and dissertations were excluded.

Search and selection

To identify potential studies, a medical librarian searched the databases from January 1990 to April 2022 in MEDLINE, EMBASE and Scopus in collaboration with the primary author. The search was limited to 1990 because the term EBP was coined in the early 90s. The search strategy employed the following keywords: ‘Evidence-Based Practice’ OR ‘evidence based medicine’ OR ‘evidence-based medicine’ OR ‘evidence based nursing’ OR ‘evidence-based nursing’ OR ‘evidence based practice’ OR ‘evidence-based practice’ OR ‘evidence based medicine’ OR ‘evidence-based medicine’ OR ‘evidence based nursing’ OR ‘evidence-based nursing’ OR ‘evidence based practice’ OR ‘evidence-based practice’ AND ‘Hospitals’ OR ‘Hospital Medicine’ OR ‘Nursing’ OR ‘Advanced Practice Nursing’ OR ‘Academic Medical Centers’ OR ‘healthcare’ OR ‘hospital’ OR ‘healthcare’ OR ‘hospital’ AND ‘Models, Organizational’ OR ‘Models, Nursing’ OR ‘framework’ OR ‘theory’ OR ‘theories’ OR ‘model’ OR ‘framework’ OR ‘theory’ OR ‘theories’ OR ‘model’. Additionally, reference lists in publications included for full-text review were screened to identify eligible models and frameworks (see online supplemental appendix A for searches).

Selection of sources of evidence

Two authors (JD and AM) independently screened titles and abstracts and selected studies for potential inclusion in the study, applying the predefined inclusion and exclusion criteria. Both authors then read the full texts of these articles to assess eligibility for final inclusion. Disagreement between the authors regarding eligibility was resolved by consensus between the three authors (JD, AM and LM-L). During the selection process, many models and frameworks were found more than once. Once a model or framework article was identified, the seminal article was reviewed for inclusion. If models or frameworks had been changed or updated since the publication of their seminal article, the most current iteration published was reviewed for inclusion. Once a model or framework was identified and verified for inclusion, all other articles listing the model or framework were excluded. This scoping review intended to identify model or framework aligned with Sackett’s model; therefore, analysing every article that used the included model or framework was unnecessary (see online supplemental appendix B for tracking form).

Data extraction and analysis

Data were collected on the following study characteristics: (1) authors, (2) publication year, (3) model or framework and (4) area(s) of focus in reference to Sackett’s five-step model. After initial selection, models and frameworks were analysed for key features and alignment to the five-step EBP process. A data analysis form was developed to map detailed information (see online supplemental appendix C for full data capture form). Data analysis focused on identifying (1) the general themes of the model or frameworks, and (2) any knowledge gaps. Data extraction and analysis were done by the primary author (JD) and verified by one other author (AM). 15

Patient and public involvement

Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

The search identified 6523 potentially relevant references (see figure 1 ). Following a review of the titles and abstracts, the primary author completed a more detailed screening of 37 full papers. From these, 19 models and frameworks were included. Table 1 summarises the 19 models and frameworks. Of the 19 models and frameworks assessed and mapped, 15 had broad target audiences, including healthcare or public health organisations or health systems. Only five models and frameworks included a target audience of individual clinicians (eg, physicians and nurses). 17–22

Retrieval and selection process.

Models and frameworks organised by integration of patient preferences and values

EBP, evidence-based practice.

Asking the question

All 19 models and frameworks included a process for asking questions. Most focused on identifying problems that needed to be addressed on an organisational or hospital level. Five used the PICO (population, intervention, comparator, outcome) format to ask specific questions related to patient care. 19–25

Acquiring the evidence

The models and frameworks gave basic instructions on acquiring literature, such as ‘conduct systematic search’ or ‘acquire resource’. 20 Four recommended sources from previously generated evidence, such as guidelines and systematic reviews. 6 21 22 26 Although most models and frameworks did not provide specifics, others suggested this work be done through EBP mentors/experts. 20 21 25 27 Seven models included qualitative evidence in the use of evidence, 6 19 21 24 27–29 while only four models considered the use of patient preference and values as evidence. 21 22 24 27 Six models recommended internal data be used in acquiring information. 17 20–22 24 27

Assessing the evidence

The models and frameworks varied greatly in the level of instruction provided in assessing the best evidence. All provided a general overview in assessing and grading the evidence. Four recommended this work be done by EBP mentors and experts. 20 25 27 30 Seven models developed specific tools to be used to assess the levels of evidence. 6 17 21 22 24 25 27

Applying the evidence

The application of evidence also varied greatly for the different models and frameworks. Seven models recommended pilot programmes to implement change. 6 21–25 31 Five recommended the use of EBP mentors and experts to assist in the implementation of evidence and quality improvement as a strategy of the models and frameworks. 20 24 25 27 Thirteen models and frameworks discussed patient values and preferences, 6 17–19 21–27 31 32 but only seven incorporated this topic into the model or framework, 21–27 and only five included tools and instructions. 21–25 Twelve of the 20 models discussed using clinical skill, but specifics of how this was incorporated was lacking in models and frameworks. 6 17–19 21–27 31

Evaluating the outcomes of change

Evaluation varied among the models and frameworks, but most involved using implementation outcome measures to determine the project’s success. Five models and frameworks provide tools and in-depth instruction for evaluation. 21 22 24–26 Monash Partners Learning Health Systems provided detailed instruction on using internal institutional data to determine success of application. 26 This framework uses internal and external data along with evidence in decision making as a benchmark for successful implementation.

EBP models and frameworks provide a process for transforming evidence into clinical practice and allow organisations to determine readiness and willingness for change in a complex hospital system. 12 The large number of models and frameworks complicates the process by confusing what the best tool is for healthcare organisations. This review examined many models and frameworks and assessed the characteristics and gaps that can better assist healthcare organisations to determine the right tool for themselves. This review identified 19 EBP models and frameworks that included the five main steps of EBP as described by Sackett. 5 The results showed that the themes of the models and frameworks are as diverse as the models and frameworks themselves. Some are well developed and widely used, with supporting validation and updates. 21 22 24 27 One such model, the Iowa EBP model, has received over 3900 requests for permission to use it and has been updated from its initial development and publication. 24 Other models provided tools and contextual instruction such as the Johns Hopkin’s model which includes a large number of supporting tools for developing PICOs, instructions for grading literature and project implementation. 17 21 22 24 27 By contrast, the ACE Star model and the An Evidence Implementation Model for Public Health Systems only provide high level overview and general instructions compared with other models and frameworks. 19 29 33

Gaps in the evidence

A consistent finding in research of clinician experience with EBP is the lack of expertise that is needed to assess the literature. 24 34 35 The models and frameworks reviewed demonstrated that the user must possess the knowledge and related skills for this step in the process. The models and frameworks varied greatly in the level of instruction to assess the evidence. Most provided a general overview in assessing and grading the evidence, though a few recommended that this work be done by EBP mentors and experts. 20 25 27 ARCC, JBI and Johns Hopkins provided robust tools and resources that would require administrative time and financial support. 21 22 27 Some models and frameworks offered vital resources or pointed to other resources for assessing evidence, 24 but most did not. While a few used mentors and experts to assist with assessing the literature, a majority did not address this persistent issue.

Sackett’s five-step model included another important consideration when implementing EBP: patient values and preferences. One criticism of EBP is that it ignores patient values and preferences. 36 Over half of the models and frameworks reported the need to include patient values and preferences, but the tools, instruction or resources for including them were limited. The ARCC model integrates patient preferences and values into the model, but it is up to the EBP mentor to accomplish this task. 37 There are many tools for assessing evidence, but few models and frameworks provide this level of guidance for incorporating patient preference and values. The inclusion of patient and family values and preferences can be misunderstood, insincere, and even tokenistic but without it there is reduced chance of success of implementation of EBP. 38 39

Strengths and limitations

Similar to other well-designed scoping reviews, the strengths of this review include a rigorous search conducted by a skilled librarian, literature evaluation by more than one person, and the utilisation of an established methodological framework (PRISMA-ScR). 14 15 Additionally, utilising the EBP five-step models as a point of alignment allows for a more comprehensive breakdown and established reference points for the reviewed models and frameworks. While scoping reviews have been completed on implementation science and knowledge translation models and framework, to our knowledge, this is the first scoping review of EBP models and frameworks. 13 14 Limitations of the study include that well-developed models and frameworks may have been excluded for not including all five steps. 40 For example, the Promoting Action on Research Implementation in Health Services (PARIHS) framework is a well-developed and validated implementation framework but did not include all five steps of an EBP model. 40 Also, some models and frameworks have been studied and validated over many years. It was beyond the scope of the review to measure the quality of the models and frameworks based on these other validated studies.

Implications and future research

Healthcare organisations can support EBP by choosing a model or framework that best suits their environment and providing clear guidance for implementing the best evidence. Some organisations may find the best fit with the ARCC and the Clinical Scholars Model because of the emphasis on mentors or the Johns Hopkins model for its tools for grading the level of evidence. 21 25 27 In contrast, other organisations may find the Iowa model useful with its feedback loops throughout its process. 24

Another implication of this study is the opportunity to better define and develop robust tools for patient and family values and preferences within EBP models and frameworks. Patient experiences are complex and require thorough exploration, so it is not overlooked, which is often the case. 39 41 The utilisation of EBP models and frameworks provide an opportunity to explore this area and provide the resources and understanding that are often lacking. 38 Though varying, models such as the Iowa Model, JBI and Johns Hopkins developed tools to incorporate patient and family values and preferences, but a majority of the models and frameworks did not. 21 22 24 An opportunity exists to create broad tools that can incorporate patient and family values and preferences into EBP to a similar extent as many of the models and frameworks used for developing tools for literature assessment and implementation. 21–25

Future research should consider appraising the quality and use of the different EBP models and frameworks to determine success. Additionally, greater clarification on what is considered patient and family values and preferences and how they can be integrated into the different models and frameworks is needed.

This scoping review of 19 models and frameworks shows considerable variation regarding how the EBP models and frameworks integrate the five steps of EBP. Most of the included models and frameworks provided a narrow description of the steps needed to assess and implement EBP, while a few provided robust instruction and tools. The reviewed models and frameworks provided diverse instructions on the best way to use EBP. However, the inclusion of patient values and preferences needs to be better integrated into EBP models. Also, the issues of EBP expertise to assess evidence must be considered when selecting a model or framework.

Supplementary Material

Acknowledgments.

We thank Keri Swaggart for completing the database searches and the Medical Writing Center at Children's Mercy Kansas City for editing this manuscript.

Contributors: All authors have read and approved the final manuscript. JD conceptualised the study design, screened the articles for eligibility, extracted data from included studies and contributed to the writing and revision of the manuscript. LM-L conceptualised the study design, provided critical feedback on the manuscript and revised the manuscript. AM screened the articles for eligibility, extracted data from the studies, provided critical feedback on the manuscript and revised the manuscript. JD is the guarantor of this work.

Funding: The article processing charges related to the publication of this article were supported by The University of Kansas (KU) One University Open Access Author Fund sponsored jointly by the KU Provost, KU Vice Chancellor for Research, and KUMC Vice Chancellor for Research and managed jointly by the Libraries at the Medical Center and KU - Lawrence

Disclaimer: No funding agencies had input into the content of this manuscript.

Competing interests: None declared.

Patient and public involvement: Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Provenance and peer review: Not commissioned; externally peer reviewed.

Supplemental material: This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Data availability statement

Ethics statements, patient consent for publication.

Not applicable.

Two decades of research show plant-based diets really are better for you

P lant-based diets have become more than a trend; they are now a cornerstone of many health recommendations. Suboptimal diets, rich in processed meats and sugars, are known culprits behind the soaring rates of several illnesses. In contrast, diets abundant in vegetables, fruits, legumes, and whole grains offer a protective shield against these diseases. The shift towards vegetarian and vegan diets, driven by health, ethical, and environmental concerns, is gaining momentum globally.

But how much of that is based on actual science? According to a new study — a lot of it. An umbrella review looked at 48 studies published from 2000 to 2023 and concluded that plant-based diets really are better for you.

In This Article

Disease and diet

Cardiovascular diseases (CVDs) and cancer are two of the biggest challenges in global health. These conditions not only steal lives but also diminish the quality of life for millions worldwide. While genetics and other factors play a role, our diet is a powerful weapon we can wield to combat these diseases. A growing body of evidence suggests that plant-based diets, particularly vegetarian and vegan options, could be the key to unlocking a healthier future.

Several studies have suggested this. However, individual studies usually look at the impact of diet on one condition or a small set of conditions.

Angelo Capodici and colleagues from University of Bologna, Italy, wanted to quantify how much plant diets help on a more general level. They conducted an “umbrella review,” where they evaluated other reviews and meta-analyses to determine how plant-based diets affect the risk factors for cardiometabolic diseases and cancer. The study excluded interventional trials and focused on observational data to provide a clearer picture of diet-related health outcomes.

Key Findings: Cardiovascular Benefits

The new study analyzed several different health markers.

・ Cholesterol and Lipid Profiles: The review confirms that plant-based diets significantly improve lipid profiles. Individuals adhering to vegetarian and vegan diets exhibit lower levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) — “bad cholesterol”. The reductions in TC and LDL-C, both critical markers for heart disease, are profound and consistent across numerous studies.

・ Inflammation and Body Weight: Plant-based diets are also associated with lower levels of inflammation and reduced body weight, which are both crucial factors in mitigating the risk of cardiovascular diseases. Lower C-reactive protein (CRP) levels among vegetarians and vegans indicate reduced inflammation. And their typically lower body mass index (BMI) suggests a healthier body weight profile.

・ Blood Pressure: While the impact on blood pressure is mixed, some studies within the review highlight significant reductions in both systolic and diastolic blood pressure among those following plant-based diets. This reduction is vital for cardiovascular health, given the strong link between high blood pressure and heart disease.

・ Glycemic Control: Plant-based diets also contribute to better glycemic control, evidenced by lower fasting glucose and glycosylated hemoglobin (HbA1c) levels. These improvements suggest a reduced risk of developing type 2 diabetes, which is a significant risk factor for cardiovascular disease.

Perhaps most excitingly, the review hints at a potential link between plant-based diets and longevity. Vegetarians seem to have a lower risk of dying from ischemic heart disease and other circulatory diseases. While more research is needed to fully understand this connection, it’s a tantalizing prospect.

Cancer Risk Reduction

The review also sheds light on the protective effects of plant-based diets against cancer. High intake of fiber, antioxidants, and phytonutrients found in plants contributes to a lower risk of various cancers. This connection was notable with those affecting the digestive system.

・ Colorectal Cancer: Plant-based diets are notably effective in reducing the risk of colorectal cancer, with evidence suggesting an 8-15% lower risk compared to omnivorous diets. This reduction is attributed to the high fiber content in plant foods, which promotes a healthy gut environment.

・ Other Cancers: While the evidence is strongest for colorectal cancer, there are indications that plant-based diets may also reduce the risk of other cancers, such as prostate and pancreatic cancers. These benefits are likely due to the overall healthier dietary patterns of vegetarians and vegans, which include lower consumption of processed meats and higher intake of protective nutrients.

Not everything is necessarily rosy for plant-based diets

Some groups benefitted from plant-based diets more than others. Factors such as geographic differences, dietary adherence, and lifestyle habits can influence the outcomes. For instance, among pregnant women specifically, vegetarian diets showed no difference in risk of gestational diabetes and hypertension compared to non-plant-based diets.

Also, despite the clear benefits, the review also highlights potential risks associated with plant-based diets — particularly if they are not well-planned. Nutritional deficiencies, such as vitamin B12, iron, and omega-3 fatty acids, can occur in more restrictive diets. Pregnant women, children, and other vulnerable groups need to ensure they are getting adequate nutrition to avoid health complications.

The bottom line

Isolating the effect of diet from all other lifestyle and genetic factors is always challenging. However, the analysis consistently found that that vegetarian and vegan diets are linked to a healthier profile across various risk factors for CVDs and cancer, including blood pressure, blood sugar control, and body mass index. These diets are associated with a reduced risk of ischemic heart disease, gastrointestinal and prostate cancers, and cardiovascular disease mortality.

More research is needed to explore the impact of plant-based diets on specific health markers and to address potential nutrient deficiencies. However, the evidence seems to strongly indicate that plant-based diets have a positive health impact.

Importantly, you don’t need to adopt an entirely plant-based diet to reap these benefits. Even reducing meat consumption and increasing the intake of plant-based foods can significantly improve health, demonstrating that small, manageable dietary changes can make a substantial difference.

Journal Reference: Capodici A, Mocciaro G, Gori D, Landry MJ, Masini A, Sanmarchi F, et al. (2024) Cardiovascular health and cancer risk associated with plant based diets: An umbrella review. PLoS ONE 19(5): e0300711. https://doi.org/10.1371/journal.pone.0300711

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Ten Vanderbilt engineering students awarded prestigious NSF Graduate Research Fellowships

Brenda Ellis

May 16, 2024, 3:30 PM

Seven engineering graduate students and three undergraduates in the Vanderbilt School of Engineering are 2024 recipients of the prestigious National Science Foundation Graduate Research Fellowship.

“These fellowships are extremely competitive, so being selected as an NSF Graduate Fellow is a tremendous recognition of our outstanding students and our faculty mentors. In addition to these students who are already at Vanderbilt, the graduate student cohort that is matriculating this fall will include several additional NSF recipients,” said E. Duco Jansen, senior associate dean for Graduate Education. The School of Engineering currently has over 45 NSF GRF awardees.

The seven current engineering graduate student winners are:

• Emily Berestesky, Biomedical Engineering
• Austin Coursey, Computer Science
• Skyler Hornback, Chemical Engineering
• William Richardson, Computer Science
• Soren Smail, Interdisciplinary Materials Science
• Jacob Schulman, Biomedical Engineering
• Harrison Walker, Interdisciplinary Materials Science

The three engineering undergraduate winners are:

• Abigail Eisenklam, Computer Science/Mathematics
• Alexander Oh, Electrical Engineering/Computer Science
• Schyler Rowland, Biomedical Engineering

Each of those fellowships provides three years of financial support inclusive of an annual stipend of $37,000 along with a $16,000 cost-of-education allowance for tuition and fees, as well as access to opportunities for professional development available to NSF-supported graduates students. It is one of the most prestigious awards for graduate students, with about 16% of applicants awarded each year.

Begun in 1952, this fellowship program is the oldest and most prestigious of its kind; 42 recipients have gone on to become Nobel laureates, and more than 450 have become members of the National Academy of Sciences.

Contact: [email protected]

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Su ZT , Hammadeh Z , Cheaib JG , Jing Y , Trock BJ , Han M. Trends in Industry-Sponsored Research Payments to Physician Principal Investigators. JAMA Netw Open. 2024;7(5):e2412432. doi:10.1001/jamanetworkopen.2024.12432

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Trends in Industry-Sponsored Research Payments to Physician Principal Investigators

• 1 James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland

After passage of the Physician Payments Sunshine Act (PPSA), the Open Payments program (OPP) was launched in 2013 to increase transparency of physician-industry financial relationships. 1 Because research payments constitute the largest payment category in the OPP, 2 , 3 we characterized trends in industry-sponsored research payments (ISRPs).

This cohort study follows the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline. We used OPP data 4 to identify ISRPs inflation-adjusted to 2022 US $ values during 2015 to 2022. In the OPP, covered recipients include teaching hospitals, physicians, and advanced practice practitioners not employed by applicable organizations reporting payments. Noncovered entities (NCEs) are organizations that do not meet the OPP definition of covered recipients. ISRPs to NCEs are reportable if a covered physician is a principal investigator (PI). 4 We analyzed ISPRs to NCEs with physician PIs because these constituted most ISRPs by value (>70%). Where multiple (up to 5 could be listed per ISRP) PIs were listed for an ISRP, we attributed the full amount of that ISRP to the primary PI given a lack of disclosure requirements about fund allocations within an ISRP. This attribution avoided double counting of the same ISRP. We tested trends in total values using linear regression and trends in per-physician ISRPs using generalized linear models with a γ distribution to account for physician effects, with a 2-sided α < .05 applied. We used Stata statistical software version 18.0 (StataCorp).

Overall, ISRPs increased 20.0%, from $6.32 billion in 2015 to $7.58 billion in 2022 ( P  = .01). ISRPs to NCEs increased 19.1%, from $4.98 billion in 2015 to $5.93 billion in 2022 ( P  = .06), and the trend was not statistically significant; the total in 2022 accounted for 47.1% of all Open Payments ($12.58 billion) that year. In contrast, ISRPs paid directly to covered physicians decreased 61.7%, from $179.5 million to $68.8 million ( P  < .001) ( Table 1 ).

ISRPs to NCEs with a physician PI increased 23.0%, from $4.52 billion in 2015 to $5.55 billion in 2022 ( P  = .03), accounting for 44.1% of all Open Payments. General internists had the highest annual median ISRPs per PI ( Table 2 ). In 2022, ISRPs were made to NCEs with 21 518 physicians as primary PIs, accounting for 2.0% of US physicians. The maximum ISRP received by an NCE with a physician PI was $89.5 million.

This cohort study found that between 2015 and 2022, ISRPs increased by 20.0% to reach $7.58 billion by 2022. In comparison, National Institutes of Health research grants increased by 24% over this period, to $31.3 billion by 2022. 5 Most ISRPs were directed to NCEs rather than teaching hospitals or physicians. While direct ISRPs to physicians steadily declined over time, ISRPs to NCEs with physician PIs increased to $5.55 billion by 2022, accounting for almost half of all Open Payments. General internists had the highest ISRPs per PI, potentially reflecting their access to patients with chronic diseases of interest for industry-sponsored pharmaceutical research.

Reporting rules in the PPSA specify that only the research entity, affiliated physician PIs, and total amount of the research payment are mandated for disclosure. 6 Consequently, the industry is not obligated to divulge specific research payment amounts allocated to individual physicians within NCEs vs payments for direct research expenses. It becomes imperative to disclose ISRPs to individual physicians in NCEs to promote transparency and accountability within the health care system, as intended by the PPSA.

Our study has several limitations, including potential data reporting errors to the OPP, attribution of an ISRP exclusively to the primary PI, and unmeasured confounding. Despite these limitations, our study reveals a substantial increase in ISRPs to NCEs, comprising nearly half of overall Open Payments. Further research is needed to investigate factors associated with these payments to NCEs and their association with regulatory oversight and financial conflicts of interest.

Accepted for Publication: March 20, 2024.

Published: May 16, 2024. doi:10.1001/jamanetworkopen.2024.12432

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Su ZT et al. JAMA Network Open .

Corresponding Author: Misop Han, MD, MS, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Marburg 146, Baltimore, MD 21287 ( [email protected] ).

Author Contributions: Dr Hammadeh and Mr Jing had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Su, Hammadeh, Han.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Su, Hammadeh, Cheaib, Han.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Su, Hammadeh, Jing, Trock.

Obtained funding: Han.

Administrative, technical, or material support: Hammadeh, Han.

Supervision: Trock, Han.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by the Boucher Family Foundation.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

Additional Contributions: We would like to thank Gerard Anderson, PhD (Johns Hopkins Bloomberg School of Public Health), for his careful review of and suggestions for the manuscript. We have obtained permission to include the name of the individual in the acknowledgment section of the manuscript. Dr Anderson was not compensated for this contribution.

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Facility for Rare Isotope Beams

At michigan state university, international research team uses wavefunction matching to solve quantum many-body problems, new approach makes calculations with realistic interactions possible.

FRIB researchers are part of an international research team solving challenging computational problems in quantum physics using a new method called wavefunction matching. The new approach has applications to fields such as nuclear physics, where it is enabling theoretical calculations of atomic nuclei that were previously not possible. The details are published in Nature (“Wavefunction matching for solving quantum many-body problems”) .

Ab initio methods and their computational challenges

An ab initio method describes a complex system by starting from a description of its elementary components and their interactions. For the case of nuclear physics, the elementary components are protons and neutrons. Some key questions that ab initio calculations can help address are the binding energies and properties of atomic nuclei not yet observed and linking nuclear structure to the underlying interactions among protons and neutrons.

Yet, some ab initio methods struggle to produce reliable calculations for systems with complex interactions. One such method is quantum Monte Carlo simulations. In quantum Monte Carlo simulations, quantities are computed using random or stochastic processes. While quantum Monte Carlo simulations can be efficient and powerful, they have a significant weakness: the sign problem. The sign problem develops when positive and negative weight contributions cancel each other out. This cancellation results in inaccurate final predictions. It is often the case that quantum Monte Carlo simulations can be performed for an approximate or simplified interaction, but the corresponding simulations for realistic interactions produce severe sign problems and are therefore not possible.

Using ‘plastic surgery’ to make calculations possible

The new wavefunction-matching approach is designed to solve such computational problems. The research team—from Gaziantep Islam Science and Technology University in Turkey; University of Bonn, Ruhr University Bochum, and Forschungszentrum Jülich in Germany; Institute for Basic Science in South Korea; South China Normal University, Sun Yat-Sen University, and Graduate School of China Academy of Engineering Physics in China; Tbilisi State University in Georgia; CEA Paris-Saclay and Université Paris-Saclay in France; and Mississippi State University and the Facility for Rare Isotope Beams (FRIB) at Michigan State University (MSU)—includes  Dean Lee , professor of physics at FRIB and in MSU’s Department of Physics and Astronomy and head of the Theoretical Nuclear Science department at FRIB, and  Yuan-Zhuo Ma , postdoctoral research associate at FRIB.

“We are often faced with the situation that we can perform calculations using a simple approximate interaction, but realistic high-fidelity interactions cause severe computational problems,” said Lee. “Wavefunction matching solves this problem by doing plastic surgery. It removes the short-distance part of the high-fidelity interaction, and replaces it with the short-distance part of an easily computable interaction.”

This transformation is done in a way that preserves all of the important properties of the original realistic interaction. Since the new wavefunctions look similar to that of the easily computable interaction, researchers can now perform calculations using the easily computable interaction and apply a standard procedure for handling small corrections called perturbation theory.  A team effort

The research team applied this new method to lattice quantum Monte Carlo simulations for light nuclei, medium-mass nuclei, neutron matter, and nuclear matter. Using precise ab initio calculations, the results closely matched real-world data on nuclear properties such as size, structure, and binding energies. Calculations that were once impossible due to the sign problem can now be performed using wavefunction matching.

“It is a fantastic project and an excellent opportunity to work with the brightest nuclear scientist s in FRIB and around the globe,” said Ma. “As a theorist , I'm also very excited about programming and conducting research on the world's most powerful exascale supercomputers, such as Frontier , which allows us to implement wavefunction matching to explore the mysteries of nuclear physics.”

While the research team focused solely on quantum Monte Carlo simulations, wavefunction matching should be useful for many different ab initio approaches, including both classical and  quantum computing calculations. The researchers at FRIB worked with collaborators at institutions in China, France, Germany, South Korea, Turkey, and United States.

“The work is the culmination of effort over many years to handle the computational problems associated with realistic high-fidelity nuclear interactions,” said Lee. “It is very satisfying to see that the computational problems are cleanly resolved with this new approach. We are grateful to all of the collaboration members who contributed to this project, in particular, the lead author, Serdar Elhatisari.”

This material is based upon work supported by the U.S. Department of Energy, the U.S. National Science Foundation, the German Research Foundation, the National Natural Science Foundation of China, the Chinese Academy of Sciences President’s International Fellowship Initiative, Volkswagen Stiftung, the European Research Council, the Scientific and Technological Research Council of Turkey, the National Natural Science Foundation of China, the National Security Academic Fund, the Rare Isotope Science Project of the Institute for Basic Science, the National Research Foundation of Korea, the Institute for Basic Science, and the Espace de Structure et de réactions Nucléaires Théorique.

Michigan State University operates the Facility for Rare Isotope Beams (FRIB) as a user facility for the U.S. Department of Energy Office of Science (DOE-SC), supporting the mission of the DOE-SC Office of Nuclear Physics. Hosting what is designed to be the most powerful heavy-ion accelerator, FRIB enables scientists to make discoveries about the properties of rare isotopes in order to better understand the physics of nuclei, nuclear astrophysics, fundamental interactions, and applications for society, including in medicine, homeland security, and industry.

The U.S. Department of Energy Office of Science is the single largest supporter of basic research in the physical sciences in the United States and is working to address some of today’s most pressing challenges. For more information, visit energy.gov/science.

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Research team develops an impact-based forecasting system for improved early flood warning

by Helmholtz Association of German Research Centres

Climate change increases the frequency of extreme events such as flooding. This reinforces the need to develop methods for more precise and faster flood forecasting in order to better protect the population in the future.

A research team from the Helmholtz Centre for Environmental Research (UFZ) and the German Research Centre for Geosciences (GFZ) has presented a flood forecasting system in Nature Communications that provides not only timely water levels but also dynamic high-resolution flood inundation maps. The researchers have been able to combine various forecasting models in such a way as to precisely forecast flood impacts on individual buildings.

Over the past years, great progress has been made in the spatiotemporal forecasting of flood events. It is thus now possible to predict maximum flood levels at locations of river gauges. Until now, however, estimates of the impacts of flooding on cities and municipalities were only rough or even completely inaccurate, especially for people at the lower river reaches away from gauge locations. However, this information is critical, as the affected population must be notified as quickly as possible in advance in order to initiate any necessary evacuation measures.

"What is needed is a state-of-the-art early flood warning system that provides high-resolution flood forecasts in a timely fashion and indicates the impacts of the flood on individual buildings," says senior author and UFZ modeler Prof. Luis Samaniego. This would be a key improvement for crisis management.

In a first step in developing the new flood forecasting system, the researchers from the two Helmholtz Centres combined the precipitation forecasts from the German Weather Service (NWP limited area ensemble prediction system) with the mesoscale hydrologic model (mHM) developed at the UFZ. This model not only provides information on water discharge, but also temporal soil moisture information—one of the critical factors for flood development.

Based on the available data from the catastrophic flood in the Ahr Valley in July 2021 and an ensemble prediction system with 20 members, they were able to predict hourly flood peak flows at gauge Altenahr in a hindcast mode. In this approach, they estimated the likelihood of exceedance of the 50-year or the 100-year flood levels.

Simulations revealed that 15% of the ensemble members would have forecast an exceedance of a 100-year flood with a lead time of 47 hours and thus nearly two days prior to the flood peak in the Ahr Valley. The closer the event came, the greater the probability that the 100-year level defined at that time would actually be exceeded: 75% of all ensemble members forecast the 100-year flood 17 hours before the flood peak, and finally 100% did so 7 hours in advance.

"If 75% of the forecasts in an ensemble predict a 100-year flood, there is a high probability that it will occur," says lead author and UFZ modeler Dr. Husain Najafi.

In the second step, the Helmholtz researchers combined the streamflow generated by mHM hydrologic model with the RIM2D hydrodynamic flood model developed by the GFZ Potsdam. RIM2D very rapidly simulates the inundation dynamics and the evolution of flood depths. This model, with a spatial resolution of 10 meters x 10 meters, first enables hourly forecasts inundation areas and depths and hence reveals which locations and to what extent specific buildings, streets, railway segments, hospitals or other critical infrastructure elements will be affected by a flooding event.

"The responsible authorities and the population therefore not only have information on a possible gauge water level 30 kilometers upstream, but also a high-resolution flood map showing the impacts of the flood. For example, they could know where people could be in danger or who have to be evacuated," says GFZ hydrologist Dr. Sergiy Vorogushyn.

The combined forecast model from the UFZ and GFZ has passed the first test in reconstructing the extreme flood event in the Ahr Valley. In a further test phase starting this summer, the automated model chain will be tested in real time as part of the second phase of the Helmholtz Climate Initiative in two additional catchments of Fils and Murr rivers in Baden-Württemberg.

If the model system also passes this phase, it can be applied for regions subject to high flood risk, especially due to flash floods. This could decisively strengthen the existing flood early warning systems and could extend the horizon of the forecasts to include flood impacts. This could significantly reduce affected populations and property damage in the future.

Journal information: Nature Communications

Provided by Helmholtz Association of German Research Centres

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Katie Wootten earns top award for fiber-based sensor research

The award was established in 2013 by alumnus Stephen White (Phys’63) whose own research experiences as an undergraduate at CU Boulder helped shape his future career. Dr. White created the award to recognize outstanding undergraduate research projects in physics. 

Pursuing fiber-based sensor research 

Katie began pursuing fiber sensor research with Juliet Gopinath, professor of electrical engineering and physics, in June 2022. She quickly became an integral member of the lab and took leadership of her experiment.

Wootten’s work on a fiber-based sensor for both strain and temperature led her to discover that different polarizations allow for directionally resolved force and temperature sensing.  She uses patterned light, light with optical orbital angular momentum, and a special kind of fiber, polarization maintaining fiber, to achieve the directionally resolved force sensing. This sensor will find many applications in monitoring structural stability, oil and gas operations, environmental monitoring and even biology.

Juliet Gopinath, Wootten’s research advisor states, “Katie is an amazing and inspiring student. Her work ethic, deep technical understanding of her project and beautiful presentations are to be commended. I am glad to have had the honor to work with her.”

While an undergraduate, Wootten presented a conference paper at the peer-reviewed IEEE Photonics Conference, and she has currently has a journal paper under review.

Research project earns top honors 

Wootten’s outstanding honors thesis titled “Orbital Angular Momentum in a Temperature and Force Fiber Sensor,” earned her a summa cum laude designation in physics from the College of Arts & Sciences Honors Program. She was also selected by the Physics Honors Council Representatives as one of two recipients of the Stephen Halley White Undergraduate Research Award, a top honor for undergraduates in physics. 

Jun Ye served as the Honors Council Representative for Wootten’s honors thesis and recommended her highly for the Stephen Halley White Award. He praised Katie’s work highly, “Katie was excellent in her thesis presentation. Her research work is outstanding and impactful.” He added, “She has submitted a journal manuscript to Optics Express.”

What’s next? 

After graduating from CU Boulder this semester with a double major in engineering physics and astrophysics, Wootten plans to pursue a PhD in Mechanical Engineering at Stanford.

Katie Wootten was recognized for this award at the Spring 2024 Physics Recognition Ceremony on May 10, 2024. 

A newsletter briefing on the health-care policy debate in Washington.

Covid origins in spotlight, as feds cut funding to virus hunters

with research by McKenzie Beard

Welcome to Thursday. I’m Dan Diamond, a reporter at The Washington Post, where my colleagues are hiring for a transportation, medicine and energy editor. (To be clear, that’s a single position — the Neapolitan sandwich of editing jobs.) Send your tri-flavored résumés and other delicious tips to [email protected] . Not a subscriber? Sign up here .

Today’s edition: A key senator is pushing to expand dental coverage to millions of Americans. Overdose deaths dropped slightly last year, but experts say the toll remains unacceptably high. But first …

The EcoHealth saga continues

What did the deputy director of the National Institutes of Health know, and when did he know it?

Top NIH official Lawrence Tabak is set to face off this morning with the House panel probing the coronavirus response. Expect lawmakers to focus on the agency’s oversight and funding of EcoHealth Alliance , a nonprofit organization that worked with the Wuhan Institute of Virology before the pandemic.

EcoHealth was thrown back into the spotlight Wednesday, after the Department of Health and Human Services said it was suspending funding to the organization and moving to debar the New York-based nonprofit from receiving additional funds, citing evidence EcoHealth had failed to monitor and report on risky virus experiments in China.

EcoHealth has said it is appealing the decision, but the news was hailed on Capitol Hill. Both Republicans and Democrats had called on HHS to review the organization’s funding and its NIH grants; GOP leaders have gone further and called for a criminal probe.

“Our investigation into EcoHealth and Dr. Daszak’s actions is not over,” Rep. Brad Wenstrup (R-Ohio), who chairs the House Select Subcommittee on the Coronavirus Pandemic , plans to say to Tabak today, in remarks shared with The Health 202. “This issue has highlighted broader concerns with the NIH — especially that it is up to the grantee to oversee themselves. That is a recipe for waste, fraud, abuse and deception.”

Years of questions

EcoHealth has been at the center of questions about SARS-CoV-2 ’s origins since the pandemic’s earliest days, given the organization’s ties to Wuhan, China — the epicenter of the outbreak — and its work to research and experiment with coronaviruses. Then-President Donald Trump publicly said his administration was looking into EcoHealth’s work, and Tabak was among the officials in April 2020 who moved to abruptly halt NIH funding to the organization. (It was later restored.)

The House coronavirus panel also recently grilled Peter Daszak , EcoHealth’s president, on his conflicting statements and outstanding questions, including why his organization waited nearly two years to submit a required report about the results of its research and activities leading up to the pandemic.

EcoHealth has repeatedly denied accusations that it played any role in the pandemic, and its defenders have said it’s been wrongly scapegoated. There’s no existing evidence EcoHealth, the Wuhan Institute of Virology or another organization had SARS-CoV-2 in its possession before the pandemic.

Federal and congressional officials also cautioned that the HHS decision to cut funding to EcoHealth shouldn’t be interpreted as a smoking gun about the virus’s origins or a possible lab leak. Officials on Wednesday told me the theory that the pandemic began naturally — when a virus spread from animals to humans — continues to be favored by several government agencies and many scientists.

But at minimum, federal officials had grown increasingly uneasy about EcoHealth’s work and safeguards, they said. “HHS wanted to be out of the EcoHealth business,” one official told me.

What Tabak will be pushed on today

Republicans’ line of attack was previewed in a letter to NIH last week, in which Wenstrup laid out Daszak’s claims and compared them with other officials’ statements under oath.

“The Select Subcommittee is eager to uncover the true sequence of events and has identified multiple occasions where Dr. Daszak directly contradicts NIH’s or NIAID’s assertions,” Wenstrup wrote. Republicans have hinted that they could refer Daszak to the Justice Department on perjury grounds.

Expect GOP lawmakers to probe Tabak’s conversations with Anthony S. Fauci , his longtime colleague at NIH and the center of persistent Republican attacks over his pandemic recommendations, his agency’s funding of EcoHealth and other issues. Fauci, who retired from government at the end of 2022, is set to testify in front of the panel in June.

Democrats, meanwhile, have tried to draw a line between what they characterized as bad actions by EcoHealth and Daszak, and the more sweeping charge that the organization helped spark the pandemic.

“While the Select Subcommittee’s probe has uncovered efforts by Dr. Peter Daszak to mislead his funders at the National Institutes of Health and the National Institute of Allergy and Infectious Diseases , it has not substantiated any allegations that federal grant funding for EcoHealth Alliance created the COVID-19 pandemic,” Rep. Raul Ruiz (D-Calif.), the top Democrat on the House coronavirus panel, plans to say in remarks today previewed with The Health 202.

Overdose deaths dropped slightly in 2023, but remain staggeringly high

Overdose deaths have surpassed 100,000 for the third consecutive year, a reminder that the nation remains mired in an intractable epidemic fueled by the potent street drug fentanyl, our colleague David Ovalle reports . 

By the numbers: An estimated 107,543 people died in 2023, a slight decrease from the previous year, according to provisional data from the CDC . Of these deaths, an estimated 74,702 were attributed to synthetic opioids such as fentanyl.

• The agency described it as the first annual decrease in deaths since 2018, although experts cautioned that the numbers could rise in ensuing years and that the toll remains unacceptably high.

The politics: The CDC yesterday pointed to the decrease as a sign that federal efforts to help prevent deaths and treat addiction in states are paying off. It could boost Biden as he seeks reelection and Republicans rip him over border security and the flow of fentanyl synthesized by Mexican criminal groups.

On the Hill

Sanders mounts another push for expanded dental coverage.

On tap today: The Senate Health, Education, Labor and Pensions Committee will hold a hearing on dental care accessibility and affordability, a topic long championed by Chair Bernie Sanders (I-Vt.). 

Sanders is also set to introduce a comprehensive bill aimed at extending dental insurance to all Medicare, Medicaid and Veterans Affairs beneficiaries. The legislation, outlined in a one-pager shared with The Health 202, also seeks to establish new access points for dental services, enhance the oral health workforce, improve education and authorize additional federal funding for oral health research. 

We’re expecting the independent firebrand to draw from his constituents’ experiences in navigating dental care challenges during the hearing, following a request this month that garnered over 1,000 responses, as noted by a source familiar with the senator's plans.

Why it matters: An estimated 68.5 million U.S. adults lacked dental insurance in 2023, according to the nonprofit CareQuest Institute for Oral Health . That’s more than 2.5 times the roughly 26 million Americans of all ages who lack health insurance .

The Centers for Disease Control and Prevention estimates that untreated dental disease costs the United States more than $45 billion in lost productivity annually, and it’s linked to a long list of serious health problems, including diabetes and heart disease.

Sen. Bernie Sanders (I-Vt.):

Today in America: - Over 40% of kids have tooth decay by the time they reach kindergarten - 20% of seniors are missing all their natural teeth and can't afford a full set of dentures - Nearly 50% of adults have some form of periodontal disease Let’s get our priorities straight. — Bernie Sanders (@SenSanders) May 15, 2024

In other news from the upper chamber …

New this a.m.: Sens. Edward J. Markey (D-Mass.) and Sanders are urging HHS to be prepared to offer support and regulatory flexibility to prevent any loss of care after Steward Health Care ’s bankruptcy filing, according to a letter sent to Secretary Xavier Becerra that was shared with The Health 202.  

The Senate rejected a GOP-led attempt to claw back billions of dollars in unspent coronavirus relief funds in a party-line vote yesterday. President Biden had already pledged to veto the bill, safeguarding Treasury Department guidance that gave states and municipalities more time to spend the money. 

And across the Capitol …

On our radar: The House Energy and Commerce Committee unveiled legislation to extend pandemic-era Medicare telehealth flexibilities for the next two years, which is up for a consideration today during a health subcommittee mark up . Among the other 22 bills on the agenda are proposals that seek to remove barriers for living organ donors, preserve access to treatments for rare disease patients and tackle fraud in Medicare and Medicaid. 

The House passed a bipartisan bill that would direct the Federal Aviation Administration to update aircraft emergency medical kits to include overdose reversal medication. It now heads to Biden’s desk. 

The House Committee on Oversight and Accountability voted to advance a bipartisan bill that would prohibit U.S. businesses that receive federal funding from purchasing equipment or contracting services from a list of designated foreign “companies of concern,” currently all of which are Chinese-owned biotechnology firms. 

Rep. Brad Wenstrup (R-Ohio):

My bill, the BIOSECURE Act, was reported favorably out of @GOPoversight today, the first in what I hope will be a multi-step approach to fortifying U.S. national health security and ending our dependence on foreign adversaries, like China, for genomic testing or basic… — Rep. Brad Wenstrup (@RepBradWenstrup) May 15, 2024

In other health news

• More self-collection test kit news. Yesterday, we told you about the Food and Drug Administration moving to expand screening for potentially lethal cervical cancer by allowing women to collect test samples themselves. In addition to the test by Becton, Dickinson and Company , the FDA also signed off on self-collection for an HPV test manufactured by Roche , our colleague Rachel Roubein writes. 
• The Centers for Medicare and Medicaid Services has abandoned its proposal to revise how drugmakers calculate the “best price” they must offer Medicaid, saying it will gather additional information before proceeding with any changes. 
• A first-of-its-kind service program will train hundreds of young adults to help their peers access mental health care and other support . The Youth Mental Health Corps is set to launch in Colorado, Michigan, Minnesota and Texas this fall, Maya Goldman reports for Axios . 

Health reads

Months after Maui fires, residents report troubling health problems (By Brianna Sacks | The Washington Post)

Most states receive D’s, F’s in maternal mental health report card (By Alejandra O’connell-Domenech | The Hill)

North Carolina lawmakers push bill to ban most public mask wearing, citing crime (By Makiya Seminera | The Associated Press)

Thanks for reading! See you tomorrow.