Assessing the evidence from neonatal nutrition research

Being up to date with current medical research in order to deliver the best possible care to patients has never been easy, and it is not easy today. Still, clinical decision-making at all levels of medical care needs to be made based on evidence. This chapter aims to provide tools for understanding how to assess the medical literature. It starts with an overview of study designs. Each of the study designs can provide useful information if applied in the appropriate situation, with the proper methods, and if properly reported. The strengths and limitations of each study design, mainly in relation to the potential to establish causality, are presented. Then, the chapter provides a summary of the key elements of practicing evidence-based medicine, the necessity of today's medicine. These key elements are as follows: formulation of an answerable question (the problem); finding the best evidence; critical appraisal of the evidence, and applying the evidence to the treatment of patients. Special focus is placed on critical appraisal of the evidence, as not all research is of good quality. Studies are frequently biased and their results are incorrect. In turn, this can lead one to draw false conclusions. While an attempt was made to discuss all of the issues in the context of studies conducted in neonatal nutrition, the principles are applicable to practicing medicine in general.