22-21st Century Controversies (part 3 of 3)

Question 1

What does PEN stand for?

Answer 1

PEN (Practice Based Evidence in Nutrition)

Question 2

What is PEN?

Answer 2

• PEN System is a robust database managed by a collaborative partnership of the British Dietetic Association, the Dietitians Association of Australia and Dietitians of Canada.
• It publishes thousands of nutrition articles annually (systematic reviews; critically-appraised journal articles; practice guidelines) providing evidence-based answers to questions in everyday practice.

Question 3

What is the purpose of PEN?

Answer 3

It uses an Evidence Grading System to provide summaries of evidence and clinical practice recommendations.

Question 4

What is the PEN evidence grading system?

Answer 4

It is used to evaluate the strength and quality of evidence based on:
•Evidence
•Strong Research Design
•Sample Size
•Clear Methodology

• Consistency
• Clinical Impact
• Generalizability
• Applicability

Question 5

What are the conditions to be a GOOD evidence (A)?

Answer 5

• good quality systematic review (SR) of randomized controlled trials (RCTs) with consistent findings and a low risk of bias
• SR of cohort studies (with homogeneity)

Question 6

What are the conditions to be a FAIR evidence (B)?

Answer 6

• strong design with minor methodological concerns
• systematic review (SR) of RCTs with heterogeneity although overall the results support the
  conclusion OR a single RCT with low risk of biasSR of
• cohort studies (with homogeneity) or two or more well-done prospective cohort studies with
  consistent findings

Question 7

What are the conditions to be a LIMITED evidence (C)?

Answer 7

• studies of weak design
• several RCTs with inconsistent results or high risk of bias
• SR of cohort and case-control studies (with heterogeneity) or several studies with some inconsistent results
• a single cohort study or two or more case-control studies
• high quality cross-sectional studies

Question 8

What are the conditions to be a POOR evidence (D)?

Answer 8

• a single study with major design flaws or from studies with such contradictory
  results

Question 9

What are the topics discussed in “More Evidence That…“article?

Answer 9

• Intellectual honesty;
• Research bias
• Nutrition controversies