Journal of Evidence-Based Practice

Beyond the paywall: the role of preprints in overcoming publication bias: Hyun Kang; J Evid-Based Pract 2025;1(1):7-11. Published online March 31, 2025; DOI: https://doi.org/10.63528/jebp.2025.00002

Preprints have become a transformative tool in scientific communication, addressing critical challenges of traditional publishing, including long peer-review timelines, high costs, and systemic publication bias. Publication bias, which disproportionately favors studies with positive or statistically significant results, undermines the comprehensiveness and accuracy of the scientific record. By offering an open platform for sharing all research findings, preprints ensure that studies with null or negative results are also represented, mitigating the selective publication that skews research fields and meta-analyses. The COVID-19 pandemic highlighted the importance of preprints, as they facilitated the rapid dissemination of urgent findings while maintaining accessibility. Unlike traditional journals, preprints bypass lengthy review processes, enabling immediate access to data and fostering timely feedback, collaboration, and application. This inclusivity and transparency enhance trust in the research process while democratizing access to scientific knowledge. Despite their advantages, preprints face challenges, such as inconsistent quality standards, discrepancies between preprints and final publications, and risks associated with unverified findings. These challenges can complicate their use in systematic reviews and evidence-based medicine, requiring careful consideration and handling.This paper explores the interplay between preprints and publication bias, detailing how preprints can reduce bias while identifying limitations that must be addressed.

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Familial risk and interaction with hypertension and hyperglycemia in primary open-angle glaucoma: Hyeong Sik Ahn, Heather Swan, Hee-Sang Lee, Sayada Zartasha Kazmi, Kun-Hoo Na, Taeuk Kang, Hyun Jung Kim; J Evid-Based Pract 2025;1(1):12-23. Published online March 31, 2025; DOI: https://doi.org/10.63528/jebp.2025.00003

Although there is a genetic component to primary open-angle glaucoma (POAG) susceptibility, few studies have investigated interactions between genetic and environmental factors. We aimed to quantify the familial risk of POAG and estimate disease risk among individuals with a positive family history and either hypertension or hyperglycemia, as well as assess their interactions. Using the National Health Insurance database, which includes information on familial relationships and lifestyle risk factors, we identified 6,217,057 individuals with first-degree relatives (FDRs) from 2002-2018. We calculated familial risk using hazard ratios (HRs) with 95% confidence intervals (CIs) which compare the risk of individuals with and without affected FDRs. Disease risk was estimated among individuals with both a positive family history and hypertension or hyperglycemia, and interactions were assessed on an additive scale. Individuals with an affected parent had a 3.13-fold (95% CI 2.74 –3.58) increased risk of disease compared to those with unaffected parents. Individuals with affected father, mother, or both affected parents showed HRs (95% CI) of 3.50 (2.86 –4.30), 2.87 (2.41 –3.44) and 4.88 (1.83 –12.98), respectively. Familial risk adjusted for lifestyle factors decreased slightly (HR 3.14), suggesting that genetic component is the predominant driver in the familial aggregation. Individuals with a positive family history and either hypertension or hyperglycemia had a markedly elevated risk of disease, with HRs of 3.42 (95% CI 2.49 –4.69) and 3.27 (95% CI 2.15 –4.97), respectively. Hypertensive or hyperglycemic individuals with a positive family history may be considered a high-risk group and glaucoma screening may be considered.

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Evidence-based practice and evidence-practice gap: status, challenges, and solutions: Soo Young Kim; J Evid-Based Pract 2025;1(1):1-6. Published online March 31, 2025; DOI: https://doi.org/10.63528/jebp.2025.00001

Evidence-Based Practice (EBP) is an approach that utilizes the best evidence for patient care, and its importance is growing in various fields to improve patient-centered care. However, the Evidence-Practice Gap (EPG) that occurs in the practical application of EBP remains a significant problem. EPG refers to the gap between research results and actual clinical practice, which can hinder the optimization of patient care and lead to inefficiencies in the healthcare system. This review introduces the concepts of EBP and EPG and examines educational approaches such as Sicilian statements and Core Competencies in Evidence-Based Practice. In addition, we discuss translational research, knowledge transfer, multidisciplinary collaboration, and evidence-based policymaking, which are key efforts to resolve EPG. In addition, we emphasize the importance of setting research directions using the Evidence Gap Map (EGM) along with national strategies to promote the spread of EBP. This paper discusses how strategic approaches and policy efforts to resolve the EPG can contribute to the actual clinical application of EBP, and suggests future research directions.

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Development of the clinical practice guideline protocol registration program and its pilot application in Korea: Hyun Jung Kim, You Kyoung Lee, Soo Young Kim, Kyu Chang Wang, Ho Sin Gwak, Yeol Kim; J Evid-Based Pract 2025;1(1):24-29. Published online March 31, 2025; DOI: https://doi.org/10.63528/jebp.2025.00004

Background
In the case of clinical practice guideline (CPG), the need for the prospective registration of protocols has been proposed several times. However, the registration of CPG protocols is not yet active. The objective of this study was to summarize the experience of the CPG protocol registration program in Korea.
Methods
This study was performed in the following order: 1) formation of a methodological expert group; 2) CPG protocol template development; 3) CPG protocol preparation and expert review; 4) exploration of the knowledge and attitude of the guideline developers toward CPG protocol.
Results
The final version of the CPG protocol templates consists of four parts (planning, development, finalization, and timetable). The protocols for 18 cancers were submitted by 14 medical societies. conflicts of interest (n = 14, 77.8%), guideline development group (GDG; n = 9, 50%), scope of CPG (n = 9, 50%), and key questions (n = 8, 44.4%) were the under-reported areas in the submitted protocols. The GDGs (n = 13, 72.7%) was the most misreported areas of the protocol. CPG developers generally agreed on the advantages of protocol registration but responded that it was difficult to understand the concepts in the protocol and fill them with appropriate content. The areas where CPG developers responded that they felt difficulty were were recommendation grade (n = 9, 75.0%), GDG composition (n = 7, 58.3%), and determining key questions (n = 7, 58.3%).
Conclusions
The CPG protocol registration program was planned and piloted in Korea, and it could be said that it is feasible. It is necessary to evaluate the developed CPG later and determine whether protocol registration affects the quality of CPG through indices such as transparency and clarity of CPG.