literature-review

name	literature-review
description	Synthesize medical literature on a clinical question — appraise evidence quality, summarize findings, and identify clinical implications.
version	1.0.0
author	Gnostor Community
license	MIT
metadata	{"hermes":{"tags":["medical","evidence-based-medicine","literature","EBM","research","appraisal","healthcare"]}}

Medical Literature Review

Structured synthesis of clinical evidence on a focused question — appraised, summarized, and contextualized for practice.

Disclaimer: This skill is for clinicians, researchers, and medical learners. Output should be verified against primary sources and current guidelines before clinical application. It does not replace formal systematic review methodology.

When to Use

• "What does the evidence say about [intervention] for [condition]?"
• "Summarize the recent literature on [topic]"
• "Find guidelines on [clinical question]"
• "Compare these two approaches based on the literature"
• "What are the landmark trials in [area]?"

What to Give Me

• Clinical question structured as PICO when possible:
  • Population
  • Intervention
  • Comparator
  • Outcome
• Setting: primary care, hospital, specialty clinic
• Depth: quick summary, full review, journal club style
• Time horizon: current consensus only, or include historical landmarks

Output Structure

## Evidence Summary: [Clinical Question]

### Bottom Line
[One paragraph — what the evidence supports for practice today]

### Strength of Evidence
- **High**: multiple RCTs, meta-analyses, consistent findings
- **Moderate**: limited RCTs or significant heterogeneity
- **Low**: observational data, expert consensus, indirect evidence

### Guidelines and Consensus
- [Society/body] [year]: [recommendation summary, grade]
- [Society/body] [year]: [recommendation summary, grade]

### Key Trials and Studies
1. **[Trial name / first author year]** — [design, n, primary finding]
   - Strengths / limitations
   - Relevance to the question

2. **[Trial]** — [...]

### Areas of Uncertainty / Active Research
[Open questions, ongoing trials, where evidence is lacking]

### Clinical Implications
[How this evidence translates to bedside decisions, including caveats]

### Sources
[Listed for verification — favor primary sources, guidelines, Cochrane]

Appraisal Principles

• Hierarchy of evidence: systematic reviews > RCTs > cohort > case-control > case series > expert opinion
• Risk of bias: randomization, blinding, allocation concealment, completeness of follow-up
• Generalizability: study population vs. patient in front of you
• Effect size and clinical significance — not just statistical significance
• Conflicts of interest and funding sources — flag when material

Evidence Resources

• PubMed / MEDLINE (primary literature)
• Cochrane Library (systematic reviews)
• UpToDate, DynaMed (synthesized references)
• Specialty society guidelines (AHA, ACC, IDSA, ACOG, AAP, etc.)
• ClinicalTrials.gov (ongoing studies)
• Trip Database, ACCESSSS (filtered searches)

What I Will Not Do

• Fabricate citations or trial results — if I'm uncertain, I will say so and recommend a primary search
• Override current guidelines with single-study findings without context
• Ignore the strength-of-recommendation grade attached to consensus statements