Sutton A J, Jones D R, Abrams K R, Sheldon T A, Song F
Department of Epidemiology and Public Health, University of Leicester, UK.
J Health Serv Res Policy. 1999 Jan;4(1):49-55. doi: 10.1177/135581969900400112.
To systematically review methods for systematic review/meta-analysis in order to identify the different methodological and statistical methods that have been proposed. A summary of the main findings is presented here, with emphasis given to health services research topics.
A thorough systematic search for methodological papers was carried out using a variety of methods, including the use of electronic databases. Approximately 1000 potentially relevant references were identified, a number of them from education, psychology and sociology.
After briefly reviewing the procedural methods required to carry out a review, and the basic statistical methods used to combine study estimates, less established methods are discussed. These include methods for dealing with publication bias, meta-regression, meta-analysis of individual patient data, the synthesis of non-randomized evidence alone and in combination with randomized studies. Bayesian modelling and economic evaluation through meta-analysis. Recommendations for meta-analytical practice are given; these are either distilled from previous guidelines, or constructed where there appears to be a broad consensus across the literature.
It is hoped that this review will provide a consistent and comprehensive, but concise, description of the methods available for synthesizing evidence, that it will promote better quality reviews of the results of health services research and identify specific areas which require methodological development.
对系统评价/荟萃分析的方法进行系统综述，以识别已提出的不同方法学和统计学方法。本文呈现主要研究结果的总结，重点关注卫生服务研究主题。
采用多种方法，包括使用电子数据库，对方法学论文进行全面系统的检索。识别出约1000篇潜在相关参考文献，其中一些来自教育、心理学和社会学领域。
在简要回顾进行综述所需的程序方法以及用于合并研究估计值的基本统计方法之后，讨论了不太成熟的方法。这些方法包括处理发表偏倚的方法、元回归、个体患者数据的荟萃分析、单独以及与随机研究相结合的非随机证据的综合、贝叶斯建模以及通过荟萃分析进行的经济评价。给出了荟萃分析实践的建议；这些建议要么是从先前的指南中提炼出来的，要么是在文献中似乎存在广泛共识的地方构建的。
希望本综述将对可用于综合证据的方法提供一致、全面但简洁的描述，促进对卫生服务研究结果进行更高质量的综述，并确定需要方法学发展的特定领域。
