Spectrum Research, Inc., Tacoma, WA 98405, USA.
Spine (Phila Pa 1976). 2010 Apr 20;35(9 Suppl):S22-7. doi: 10.1097/BRS.0b013e3181d70494.
Systematic review.
To provide a detailed description of the methods undertaken in the systematic search and analytical summary of patient safety issues in spinal surgery, and to describe the process used to come to a clinical recommendation regarding challenges in the management of patients undergoing spine surgery.
A solid understanding of complication type, incidence, risk factors, and impact is implicit to the physician's role in developing an informed patient centered decision with respect to surgical intervention. We present methods used in conducting the systematic, evidence-based reviews, and expert panel recommendations of key challenges to the spine surgical practice. It is our desire that spine surgeons will use the information from these reviews together with an understanding of their own capacities and experience to better inform patients with respect to potential treatment outcomes, safety, and life impact.
A systematic search and critical review of the English language literature was undertaken for articles published on the safety of various surgical spine conditions. Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed. The strength of evidence for the overall body of literature in each topic area was determined by 2 independent reviewers considering study quality, study quantity, and consistency of results. Disagreements were resolved by consensus. Findings from studies meeting inclusion criteria were summarized. From these summaries, clinical recommendations were formulated from consensus achieved among subject experts through the Delphi process.
We identified and screened 2020 citations in 13 topic areas relating to safety in spine surgery. Of these, 273 met our predetermined inclusion criteria and were used to attempt to answer specific clinical questions within each topic area.
We undertook systematic reviews to establish a baseline of the current evidence on patient safety issues in spine surgery. This article reports the methods used in the reviews.
系统评价。
详细描述脊柱外科患者安全问题系统检索和分析总结所采用的方法，并描述用于提出脊柱外科患者管理挑战临床建议的过程。
了解并发症类型、发生率、风险因素和影响是医生在制定明智的以患者为中心的手术干预决策方面的作用所在。我们介绍了在进行系统的、基于证据的综述以及脊柱外科实践关键挑战的专家小组建议时所采用的方法。我们希望脊柱外科医生将使用这些综述中的信息，并结合自身能力和经验，更好地告知患者潜在的治疗结果、安全性和生活影响。
对各种脊柱手术条件安全性的英文文献进行了系统检索和批判性评价。使用预先设定的标准筛选引文的相关性，并对相关研究进行了批判性评价。通过 2 位独立审查员考虑研究质量、研究数量和结果的一致性，确定每个主题领域文献整体证据的强度。意见分歧通过共识解决。总结符合纳入标准的研究结果。根据德尔菲法在主题专家之间达成的共识，从这些总结中制定临床建议。
我们确定并筛选了与脊柱外科安全相关的 13 个主题领域的 2020 条引文。其中，273 项符合我们预先设定的纳入标准，并用于尝试回答每个主题领域的具体临床问题。
我们进行了系统评价，以建立脊柱外科患者安全问题当前证据的基准。本文报告了综述中使用的方法。
