Department of Anaesthesia and Critical Care, University Hospital of Würzburg, Würzburg, Germany.
Eur J Anaesthesiol. 2010 Sep;27(9):763-72. doi: 10.1097/EJA.0b013e32833a560a.
One approach to clinical decision-making requires the integration of the best available research evidence with individual clinical expertise and patient values, and is known as evidence-based medicine (EBM). In clinical decision-making with the current best evidence, systematic reviews have an important role. This review article covers the basic principles of systematic reviews and meta-analyses, and their role in the process of evidence-based decision-making. The problems associated with traditional narrative reviews are discussed, as well as the way systematic reviews limit bias associated with the assembly, critical appraisal and synthesis of studies addressing specific clinical questions. The relevant steps in writing a systematic review from the formulation of an initial research question to sensitivity analyses in conjunction with the combined analysis of the pooled data are described. Important issues that need to be considered when appraising a systematic review or meta-analysis are outlined. Some of the terms that are used in the reporting of systematic reviews and meta-analyses, such as relative risk, confidence interval, Forest plot or L'Abbé plot, will be introduced and explained.
一种临床决策方法需要将最佳可用的研究证据与个体临床专业知识和患者价值观相结合，这种方法被称为循证医学（EBM）。在当前最佳证据的临床决策中，系统评价具有重要作用。本文综述了系统评价和荟萃分析的基本原理及其在循证决策过程中的作用。讨论了与传统叙述性综述相关的问题，以及系统评价如何限制与特定临床问题相关的研究的组装、批判性评估和综合相关的偏倚。描述了从最初研究问题的制定到与合并数据分析相关的敏感性分析的系统综述写作的相关步骤。概述了当评估系统评价或荟萃分析时需要考虑的重要问题。本文还介绍并解释了一些在系统评价和荟萃分析报告中使用的术语，如相对风险、置信区间、森林图或 L'Abbé 图。
