系统评价医疗干预措施的系统评价的方法学。
Methodology in conducting a systematic review of systematic reviews of healthcare interventions.
机构信息
School of Nursing and Midwifery, University of Dublin, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
出版信息
BMC Med Res Methodol. 2011 Feb 3;11(1):15. doi: 10.1186/1471-2288-11-15.
BACKGROUND
Hundreds of studies of maternity care interventions have been published, too many for most people involved in providing maternity care to identify and consider when making decisions. It became apparent that systematic reviews of individual studies were required to appraise, summarise and bring together existing studies in a single place. However, decision makers are increasingly faced by a plethora of such reviews and these are likely to be of variable quality and scope, with more than one review of important topics. Systematic reviews (or overviews) of reviews are a logical and appropriate next step, allowing the findings of separate reviews to be compared and contrasted, providing clinical decision makers with the evidence they need.
METHODS
The methods used to identify and appraise published and unpublished reviews systematically, drawing on our experiences and good practice in the conduct and reporting of systematic reviews are described. The process of identifying and appraising all published reviews allows researchers to describe the quality of this evidence base, summarise and compare the review's conclusions and discuss the strength of these conclusions.
RESULTS
Methodological challenges and possible solutions are described within the context of (i) sources, (ii) study selection, (iii) quality assessment (i.e. the extent of searching undertaken for the reviews, description of study selection and inclusion criteria, comparability of included studies, assessment of publication bias and assessment of heterogeneity), (iv) presentation of results, and (v) implications for practice and research.
CONCLUSION
Conducting a systematic review of reviews highlights the usefulness of bringing together a summary of reviews in one place, where there is more than one review on an important topic. The methods described here should help clinicians to review and appraise published reviews systematically, and aid evidence-based clinical decision-making.
背景
已经发表了数百项关于产妇护理干预措施的研究，对于大多数参与提供产妇护理的人来说，这些研究太多了，无法在做出决策时识别和考虑。显然，需要对个别研究进行系统评价，以便在一个地方评估、总结和汇集现有研究。然而，决策者越来越面临大量这样的综述，而且这些综述可能质量和范围不一，对于重要的主题，可能有不止一个综述。系统评价（或综述）的综述是一个合乎逻辑和适当的下一步，允许比较和对比单独的综述结果，为临床决策者提供他们需要的证据。
方法
我们描述了用于系统地识别和评估已发表和未发表的综述的方法，这些方法借鉴了我们在系统综述的开展和报告方面的经验和良好做法。识别和评估所有已发表的综述的过程使研究人员能够描述这一证据基础的质量，总结和比较综述的结论，并讨论这些结论的强度。
结果
在（i）来源、（ii）研究选择、（iii）质量评估（即综述搜索的程度、研究选择和纳入标准的描述、纳入研究的可比性、发表偏倚的评估和异质性的评估）、（iv）结果呈现以及（v）对实践和研究的影响等方面，描述了方法学挑战和可能的解决方案。
结论
对综述进行系统评价突出了将多个重要主题的综述汇总到一个地方的有用性。这里描述的方法应该有助于临床医生系统地审查和评估已发表的综述，并有助于基于证据的临床决策。
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