Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
Nephron Clin Pract. 2011;119(1):c50-60; discussion c61. doi: 10.1159/000324432. Epub 2011 Jun 15.
Renal practitioners are expected to apply the best available evidence from rigorous scientific research to clinical decision-making and also for policy-making for those involved. Advances in information technology and unprecedented access to data have simplified the process for the search of best available evidence to guide practice. However, it is challenging to cope with the increasing volume of publications in nephrology and other areas of medicine. Accordingly, systematic reviews and meta-analysis have greatly facilitated best practice and effective clinical decision-making. Conducting a systematic review/meta-analysis involves a number of steps that start with protocol development and research question formulation, design and study selection criteria, followed by retrieval of potentially relevant studies, selection of those studies to be included and evaluation of a study's risk of bias. Systematic reviews and meta-analyses have both strengths and weaknesses. Many of the perceived limitations of meta-analysis are not inherent in the methodology, but actually represent deficits in the conduct or reporting of individual primary studies. With the continuous proliferation of published renal clinical studies, such publications will continue to be an important resource for clinicians and researchers in nephrology. It is therefore important for nephrologists to keep abreast of developments in this field, which requires some knowledge about how these studies are conducted, reported and how to appraise them for application to clinical practice or policy-making.
肾脏科医生在进行临床决策和制定政策时，需要将最优质的现有证据应用于实践。信息技术的进步和前所未有的数据获取方式，简化了寻找最佳证据以指导实践的过程。然而，面对肾脏病学和其他医学领域出版物数量的不断增加，这一过程颇具挑战性。因此，系统评价和荟萃分析极大地促进了最佳实践和有效的临床决策。进行系统评价/荟萃分析涉及多个步骤，首先是制定方案和研究问题的表述、设计和研究选择标准，然后检索可能相关的研究，选择要纳入的研究并评估研究的偏倚风险。系统评价和荟萃分析都有其优缺点。许多人认为荟萃分析存在局限性，但实际上这些局限性并非源于该方法本身，而是源于个别原始研究的实施或报告存在缺陷。随着已发表的肾脏临床研究不断增加，此类出版物将继续成为肾脏病学家和研究人员的重要资源。因此，肾脏科医生了解该领域的最新进展非常重要，这需要他们掌握这些研究的实施、报告方式，并了解如何将其应用于临床实践或决策制定。
