Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, Rockville, MD 20850, USA.
Ann Intern Med. 2012 Sep 18;157(6):439-45. doi: 10.7326/0003-4819-157-6-201209180-00515.
Insights from systematic reviews can help new studies better meet the priorities and needs of patients and communities. However, systematic reviews unfortunately have not yet achieved this position to direct and guide new research studies. The Agency for Healthcare Research and Quality's Evidence-based Practice Center Program uses systematic reviews to identify gaps in current evidence and has developed a systematic process of prioritizing these gaps with stakeholder input into clearly defined "future research needs." Eight Evidence-based Practice Centers began to apply this effort in 2010 to various clinical and policy topics. Gaps that prevented systematic reviewers from answering central questions of the review may include insufficient studies on subpopulations, insufficient studies with appropriate comparators, lack of appropriate outcomes measured, and methods problems. Stakeholder panels, consisting of advocacy groups, patients, researchers, clinicians, funders, and policymakers, help refine the gaps through multiple conference calls and prioritization exercises. Each report highlights a focused set of 4 to 15 high-priority needs with an accompanying description of possible considerations for study design. Identification of high-priority research needs could potentially speed the development and implementation of high-priority, stakeholder-engaged research.
系统评价的结果可以帮助新的研究更好地满足患者和社区的优先事项和需求。然而，令人遗憾的是，系统评价尚未发挥这一作用，无法直接指导新的研究。美国医疗保健研究与质量署（AHRQ）的循证实践中心项目利用系统评价来确定现有证据中的差距，并制定了一个系统的过程，通过利益相关者的投入，对明确界定的“未来研究需求”进行优先排序。2010 年，八个循证实践中心开始将这一工作应用于各种临床和政策主题。妨碍系统评价者回答审查核心问题的差距可能包括对亚人群的研究不足、缺乏适当对照的研究、缺乏适当的测量结果以及方法问题。由倡导团体、患者、研究人员、临床医生、资助者和政策制定者组成的利益相关者小组通过多次电话会议和优先级确定练习来帮助完善差距。每一份报告都强调了一组 4 到 15 个高度优先的需求，并附有对研究设计可能考虑因素的描述。确定高度优先的研究需求有可能加快高优先级、利益相关者参与的研究的制定和实施。
