Tsafnat Guy, Glasziou Paul, Choong Miew Keen, Dunn Adam, Galgani Filippo, Coiera Enrico
Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
Syst Rev. 2014 Jul 9;3:74. doi: 10.1186/2046-4053-3-74.
Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects.We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time.
系统评价作为循证医学的基石，其产出速度不足以支持临床实践。制作成本、所需专业知识的可得性和及时性常被认为是造成延迟的主要因素。本次针对旨在支持或自动化系统评价中各项任务（尤其是随机对照临床试验的系统评价）的信息系统现状的详细调查，揭示了多个并行研究项目趋于融合的趋势。我们对描述支持或自动化系统评价过程或系统评价各项任务的信息学系统的文献进行了调查。多个项目致力于自动化、简化和/或精简系统评价的特定任务。有些任务已完全自动化，而其他任务仍主要依靠人工操作。在本综述中，我们描述了每项任务及其自动化对整个系统评价过程的影响，总结了现有信息系统对每项任务的支持，并强调了实现任务自动化还需要进一步研究的方向。自动化系统评价任务的系统整合可能会带来经过修订的系统评价工作流程。我们设想，优化后的工作流程将催生这样一种系统，即每个系统评价都被描述为一个计算机程序，它能自动检索相关试验、评估试验、提取和综合数据、评估偏倚风险、进行荟萃分析计算并实时生成报告。
