Aromataris Edoardo, Fernandez Ritin, Godfrey Christina M, Holly Cheryl, Khalil Hanan, Tungpunkom Patraporn
1The Joanna Briggs Institute, University of Adelaide, Adelaide, South Australia 2School of Nursing, University of Wollongong; Centre for Research in Nursing and Health, St George Hospital, Sydney, Australia 3Queen's Joanna Briggs Collaboration, Queen's University School of Nursing, Kingston, Ontario, Canada 4Northeast Institute for Evidence Synthesis and Translation Rutgers, University School of Nursing Newark, New Jersey, USA 5Monash University, School of Rural Health, Victoria, Australia 6Thailand Centre for Evidence Based Nursing, Midwifery, and Health Science: a Collaborating Centre of JBI, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
Int J Evid Based Healthc. 2015 Sep;13(3):132-40. doi: 10.1097/XEB.0000000000000055.
With the increase in the number of systematic reviews available, a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of reviews of existing systematic reviews. Syntheses of existing systematic reviews are referred to by many different names, one of which is an umbrella review. An umbrella review allows the findings of reviews relevant to a review question to be compared and contrasted. An umbrella review's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence, namely other systematic reviews and meta-analyses. A methodology working group was formed by the Joanna Briggs Institute to develop methodological guidance for the conduct of an umbrella review, including diverse types of evidence, both quantitative and qualitative. The aim of this study is to describe the development and guidance for the conduct of an umbrella review.
Discussion and testing of the elements of methods for the conduct of an umbrella review were held over a 6-month period by members of a methodology working group. The working group comprised six participants who corresponded via teleconference, e-mail and face-to-face meeting during this development period. In October 2013, the methodology was presented in a workshop at the Joanna Briggs Institute Convention. Workshop participants, review authors and methodologists provided further testing, critique and feedback on the proposed methodology.
This study describes the methodology and methods developed for the conduct of an umbrella review that includes published systematic reviews and meta-analyses as the analytical unit of the review. Details are provided regarding the essential elements of an umbrella review, including presentation of the review question in a Population, Intervention, Comparator, Outcome format, nuances of the inclusion criteria and search strategy. A critical appraisal tool with 10 questions to help assess risk of bias in systematic reviews and meta-analyses was also developed and tested. Relevant details to extract from included reviews and how to best present the findings of both quantitative and qualitative systematic reviews in a reader friendly format are provided.
Umbrella reviews provide a ready means for decision makers in healthcare to gain a clear understanding of a broad topic area. The umbrella review methodology described here is the first to consider reviews that report other than quantitative evidence derived from randomized controlled trials. The methodology includes an easy to use and informative summary of evidence table to readily provide decision makers with the available, highest level of evidence relevant to the question posed.
随着可用系统评价数量的增加，为医疗保健领域的决策者提供所需证据的合理下一步是对现有系统评价进行综述。对现有系统评价的综合有许多不同的名称，其中之一是伞状综述。伞状综述可以对与某一综述问题相关的各项综述结果进行比较和对比。伞状综述最显著的特点是，这类证据综合仅纳入最高级别的证据，即其他系统评价和荟萃分析。乔安娜·布里格斯研究所成立了一个方法学工作组，以制定进行伞状综述的方法学指南，包括定量和定性等多种类型的证据。本研究的目的是描述伞状综述的制定过程及实施指南。
一个方法学工作组的成员在6个月的时间里对伞状综述方法的各个要素进行了讨论和测试。该工作组由6名参与者组成，在这一制定阶段通过电话会议、电子邮件和面对面会议进行沟通。2013年10月，该方法在乔安娜·布里格斯研究所大会的一个研讨会上进行了展示。研讨会参与者、综述作者和方法学家对所提出的方法进行了进一步的测试、批评和反馈。
本研究描述了为进行伞状综述而开发的方法，该综述将已发表的系统评价和荟萃分析作为综述的分析单元。文中提供了伞状综述基本要素的详细信息，包括以人群、干预措施、对照、结局格式呈现综述问题、纳入标准的细微差别和检索策略。还开发并测试了一个包含10个问题的批判性评价工具，以帮助评估系统评价和荟萃分析中的偏倚风险。文中提供了从纳入的综述中提取的相关详细信息，以及如何以读者友好的格式最好地呈现定量和定性系统评价的结果。
伞状综述为医疗保健领域的决策者提供了一种便捷的方式，使其能够清楚地了解一个广泛的主题领域。这里描述的伞状综述方法首次考虑了报告除随机对照试验得出的定量证据之外的其他证据的综述。该方法包括一个易于使用且信息丰富的证据表总结，以便随时为决策者提供与所提出问题相关的现有最高级别证据。
