Alloo Jasmin, Vallath Sanya, Del Mar Chris, Carter Matt, Thorning Sarah, Clark Justin
School of Medicine, Bond University, Gold Coast, Australia.
Cochrane Acute Respiratory Infections Group, Gold Coast, Australia.
Syst Rev. 2017 Apr 13;6(1):82. doi: 10.1186/s13643-017-0472-0.
Cochrane primarily aims to systematically review trials of effectiveness that are important to inform clinical decisions. Editorial groups support authors to achieve high-quality reviews and prioritise review proposals in their clinical domain that are submitted or elicited. Prioritising proposals requires two approaches, identifying (1) clinical practises for which the evidence of effectiveness is uncertain and (2) interventions in which there are trials of effectiveness (especially randomised controlled trials (RCTs)) not systematically reviewed. This study addresses this second approach for the Cochrane Acute Respiratory Infections Group (CARIG) in order to identify RCTs of acute respiratory infections that have not been systematically reviewed.
We exported, on the 9th of September 2014, and then compared the group's trials register of RCTs against a list of current Cochrane ARI (systematic) Reviews to identify gaps in topics (the same intervention and health condition) where completed trials have not been systematically reviewed. We assigned a principle intervention and health condition to each of 157 Cochrane reviews (CRs) and 5393 RCTs.
A majority of topics had been systematically reviewed; however, a substantial number (2174 or 41%) of RCTs were not included in any review. The topic that had been systematically reviewed the most was antibiotic vs placebo for pneumonia with 11 CRs and 205 RCTs. The topic that was the subject of most RCTs was vaccination for influenza with 525 RCTs and 6 CRs. Also, 6 CRs had no RCTs ('empty reviews').
We identified many RCT topics that have not been systematically reviewed. They need to be addressed in a separate process to establish their priority to clinicians.
Cochrane的主要目标是系统评价对临床决策具有重要意义的疗效试验。编辑团队支持作者开展高质量的评价，并对提交或征集的其临床领域的评价建议进行优先排序。对建议进行优先排序需要两种方法，一是确定（1）有效性证据不确定的临床实践，二是存在有效性试验（尤其是随机对照试验（RCT））但未进行系统评价的干预措施。本研究针对Cochrane急性呼吸道感染组（CARIG）的第二种方法，以识别尚未进行系统评价的急性呼吸道感染RCT。
我们于2014年9月9日导出该组的RCT试验注册信息，然后将其与当前Cochrane急性呼吸道感染（系统）评价列表进行比较，以确定在已完成试验但未进行系统评价的主题（相同干预措施和健康状况）方面的差距。我们为157项Cochrane评价（CR）和5393项RCT分别指定了主要干预措施和健康状况。
大多数主题已进行系统评价；然而，相当数量（2174项或41%）的RCT未纳入任何评价。系统评价最多的主题是肺炎的抗生素与安慰剂对照，有11项CR和205项RCT。RCT数量最多的主题是流感疫苗接种，有525项RCT和6项CR。此外，有6项CR没有RCT（“空评价”）。
我们识别出许多尚未进行系统评价的RCT主题。需要通过一个单独的过程来处理这些主题，以确定它们对临床医生的重要性。
