1 Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Glasgow, UK.
2 Department of Internal Medicine and Cardiology, Oslo University Hospital, Oslo, Norway.
Int J Stroke. 2018 Feb;13(2):138-156. doi: 10.1177/1747493017743796. Epub 2017 Nov 17.
High quality up-to-date systematic reviews are essential in order to help healthcare practitioners and researchers keep up-to-date with a large and rapidly growing body of evidence. Systematic reviews answer pre-defined research questions using explicit, reproducible methods to identify, critically appraise and combine results of primary research studies. Key stages in the production of systematic reviews include clarification of aims and methods in a protocol, finding relevant research, collecting data, assessing study quality, synthesizing evidence, and interpreting findings. Systematic reviews may address different types of questions, such as questions about effectiveness of interventions, diagnostic test accuracy, prognosis, prevalence or incidence of disease, accuracy of measurement instruments, or qualitative data. For all reviews, it is important to define criteria such as the population, intervention, comparison and outcomes, and to identify potential risks of bias. Reviews of the effect of rehabilitation interventions or reviews of data from observational studies, diagnostic test accuracy, or qualitative data may be more methodologically challenging than reviews of effectiveness of drugs for the prevention or treatment of stroke. Challenges in reviews of stroke rehabilitation can include poor definition of complex interventions, use of outcome measures that have not been validated, and poor generalizability of results. There may also be challenges with bias because the effects are dependent on the persons delivering the intervention, and because masking of participants and investigators may not be possible. There are a wide range of resources which can support the planning and completion of systematic reviews, and these should be considered when planning a systematic review relating to stroke.
高质量的最新系统评价对于帮助医疗保健从业者和研究人员跟上大量快速增长的证据至关重要。系统评价使用明确、可重复的方法回答预先定义的研究问题，以确定、批判性评估和综合主要研究的结果。系统评价制作的关键阶段包括在方案中阐明目的和方法、寻找相关研究、收集数据、评估研究质量、综合证据和解释发现。系统评价可以解决不同类型的问题，例如干预措施效果、诊断测试准确性、预后、疾病的患病率或发病率、测量仪器的准确性或定性数据的问题。对于所有的评价，重要的是要定义标准，如人群、干预、比较和结果，并确定潜在的偏倚风险。康复干预措施的效果评价或观察性研究、诊断测试准确性或定性数据的评价可能比药物预防或治疗中风效果的评价更具方法学挑战性。中风康复评价的挑战可能包括复杂干预措施定义不明确、使用未经验证的结果测量指标以及结果的普遍性较差。由于效果取决于实施干预措施的人员，并且由于无法对参与者和研究人员进行掩蔽，因此也可能存在偏倚的挑战。有各种各样的资源可以支持系统评价的规划和完成，在规划与中风相关的系统评价时，应该考虑这些资源。
