Ciapponi Agustín, Glujovsky Demián, Virgilio Sacha Alexis, Bardach Ariel Esteban
Institute for Clinical Effectiveness and Health Policy, Center for Research in Epidemiology and Public Health, National Scientific and Technical Research Council Buenos Aires, Argentina.
Institute for Clinical Effectiveness and Health Policy, Center for Research in Epidemiology and Public Health, National Scientific and Technical Research Council Buenos Aires, Argentina.
Value Health Reg Issues. 2017 Dec;14:64-72. doi: 10.1016/j.vhri.2017.07.011. Epub 2017 Sep 9.
To describe the experience, pitfalls, and lessons learned in conducting and disseminating epidemiological systematic reviews (SRs) in Latin America and the Caribbean between 2007 and 2016.
We used a mixed-methods approach, including a descriptive cross-sectional study and a qualitative study of pitfalls and lessons learned. The following end points were analyzed: number of primary research studies included, country of origin, study design, risk of bias, citations in social media, number of researchers and experts involved, and time devoted by them to conduct SRs. Data for the qualitative study were collected through sessions with multiprofessional focus groups of the reviewers' core team held from February to March 2016. We performed a thematic analysis of the following domains: sources of information, evidence quantity and quality, statistical analysis, and dissemination of findings in both academic and social media.
A total of 19 SRs were produced, including 1016 primary research studies. Brazil (35%) and Argentina (19%) contributed the largest number of studies. The most frequent design was cross-sectional (35%). Only 27% of the studies included in the SRs were judged as having a low risk of bias. We identified key challenges at different stages of the process. We found substantial difficulties in all domains derived from the thematic analysis and proposed potential solutions for each of them.
There are large gaps in epidemiological evidence from primary research, particularly from population-based studies. Special approaches are needed to identify, assess, synthesize, interpret, and disseminate epidemiological evidence from Latin America and the Caribbean.
描述2007年至2016年间在拉丁美洲和加勒比地区开展及传播流行病学系统评价（SRs）的经验、陷阱和教训。
我们采用了混合方法，包括描述性横断面研究以及关于陷阱和经验教训的定性研究。分析了以下终点：纳入的原始研究数量、研究来源国、研究设计、偏倚风险、社交媒体中的引用、参与的研究人员和专家数量，以及他们开展SRs所花费的时间。定性研究的数据通过与评审核心团队的多专业焦点小组在2016年2月至3月期间举行的会议收集。我们对以下领域进行了主题分析：信息来源、证据数量和质量、统计分析，以及在学术和社交媒体上的研究结果传播。
共产生了19项SRs，包括1016项原始研究。巴西（35%）和阿根廷（19%）贡献的研究数量最多。最常见的设计是横断面研究（35%）。纳入SRs的研究中只有27%被判定为偏倚风险较低。我们在该过程的不同阶段确定了关键挑战。我们在主题分析得出的所有领域都发现了重大困难，并针对每个领域提出了潜在解决方案。
来自原始研究的流行病学证据存在很大差距，特别是来自基于人群的研究。需要特殊方法来识别、评估、综合、解释和传播来自拉丁美洲和加勒比地区的流行病学证据。
