Pacific Northwest Evidence-based Practice Center, Portland, OR 97239, USA.
University of Connecticut Evidence-based Practice Center, Storrs, CT 06269, USA.
J Clin Epidemiol. 2018 Jun;98:98-104. doi: 10.1016/j.jclinepi.2018.01.007. Epub 2018 Feb 2.
Systematic reviews should provide balanced assessments of benefits and harms, while focusing on the most important outcomes. Selection of harms to be reviewed can be a challenge due to the potential for large numbers of diverse harms.
A workgroup of methodologists from Evidence-based Practice Centers (EPCs) developed consensus-based guidance on selection and prioritization of harms in systematic reviews. Recommendations were informed by a literature scan, review of Evidence-based Practice Center reports, and interviews with experts in conducting reviews or assessing harms and persons representing organizations that commission or use systematic reviews.
Ten recommendations were developed on selection and prioritization of harms, including routinely focusing on serious as well as less serious but frequent or bothersome harms; routinely engaging stakeholders and using literature searches and other data sources to identify important harms; using a prioritization process (formal or less formal) to inform selection decisions; and describing the methods used to select and prioritize harms.
We provide preliminary guidance for a more structured approach to selection and prioritization of harms in systematic reviews.
系统评价应平衡评估获益和危害，同时关注最重要的结局。由于危害的多样性和潜在数量巨大，选择要评价的危害可能具有挑战性。
来自循证实践中心（EPC）的方法学家工作组制定了关于系统评价中危害选择和优先级排序的共识指南。建议是通过文献扫描、EPC 报告审查以及对进行审查或评估危害的专家和代表委托或使用系统评价的组织的人员进行访谈而得出的。
制定了 10 项关于危害选择和优先级排序的建议，包括常规关注严重和不太严重但频繁或令人烦恼的危害；常规让利益相关者参与，并使用文献检索和其他数据源来确定重要危害；使用优先级排序过程（正式或非正式）为选择决策提供信息；并描述用于选择和优先排序危害的方法。
我们为系统评价中危害的选择和优先级排序提供了更结构化方法的初步指导。
