Linares-Espinós E, Hernández V, Domínguez-Escrig J L, Fernández-Pello S, Hevia V, Mayor J, Padilla-Fernández B, Ribal M J
Hospital Universitario La Paz, Madrid, España.
Hospital Universitario Fundación Alcorcón, Madrid, España.
Actas Urol Esp (Engl Ed). 2018 Oct;42(8):499-506. doi: 10.1016/j.acuro.2018.01.010. Epub 2018 May 3.
The objective of evidence-based medicine is to employ the best scientific information available to apply to clinical practice. Understanding and interpreting the scientific evidence involves understanding the available levels of evidence, where systematic reviews and meta-analyses of clinical trials are at the top of the levels-of-evidence pyramid.
The review process should be well developed and planned to reduce biases and eliminate irrelevant and low-quality studies. The steps for implementing a systematic review include (i) correctly formulating the clinical question to answer (PICO), (ii) developing a protocol (inclusion and exclusion criteria), (iii) performing a detailed and broad literature search and (iv) screening the abstracts of the studies identified in the search and subsequently of the selected complete texts (PRISMA).
Once the studies have been selected, we need to (v) extract the necessary data into a form designed in the protocol to summarise the included studies, (vi) assess the biases of each study, identifying the quality of the available evidence, and (vii) develop tables and text that synthesise the evidence.
A systematic review involves a critical and reproducible summary of the results of the available publications on a particular topic or clinical question. To improve scientific writing, the methodology is shown in a structured manner to implement a systematic review.
循证医学的目标是运用可得的最佳科学信息应用于临床实践。理解和解读科学证据涉及了解可用的证据水平，其中临床试验的系统评价和荟萃分析处于证据水平金字塔的顶端。
综述过程应精心设计和规划，以减少偏倚并排除无关和低质量的研究。实施系统评价的步骤包括：（i）正确制定要回答的临床问题（PICO）；（ii）制定方案（纳入和排除标准）；（iii）进行详细而广泛的文献检索；以及（iv）筛选检索中识别出的研究的摘要，随后筛选选定的全文（PRISMA）。
一旦选定研究，我们需要：（v）将必要的数据提取到方案中设计的表格形式，以总结纳入的研究；（vi）评估每项研究的偏倚，确定可得证据的质量；以及（vii）编制综合证据的表格和文本。
系统评价涉及对关于特定主题或临床问题的现有出版物结果进行批判性和可重复的总结。为了改进科学写作，以结构化方式展示实施系统评价的方法。
