Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK.
Evid Based Ment Health. 2018 Aug;21(3):95-100. doi: 10.1136/ebmental-2018-300014. Epub 2018 Jul 13.
Evidence syntheses such as systematic reviews and meta-analyses provide a rigorous and transparent knowledge base for translating clinical research into decisions, and thus they represent the basic unit of knowledge in medicine. Umbrella reviews are reviews of previously published systematic reviews or meta-analyses. Therefore, they represent one of the highest levels of evidence synthesis currently available, and are becoming increasingly influential in biomedical literature. However, practical guidance on how to conduct umbrella reviews is relatively limited.
We present a critical educational review of published umbrella reviews, focusing on the essential practical steps required to produce robust umbrella reviews in the medical field.
The current manuscript discusses 10 key points to consider for conducting robust umbrella reviews. The points are: ensure that the umbrella review is really needed, prespecify the protocol, clearly define the variables of interest, estimate a common effect size, report the heterogeneity and potential biases, perform a stratification of the evidence, conduct sensitivity analyses, report transparent results, use appropriate software and acknowledge the limitations. We illustrate these points through recent examples from umbrella reviews and suggest specific practical recommendations.
The current manuscript provides a practical guidance for conducting umbrella reviews in medical areas. Researchers, clinicians and policy makers might use the key points illustrated here to inform the planning, conduction and reporting of umbrella reviews in medicine.
系统评价和荟萃分析等证据综合为将临床研究转化为决策提供了严格透明的知识库，因此它们是医学知识的基本单位。伞式综述是对先前发表的系统评价或荟萃分析的综述。因此，它们代表了目前可用的最高级别的证据综合之一，并且在生物医学文献中越来越有影响力。然而，关于如何进行伞式综述的实用指南相对有限。
我们对已发表的伞式综述进行了批判性教育性评价，重点介绍了在医学领域进行稳健的伞式综述所需的基本实用步骤。
目前的手稿讨论了进行稳健的伞式综述时需要考虑的 10 个要点。这些要点是：确保确实需要进行伞式综述，预先制定方案，清楚定义感兴趣的变量，估计共同的效应大小，报告异质性和潜在偏倚，对证据进行分层，进行敏感性分析，报告透明的结果，使用适当的软件，并承认局限性。我们通过最近来自伞式综述的例子来说明这些要点，并提出了具体的实用建议。
目前的手稿为医学领域进行伞式综述提供了实用指南。研究人员、临床医生和政策制定者可以使用这里说明的要点来告知医学中伞式综述的规划、进行和报告。
