Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia.
Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Transplantation. 2018 Sep;102(9):1415-1418. doi: 10.1097/TP.0000000000002314.
Decision making in transplantation is complex, dynamic, and often made under the context of uncertainties. In the case of diagnostic uncertainties, symptoms can be indistinct, with overlap between many different conditions. Even if the correct diagnoses are known, treatment strategies for the same condition may vary and are largely dependent on clinicians' preference and personal experiences. Systematic reviews and meta-analyses challenge the conventional role of the experts and their perceptions and rely, instead, on the best available evidence to guide clinical decision making. Through careful searching and closely examining, appraising, and synthesizing all available evidence, systematic reviews and meta-analyses provide the necessary and relevant information to better inform healthcare management and policy making by highlighting evidence that is pertinent to decisions. This commentary provides an overview of the concepts and methods used in systematic review, highlighting the potential capability of these methods in transplantation and how they may facilitate clinical decision making in transplantation.
移植决策是复杂的、动态的，并且常常是在不确定的情况下做出的。在诊断不确定的情况下，症状可能不明显，许多不同的病症之间存在重叠。即使知道正确的诊断，同一病症的治疗策略也可能有所不同，而且在很大程度上取决于临床医生的偏好和个人经验。系统评价和荟萃分析挑战了专家的传统作用及其观念，而是依赖于最佳可用证据来指导临床决策。通过仔细搜索、仔细检查、评估和综合所有可用证据，系统评价和荟萃分析通过突出与决策相关的证据，为更好地告知医疗保健管理和政策制定提供了必要和相关的信息。本评论概述了系统评价中使用的概念和方法，强调了这些方法在移植中的潜在能力，以及它们如何有助于移植中的临床决策。
