Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, 4-472 Edmonton Clinic Health Academy, 11405 87 Avenue NW, Edmonton, AB, T6G-1C9, Canada.
Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal.
Syst Rev. 2019 Jan 22;8(1):29. doi: 10.1186/s13643-018-0768-8.
Overviews of reviews of healthcare interventions (overviews) integrate information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. Overviews may identify multiple SRs that examine the same intervention for the same condition and include some, but not all, of the same primary studies. Different researchers use different approaches to manage these "overlapping SRs," but each approach has advantages and disadvantages. This study aimed to develop an evidence-based decision tool to help researchers make informed inclusion decisions when conducting overviews of healthcare interventions.
We used a two-stage process to develop the decision tool. First, we conducted a multiple case study to obtain empirical evidence upon which the tool is based. We systematically conducted seven overviews five times each, making five different decisions about which SRs to include in the overviews, for a total of 35 overviews; we then examined the impact of the five inclusion decisions on the overviews' comprehensiveness and challenges, within and across the seven overview cases. Second, we used a structured, iterative process to transform the evidence obtained from the multiple case study into an empirically based decision tool with accompanying descriptive text.
The resulting decision tool contains four questions: (1) Do Cochrane SRs likely examine all relevant intervention comparisons and available data? (2) Do the Cochrane SRs overlap? (3) Do the non-Cochrane SRs overlap? (4) Are researchers prepared and able to avoid double-counting outcome data from overlapping SRs, by ensuring that each primary study's outcome data are extracted from overlapping SRs only once? Guidance is provided to help researchers answer each question, and empirical evidence is provided regarding the advantages, disadvantages, and potential trade-offs of the different inclusion decisions.
This evidence-based decision tool is designed to provide researchers with the knowledge and means to make informed inclusion decisions in overviews. The tool can provide practical guidance and support for overview authors by helping them consider questions that could affect the comprehensiveness and complexity of their overviews. We hope this tool will be a useful resource for researchers conducting overviews, and we welcome discussion, testing, and refinement of the proposed tool.
医疗干预措施的综述（概述）整合了来自多个系统评价（SR）的信息，为决策提供了对相关证据的单一综合。概述可能会确定多个针对相同疾病和干预措施的 SR，并包含部分但不是全部相同的原始研究。不同的研究人员使用不同的方法来管理这些“重叠的 SR”，但每种方法都有其优点和缺点。本研究旨在开发一种基于证据的决策工具，帮助研究人员在进行医疗干预措施的综述时做出明智的纳入决策。
我们使用两阶段的方法来开发决策工具。首先，我们进行了一项多案例研究，以获得该工具所依据的实证证据。我们系统地进行了七次概述，每次进行五次，总共进行了 35 次不同的决策，即决定纳入哪些 SR 进行概述；然后，我们在七个概述案例内和之间检查了这五种纳入决策对概述全面性和挑战的影响。其次，我们使用结构化、迭代的过程，将多案例研究中获得的证据转化为基于经验的决策工具，并附有描述性文本。
该决策工具包含四个问题：（1） Cochrane SR 是否有可能检查所有相关干预比较和可用数据？（2） Cochrane SR 是否重叠？（3）非 Cochrane SR 是否重叠？（4）研究人员是否准备好并能够避免重复计算重叠 SR 中来自相同研究的结果数据，通过确保从重叠 SR 中仅提取每个原始研究的结果数据一次？为帮助研究人员回答每个问题提供了指导，并提供了关于不同纳入决策的优点、缺点和潜在权衡的实证证据。
这个基于证据的决策工具旨在为研究人员提供在综述中做出明智纳入决策的知识和手段。该工具可以通过帮助概述作者考虑可能影响其综述全面性和复杂性的问题，为概述作者提供实用的指导和支持。我们希望这个工具能成为进行综述的研究人员的有用资源，欢迎对提出的工具进行讨论、测试和改进。
