Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
Swiss Paraplegic Research, Nottwil, Switzerland.
Eur J Epidemiol. 2020 Jan;35(1):49-60. doi: 10.1007/s10654-019-00576-5. Epub 2019 Nov 13.
To inform evidence-based practice in health care, guidelines and policies require accurate identification, collation, and integration of all available evidence in a comprehensive, meaningful, and time-efficient manner. Approaches to evidence synthesis such as carefully conducted systematic reviews and meta-analyses are essential tools to summarize specific topics. Unfortunately, not all systematic reviews are truly systematic, and their quality can vary substantially. Since well-conducted evidence synthesis typically involves a complex set of steps, we believe formulating a cohesive, step-by-step guide on how to conduct a systemic review and meta-analysis is essential. While most of the guidelines on systematic reviews focus on how to report or appraise systematic reviews, they lack guidance on how to synthesize evidence efficiently. To facilitate the design and development of evidence syntheses, we provide a clear and concise, 24-step guide on how to perform a systematic review and meta-analysis of observational studies and clinical trials. We describe each step, illustrate it with concrete examples, and provide relevant references for further guidance. The 24-step guide (1) simplifies the methodology of conducting a systematic review, (2) provides healthcare professionals and researchers with methodologically sound tools for conducting systematic reviews and meta-analyses, and (3) it can enhance the quality of existing evidence synthesis efforts. This guide will help its readers to better understand the complexity of the process, appraise the quality of published systematic reviews, and better comprehend (and use) evidence from medical literature.
为了为医疗保健提供循证实践,指南和政策需要以全面、有意义且高效的方式准确识别、整理和整合所有可用证据。综合证据的方法,如精心进行的系统评价和荟萃分析,是总结特定主题的重要工具。不幸的是,并非所有的系统评价都是真正系统的,其质量可能有很大差异。由于良好的证据综合通常涉及一系列复杂的步骤,我们认为制定一个连贯的、逐步的指南,说明如何进行系统评价和荟萃分析是至关重要的。虽然大多数关于系统评价的指南都侧重于如何报告或评估系统评价,但它们缺乏关于如何有效综合证据的指导。为了促进证据综合的设计和发展,我们提供了一个清晰简洁的、24 步的关于如何进行观察性研究和临床试验的系统评价和荟萃分析的指南。我们描述了每一步,用具体的例子来说明,并提供了进一步指导的相关参考文献。该 24 步指南 (1) 简化了进行系统评价的方法学,(2) 为医疗保健专业人员和研究人员提供了进行系统评价和荟萃分析的方法学上合理的工具,(3) 它可以提高现有证据综合工作的质量。本指南将帮助读者更好地理解该过程的复杂性,评估已发表系统评价的质量,并更好地理解(和使用)来自医学文献的证据。
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