Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, 4-486C Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, AB, T6G 1C9, Canada.
Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, 4-482C Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, AB, T6G 1C9, Canada.
Syst Rev. 2020 Nov 4;9(1):254. doi: 10.1186/s13643-020-01509-0.
BACKGROUND: Overviews of reviews (overviews) provide an invaluable resource for healthcare decision-making by combining large volumes of systematic review (SR) data into a single synthesis. The production of high-quality overviews hinges on the availability of practical evidence-based guidance for conduct and reporting. OBJECTIVES: Within the broad purpose of informing the development of a reporting guideline for overviews, we aimed to provide an up-to-date map of existing guidance related to the conduct of overviews, and to identify common challenges that authors face when undertaking overviews. METHODS: We updated a scoping review published in 2016 using the search methods that had produced the highest yield: ongoing reference tracking (2014 to March 2020 in PubMed, Scopus, and Google Scholar), hand-searching conference proceedings and websites, and contacting authors of published overviews. Using a qualitative meta-summary approach, one reviewer extracted, organized, and summarized the guidance and challenges presented within the included documents. A second reviewer verified the data and synthesis. RESULTS: We located 28 new guidance documents, for a total of 77 documents produced by 34 research groups. The new guidance helps to resolve some earlier identified challenges in the production of overviews. Important developments include strengthened guidance on handling primary study overlap at the study selection and analysis stages. Despite marked progress, several areas continue to be hampered by inconsistent or lacking guidance. There is ongoing debate about whether, when, and how supplemental primary studies should be included in overviews. Guidance remains scant on how to extract and use appraisals of quality of the primary studies within the included SRs and how to adapt GRADE methodology to overviews. The challenges that overview authors face are often related to the above-described steps in the process where evidence-based guidance is lacking or conflicting. CONCLUSION: The rising popularity of overviews has been accompanied by a steady accumulation of new, and sometimes conflicting, guidance. While recent guidance has helped to address some of the challenges that overview authors face, areas of uncertainty remain. Practical tools supported by empirical evidence are needed to assist authors with the many methodological decision points that are encountered in the production of overviews.
背景:综述的概述为医疗保健决策提供了宝贵的资源,通过将大量系统评价(SR)数据合并为单一的综合报告。高质量概述的制作取决于为实施和报告提供实用的基于证据的指南。
目的:在为概述制定报告指南的广泛目的范围内,我们旨在提供与概述实施相关的现有指南的最新图谱,并确定作者在进行概述时面临的常见挑战。
方法:我们使用产生最高产量的搜索方法更新了 2016 年发表的范围综述:持续参考跟踪(2014 年至 2020 年 3 月在 PubMed、Scopus 和 Google Scholar 中)、手检会议记录和网站,以及联系已发表综述的作者。使用定性元总结方法,一位审阅者提取、组织和总结了纳入文献中提出的指南和挑战。第二位审阅者验证了数据和综合报告。
结果:我们找到了 28 份新的指南文件,共有 34 个研究小组制作了 77 份文件。新的指南有助于解决概述制作中以前确定的一些挑战。重要的进展包括在研究选择和分析阶段加强处理主要研究重叠的指导。尽管取得了显著进展,但在几个领域仍受到缺乏或不一致的指导的阻碍。关于是否、何时以及如何在概述中纳入补充主要研究仍存在争议。关于如何在纳入的 SR 中提取和使用对主要研究的评估以及如何将 GRADE 方法应用于概述的指南仍然很少。概述作者面临的挑战通常与上述步骤相关,这些步骤中缺乏或存在冲突的基于证据的指导。
结论:随着概述的日益普及,新的、有时甚至相互冲突的指南也在不断积累。虽然最近的指南帮助解决了概述作者面临的一些挑战,但仍存在不确定性。需要实用的工具来支持证据,以帮助作者在制作概述时遇到的许多方法决策点。
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