Rubinstein Matthew L, Wolk Donna M, Babady N Esther, Johnson J Kristie, Atkinson Bridgette, Makim Roshni, Parrott J Scott
Department of Clinical Laboratory and Medical Imaging Sciences, Department of Interdisciplinary Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA.
Molecular and Microbial Diagnostics and Development, Geisinger Medical Laboratories, Diagnostic Medicine Institute, Danville, PA, USA.
J Appl Lab Med. 2021 Jul 7;6(4):1012-1024. doi: 10.1093/jalm/jfab041.
Laboratory and other healthcare professionals participate in developing clinical practice guidelines through systematic review of the evidence. A significant challenge is the identification of areas for analytic focus when the evidence consists of several categories of interventions and outcomes that span both laboratory and clinical processes. The challenge increases when these interventions present as sets of combined interventions. A scoping review may provide a transparent and defensible analytic route forward for systematic reviews challenged in this manner.
A scoping review was carried out to characterize the evidence on rapid identification of bloodstream infections. Fifty-five studies previously identified by the supported systematic review were charted in duplicate. Charted records were analyzed using descriptive content analysis and evidence mapping with a 5-step process.
The 5-step analysis culminated in the characterization of 9 different intervention chain configurations that will facilitate the comparison of complex intervention practices across studies. Furthermore, our evidence map indicates that the current evidence base is strongly centered on 3 specific clinical outcomes, and it links these outcomes to the most represented intervention chain configurations. The scoping review effort generated a route forward for the supported systematic review and meta-analysis.
实验室及其他医疗保健专业人员通过对证据进行系统评价来参与临床实践指南的制定。当证据由跨越实验室和临床过程的几类干预措施和结果组成时,一个重大挑战是确定分析重点领域。当这些干预措施以联合干预措施集的形式呈现时,挑战会增加。范围综述可能为以这种方式受到挑战的系统评价提供一条透明且合理的分析路径。
开展了一项范围综述,以描述关于快速识别血流感染的证据。由支持的系统评价先前确定的55项研究被重复绘制图表。使用描述性内容分析和五步证据映射过程对绘制的记录进行分析。
五步分析最终确定了9种不同的干预链配置,这将有助于比较不同研究中的复杂干预实践。此外,我们的证据图谱表明,当前的证据基础强烈集中在3个特定的临床结果上,并将这些结果与最具代表性的干预链配置联系起来。范围综述工作为支持的系统评价和荟萃分析提供了一条前进的道路。