Ageing and Health, Usher Institute, Edinburgh University, Edinburgh, UK.
NIHR Evidence Synthesis Group @Complex Review Support Unit.
Age Ageing. 2023 Nov 2;52(11). doi: 10.1093/ageing/afad194.
Systematically reviewing all the available evidence and then creating summary analyses of the pooled data is the foundation of evidence-based practice. Indeed, this evidence synthesis approach informs much of the care of older adults in hospital and community. It is perhaps no surprise that the journal Age and Ageing is a frequent platform for publishing research papers based on systematic review and synthesis. This research has evolved substantially from the early days of evidence-based medicine and the Cochrane Collaboration. The traditional approach would be a quantitative summary, calculated using pair-wise meta-analysis of randomised controlled trials of drug versus placebo, or a synthesis of observational studies to create summaries of prevalence, associations and outcomes. Methods have evolved and newer techniques such as scoping reviews, test accuracy meta-analysis and qualitative synthesis are all now available. The sophistication of these methods is driven in part by the increasingly complex decisions that need be made in contemporary older adult care. Age and Ageing continues to champion established and novel evidence synthesis approaches, and in the accompanying Collection exemplars of these differing methods are presented and described. Whilst there is marked heterogeneity in the techniques used, the consistent and defining feature of all these papers is the desire to comprehensively, and critically summarise the evidence in order to answer the most pertinent questions regarding older adult care.
系统地回顾所有可用的证据,然后对汇总数据进行综合分析,是循证实践的基础。事实上,这种证据综合方法为医院和社区中老年人的大部分护理提供了信息。毫不奇怪,《年龄与衰老》杂志经常成为发表基于系统评价和综合研究论文的平台。这项研究从循证医学和 Cochrane 协作组织的早期阶段就有了很大的发展。传统的方法是使用药物与安慰剂的随机对照试验的两两荟萃分析进行定量总结,或者对观察性研究进行综合,以汇总患病率、关联和结果的摘要。方法已经发展,现在可以使用范围综述、测试准确性荟萃分析和定性综合等新技术。这些方法的复杂性部分是由当代老年护理中需要做出的日益复杂的决策所驱动的。《年龄与衰老》继续支持既定和新颖的证据综合方法,并在随附的专集中展示和描述了这些不同方法的范例。虽然所使用的技术存在明显的异质性,但所有这些论文的一致和定义特征都是希望全面、批判性地总结证据,以回答关于老年护理的最相关问题。