专家如何开展诊断试验的快速综述：对研究者观点的定性探索
How to develop rapid reviews of diagnostic tests according to experts: A qualitative exploration of researcher views.
作者信息
Arevalo-Rodriguez Ingrid, Baxter Susan, Steingart Karen R, Tricco Andrea C, Nussbaumer-Streit Barbara, Kaunelis David, Alonso-Coello Pablo, Bossuyt Patrick M, Zamora Javier
机构信息
Clinical Biostatistics Unit Hospital Universitario Ramón y Cajal Madrid Spain.
CIBER of Epidemiology and Public Health (CIBERESP) Madrid Spain.
出版信息
Cochrane Evid Synth Methods. 2023 Apr 13;1(2):e12006. doi: 10.1002/cesm.12006. eCollection 2023 Apr.
BACKGROUND
Rapid reviews (RRs) have been used to provide timely evidence for policymakers, health providers, and the public in several healthcare scenarios, most recently during the coronavirus disease 2019 pandemic. Despite the essential role of diagnosis in clinical management, data about how to perform RRs of diagnostic tests are scarce. We aimed to explore the views and perceptions of experts in evidence synthesis and diagnostic evidence about the value of methods used to accelerate the review process.
METHODS
We performed semistructured interviews with a purposive sample of experts in evidence synthesis and diagnostic evidence. We carried out the interviews in English between July and December 2021. Initial reading and coding of the transcripts were performed using NVIVO qualitative data analysis software.
RESULTS
Of a total of 23 invited experts, 16 (70%) responded. We interviewed all 16 participants representing key roles in evidence synthesis. We identified 14 recurring themes including the review question, characteristics of the review team, and use of automation, as the topics with the highest number of quotes. Some participants considered several methodological "shortcuts" to be ineffective or risky, such as automating quality appraisal, using only one reviewer for diagnostic data extraction and only performing descriptive analysis. The introduction of limits might depend on whether the test being assessed is a new test, the availability of alternative tests, the needs of providers and patients, and the availability of high-quality systematic reviews.
CONCLUSIONS
Our findings suggest that organizational strategies (e.g., defining the review question, availability of a highly experienced team) may have a role in conducting RRs of diagnostic tests. Several methodological shortcuts were considered inadequate for accelerating the review process, though they need to be assessed in well-designed studies. Improved reporting of RRs would support evidence-based decision-making and help users of RRs understand their limitations.
背景
快速综述（RRs）已被用于在多种医疗场景中为政策制定者、医疗服务提供者和公众提供及时的证据，最近一次是在2019年冠状病毒病大流行期间。尽管诊断在临床管理中起着至关重要的作用，但关于如何对诊断试验进行快速综述的数据却很少。我们旨在探讨证据综合和诊断证据方面的专家对用于加速综述过程的方法的价值的看法和认知。
方法
我们对证据综合和诊断证据方面的专家进行了有目的抽样的半结构化访谈。访谈于2021年7月至12月以英语进行。使用NVIVO定性数据分析软件对访谈记录进行初步阅读和编码。
结果
在总共23位受邀专家中，16位（70%）做出了回应。我们采访了所有16位代表证据综合关键角色的参与者。我们确定了14个反复出现的主题，包括综述问题、综述团队的特征以及自动化的使用，这些是引用次数最多的主题。一些参与者认为一些方法上的“捷径”是无效的或有风险的，比如自动进行质量评估、仅使用一名审阅者提取诊断数据以及仅进行描述性分析。限制的引入可能取决于所评估的测试是否为新测试、替代测试的可用性、提供者和患者的需求以及高质量系统综述的可用性。
结论
我们的研究结果表明，组织策略（例如，定义综述问题、拥有经验丰富的团队）可能在进行诊断试验的快速综述中发挥作用。一些方法上的捷径被认为不足以加速综述过程，不过它们需要在精心设计的研究中进行评估。改进快速综述的报告将支持基于证据的决策，并帮助快速综述的使用者了解其局限性。
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