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ID:62070329
大小:1.57 MB
页数:36页
时间:2021-04-14
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1、IntroductiontoSystematicReviewWhyreviewtheliteraturesystematically?WeoftenneedtomakesenseofmultiplestudiesaddressingthesamequestionWecaneitherpickthosestudiesthatmostagreewithourpreconceptionsormakeanunbiasedassessmentofasmanyofthestudiesaspossibleTheunbias
2、edapproachisknownassystematicreview,andwhendonewellcanleadtothemostreliablesynthesisofthedata.Cumulativemeta-analysisExpertopinionTheuseofthrombolysisinmyocardialinfarctionRCTs-clearbenefitExpertsfollow‘Tocallinthestatisticianaftertheexperimentisdonemaybeno
3、morethanaskinghimtoperformapost-mortemexamination:hemaybeabletosaywhattheexperimentdiedof’SirR.A.FisherKarlPearsonAdvantagesanddisadvantagesofsystematicreviewtoyourresearchprojectsAsystematicreviewofyourresearchquestionwilltakelongerthanasimplenarrativerevi
4、ewTheresultsofyoursystematicreview(evenifinincludesameta-analysis)maybewrongDiscrepanciesbetweenmetaanalysisandsubsequentrandomisedcontrolledtrialsNEnglJMed1997;337:536-42.65%70%However,asystematicreviewismorelikelytobepublishedandcitedthananarrativeone!Sys
5、tematicreview–overviewofprocessClearquestiontoanswer,andpre-specifiedselectioncriteriaClearlydefinedmethodsfordataextraction–toremoveasmuchbiasaspossiblefromthedataselectionprocessComprehensivesearchofthepublished(andiftimeavailableunpublished)literature–to
6、ensure‘negative’studiesarefoundwhichmightnotbepublishedinthetoptierjournalsDuplicationofdataextractionandstudyselectionSummaryestimation–ifsufficienthighqualitystudiesarefoundPosingtheresearchquestionPatientsInterventionControlOutcomeDecidewhattypeandqualit
7、yofstudiesyouwillaccept;thiswillbedifferentforanestablishedtreatmenttoanewbiomarkerofdiseaseAgoodquestionwillhelptodefineyoursearchstrategyandstudyselectione.g.Inneurologicallyasymptomaticpeople,whatistheprevalenceofimagingfindingsonhighresolutionbrainMRima
8、ges?Inpatientswithinoneweekafterischaemicstroke,whatistheprognosticvalueofIL6fordisabilityordeath?Inpatientswithin48hoursofsubarachnoidhaemorrhage,whatisthevalueoforalsimvastatincomparedtocontrolforpre
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