Systematic review
2 likes458 views
The document discusses the importance of systematic reviews in summarizing the effects of treatments, particularly regarding clot busters for heart attacks, highlighting their inadequacy compared to traditional reviews. It outlines the systematic review process, including defining a therapeutic question, comprehensive literature searching, assessing eligibility and quality, and synthesizing findings, while also noting challenges such as publication bias and accessibility. Key characteristics of systematic reviews, including clearly stated objectives and comprehensive search strategies, are emphasized as essential for effective research synthesis.
Systematic review
- 1. Systematic ReviewDr. F. Jahedi2011
- 3. emphasised in 1992:Inadequacy of traditional reviews If original studies of the effects of clot busters after heart attacks had been systematically reviewed the benefits of therapy would have been apparent as early as the mid-1970s.Need for a rigorous systematic approach Text books and narrative reviews were woefully inadequate in summarising the current state of knowledge.
- 4. When systematic reviews are neededWhenever there is:Explosion in biomedical publishingA substantive questionSeveral primary studies (perhaps with disparate findings)Substantial uncertainty
- 5. The process of systematic reviewDefining an appropriate therapeutic questionSearching the literature (For an unbiased assessment, this search must cover all the literature)Assessing the studiesEligibility for inclusionStudy quality Reported findingsCombining the resultsQualitativeQuantitative => Meta-analysisPlacing the findings in context
- 6. A good Systematic ReviewFormulates a QuestionConducts a Literature SearchRefines the search by applying predetermined inclusion and exclusion criteriaExtracts the appropriate data and assess their quality and validitySynthesizes, interprets, and reports data
- 7. Key Characteristics of Systematic ReviewsClearly stated title and objectives Comprehensive strategy to search for relevant studies (unpublished and published)Explicit and justified criteria for the inclusion or exclusion of any studyClear presentation of characteristics of each study included and an analysis of methodological qualityComprehensive list of all studies excluded and justification for exclusion
- 8. Literature Search ChallengesDatabase Bias Publication Bias English-language bias Citation bias
- 9. Hierarchies of evidenceI–1 Systematic review of several double-blind randomised control trials.I–2 One or more large double- blind randomised control trials.II–1 One or more well-conducted cohort studies.II–2 One or more well-conducted case-control studies.II–3 A dramatic uncontrolled experiment.III Expert committee sitting in review; peer leader opinion.IV Personal experience.
- 10. Challenges
- 11. Challenges:On the user side:Physical accessibility / conditions of access (costs, convenience, filters)Computer literacyHealth literacyOn the information provider side:FindabilityReadability Design and usability
- 19. Visualization from the various routes through a portion of the Internet