Systematic Review - SF Coordinating Center Study …：系统回顾—旧金山协调中心的研究….ppt

* * * * Always assess selection and allocation bias, blinding and handling of patient attrition * * * Before deciding which approach to take, it is important to tabulate the findings from the studies and examine heterogeneity (i.e. diversity of studies). * * * * These issues should be included in the discussion and recommendations section of a systematic review: * The size and consistency of the results (particularly important in population based studies where a small effect at the community level may have much significance unlike the effect of comparable size at the individual level) * * * * * * * * * NOTE: meta-analysis is simply the statistical combination of findings; it should not be considered as a type of review * The Cochrane Collaboration is a group of over 27,000 volunteers in more than 90 countries who review the effects of health care interventions tested in biomedical randomized controlled trials.[3] A few more recent reviews have also studied the results of non-randomized, observational studies. The results of these systematic reviews are published as Cochrane Reviews in the Cochrane Library. * * * Driven by evidence-based medicine movement and Cochrane collaboration * Determine effect estimates in key subgroups (e.g. based on gender, race/ethnicity or age) Identify (through meta-regression) the sources of heterogeneity in prior studies * Although meta-analysis is most widely known in biomedical settings for its application to clinical trials, the technique can also be used to synthesize/analyze other study designs: Observational studies (e.g. case control, cohorts, cross-sectional prevalence studies, etc.) Studies evaluating diagnostic tests (sensitivity, specificity, predictive value) * * * * Usually the best if systematic reviews and meta-analyses are conducted by teams that include investigators with both methodologic and content expertise. * * * * * * * Background give rationale for systematic review as well as importance of rese