Systematic review and meta-analysis (original) (raw)
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Systematic Reviews and Meta-Analysis
Journal of Wound Ostomy and Continence Nursing, 2008
Systematic reviews are designed to answer a focused clinical question. They employ a predetermined explicit methodology to comprehensively search for, select, appraise, and analyze studies. Meta-analysis is the statistical pooling of the results of studies that are part of a systematic review. Systematic reviews are research studies and, like other studies, they need to be based on a structured and valid methodology and take measures to minimize bias. High-quality systematic reviews can be powerful tools to support clinical decision-making, as well as summarize current knowledge in relation to an area of research interest. This article describes the methodology that should be used when doing a systematic review, presents guidelines for reporting the review, and provides a guideline for critically appraising published reviews.
A practical guide to understanding systematic reviews and meta-analyses
Otolaryngology - Head and Neck Surgery, 2010
A systematic review is a transparent and unbiased review of available information. The published systematic review must report the details of the conduct of the review as one might report the details of a primary research project. A meta-analysis is a powerful and rigorous statistical approach to synthesize data from multiple studies, preferably obtained from a systematic review, in order to enlarge the sample size from smaller studies to test the original hypothesis and/or to generate new ones.
Systematic reviews & meta-analyses
Current Anaesthesia & Critical Care, 2005
Systematic reviews and meta-analyses are becoming more prevalent in the published literature and are routinely being used in the evidence-based approach to medicine. This article describes the process and methodology of conducting systematic reviews and meta-analyses and discusses the factors that affect the quality of the results and conclusions.
JAMA, 2014
Clinical decisions should be based on the totality of the best evidence and not the results of individual studies. When clinicians apply the results of a systematic review or meta-analysis to patient care, they should start by evaluating the credibility of the methods of the systematic review, ie, the extent to which these methods have likely protected against misleading results. Credibility depends on whether the review addressed a sensible clinical question; included an exhaustive literature search; demonstrated reproducibility of the selection and assessment of studies; and presented results in a useful manner. For reviews that are sufficiently credible, clinicians must decide on the degree of confidence in the estimates that the evidence warrants (quality of evidence). Confidence depends on the risk of bias in the body of evidence; the precision and consistency of the results; whether the results directly apply to the patient of interest; and the likelihood of reporting bias. Sh...
Systematic review and meta-analysis methodology
Blood, 2010
Systematic reviews and meta-analyses are being increasingly used to summarize medical literature and identify areas in which research is needed. Systematic reviews limit bias with the use of a reproducible scientific process to search the literature and evaluate the quality of the individual studies. If possible the results are statistically combined into a meta-analysis in which the data are weighted and pooled to produce an estimate of effect. This article aims to provide the reader with a practical overview of systematic review and meta-analysis methodology, with a focus on the process of performing a review and the related issues at each step.
European Journal of Epidemiology
To inform evidence-based practice in health care, guidelines and policies require accurate identification, collation, and integration of all available evidence in a comprehensive, meaningful, and time-efficient manner. Approaches to evidence synthesis such as carefully conducted systematic reviews and meta-analyses are essential tools to summarize specific topics. Unfortunately, not all systematic reviews are truly systematic, and their quality can vary substantially. Since well-conducted evidence synthesis typically involves a complex set of steps, we believe formulating a cohesive, step-by-step guide on how to conduct a systemic review and meta-analysis is essential. While most of the guidelines on systematic reviews focus on how to report or appraise systematic reviews, they lack guidance on how to synthesize evidence efficiently. To facilitate the design and development of evidence syntheses, we provide a clear and concise, 24-step guide on how to perform a systematic review and meta-analysis of observational studies and clinical trials. We describe each step, illustrate it with concrete examples, and provide relevant references for further guidance. The 24-step guide (1) simplifies the methodology of conducting a systematic review, (2) provides healthcare professionals and researchers with methodologically sound tools for conducting systematic reviews and meta-analyses, and (3) it can enhance the quality of existing evidence synthesis efforts. This guide will help its readers to better understand the complexity of the process, appraise the quality of published systematic reviews, and better comprehend (and use) evidence from medical literature.
Systematic reviews and meta-analyses: when they are useful and when to be careful
Kidney International, 2009
Systematic reviews and meta-analyses are increasingly popular study designs in clinical research. A systematic review is a summary of the medical literature that uses explicit and reproducible methods for searching the literature and critical appraisal of individual studies; in contrast, a meta-analysis is a mathematical synthesis of the results of these individual studies. These study designs can be useful tools for summarizing the increasing amount of knowledge that is gained from scientific papers on a certain topic. In addition, combining individual studies in a metaanalysis increases statistical power, resulting in more precise effect estimates. Although the specific methodology of systematic reviews includes steps to minimize bias in all stages of the process, investigators should be aware of potential biases such as poor quality of included studies, heterogeneity between studies, and the presence of publication and outcome reporting bias. This paper explains how systematic reviews and meta-analyses should be performed and how to interpret and implement their results. In addition, we discuss when meta-analyses are useful and when they are not.
Understanding systematic reviews and meta-analysis
Archives of Disease in Childhood, 2005
Health care professionals are increasingly required to base clinical decisions on the best available evidence. Evidence based medicine (EBM) is a systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patient values. This paper explains the concept of EBM and introduces the five step EBM model: formulation of answerable clinical questions; searching for evidence; critical appraisal; applicability of evidence; evaluation of performance. Subsequent articles will focus on the principles and critical appraisal of randomised controlled trials, systematic reviews, and meta-analyses, and provide a practical demonstration of the five step EBM model using a real life clinical scenario.