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Evaluating Systematic Reviews
How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care
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. Shared decision making requires understanding of the estimates of magnitude of beneficial and harmful effects, and confidence in those estimates.
What is a Systematic Review?
A systematic review attempts to collate all empirical evidence that fits pre-specified eligibility criteria in order to answer a specific research question. It uses explicit, systematic methods that are selected with a view to minimizing bias, thus providing more reliable findings from which conclusions can be drawn and decisions made (Antman 1992, Oxman 1993). The key characteristics of a systematic review are:
- a clearly stated set of objectives with pre-defined eligibility criteria for studies;
- an explicit, reproducible methodology;
- a systematic search that attempts to identify all studies that would meet the eligibility criteria;
- an assessment of the validity of the findings of the included studies, for example through the assessment of risk of bias; and
- a systematic presentation, and synthesis, of the characteristics and findings of the included studies.
FAU Resources: Books
Assembling the Pieces of a Systematic Review by
Publication Date: 2017-03-03
Please note, FAU medical librarians are unable to conduct systematic reviews. If you are interested in a self-directed learning resource, or simply understanding the process in depth, this print resource is available through the FAU collection.
Systematic Review Resources
The Cochrane Library is a collection of six databases that contain different types of independent evidence to inform healthcare decision making, and a seventh database that provides information about groups in The Cochrane Collaboration: The Cochrane Central Registry of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Database of Abstracts of Review of Effects, Health Technology Assessment, and NHS Economic Evaluation Database.