Systematic Reviews to Answer Health Care Questions

Systematic Reviews to Answer Health Care Questions
Author: Heidi D. Nelson
Publisher: LWW
Total Pages: 0
Release: 2014
Genre: Medical care
ISBN: 9781451187717

"Systematic Evidence Reviews to Answer Health Care Questions provides accessible, concise information about the state-of-the-art methods of systematic review, from key question formulation and selecting evidence to assessing the quality of included studies and reporting results. Key topics are organized around essential steps in conducting reviews as well as important issues or dilemmas encountered during the process. Although the state-of-the-art methods serve as core material, the book also presents different approaches that are sometimes needed when basic rules do not apply. Its perspective is practical and patient-centered. The book incorporates information from sources representing standards in the field, as well as from teaching and training materials developed at the Oregon Evidence-based Practice Center. Examples from existing projects are used to illustrate specific issues throughout the book. Medical practice guidelines, health care policies, and insurance coverage decisions are increasingly informed by evidence from clinical trials and other research of the benefits, harms, and comparisons of treatments, tests, and procedures. Systematic reviews provide a scientific approach to collecting and synthesizing biomedical information to answer questions that are essential to developing these guidelines and policies. However, standards for conducting systematic reviews have been lacking, and translation of evidence to practice has often been derailed when researchers hand off their systematic reviews to users who are unfamiliar with how to effectively use them. Several types of systematic reviews have evolved depending on the scope and goals of the review, such as technology assessments, comparative effectiveness reviews, and state-of-the-science reviews, for example. Although the different types of systematic reviews have much in common, they also vary in important ways. Each review requires methods appropriate to the specific clinical and health care questions it addresses, its scope, and the existing body of research. For example, a comparative effectiveness review of two or more medications previously studied in several high-quality randomized controlled trials would most likely use methods of statistical meta-analysis to pool trials to compare medications. In contrast, a state-of-the-science review to determine if specific symptoms are related to a health condition would qualitatively synthesize results of observational studies. As with all research, investigators are confronted with many decisions during the course of conducting a systematic evidence review. While investigators need to embrace the standards and accepted methodology of the discipline, they must also approach each question as unique in order to achieve meaningful results."--Provided by publisher.

Finding What Works in Health Care

Finding What Works in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 267
Release: 2011-07-20
Genre: Medical
ISBN: 0309164257

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Systematic Reviews to Answer Health Care Questions

Systematic Reviews to Answer Health Care Questions
Author: Heidi D. Nelson
Publisher: Lippincott Williams & Wilkins
Total Pages: 313
Release: 2024-02-21
Genre: Medical
ISBN: 1975211103

Accessible, practical, and student-friendly, Systematic Reviews to Answer Health Care Questions, Second Edition, by Dr. Heidi D. Nelson, uses easy-to-understand, step-by-step instruction and real-world examples to illustrate important concepts and principles of today’s systematic reviews. You’ll learn how to form key questions, select evidence, and perform comprehensive reviews not just in predictable circumstances, but when basic rules don’t apply—honing your ability to think critically and solve problems. Perfect for investigators, medical students and faculty, practitioners, policymakers, and others who need to refine their understanding of or approach to systematic reviews, this powerful text goes beyond merely teaching how to catalog and collect, helping readers learn to evaluate, synthesize, and deliver results that will help shape the practice of health care.

Systematic Reviews in Health Care

Systematic Reviews in Health Care
Author: Paul Glasziou
Publisher: Cambridge University Press
Total Pages: 151
Release: 2001-11-08
Genre: Medical
ISBN: 1139432214

What do we do if different studies appear to give different answers? When applying research to questions for individual patients or for health policy, one of the challenges is interpreting such apparently conflicting research. A systematic review is a method to systematically identify relevant research, appraise its quality, and synthesize the results. The last two decades have seen increasing interest and developments in methods for doing high quality systematic reviews. Part I of this book provides a clear introduction to the concepts of reviewing, and lucidly describes the difficulties and traps to avoid. A unique feature of the book is its description, in Part II, of the different methods needed for different types of health care questions: frequency of disease, prognosis, diagnosis, risk, and management. As well as illustrative examples, there are exercises for each of the sections. This is essential reading for those interested in synthesizing health care research.

Systematic Reviews in Health Research

Systematic Reviews in Health Research
Author: Matthias Egger
Publisher: John Wiley & Sons
Total Pages: 608
Release: 2022-05-11
Genre: Medical
ISBN: 1119099382

Systematic Reviews in Health Research Explore the cutting-edge of systematic reviews in healthcare In this Third Edition of the classic Systematic Reviews textbook, now titled Systematic Reviews in Health Research, a team of distinguished researchers deliver a comprehensive and authoritative guide to the rapidly evolving area of systematic reviews and meta-analysis. The book demonstrates why systematic reviews—when conducted properly—provide the highest quality evidence on clinical and public health interventions and shows how they contribute to inference in many other contexts. The new edition reflects the broad role of systematic reviews, including: Twelve new chapters, covering additional study designs, methods and software, for example, on genetic association studies, prediction models, prevalence studies, network and dose-response meta-analysis Thorough update of 15 chapters focusing on systematic reviews of interventions Access to a companion website offering supplementary materials and practical exercises (www.systematic-reviews3.org) A key text for health researchers, Systematic Reviews in Health Research is also an indispensable resource for practitioners, students, and instructors in the health sciences needing to understand research synthesis.

Systematic Reviews in Health Research

Systematic Reviews in Health Research
Author: Matthias Egger
Publisher: John Wiley & Sons
Total Pages: 612
Release: 2022-06-21
Genre: Medical
ISBN: 1405160500

Systematic Reviews in Health Research Explore the cutting-edge of systematic reviews in healthcare In this Third Edition of the classic Systematic Reviews textbook, now titled Systematic Reviews in Health Research, a team of distinguished researchers deliver a comprehensive and authoritative guide to the rapidly evolving area of systematic reviews and meta-analysis. The book demonstrates why systematic reviews—when conducted properly—provide the highest quality evidence on clinical and public health interventions and shows how they contribute to inference in many other contexts. The new edition reflects the broad role of systematic reviews, including: Twelve new chapters, covering additional study designs, methods and software, for example, on genetic association studies, prediction models, prevalence studies, network and dose-response meta-analysis Thorough update of 15 chapters focusing on systematic reviews of interventions Access to a companion website offering supplementary materials and practical exercises (www.systematic-reviews3.org) A key text for health researchers, Systematic Reviews in Health Research is also an indispensable resource for practitioners, students, and instructors in the health sciences needing to understand research synthesis.

Finding What Works in Health Care

Finding What Works in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 267
Release: 2011-06-20
Genre: Medical
ISBN: 0309216710

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Knowing What Works in Health Care

Knowing What Works in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 279
Release: 2008-05-29
Genre: Medical
ISBN: 0309113563

There is currently heightened interest in optimizing health care through the generation of new knowledge on the effectiveness of health care services. The United States must substantially strengthen its capacity for assessing evidence on what is known and not known about "what works" in health care. Even the most sophisticated clinicians and consumers struggle to learn which care is appropriate and under what circumstances. Knowing What Works in Health Care looks at the three fundamental health care issues in the United States-setting priorities for evidence assessment, assessing evidence (systematic review), and developing evidence-based clinical practice guidelines-and how each of these contributes to the end goal of effective, practical health care systems. This book provides an overall vision and roadmap for improving how the nation uses scientific evidence to identify the most effective clinical services. Knowing What Works in Health Care gives private and public sector firms, consumers, health care professionals, benefit administrators, and others the authoritative, independent information required for making essential informed health care decisions.

Systematic Reviews

Systematic Reviews
Author:
Publisher:
Total Pages: 281
Release: 2009
Genre: Electronic books
ISBN: 9781900640473

For adults. There is a pressing need for methodologically sound RCTs to confirm whether such interventions are helpful and, if so, for whom.

Framework for Determining Research Gaps During Systematic Review

Framework for Determining Research Gaps During Systematic Review
Author: U. S. Department of Health and Human Services
Publisher: Createspace Independent Pub
Total Pages: 70
Release: 2013-03-23
Genre: Medical
ISBN: 9781483944296

The identification of gaps from systematic reviews is essential to the practice of ''evidence-based research.'' Health care research should begin and end with a systematic review. A comprehensive and explicit consideration of the existing evidence is necessary for the identification and development of an unanswered and answerable question, for the design of a study most likely to answer that question, and for the interpretation of the results of the study. In a systematic review, the consideration of existing evidence often highlights important areas where deficiencies in information limit our ability to make decisions. We define a research gap as a topic or area for which missing or inadequate information limits the ability of reviewers to reach a conclusion for a given question. A research gap may be further developed, such as through stakeholder engagement in prioritization, into research needs. Research needs are those areas where the gaps in the evidence limit decision making by patients, clinicians, and policy makers. A research gap may not be a research need if filling the gap would not be of use to stakeholders that make decisions in health care. The clear and explicit identification of research gaps is a necessary step in developing a research agenda. Evidence reports produced by Evidence-based Practice Centers (EPCs) have always included a future research section. However, in contrast to the explicit and transparent steps taken in the completion of a systematic review, there has not been a systematic process for the identification of research gaps. We developed a framework to systematically identify research gaps from systematic reviews. This framework facilitates the classification of where the current evidence falls short and why the evidence falls short. The framework included two elements: (1) the characterization the gaps and (2) the identification and classification of the reason(s) for the research gap. The PICOS structure (Population, Intervention, Comparison, Outcome and Setting) was used in this framework to describe questions or parts of questions inadequately addressed by the evidence synthesized in the systematic review. The issue of timing, sometimes included as PICOTS, was considered separately for Intervention, Comparison, and Outcome. The PICOS elements were the only sort of framework we had identified in an audit of existing methods for the identification of gaps used by EPCs and other related organizations (i.e., health technology assessment organizations). We chose to use this structure as it is one familiar to EPCs, and others, in developing questions. It is not only important to identify research gaps but also to determine how the evidence falls short, in order to maximally inform researchers, policy makers, and funders on the types of questions that need to be addressed and the types of studies needed to address these questions. Thus, the second element of the framework was the classification of the reasons for the existence of a research gap. For each research gap, the reason(s) that most preclude conclusions from being made in the systematic review is chosen by the review team completing the framework. To leverage work already being completed by review teams, we mapped the reasons for research gaps to concepts from commonly used evidence grading systems. Our objective in this project was to complete two types of further evaluation: (1) application of the framework across a larger sample of existing systematic reviews in different topic areas, and (2) implementation of the framework by EPCs. These two objectives were used to evaluate the framework and instructions for usability and to evaluate the application of the framework by others, outside of our EPC, including as part of the process of completing an EPC report. Our overall goal was to produce a revised framework with guidance that could be used by EPCs to explicitly identify research gaps from systematic reviews.