"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.

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 Evidence Reviews to Answer Health Care Questions is your most effective, A-to-Z guide to conducting thorough, comprehensive systematic reviews. By breaking down topics and essential steps, this volume teaches you how to form key questions, select evidence, and perform illuminating review not just in predictable circumstances, but when basic rules don’t apply—honing your ability to think critically and solve problems. You’ll learn how to define a review’s purpose and scope, develop research questions, build a team, and even manage your project to maximize efficacy. If you’re looking to refine your approach to systematic reviews, don’t just catalog and collect; use this powerful text to evaluate, synthesize, and deliver results that will help shape the health care industry. FEATURES Presented in standard format throughout to allow for more practical, easy to read approach Provides useful instruction on how to conduct a high-quality systematic review that meets the recent standards of the Institute of Medicine Accessible, concise information about the state-of-the-art methods of systematic review, from key question formulation to assessing the quality of included studies and reporting results Illustrated throughout with real-world examples from systematic reviews that have been used to inform practice guidelines and health policy

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.

This work provides a thought-provoking account of how medical treatments can be tested with unbiased or 'fair' trials and explains how patients can work with doctors to achieve this vital goal. It spans the gamut of therapy from mastectomy to thalidomide and explores a vast range of case studies.

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

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.

Healthcare providers, consumers, researchers and policy makers are inundated with unmanageable amounts of information, including evidence from healthcare research. It has become impossible for all to have the time and resources to find, appraise and interpret this evidence and incorporate it into healthcare decisions. Cochrane Reviews respond to this challenge by identifying, appraising and synthesizing research-based evidence and presenting it in a standardized format, published in The Cochrane Library (www.thecochranelibrary.com). The Cochrane Handbook for Systematic Reviews of Interventions contains methodological guidance for the preparation and maintenance of Cochrane intervention reviews. Written in a clear and accessible format, it is the essential manual for all those preparing, maintaining and reading Cochrane reviews. Many of the principles and methods described here are appropriate for systematic reviews applied to other types of research and to systematic reviews of interventions undertaken by others. It is hoped therefore that this book will be invaluable to all those who want to understand the role of systematic reviews, critically appraise published reviews or perform reviews themselves.

This timely, engaging book provides an overview of the nature, logic, diversity and process of undertaking systematic reviews as part of evidence informed decision making. A focused, accessible and technically up-to-date book, it covers the full breadth of approaches to reviews from statistical meta analysis to meta ethnography. It is ideal for anyone undertaking their own systematic review - providing all the necessary conceptual and technical background needed to make a good start on the process. The content is divided into five clear sections: • Approaches to reviewing • Getting started • Gathering and describing research • Appraising and synthesising data • Making use of reviews/models of research use. Easy to read and logically structured, this book is essential reading for anyone doing systematic reviews. David Gough is Professor of Evidence Informed Policy and Practice and Director of SSRU and its EPPI-Centre and Co-Editor of the journal Evidence & Policy. Sandy Oliver is Professor of Public Policy and Deputy Director of SSRU and its EPPI-Centre. James Thomas is Reader in Social Policy, Assistant Director of SSRU and Associate Direcctor of the EPPI-Centre.

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.