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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 19 recordsLinked to original sources
PubMed2005

Which resources should be used to identify RCT/CCTs for systematic reviews: a systematic review.

BACKGROUND: Systematic reviewers seek to comprehensively search for relevant studies and summarize these to present the most valid estimate of intervention effectiveness. The more resources searched, the higher the yield, and thus time and costs required to conduct a systematic review. While there is an abundance of evidence to suggest how extensive a search for randomized controlled trials (RCTs) should be, it is neither conclusive nor consistent. This systematic review was conducted in order to assess the value of different resources to identify trials for inclusion in systematic reviews. METHODS: Seven electronic databases, four journals and Cochrane Colloquia were searched. Key authors were contacted and references of relevant articles screened. Included studies compared two or more sources to find RCTs or controlled clinical trials (CCTs). A checklist was developed and applied to assess quality of reporting. Data were extracted by one reviewer and checked by a second. Medians and ranges for precision and recall were calculated; results were grouped by comparison. Meta-analysis was not performed due to large heterogeneity. Subgroup analyses were conducted for: search strategy (Cochrane, Simple, Complex, Index), expertise of the searcher (Cochrane, librarian, non-librarian), and study design (RCT and CCT). RESULTS: Sixty-four studies representing 13 electronic databases met inclusion criteria. The most common comparisons were MEDLINE vs. handsearching (n = 23), MEDLINE vs. MEDLINE+handsearching (n = 13), and MEDLINE vs. reference standard (n = 13). Quality was low, particularly for the reporting of study selection methodology. Overall, recall and precision varied substantially by comparison and ranged from 0 to 100% and 0 to 99%, respectively. The trial registries performed the best with median recall of 89% (range 84, 95) and median precision of 96.5% (96, 97), although these results are based on a small number of studies. Inadequate or inappropriate indexing was the reason most cited for missing studies. Complex and Cochrane search strategies (SS) performed better than Simple SS. CONCLUSION: Multiple-source comprehensive searches are necessary to identify all RCTs for a systematic review, although indexing needs to be improved. Although trial registries demonstrated the highest recall and precision, the Cochrane SS or a Complex SS in consultation with a librarian are recommended. Continued efforts to develop CENTRAL should be supported.

Databases, Bibliographic↗
PubMed2006

A systematic review of systematic reviews and meta-analyses of animal experiments with guidelines for reporting.

To maximize the findings of animal experiments to inform likely health effects in humans, a thorough review and evaluation of the animal evidence is required. Systematic reviews and, where appropriate, meta-analyses have great potential in facilitating such an evaluation, making efficient use of the animal evidence while minimizing possible sources of bias. The extent to which systematic review and meta-analysis methods have been applied to evaluate animal experiments to inform human health is unknown. Using systematic review methods, we examine the extent and quality of systematic reviews and meta-analyses of in vivo animal experiments carried out to inform human health. We identified 103 articles meeting the inclusion criteria: 57 reported a systematic review, 29 a systematic review and a meta-analysis, and 17 reported a meta-analysis only. The use of these methods to evaluate animal evidence has increased over time. Although the reporting of systematic reviews is of adequate quality, the reporting of meta-analyses is poor. The inadequate reporting of meta-analyses observed here leads to questions on whether the most appropriate methods were used to maximize the use of the animal evidence to inform policy or decision-making. We recommend that guidelines proposed here be used to help improve the reporting of systematic reviews and meta-analyses of animal experiments. Further consideration of the use and methodological quality and reporting of such studies is needed.

Animal Experimentation↗
PubMedDate not supplied

Systematic review of systematic reviews of acupuncture published 1996-2005.

Systematic reviews of acupuncture have tended to support its use, but few applied rigorous inclusion criteria. We tested the credibility of conclusions of systematic reviews of acupuncture published since 1996 by applying rigorous inclusion criteria. Reinterpretation used randomised and double blind trials with valid outcomes or design, and with information available from at least four trials or from 200 patients. Qualified support for acupuncture was originally reported in 12 out of 35 systematic reviews, and strong support was found in another six. Applying stricter inclusion criteria, however, showed that none of the 35 reviews supported acupuncture, predominantly because there were too few patients in the randomised, double blind studies. Six reviews with more than 200 patients in randomised, double blind studies had good evidence of no benefit. Systematic reviews of acupuncture have overstated effectiveness by including studies likely to be biased. They provide no robust evidence that acupuncture works for any indication.

Acupuncture Therapy↗
PubMed2006

A systematic review of systematic reviews of spinal manipulation.

OBJECTIVES: To systematically collate and evaluate the evidence from recent systematic reviews of clinical trials of spinal manipulation. DESIGN: Literature searches were carried out in four electronic databases for all systematic reviews of the effectiveness of spinal manipulation in any indication, published between 2000 and May 2005. Reviews were defined as systematic if they included an explicit and repeatable inclusion and exclusion criteria for studies. RESULTS: Sixteen papers were included relating to the following conditions: back pain (n=3), neck pain (n=2), lower back pain and neck pain (n=1), headache (n=3), non-spinal pain (n=1), primary and secondary dysmenorrhoea (n=1), infantile colic (n=1), asthma (n=1), allergy (n=1), cervicogenic dizziness (n=1), and any medical problem (n=1). The conclusions of these reviews were largely negative, except for back pain where spinal manipulation was considered superior to sham manipulation but not better than conventional treatments. CONCLUSIONS: Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.

Asthma↗
PubMed2002

A systematic review of systematic reviews of homeopathy.

Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.

Arnica↗
PubMed2003

[What is the systematic review?].

Systematic reviewing provides a major backbone for evidence-based laboratory medicine(EBLM). Compared with a usual review paper, a systematic review is characterized by pursuing both the most comprehensive search for available evidence and the highest level of scientific quality. The word of 'scientific' does not mean a scientific truth but means a reliable result proven by a scientific method. According to the best effort policy of EBM, a result including some statistical bias may be adopted as the current best evidence if better ones are not available. In addition, EBLM requires specialized approaches because of the following reasons. (1) Many factors, such as analytical errors or lack of standardization may cause various statistical biases in the laboratory data. (2) Unlike the effectiveness of therapeutic measures that can be evaluated by comparing only two groups, there are almost infinite combinations of diagnostic tests and phases of clinical courses, and it is hardly possible to statistically match the patient group with the control group at any of those combinations. (3) Unlike medication, which has direct effects on a patient's outcome, many steps must be taken to analyze the effects of laboratory tests. From now, more effort should be dedicated to promoting systematic reviewing in laboratory medicine.

Evidence-Based Medicine↗
PubMed2006

Types of clinical studies. Systematic reviews.

Systematic reviews are analytic instruments that summarize the best available scientific evidence in order to provide evidence-based answers to clinically relevant questions. Meta-analyses are systematic reviews with a quantitative analysis of results. The process of conducting a systematic review is a rigorous and standardized procedure that includes: 1) formulating a clinically relevant question; 2) explicit selection of studies (primary or secondary) to be included in the review; 3) critical appraisal of the relevant evidence; 4) summarizing the evidence; and 5) statistical analysis of the results. In this paper we describe the steps involved in conducting a systematic review of scientific evidence, the methodology, and problems.

Clinical Trials as Topic↗
PubMed2003

A guide to developing a systematic review.

Systematic reviews are used to gather information from a variety of sources and distill information based on best evidence synthesis, while also excluding poor quality studies via explicit validity checks. This article provides a roadmap to conducting a systematic review with the Cochrane Collaboration and uses an example of a completed systematic review. The literature is drawn upon to provide rationale for the processes undertaken. The aim of the sample systematic review was to identify and review all randomized controlled trials evaluating disposable surgical face masks worn by surgical team members during clean surgery to prevent postoperative surgical wound infection.

Female↗
PubMed1997

A guide to interpreting discordant systematic reviews.

Systematic reviews are becoming prominent tools to guide health care decisions. As the number of published systematic reviews increases, it is common to find more than 1 systematic review addressing the same or a very similar therapeutic question. Despite the promise for systematic reviews to resolve conflicting results of primary studies, conflicts among reviews are now emerging. Such conflicts produce difficulties for decision-makers (including clinicians, policy-makers, researchers and patients) who rely on these reviews to help them make choices among alternative interventions when experts and the results of trials disagree. The authors provide an adjunct decision tool--a decision algorithm--to help decision-makers select from among discordant reviews.

Algorithms↗
PubMed2002

A guide to systematic reviews.

Systematic reviews have become widely used for evaluating evidence across all fields of biomedicine. The objective of a systematic review is to provide a comprehensive and contemporary appraisal of research using transparent methods whilst aiming to minimize bias. In essence, research methodology is employed in the conduct of the review. Such reviews are therefore fundamentally different from traditional 'narrative' review articles in their purpose and in their potential to aid clinical decision-making. This paper is a guide to the rationale and nature of systematic reviews and will provide a background to understanding their use in clinical practice.

Dental Research↗
PubMed2004

The effectiveness of public health nursing: the problems and solutions in carrying out a review of systematic reviews.

BACKGROUND: In 1999 the Scottish Office, United Kingdom, intimated that the Chief Nursing Officer would undertake a policy review of nurses' contribution to improving the public's health. The importance of reviewing the scientific literature on the effectiveness of public health nursing was recognized as a crucial part of the policy review. A final report was expected within a 6-month period. The reason for the short time period was to fit the policy-making schedule. This paper discusses our literature review for this work. AIMS: The aim was to conduct a review of the international scientific literature that gave the greatest coverage of the role and potential role of nurses in improving the public's health in relation to 14 major health topics. This paper describes the methods used, outlines the rationale underpinning the methods, discusses the problems encountered and offers solutions to some of these problems. METHODS: The initial search for relevant scientific literature revealed 709 suitable primary papers. Reviewing this number was beyond the time limit set by the funding organization. Therefore, a decision was made to concentrate on the evidence contained in systematic reviews. Reviewing systematic reviews raises a number of methodological problems to which there are often no predetermined solutions, such as ensuring that important interventions are included, assessing the relevance and quality of the reviews, and grading the strength of the evidence. DISCUSSION: Reviewing systematic reviews provides the scope to increase the number of topics that might be covered. However, it is possible that a number of interventions may be missed, particularly those that are not subject to review or those assessed using qualitative techniques. The definition of public health nursing used in the present study was also restrictive, and could be widened to include community interventions. Finally, assessing the quality of reviews and grading the evidence proved difficult and there is lack of consensus on how these tasks should be achieved. Nevertheless, the review presented policy makers with accessible information on a large number of relevant international studies.

Delivery of Health Care↗
PubMed2005

Systematic reviews need systematic searchers.

PURPOSE: This paper will provide a description of the methods, skills, and knowledge of expert searchers working on systematic review teams. BRIEF DESCRIPTION: Systematic reviews and meta-analyses are very important to health care practitioners, who need to keep abreast of the medical literature and make informed decisions. Searching is a critical part of conducting these systematic reviews, as errors made in the search process potentially result in a biased or otherwise incomplete evidence base for the review. Searches for systematic reviews need to be constructed to maximize recall and deal effectively with a number of potentially biasing factors. Librarians who conduct the searches for systematic reviews must be experts. DISCUSSION/CONCLUSION: Expert searchers need to understand the specifics about data structure and functions of bibliographic and specialized databases, as well as the technical and methodological issues of searching. Search methodology must be based on research about retrieval practices, and it is vital that expert searchers keep informed about, advocate for, and, moreover, conduct research in information retrieval. Expert searchers are an important part of the systematic review team, crucial throughout the review process-from the development of the proposal and research question to publication.

Databases, Bibliographic↗
PubMed2006

What predicts outcome in non-operative treatments of chronic low back pain? A systematic review.

Systematic reviews have shown that as non-operative treatments exercise, behavioural and multimodal treatment programs are effective for chronic low back pain. There is, however, a lack of knowledge concerning the association between changes in treatment process variables and changes in outcome for the three treatment forms. The objective of this systematic review was to evaluate which changes in treatment process variables predict outcome of exercise, behavioural and multimodal treatment of chronic low back pain. Medline, Embase and PsychInfo were systematically searched. A descriptive analysis was used to summarize the results regarding the outcomes pain, disability and return to work (RTW). 13 studies were identified. The results showed that functional coping mechanisms and pain reduction were associated with a decrease in disability and increase in RTW, and physical performance factors were not. Related to pain reduction decreases in disability, functional coping mechanisms as well as physical performance factors were associated. Strong conclusions cannot be drawn from this review, because of the heterogeneity and the limited number of studies. The results of this review raise the question if changes in behavioural variables and reductions of disability which facilitate an improvement in function, may be more important than physical performance factors for successful treatment of chronic low back pain. This is relevant for the refinement of future treatment programs.

Chronic Disease↗