Systematic Reviews
The writer of a systematic review uses an explicit and rigorous method
to identify, critically appraise, and then synthesize relevant studies in
the published medical research. A meta analysis is a type of systematic
review using quantitative mehtods to assess research from different
studies.
Benefits of the systematic review include:
- Reduces the amount of literature the clinician must read
- Assesses consistency across studies
- Widens the generalizability of individual studies across participants
and settings
Important: To access these
electronic
resources you must be on the Yale network or use a remote access option such as the VPN or proxy server.
Resources for Finding Systematic Reviews
| Title |
Description |
|
USPSTF - AHRQ
|
Evidence synthesis and systematic evidence reviews. |
The Cochrane Library
|
The Cochrane Collaboration prepares, maintains and disseminates
systematic reviews of health care interventions focusing
primarily on systematic reviews of controlled trials of
therapeutic interventions. The Cochrane Database of Systematic
Reviews(CDSR) includes full text of regularly updated systematic
reviews of the effects of health care. The Database of
Abstracts of Reviews of Effectiveness (DARE) identifies the
best quality systematic reviews. DARE complements the CDSR by
offering a selection of quality assessed reviews in those
subjects where there is currently no Cochrane review. Also
includes the Cochrane Controlled Trials Register, the NHS
Economic Evaluation Database a, the Health Technology
Assessment and the Cochrane Methodology Register.
|
|
CINAHL
|
The CINAHL (Cumulative Index to Nursing and Allied Health Literature)
contains citations to systematic reviews in the journal literature. To
find them, do a subject search and limit to English and Human. Narrow
the search more by using the saved expert search "CINAHL Meta Analysis."
|
|
The Joanna Briggs Institute for EBP and Midwifery
|
Some systematic reviews are freely available at this site. |
| Ovid
MEDLINE |
To find
systematic reviews in MEDLINE, do a subject search. Limit to
human and English. Limit the search to "EBM Reviews" (Best
Evidence, Cochrane Systematic Review, DARE, CCTR). |
|
National Quality Measures Clearinghouse
|
NQMC is sponsored by AHRQ to promote widespread access to quality measures by the health care community and other interested individuals.
Key components include: structured, standardized abstracts (summaries) containing information about measures and their development;
a utility for comparing attributes of two or more quality measures in a side-by-side comparison;
links to full-text quality measures (when available) and/or ordering details for the full measure. |
|
The Sarah Cole Hirsh Institute for Best Nursing Practices Based on Evidence
|
Affiliated with the Frances Payne Bolton School of Nursing at Case Western Reserve. Systematic Reviews are published in the Open Access publication "Online Journal of Issues in Nursing" |
| |
|
Using Systematic Reviews
After finding a systematic review or meta analysis, the clinician
still must determine both its quality and its worth to the clinician's
own practice. Questions you should ask yourself about a systematic
review include:
- Are the studies reviewed of high scientific merit (i.e., are they
randomized controlled studies)?
- Does the review explicitly state the method used to find trials?
- Were results consistent from study to study?
- Are the patients included in the studies so different from my own
that the results might not be valid in my practice?
- Were all clinical outcomes (harm and benefits) considered?
- How do my own patient's values and preferences correspond to the
results decribed in the study?
References
Acton, G. J. (2001). Meta-analysis: a tool for evidence-based
practice. AACN Clinical Issues: Advanced Practice in Acute & Critical
Care, 12(4), 539-545.
Ciliska, D., Cullum, N., & Marks, S. (2001). EBN users' guide.
Evaluation of systematic reviews of treatment or prevention
interventions. Evidence-Based Nursing, 4(4), 100-104.
Cook, D. J., Mulrow, C. D., & Haynes, R. B. (1997). Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med, 126(5), 376-380.
Egger, M., & Smith, G. D. (1995). Misleading meta-analysis. BMJ, 310(6982), 752-754.
Greenhalgh, T. (1997). Papers that summarise other papers (systematic reviews and meta-analyses). BMJ, 315(7109), 672-675.
Hunt, D. L., & McKibbon, K. A. (1997). Locating and appraising
systematic reviews. Ann Intern Med, 126(7), 532-538.
Melnyk, B. M. (2004). Integrating levels of evidence into clinical decision making. Pediatric Nursing, 30(4), 323-325.
Stevens, K. R. (2001). Systematic reviews: the heart of evidence-based
practice. AACN Clinical Issues: Advanced Practice in Acute & Critical
Care, 12(4), 529-538.
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