Finding What Works in Health Care Standards for Systematic Reviews (2011) / Chapter Skim
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6 Improving the Quality of Systematic Reviews: Discussion, Conclusions, and Recommendations
6 Improving the Quality of Systematic Reviews: Discussion, Conclusions, and Recommendations
Pages 223-234
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From page 223... ...
Department of Health and Human Services should collaborate to improve the science and environment for SRs of CER. Although the recommended SR standards presented in this report are based on the best available evidence and current practice of respected organizations, many of the standards should be considered provisional pending more methods research.
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From page 224... ...
and, in particular, its Methodol ogy Committee, as a potentially appropriate organization to provide comprehensive oversight and coordination of the development of the science and to promote the environment for SRs in support of CER in the United States. The committee views PCORI as an unusually timely development -- albeit untested -- that should help advance the field of SRs as an essential component of its overall mission, building on the strengths of well-established programs in the United States (e.g., AHRQ, National Institutes of Health [NIH]
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From page 225... ...
Although the committee believes the recommended standards and elements of performance presented in this report are founded on the best available evidence and current practice of respected organizations, all SR standards should be considered provisional pending additional experience and research on SR methods. The committee recognizes that each of its recommended standards could be examined in appropriately designed research, with the expectation that some items would be validated, some discarded, and some added.
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From page 226... ...
replication of methodological research and SRs of methods, PCORI will contribute to ensuring that standards are evidence based. SR methods research will also help to identify gaps in the literature and, through the application of the findings of empirical, "meta-epidemiologic" approaches (i.e., investigations of how particular features of study design or study populations relate to the validity and applicability of primary studies)
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From page 227... ...
Similarly, generalist librarians and other information specialists may require special training or experience in conducting SRs, including special knowledge of bibliographic database-specific search terms, to design and execute the search strategy appropriately. Little descriptive information is available about how the issues of personnel and expertise are handled in various SR enterprises, and the evidence base comparing different approaches is inadequate.
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From page 228... ...
to comparisons of different modeling approaches. Despite ongoing research in the field, many outstanding questions remain, particularly related to the synthesis of complex multivariate data structures.
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From page 229... ...
The committee also notes that in current practice, the process of conducting some SRs is often formally separated from processes in which they are actually used. Although appropriate objectivity and freedom from undue influence need to be maintained, the committee believes that research examining the utility of connecting the SR with its intended users (e.g., clinical guidelines groups, practicing clinicians, and patients)
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From page 230... ...
The committee also underscores that its recommended standards and elements of performance for publicly funded SRs are provisional, subject to change as the science of SRs advances and lessons are learned from applying the standards in practice. A mecha nism is needed to monitor the progress of the science and update the standards periodically to reflect current best practice.
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From page 231... ...
,6 publicly posting protocols and reviews, using public mechanisms to ensure timely updating of protocols and reviews, guaranteeing access to data from primary studies for use in SRs, and ensuring that SRs are a required part of planning, designing, and conducting future primary CER. Establishing a collaborative methodologic research infrastructure will also be valuable to advancing the science of SRs.
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From page 232... ...
When publicly funded SRs are intended to be used in support of clinical guidance, these reviews should be formally linked with guidelines committees that also meet rigorous standards. The use and usefulness of SRs commissioned as part of a guidelines process should be evaluated once the guideline is implemented, with a feedback loop into future reviews on similar topics and methods used to conduct the review.
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From page 233... ...
The recommended standards are an appropriate starting point for publicly funded reviews in the United States (including PCORI, federal, state, and local funders) because of the heightened attention and potential clinical impact of major reviews sponsored by public agencies.
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From page 234... ...
The committee assigns these groups with responsibility and accountability for coordinating and moving the agenda ahead. The committee found compelling evidence that having highquality SRs based on rigorous standards is a topic of international concern, and that individual colleagues, professional organizations, and publicly funded agencies in other countries make up a large proportion of the world's expertise on the topic.
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