Wednesday, July 9, 2014

Systematic Reviews - Application to Clinical Practice

The latest entry in JAMA's valuable "Users' Guides to the Medical Literature" series says "clinical decisions should be based on the totality of the best evidence and not the results of individual studies." This article addresses how to determine the credibility of a systematic review and assess confidence in the evidence using a handy set of questions as a "Guide for Appraising and Applying the Results of a Systematic Review and Meta-analysis."

"In 1994, a Users’ Guide on how to use an overview article was published in JAMA and presented a framework for critical appraisal of systematic reviews. In retrospect, this framework did not distinguish between 2 very different issues: the rigor of the review methods and the confidence in estimates (quality of evidence) that the results warrant. The current Users’ Guide reflects the evolution of thinking since that time and presents a contemporary conceptualization."

Murad M, Montori VM, Ioannidis JA, et al. How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care: Users’ Guides to the Medical Literature. JAMA. 2014;312(2):171-179. doi:10.1001/jama.2014.5559. and put "Users' Guides to the Medical Literature" in the search box

Oxman AD, Cook DJ, Guyatt GH, et al. Users' Guides to the Medical Literature: VI. How to Use an Overview. JAMA. 1994;272(17):1367-1371. doi:10.1001/jama.1994.03520170077040.