The Systematic Review Process - University of Washington：系统回顾-华盛顿大学.ppt

Katherine * Katherine: In addition to study population (diseases/conditions to be included, e.g, SCI in our example), this also includes: * Katherine * Katherine: You’ll want to categorize your articles once you have gathered them all. Here is an example from Measuring depression in persons with spinal cord injury: A systematic review * Katherine: ABREVIATED LIST: Keep in mind that this classification system is ONLY to help determine which studies should be included in the review and is NOT related to grading the evidence. We will discuss grading in a few minutes. * Katherine * Katherine---This is an end of good planning. Common for publication---is a diagram of your methodology! If did all things correctly you should be able to create one of these. * Pat: Earlier, we talked about some of the issues around evidence in rehab. Let’s talk now about some of the most common approaches to evaluating or ‘grading’ the evidence. * * * Pat: so far, we’ve highlighted some of the most problematic steps in the process, namely: developing a good clinical question, creating a plan, categorizing the articles, and grading the evidence. Next, we’ll talk about creating consumer clinical materials from your review. * kurt * Pat: We’re now ready to take the next step develop user products from our systematic review. * Pat * Pat * Pat * * AAN Evidence classified class I (low risk of bias) through IV (very high risk of bias) Evidence graded A (consistent with class 1 studies) and recommend treatment as established as safe and effective through D (class 4 studies or a mix of 4 classes). Insufficient evidence to support a conclusion of effectiveness GRADE Classified high, moderate, low and very low Randomized trial = high Observational study = low Any other evidence = very low Note: in GRADE, look at study design first but there are many other criteria to consider in assigning a grade of evidence Recommendations (strong or weak) based on classification Steps in Conducting a Sy