世纪医生核心能力与循证医学文献检索ppt课件.ppt

Systematic Reviews Meta-analyses（1） 系统评价的特点/Systematic Review: 文献的结构性综述/Structured review of the literature 收入及淘汰标准的设定/Set inclusion exclusion criteria 研究设计质量的评价/Assess study design quality 研究方法学质量的评价/Assess methodological quality (rarely) 研究结果的编辑摘要/Compile summarize results 目标：确定一个特殊项目的必威体育精装版证据 /Goal: determine what the current evidence is on a specific topic Systematic Reviews Meta-analyses（2） 荟萃分析特点/Meta-Analysis: 也有文献的结构性综述/Also a structured review of the literature 收入及淘汰标准的设置/Set inclusion exclusion criteria 研究质量的评价/Assess study design quality 研究方法学评价（很少）/Assess methodological quality (rarely) 对收入的各组研究综合结果的统计学分析/Perform statistics on the integrated results of the grouped studies 目标：从多组数据分析结果得出综合结论 /Goal: draw conclusions from the results of the analysis of the grouped data University of Iowa 指出：Systematic Reviews 是最佳证据 Goal: Summaries of best evidence; information overload Top level of evidence; everyone doing them Most are fair in terms of value Over 1.3 Million listed in MEDLINE alone About 5000 on the knee alone Need to evaluate carefully -Sports Medicine Rounds（2007） SR 能使你成为聪明的科技文献的阅读者 不能仅仅阅读摘要、结论和图表 假说、方法和结果才是最重要的 研究设计的适当性 没有偏倚 基于结果和一致性方法的结论 -Sports Medicine Rounds（2007） 我们能相信普通综述吗？研究结果令人担忧 1. Study of 36 review articles using 10 criteria for determining rigor Overall rating of rigor: -Experts correlation = 0.23 -Non-experts correlation = 0.78 ↑ expertise of writer = stronger prior opinion → less time spent on review → lower quality 2. Study of quality of 35 review articles on type 2 DM -Ave. score 1/15; best score 5/15 Experts – should do research Non-experts – should write due to less bias -Oxman AD, Guyatt GH. The science or reviewing research. Ann N Y Acad Sci 1993;703:125-33. Shaughnessy AF, Slawson DC. What happened to the valid POEMs? A survey of review articles on the treatment of type 2 diabetes. British Medical Journal 2003;327:266-9. 5) 如何检索系统评价文献？ A） Pubmed：高级检索限定在 Systematic Reviews [Subset] 和 Meta analysis [Type of Article]；