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The usefulness and interpretation of systematic reviews

  • Katharine A. Smith, Andrea Cipriani and John R. Geddes
  • Please note an addendum has been issued for this article.
Summary

Keeping up to date with the best evidence on treatment interventions is an essential part of clinical practice, but it can seem an overwhelming task for busy clinicians. Systematic reviews and meta-analyses provide a useful and convenient summary of knowledge and form an essential part of an evidence-based approach to clinical practice. However, these reviews vary in methodology and therefore in the quality of the recommendations they provide. Clinicians need to feel confident in their skills of critical appraisal, so that they can assess the relative merits of systematic reviews. In this article we discuss the strengths and limitations of different types of evidence synthesis to enable the reader to feel more confident in assessing the scientific information to use in clinical practice.

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Copyright
Corresponding author
Dr Katharine Smith, NIHR Oxford cognitive health Clinical Research Facility, Warneford Hospital, Oxford OX3 7JX, UK. Email: katharine.smith@psych.ox.ac.uk
Footnotes
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For a commentary see pp. 142–144, this issue.

LEARNING OBJECTIVES

• Understand what a systematic review is and how to perform a critical appraisal of its strengths and limitations, including identifying the potential sources of bias

• Understand what a meta-analysis is and when to use it, how to assess its internal and external validity, and the difficulties of clinical and statistical heterogeneity

• Appreciate advanced methodologies (e.g. individual patient data meta-analysis and network meta-analysis) used to individualise treatment response and evaluate comparative effectiveness

DECLARATION OF INTEREST

None

Footnotes
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The usefulness and interpretation of systematic reviews

  • Katharine A. Smith, Andrea Cipriani and John R. Geddes
  • Please note an addendum has been issued for this article.
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