Beruflich Dokumente
Kultur Dokumente
Systematic review uses explicit methods to identify, select, appraise, and synthesize
results from similar but separate studies
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Section A
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Information about Health Care Is Everywhere
But how do you know if one health care intervention works better than another
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Typical Clinical Questions
Do annual general health checks (annual physical exams) reduce illness and mortality?
Is an “early” epidural as effective and safe as a “late” epidural for women in labor?
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Too Much
Information
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Timing of Epidural
When a woman is in labor, the appropriate time to give an epidural during childbirth is when
she asks for it, a new study suggests …
The Cochrane researchers reviewed data from nine studies involving 15,752 first-time
mothers who were randomly assigned to “early” or “late” groups … When the results were
analyzed, those who had early epidurals were no more or less likely to need a
Caesarean section than those who had late epidurals. Earlier epidurals made no
difference to the likelihood of needing an assisted birth involving forceps or suction,
or to the amount of time spent in the second, “pushing” stage of labor.
Source: Sng et al. (2014). Cochrane Database of Systematic Reviews, Issue 10. 10
Annual Physical
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Annual Physical
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What Is a Systematic Review?
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What Is a Systematic Review?
Systematic
reviews
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What Is a Systematic Review?
Systematic
reviews
Systematic
reviews with
meta-analyses Reviews that are not
systematic
All reviews (traditional, narrative
reviews)
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“Traditional” Narrative Reviews
No standard format
Quantitative synthesis rarely used to integrate the information from multiple studies
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Methods Used in Medical and Epidemiology Review Articles
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Systematic Reviews Summarize the Evidence
Evidence-based medicine
Evidence-based policy
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Evidence-Based Health Care
The integration of best research evidence with clinical expertise and patient
values.
—Sackett, 2000
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Health Care
Overspending in
the United States
From the IOM’s analysis of its own 2010 data. You can see there are a whole bunch
of sources for unnecessary spending that range from inefficient services to excess
services and administrative costs.
Source: IOM Best Care at Lower Cost. (2012). 21
Definition of Comparative Effectiveness Research (CER)
Source: IOM Committee on Initial National Priorities for CER. (June 30, 2009). 22
PCORI
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Joe Selby
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Joe Selby
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