目的 介紹系統評價的閱讀方法。
方法 全面檢索當前有關閱讀與評價醫學文獻的論文、專著,總結歸納出指導閱讀系統評價的一般原則和方法。
結果 以下十個要點有助于科學、快速、高效閱讀系統評價:①是否有同類評價?②是否屬最新更新?③是否整合了之前相關的系統評價?④是否制定和實施了完善的檢索策略?⑤是否對原始研究進行了質量評價?⑥是否對原始研究結果進行了適當合并?⑦是否對其自身局限性或不足予以說明?⑧是否提出了下一階段需要解決的問題?⑨是否充分報告了摘要和全文?⑩是否能夠用于解決實際問題?本文還從對系統評價利用的角度,將讀者分為四個人群:衛生政策制定者、衛生保健提供者、研究人員、患者及普通用戶。
結論 應重視對系統評價的閱讀,以便更好的指導決策,推動循證實踐。
引用本文: 陳耀龍,王夢書,張文娟,劉婷蘭,王紫薇,趙宇,赫萬佳,伍媛媛,張玉婷,李幼平. 如何閱讀系統評價. 中國循證醫學雜志, 2009, 09(9): 1010-1017. doi: 10.7507/1672-2531.20090178 復制
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4. | 陳耀龍, 杜亮, 何丹端,等. 《中國循證醫學雜志》作者閱讀習慣調查. 中國循證醫學雜, 2008, 5(5): 312-314. |
5. | Boseley S. News report. The Guardian, June 24, 1998. |
6. | 0000 articles or 120? Evid. Based Med, 2006, 11: 40. |
7. | Mike Wilson. Evidence-Based Medicine: would you rather read. |
8. | McKibbon KA, Wilczynski NL, Haynes RB. What do evidence-based secondary journals tell us about the publication of clinically important articles in primary healthcare journals? BMC Med, 2004, 2: 33. |
9. | 陳耀龍, 艾昌林, 李幼平. “循證”冠名的醫學期刊比較研究. 中國循證醫學雜志, 2007, 7(4): 289-295. |
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11. | Trisha Greenhalgh. How to Read a Paper: The Basics of Evidence- Based Medicine. 3 edition. 2006. 114-134. |
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19. | Shojania KG, Sampson M, Ansari MT, et al. How quickly do systematic reviews go out of date? A survival analysis. Ann Intern Med, 2007,147:224-233. |
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22. | Yusuf S, Teo K, Woods K. Intravenous magnesium in acute myocardial infarction. An effective, safe, simple, and inexpensive intervention. Circulation, 1993, 87(6): 2043-2046. |
23. | ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. Lancet, 1995, 345(8951): 669-685. |
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25. | Moher D, Tsertsvadze A, Tricco A, et al. When and how to update systematic reviews. Cochrane Database of Systematic Reviews. 2008, Issue 1. Art. No.: MR000023. DOI: 10.1002/14651858.MR000023. pub3. |
26. | Whitlock EP, Lin JS, Chou R, et al. Using existing systematic reviews in complex systematic reviews. Ann Intern Med, 2008, 148: 776-782. |
27. | Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. BMJ, 1994, 309: 1286-1291. |
28. | Mallett S, Hopewell S, Clarke M. Grey literature in systematic reviews: The first 1000 Cochrane systematic reviews. Fourth Symposium on Systematic Reviews: Pushing the Boundaries, Oxford (UK), 2002. |
29. | Moher D, Cook DJ, Eastwood S, et al. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. quality of reporting of meta-analyses. Lancet, 1999, 354(9193): 1896-1900. |
30. | Smith ML. Publication bias and meta-analysis. Eval Educ,1980, 4: 22-24. |
31. | McAuley L, Moher D, Tugwell P. The influence of grey literature on meta-analysis. MSc Thesis: University of Ottawa, 1999. |
32. | Moher D, Pham B, Klassen TP, et al. Does the language of publication of reports of randomized trials influence the estimates of intervention effectiveness reported in meta-analyses? 6th Cochrane Colloquium; 1998. |
33. | Grégoire G, Derderian F, Le Lorier J. Selecting the language of the publications included in a meta-analysis: is there a Tower of Babel bias? J Clin Epidemiol, 1995, 48(1): 159-163. |
34. | Moher D, Fortin P, Jadad AR, et al. Completeness of reporting of trials published in languages other than English: implications for conduct and reporting of systematic reviews. Lancet, 1996, 347: 363-366. |
35. | Egger M, Zellweger-Z?hner T, Schneider M, et al. Language bias in randomised controlled trials published in English and German. Lancet, 1997, 350: 326-359. |
36. | Moher D, Jadad AR, Nichol G, et al. Assessing the quality of randomized controlled trials: an annotated bibliography of scales and checklists. Control Clin Trials, 1995, 16(1): 62-73. |
37. | 李靜, 李幼平. 不斷完善與發展的Cochrane系統評價. 中國循證醫學雜志, 2008, 8(9): 742-743. |
38. | 孫玉亮, 趙今, 吳泰相等. 口腔扁平苔蘚治療的系統評價. 中國循證醫學雜志, 2009, 9(3): 323-330. |
39. | Bero L, Rennie D. The Cochrane Collaboration: preparing, maintaining, and disseminating systematic reviews of the effects of health care. J Am Med Ass, 1995, 274(24): 1935-1938. |
40. | Sacks HS, Berrier J, Reitman D, et al. Meta-analyses of randomized controlled trials. N Engl J Med, 1987, 316: 450-455. |
41. | Sacks HS, Reitman D, Pagano D, et al. Meta-analysis: an update. Mt Sinai J Med, 1996; 63: 216-224. |
42. | Unknown. Available from: http://group.bmj.com/products/evidencecentre/ evidence-based-medicine-resources/20-10-08.pdf/view. Accessed on 2009-4-5. |
43. | Hopewell S, Clarke M, Moher D, et al. CONSORT for reporting randomized controlled trials in journal and conference abstracts: explanation and elaboration. PLoS Med, 5(1): e20. |
44. | Drummond MF, Sculpher MJ, Torrance GW, 等. 衛生保健項目經濟學評估方法. 第3版. 李士雪, 主譯. 北京:人民衛生出版社. 2008. 320. |
45. | Swingler GH, Volmink J, Ioannidis JP. Number of published systematic reviews and global burden of disease: database analysis. BMJ, 2003, 327(7423): 1083-1084. |
46. | Waters E, Doyle J. Systematic reviews of public health in developing countries are in train. BMJ, 2004, 328(7439): 585. |
47. | Chinnock P, Siegfried N, Clarke M. Is evidence-based medicine relevant to the developing world? PLoS Med, 2005, 2(5): e107. |
48. | West S, King V, Carey TS, et al. Systems to Rate the Strength of Scientific Evidence. Evidence Report/Technology Assessment No. |
49. | (Prepared by the Research Triangle Institute–University of North Carolina Evidence-based Practice Center under Contract No. 290-97-0011). AHRQ Publication No. 02-E016. Rockville, MD: Agency for Healthcare Research and Quality. April 2002. |
50. | Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol, 1991, 44: 1271-1278. |
51. | Oxman AD, Guyatt GH, Singer J, et al. Agreement among reviewers of review articles. J Clin Epidemiol, 1991, 44: 91-98. |
52. | Irwig L, Tosteson AN, Gatsonis C, et al. Guidelines for meta-analyses evaluating diagnostic tests. Ann Intern Med, 1994, 120: 667-676. |
53. | Sacks HS, Reitman D, Pagano D, et al. Meta-analysis: an update. Mt Sinai J Med, 1996, 63: 216-224. |
54. | Auperin A, Pignon JP, Poynard T. Review article: critical review of meta-analyses of randomized clinical trials in hepatogastroenterology. Alimentary Pharmacol Ther, 1997, 11: 215-225. |
55. | Beck CT. Use of meta-analysis as a teaching strategy in nursing research courses. J Nurs Educ, 1997, 36: 87-90. |
56. | Smith AF. An analysis of review articles published in four anaesthesia journals. Can J Anaesth, 1997, 44: 405-409. |
57. | Barnes DE, Bero LA. Why review articles on the health effects of passive smoking reach different conclusions. JAMA, 1998, 279: 1566-1570. |
58. | Clarke M, Oxman AD. Cochrane Reviewer’s Handbook 4.0. The Cochrane Collaboration; 1999. |
59. | Khan KS, Ter Riet G, Glanville J, et al. Undertaking Systematic Reviews of Research on Effectiveness. CRD’s Guidance for Carrying Out or Commissioning Reviews: York, England: University of York, NHS Centre for Reviews and Dissemination; 2000. |
60. | New Zealand Guidelines Group. Tools for Guideline Development & Evaluation. http://www.nzgg.org.nz/. |
61. | Harbour R, Miller J. A new system [Scottish Intercollegiate Guidelines Network (SIGN)] for grading recommendations in evidence based guidelines. BMJ, 2001, 323: 334-336. |
62. | Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med, 1997, 126: 376-380. |
63. | Hunt DL, McKibbon KA. Locating and appraising systematic reviews. Ann Intern Med, 1997, 126: 532-538. |
64. | McQuay HJ, Moore A. Using numerical results from systematic reviews in clinical practice. Ann Intern Med, 1997, 126: 712-720. |
65. | Badgett RG, O’Keefe M, Henderson MC. Using systematic reviews in clinical education. Ann Intern Med, 1997, 126: 886-891. |
66. | Bero LA, Jadad AR. How consumers and policymakers can use systematic reviews for decision making. Ann Intern Med, 1997, 127: 37-42. |
67. | Cook DJ, Greengold NL, Ellrodt AG, et al. The relation between systematic reviews in practice guidelines. Ann Intern Med, 1997, 127: 210-216. |
68. | Counsell C. Formulating questions and locating primary studies for inclusion in systematic reviews. Ann Intern Med, 1997, 127: 380-387. |
69. | Meade MO, Richardson WS. Selecting and appraising studies for a systematic review. Ann Intern Med, 1997, 127: 531-537. |
70. | Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med, 1997, 127: 820-826. |
71. | Cooper HM. Chief editor.The analysis and interpretation stage. In: The Integrative Research Review: A Systematic Approach. Beverly Hills, CA: Sage. 1984: 79-113. |
72. | Bero LA, Jadad AR. How consumers and policymakers can use systematic reviews for decision making. Ann Intern Med, 1997, 127(1):37-42. |
73. | Mulrow C, Langhorne P, Grimshaw J. Integrating Heterogeneous Pieces of Evidence in Systematic Reviews. Ann Intern Med, 127(11): 989-995. |
74. | Leeflang MM, Deeks JJ, Gatsonis C, et al. Systematic reviews of diagnostic test accuracy. Ann Intern Med, 2008, 149(12): 889-897. |
75. | Hayden JA, C?té P, Bombardier C. Evaluation of the Quality of Prognosis Studies in Systematic Reviews. Ann Intern Med, 2006, 144(6): 427-437. |
- 1. Unknown. Available from: http://www.ulrichsweb.com/ulrichsweb, accessed on 2009-03-15.
- 2. How to read clinical journals: I. why to read them and how to start reading them critically. Can Med Assoc J, 1981, 124(5): 555-558.
- 3. Sackett DL, Richardson WS, Rosenberg W, et al. Evidence-based medicine. How to practice and teach EBM. Edinburgh: Chrurchill Livingston, 1997, 1-60.
- 4. 陳耀龍, 杜亮, 何丹端,等. 《中國循證醫學雜志》作者閱讀習慣調查. 中國循證醫學雜, 2008, 5(5): 312-314.
- 5. Boseley S. News report. The Guardian, June 24, 1998.
- 6. 0000 articles or 120? Evid. Based Med, 2006, 11: 40.
- 7. Mike Wilson. Evidence-Based Medicine: would you rather read.
- 8. McKibbon KA, Wilczynski NL, Haynes RB. What do evidence-based secondary journals tell us about the publication of clinically important articles in primary healthcare journals? BMC Med, 2004, 2: 33.
- 9. 陳耀龍, 艾昌林, 李幼平. “循證”冠名的醫學期刊比較研究. 中國循證醫學雜志, 2007, 7(4): 289-295.
- 10. Sackett DL, Haynes RB. 13 steps, 100 people, and 1 000 000 thanks [Editorial]. ACP J Club, 1997, 127: A14.
- 11. Trisha Greenhalgh. How to Read a Paper: The Basics of Evidence- Based Medicine. 3 edition. 2006. 114-134.
- 12. Unknown. Available from http://www.systematic-reviews.com. Available .Accessed on 2009-3-15.
- 13. Unknown. Available from http://www.unitedbiosource.comhttp:// www.systematic-reviews.com.Accessed on 2009-3-15.
- 14. Becker LA, Oxman AD. Chapter 22: Overviews of reviews. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www. cochranehandbook.org.
- 15. Russell K, Kiddoo D. The Cochrane Library and nocturnal enuresis: an umbrella review. Evid-Based Child Health, 2006, 1: 5-8.
- 16. Unknown. Available from http://clinicalevidence.bmj.com/ceweb/ conditions/chd/0305/0305.jsp.Accessed on 2009-3-15.
- 17. Unknown. Available from http://www3.interscience.wiley.com/ journal/112100413/home,Accessed on 2009-3-15.
- 18. Moher D, Tetzlaff J, Tricco AC, et al. Epidemiology and reporting characteristics of systematic reviews. PLoS Med, 2007, 4(3): e78.
- 19. Shojania KG, Sampson M, Ansari MT, et al. How quickly do systematic reviews go out of date? A survival analysis. Ann Intern Med, 2007,147:224-233.
- 20. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Washington, DC: U.S. Department of Health and Human Services; 2008. http://aidsinfo.nih.gov/contentfiles/ adultandadolescentgl.pdf on 1 December 2008.
- 21. LeLorier J, Grégoire G, Benhaddad A, et al. Discrepancies between meta-analyses and subsequent large randomized, controlled trials. N Engl J Med, 1997, 337(8): 536-542.
- 22. Yusuf S, Teo K, Woods K. Intravenous magnesium in acute myocardial infarction. An effective, safe, simple, and inexpensive intervention. Circulation, 1993, 87(6): 2043-2046.
- 23. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. Lancet, 1995, 345(8951): 669-685.
- 24. Moher D, Tsertsvadze A. Systematic reviews: when is an update an update? Lancet, 2006, 367: 881-883.
- 25. Moher D, Tsertsvadze A, Tricco A, et al. When and how to update systematic reviews. Cochrane Database of Systematic Reviews. 2008, Issue 1. Art. No.: MR000023. DOI: 10.1002/14651858.MR000023. pub3.
- 26. Whitlock EP, Lin JS, Chou R, et al. Using existing systematic reviews in complex systematic reviews. Ann Intern Med, 2008, 148: 776-782.
- 27. Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. BMJ, 1994, 309: 1286-1291.
- 28. Mallett S, Hopewell S, Clarke M. Grey literature in systematic reviews: The first 1000 Cochrane systematic reviews. Fourth Symposium on Systematic Reviews: Pushing the Boundaries, Oxford (UK), 2002.
- 29. Moher D, Cook DJ, Eastwood S, et al. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. quality of reporting of meta-analyses. Lancet, 1999, 354(9193): 1896-1900.
- 30. Smith ML. Publication bias and meta-analysis. Eval Educ,1980, 4: 22-24.
- 31. McAuley L, Moher D, Tugwell P. The influence of grey literature on meta-analysis. MSc Thesis: University of Ottawa, 1999.
- 32. Moher D, Pham B, Klassen TP, et al. Does the language of publication of reports of randomized trials influence the estimates of intervention effectiveness reported in meta-analyses? 6th Cochrane Colloquium; 1998.
- 33. Grégoire G, Derderian F, Le Lorier J. Selecting the language of the publications included in a meta-analysis: is there a Tower of Babel bias? J Clin Epidemiol, 1995, 48(1): 159-163.
- 34. Moher D, Fortin P, Jadad AR, et al. Completeness of reporting of trials published in languages other than English: implications for conduct and reporting of systematic reviews. Lancet, 1996, 347: 363-366.
- 35. Egger M, Zellweger-Z?hner T, Schneider M, et al. Language bias in randomised controlled trials published in English and German. Lancet, 1997, 350: 326-359.
- 36. Moher D, Jadad AR, Nichol G, et al. Assessing the quality of randomized controlled trials: an annotated bibliography of scales and checklists. Control Clin Trials, 1995, 16(1): 62-73.
- 37. 李靜, 李幼平. 不斷完善與發展的Cochrane系統評價. 中國循證醫學雜志, 2008, 8(9): 742-743.
- 38. 孫玉亮, 趙今, 吳泰相等. 口腔扁平苔蘚治療的系統評價. 中國循證醫學雜志, 2009, 9(3): 323-330.
- 39. Bero L, Rennie D. The Cochrane Collaboration: preparing, maintaining, and disseminating systematic reviews of the effects of health care. J Am Med Ass, 1995, 274(24): 1935-1938.
- 40. Sacks HS, Berrier J, Reitman D, et al. Meta-analyses of randomized controlled trials. N Engl J Med, 1987, 316: 450-455.
- 41. Sacks HS, Reitman D, Pagano D, et al. Meta-analysis: an update. Mt Sinai J Med, 1996; 63: 216-224.
- 42. Unknown. Available from: http://group.bmj.com/products/evidencecentre/ evidence-based-medicine-resources/20-10-08.pdf/view. Accessed on 2009-4-5.
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- 45. Swingler GH, Volmink J, Ioannidis JP. Number of published systematic reviews and global burden of disease: database analysis. BMJ, 2003, 327(7423): 1083-1084.
- 46. Waters E, Doyle J. Systematic reviews of public health in developing countries are in train. BMJ, 2004, 328(7439): 585.
- 47. Chinnock P, Siegfried N, Clarke M. Is evidence-based medicine relevant to the developing world? PLoS Med, 2005, 2(5): e107.
- 48. West S, King V, Carey TS, et al. Systems to Rate the Strength of Scientific Evidence. Evidence Report/Technology Assessment No.
- 49. (Prepared by the Research Triangle Institute–University of North Carolina Evidence-based Practice Center under Contract No. 290-97-0011). AHRQ Publication No. 02-E016. Rockville, MD: Agency for Healthcare Research and Quality. April 2002.
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- 51. Oxman AD, Guyatt GH, Singer J, et al. Agreement among reviewers of review articles. J Clin Epidemiol, 1991, 44: 91-98.
- 52. Irwig L, Tosteson AN, Gatsonis C, et al. Guidelines for meta-analyses evaluating diagnostic tests. Ann Intern Med, 1994, 120: 667-676.
- 53. Sacks HS, Reitman D, Pagano D, et al. Meta-analysis: an update. Mt Sinai J Med, 1996, 63: 216-224.
- 54. Auperin A, Pignon JP, Poynard T. Review article: critical review of meta-analyses of randomized clinical trials in hepatogastroenterology. Alimentary Pharmacol Ther, 1997, 11: 215-225.
- 55. Beck CT. Use of meta-analysis as a teaching strategy in nursing research courses. J Nurs Educ, 1997, 36: 87-90.
- 56. Smith AF. An analysis of review articles published in four anaesthesia journals. Can J Anaesth, 1997, 44: 405-409.
- 57. Barnes DE, Bero LA. Why review articles on the health effects of passive smoking reach different conclusions. JAMA, 1998, 279: 1566-1570.
- 58. Clarke M, Oxman AD. Cochrane Reviewer’s Handbook 4.0. The Cochrane Collaboration; 1999.
- 59. Khan KS, Ter Riet G, Glanville J, et al. Undertaking Systematic Reviews of Research on Effectiveness. CRD’s Guidance for Carrying Out or Commissioning Reviews: York, England: University of York, NHS Centre for Reviews and Dissemination; 2000.
- 60. New Zealand Guidelines Group. Tools for Guideline Development & Evaluation. http://www.nzgg.org.nz/.
- 61. Harbour R, Miller J. A new system [Scottish Intercollegiate Guidelines Network (SIGN)] for grading recommendations in evidence based guidelines. BMJ, 2001, 323: 334-336.
- 62. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med, 1997, 126: 376-380.
- 63. Hunt DL, McKibbon KA. Locating and appraising systematic reviews. Ann Intern Med, 1997, 126: 532-538.
- 64. McQuay HJ, Moore A. Using numerical results from systematic reviews in clinical practice. Ann Intern Med, 1997, 126: 712-720.
- 65. Badgett RG, O’Keefe M, Henderson MC. Using systematic reviews in clinical education. Ann Intern Med, 1997, 126: 886-891.
- 66. Bero LA, Jadad AR. How consumers and policymakers can use systematic reviews for decision making. Ann Intern Med, 1997, 127: 37-42.
- 67. Cook DJ, Greengold NL, Ellrodt AG, et al. The relation between systematic reviews in practice guidelines. Ann Intern Med, 1997, 127: 210-216.
- 68. Counsell C. Formulating questions and locating primary studies for inclusion in systematic reviews. Ann Intern Med, 1997, 127: 380-387.
- 69. Meade MO, Richardson WS. Selecting and appraising studies for a systematic review. Ann Intern Med, 1997, 127: 531-537.
- 70. Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med, 1997, 127: 820-826.
- 71. Cooper HM. Chief editor.The analysis and interpretation stage. In: The Integrative Research Review: A Systematic Approach. Beverly Hills, CA: Sage. 1984: 79-113.
- 72. Bero LA, Jadad AR. How consumers and policymakers can use systematic reviews for decision making. Ann Intern Med, 1997, 127(1):37-42.
- 73. Mulrow C, Langhorne P, Grimshaw J. Integrating Heterogeneous Pieces of Evidence in Systematic Reviews. Ann Intern Med, 127(11): 989-995.
- 74. Leeflang MM, Deeks JJ, Gatsonis C, et al. Systematic reviews of diagnostic test accuracy. Ann Intern Med, 2008, 149(12): 889-897.
- 75. Hayden JA, C?té P, Bombardier C. Evaluation of the Quality of Prognosis Studies in Systematic Reviews. Ann Intern Med, 2006, 144(6): 427-437.