Research critique of benefits of systematic

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Open Peer Review reports Background Our research team read with interest the article by Perman et al. This step is most important since the remaining steps will be based on this. Given the explosion of medical literature, and the fact that time is always scarce, review articles play a vital role in decision making in evidence-based medical practice. Because of this, when carried out well, they provide reliable estimates about the effects of interventions so that conclusions are defensible. It is the statistical analysis of a large collection of analysis and results from individual studies for the purpose of integrating the findings. Systematic reviews aim to inform and facilitate this process through research synthesis of multiple studies, enabling increased and efficient access to evidence. Combining studies Homogeneity of different studies can be estimated at a glance from a forest plot explained below. The practice of evidence-based medicine is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient's values and expectations. However, to keep abreast with the continuously increasing number of publications in health research, a primary healthcare professional would need to read an insurmountable number of articles every day, covered in more than 13 million references and over biomedical and health journals in Medline alone. For example, the quality of a randomized controlled trial can be assessed by finding out the answers to the following questions: Was the assignment to the treatment groups really random?

We believe the lack of a comprehensive and systematic search and screening process has omitted relevant articles, and therefore led to potentially incorrect conclusions being drawn based on incomplete data. Interpret results: Graph The results of a meta-analysis are usually presented as a graph called forest plot because the typical forest plots appear as forest of lines.

Individual study results are displayed in rows.

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Another potentially-useful addition to this particular review, given the topic, would have been a grey literature search, in order to capture program evaluation documents reported by health departments and school boards. Other studies looked at the effectiveness of particular school-based organizational factors, such as the impact of immunization recalls on uptake [ 19 ]. We hope that by noting some of the characteristics and limitations of this systematic review and the review process, we will draw attention to the need for rigour and demonstrate some of the pitfalls in not complying with best practice guidelines when conducting and publishing systematic reviews. In addition, the search keywords appeared potentially overly simplistic for a sophisticated data collection effort. Given the explosion of medical literature, and the fact that time is always scarce, review articles play a vital role in decision making in evidence-based medical practice. For example, the quality of a randomized controlled trial can be assessed by finding out the answers to the following questions: Was the assignment to the treatment groups really random? Sift the studies to select relevant ones To select the relevant studies from the searches, we need to sift through the studies thus identified. The diamond in the last row of the graph illustrates the overall result of the meta-analysis. Upon reviewing the Perman et al. Terminologies Systematic review A systematic review is a summary of the medical literature that uses explicit and reproducible methods to systematically search, critically appraise, and synthesize on a specific issue.

The final step is calculating the common estimate and its confidence interval with the original data or with the summary statistics from all the studies. To find out the solutions or answers to a clinical question like this, one has to refer textbooks, ask a colleague, or search electronic database for reports of clinical trials.

Research critique of benefits of systematic

Assess the quality of studies The steps undertaken in evaluating the study quality are early definition of study quality and criteria, setting up a good scoring system, developing a standard form for assessment, calculating quality for each study, and finally using this for sensitivity analysis. School-based vaccination programmes: a systematic review of the evidence on organization and delivery in high income countries. That said, it is broadly accepted that systematic reviews can rarely be or be proved to be exhaustive, and so assessments of comprehensiveness come down to the added value of expanded searches. Limitations of our critique It is important to note some of the limitations in our critique of the Perman et al. These included Lind et al. Did the analyses include intention-to-treat analysis? These include articles by Gottvall et al. The stated aim of the study was to identify and synthesize contextual and organisational factors that act as barriers or enablers to effective vaccine delivery in school-based settings.

Identified gaps in the literature may be addressed through an alternate search and screening strategy Perman et al. Systematic reviews adhere to a strict scientific design based on explicit, pre-specified, and reproducible methods.

Were the assessors, the care provider, and the patient blinded? These include articles by Gottvall et al.

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Ramsay3 angus. For example, if the lower confidence interval of every trial is below the upper of all the others, i. The evidence comes from good reviews which is a state-of-the-art synthesis of current evidence on a given research question.

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E-mail: moc. Conclusions While Perman et al. The best estimate of treatment effect can be derived from the weighted summary statistics of all studies which will be based on weighting to sample size, standard errors, and other summary statistics.

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Systematic Reviews and Meta