Research synthesis

研究综合
  • 文章类型: Journal Article
    单病例设计(SCD)用于评估干预措施对个体参与者的影响。通过在不同条件下重复测量参与者,SCD研究侧重于个体影响,而不是群体总结。SCD的主要局限性仍然是其对更广泛人群的普遍性,降低他们的发现与实践和政策制定的相关性。考虑到这个限制,在过去的几十年中,从调查同一研究问题的不同研究中合成SCD数据的方法学发展(例如,多层次建模)得到了加强。然而,这些技术仅限于一次比较两种干预措施,并且只能纳入直接比较两种感兴趣治疗方法的研究证据。这些限制可以通过使用结合直接和间接证据的网络荟萃分析来解决,以同时比较多种干预措施。尽管有潜力,网络元分析技术尚未应用于SCD数据。因此,在本文中,我们认为,网络荟萃分析可能是一个有价值的工具,以综合SCD数据。我们使用真实的数据集演示了网络荟萃分析在SCD数据中的使用,我们通过反思SCD研究人员在将网络荟萃分析方法应用于其数据时可能面临的挑战来得出结论。
    Single-case designs (SCDs) are used to evaluate the effects of interventions on individual participants. By repeatedly measuring participants under different conditions, SCD studies focus on individual effects rather than on group summaries. The main limitation of SCDs remains its generalisability to wider populations, reducing the relevance of their findings for practice and policy making. With this limitation in mind, methodological developments for synthesising SCD data from different studies that investigate the same research question have intensified in the past decades (e.g. multilevel modelling). However, these techniques are restricted to comparing two interventions at a time and can only incorporate evidence from studies that directly compare the two treatments of interest. These limitations could be addressed by using network meta-analysis that incorporates both direct and indirect evidence to simultaneously compare multiple interventions. Despite its potential, network meta-analytical techniques have yet to be applied to SCD data. Thus, in this paper, we argue that network meta-analysis can be a valuable tool to synthesise SCD data. We demonstrate the use of network meta-analysis in SCD data using a real dataset, and we conclude by reflecting on the challenges that SCD researchers might face when applying network meta-analysis methods to their data.
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  • 文章类型: Journal Article
    随机对照试验(RCT)是评估治疗在医疗保健中是否有效的金标准方法,但可能很难找到和使用。我们描述了系统的开发和评估,以自动查找和分类所有新的RCT报告。
    Trialstreamer持续监测PubMed和世界卫生组织国际临床试验注册平台,使用经过验证的分类器在人类中寻找新的RCT。我们结合机器学习和基于规则的方法从RCT摘要中提取信息,包括试验PICO的自由文本描述(人群,干预措施/比较器,和结果)元素并将这些片段映射到规范化的MeSH(医学主题词)词汇术语。我们还确定了样本量,预测偏差的风险,并提取传达关键发现的文本。我们将所有提取的数据存储在数据库中,我们可以免费下载,通过搜索门户,允许用户输入结构化临床查询。结果自动排名,以优先考虑更大和更高质量的研究。
    截至2020年6月初,我们已经索引了673.191种RCT出版物,其中22.363在2020年前5个月发布(每天142个)。我们还包括来自国际临床试验注册平台的304.111个试验注册。试验样本量中位数为66。
    我们提出了一种用于查找和分类RCT的自动化系统。这产生了一种新的资源:为人类所有已发布的RCT自动提取的结构化信息数据库。我们在我们的网站(https://trialstreamer)上提供此数据库的每日更新。robotreviewer.net)。
    Randomized controlled trials (RCTs) are the gold standard method for evaluating whether a treatment works in health care but can be difficult to find and make use of. We describe the development and evaluation of a system to automatically find and categorize all new RCT reports.
    Trialstreamer continuously monitors PubMed and the World Health Organization International Clinical Trials Registry Platform, looking for new RCTs in humans using a validated classifier. We combine machine learning and rule-based methods to extract information from the RCT abstracts, including free-text descriptions of trial PICO (populations, interventions/comparators, and outcomes) elements and map these snippets to normalized MeSH (Medical Subject Headings) vocabulary terms. We additionally identify sample sizes, predict the risk of bias, and extract text conveying key findings. We store all extracted data in a database, which we make freely available for download, and via a search portal, which allows users to enter structured clinical queries. Results are ranked automatically to prioritize larger and higher-quality studies.
    As of early June 2020, we have indexed 673 191 publications of RCTs, of which 22 363 were published in the first 5 months of 2020 (142 per day). We additionally include 304 111 trial registrations from the International Clinical Trials Registry Platform. The median trial sample size was 66.
    We present an automated system for finding and categorizing RCTs. This yields a novel resource: a database of structured information automatically extracted for all published RCTs in humans. We make daily updates of this database available on our website (https://trialstreamer.robotreviewer.net).
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  • 文章类型: Letter
    Research synthesis is an important approach to summarizing a body of literature. Usually, the goal is to determine the effectiveness of an intervention, to determine the strength of association between two factors, to determine the prevalence of a condition, or to scope the literature. Research synthesis methods can also be used to appraise the quantity and quality of research output from institutions or countries. In the latter case, standard quantitative systematic review methodologies would not apply and investigators must borrow strategies from qualitative syntheses and bibliometric analyses to develop a complete and meaningful appraisal of the literature from a given country.
    In this paper, we use the example of Cameroon to highlight some of the challenges and opportunities of appraising a body of country-specific literature. A comprehensive and exhaustive search of the literature was conducted to identify health-related literature from Cameroon published from 2005 to 2014. Titles were screened in duplicate.
    A total of 8624 studies were retrieved of which 721 were retained. The main challenges were making a choice of synthesis approach; selecting the right databases, data storage and management; and sustaining the team. Key opportunities include enhanced networking, a detailed appraisal of funding sources, international collaborations, language of publication, and issues with study design. The product is a comprehensive and informative body of evidence that can be used to inform policy with regards to international collaboration, location of research studies, language of publication, knowledge areas of focus, and gaps.
    Knowledge synthesis approaches can be adapted for appraisal of country-specific research and offer opportunities for in-depth appraisal of research output.
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  • 文章类型: Journal Article
    Systematic reviews of qualitative evidence have been widely used to provide information on the context and implementation of interventions, and their potential barriers and facilitators. However, such reviews face a number of methodological challenges, and there are ongoing debates as to how qualitative evidence can best be used to inform our understanding of interventions. In this paper, we use a case study of two systematic reviews of qualitative evidence on the prevention of skin cancer to explore these issues. We find that qualitative evidence not directly related to interventions is likely to be of value for such reviews, that it is often not possible to construct fully comprehensive search strategies, and that there are diminishing returns to the synthesis, in terms of added value or insight, from the inclusion of large numbers of primary studies. We conclude that there are a number of ways in which systematic reviews of qualitative evidence can be utilised in conjunction with evidence on intervention effectiveness, without compromising the rigour of the review process. In particular, the use of theory to inform frameworks for synthesis is a promising way to integrate a broader range of qualitative evidence. Copyright © 2012 John Wiley & Sons, Ltd.
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