Medicine: Mind the Gap - The opportunities and challenges of using systematic reviews to summarize knowledge about “what works” in disease prevention and health promotions

Medicine Mind the Gap Seminar Whether discussing priorities for comparative effectiveness research (CER) from a funder's or researcher’s perspective, understanding knowledge gaps, or setting guidelines for care, systematic reviews of existing research hold the promise of scientifically summarizing "what works" at any point in time. However, many of us are content to use nonsystematic methods to synthesize knowledge; non-systematic methods certainly use fewer resources, and in a given field experts believe they know the literature sufficiently to avoid the investment. Yet, by using a nonsystematic approach to summarizing what is known, we are effectively applying a double standard: although we demand that the primary research studies minimize the risk of bias in their design and implementation, we accept the possibility of bias in synthesizing the primary research ("meta-bias"). We will review models of how systematic reviews are being used globally to plan, implement, and derive recommendations from CER. We will then review some of the existing challenges to using systematic reviews and methods being used to address these challenges. Kay Dickersin, M.A., Ph.D., is Professor of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. At Johns Hopkins, she also serves as the Director for the Center for Clinical Trials and Evidence Synthesis External Website Policy, whose faculty, staff and students are involved in methodologic research related to clinical trials...
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