Document Detail

How to read a systematic review and meta-analysis and apply the results to patient care: users' guides to the medical literature.
MedLine Citation:
PMID:  25005654     Owner:  NLM     Status:  MEDLINE    
Clinical decisions should be based on the totality of the best evidence and not the results of individual studies. When clinicians apply the results of a systematic review or meta-analysis to patient care, they should start by evaluating the credibility of the methods of the systematic review, ie, the extent to which these methods have likely protected against misleading results. Credibility depends on whether the review addressed a sensible clinical question; included an exhaustive literature search; demonstrated reproducibility of the selection and assessment of studies; and presented results in a useful manner. For reviews that are sufficiently credible, clinicians must decide on the degree of confidence in the estimates that the evidence warrants (quality of evidence). Confidence depends on the risk of bias in the body of evidence; the precision and consistency of the results; whether the results directly apply to the patient of interest; and the likelihood of reporting bias. Shared decision making requires understanding of the estimates of magnitude of beneficial and harmful effects, and confidence in those estimates.
Mohammad Hassan Murad; Victor M Montori; John P A Ioannidis; Roman Jaeschke; P J Devereaux; Kameshwar Prasad; Ignacio Neumann; Alonso Carrasco-Labra; Thomas Agoritsas; Rose Hatala; Maureen O Meade; Peter Wyer; Deborah J Cook; Gordon Guyatt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA     Volume:  312     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-07-09     Completed Date:  2014-07-16     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  171-9     Citation Subset:  AIM; IM    
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MeSH Terms
Bias (Epidemiology)
Decision Making*
Evidence-Based Practice / methods*
Meta-Analysis as Topic*
Patient Care / standards
Reproducibility of Results
Review Literature as Topic*
Grant Support
//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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