Evaluating and optimising the retrieval of research evidence for systematic reviews of adverse effects
Lead Research Organisation:
University of York
Department Name: Centre for Reviews and Dissemination
Abstract
Well-conducted systematic reviews contain a comprehensive summary of the available evidence on a given topic, and are valuable sources of information for decision-makers. However, most systematic reviews focus on establishing the benefits rather than the side effects of treatments.
Whilst methods for identifying evidence relating to the benefits of treatments are well established, little is know about how best to find the evidence on the side effects of a treatment. By using a series of systematic reviews as case studies this research (by a health information scientist) will investigate:
1) Which types of research are most helpful for identifying information on side effects
2) Which are the best places to look for information on side effects (e.g. Internet, databases, etc.)
3) What are the best ways to search for side effects in the databases available
By providing guidance on what types of research to look for, where to look and how, this study will help researchers produce more balanced systematic reviews that look at both the benefits and harms of treatments. This should lead to better informed decisions by health care providers and patients, and could in turn lead to fewer patients being harmed by potentially avoidable side effects.
Whilst methods for identifying evidence relating to the benefits of treatments are well established, little is know about how best to find the evidence on the side effects of a treatment. By using a series of systematic reviews as case studies this research (by a health information scientist) will investigate:
1) Which types of research are most helpful for identifying information on side effects
2) Which are the best places to look for information on side effects (e.g. Internet, databases, etc.)
3) What are the best ways to search for side effects in the databases available
By providing guidance on what types of research to look for, where to look and how, this study will help researchers produce more balanced systematic reviews that look at both the benefits and harms of treatments. This should lead to better informed decisions by health care providers and patients, and could in turn lead to fewer patients being harmed by potentially avoidable side effects.
Technical Summary
Balanced decision making in health care requires that both the intended beneficial effects and the unwanted adverse effects of interventions are considered. However, the vast majority of systematic reviews focus on clinical effectiveness without addressing adverse effects. Although the methods used in systematic reviews of clinical effectiveness are well established these methods are not directly transferable to reviews of adverse effects. There is currently little guidance on the most effective methods to conduct systematic reviews of adverse effects, particularly in the areas of identifying appropriate study designs and the retrieval of research evidence.
This proposed research aims to identify the optimal methods of retrieval of research evidence on adverse effects for systematic reviews of health care. Three particular issues will be addressed;
1) The optimal selection of available study designs (for example, observational studies, case reports)
2) The optimal selection of sources of information (for example, databases, contacting manufacturers)
3) The most efficient search strategies for identifying research evidence on adverse effects
A sample of systematic reviews of adverse effects will be selected to explore the impact of using different methodologies on the results of each review. Techniques such as meta-meta-analysis, sensitivity analysis, and logistic regression will be used to assess the effects of; including or excluding particular study designs, using different sources of information and using different search methods to identify the research evidence.
The main outcome of this research will be guidance about the types of studies to search for, which sources to search and how to search them efficiently. This guidance will help reviewers identify research evidence on adverse effects more easily and encourage them to include information on adverse effects in systematic reviews. This will help to redress the current over-emphasis on efficacy in systematic reviews which in turn should lead to more balanced decision making. This could also lead to fewer interventions being prescribed inappropriately and fewer patients being harmed by potentially avoidable adverse effects.
This proposed research aims to identify the optimal methods of retrieval of research evidence on adverse effects for systematic reviews of health care. Three particular issues will be addressed;
1) The optimal selection of available study designs (for example, observational studies, case reports)
2) The optimal selection of sources of information (for example, databases, contacting manufacturers)
3) The most efficient search strategies for identifying research evidence on adverse effects
A sample of systematic reviews of adverse effects will be selected to explore the impact of using different methodologies on the results of each review. Techniques such as meta-meta-analysis, sensitivity analysis, and logistic regression will be used to assess the effects of; including or excluding particular study designs, using different sources of information and using different search methods to identify the research evidence.
The main outcome of this research will be guidance about the types of studies to search for, which sources to search and how to search them efficiently. This guidance will help reviewers identify research evidence on adverse effects more easily and encourage them to include information on adverse effects in systematic reviews. This will help to redress the current over-emphasis on efficacy in systematic reviews which in turn should lead to more balanced decision making. This could also lead to fewer interventions being prescribed inappropriately and fewer patients being harmed by potentially avoidable adverse effects.