医学研究生应如何解读和撰写系统评价

Expounding and writing a systematic review in the training of medical postgraduates

系统评价是循证医学的重要研究方法和最佳证据的重要来源。对医学研究生而言,正确掌握系统评价的基本方法,解决临床诊疗或医学研究中的具体问题是教学内容的重要实践过程。系统评价的质量不仅源于原始个体研究的质量,还取决于系统评价制作的严格程度。只有坚持使用严格的评价方法(包括全面的文献检索、个体研究的质量评价、恰当的统计分析方法和对估计值和偏倚风险的信度评估等),降低混杂和偏倚,才能得到准确的结果。因此,本文旨在总结医学领域全面严格的系统评价的重要特征及医学研究生论文中常见的概念性和方法性问题,使医学研究生能更加合理有效地从多项医学数据中汲取信息,并运用正确的统计方法得出可靠的结论。

Systematic review is the major methodology and the best information source for evidence- based medicine. For medical postgraduates, how to grasp the correct procedures of a systematic review and deal with specific questions stemming from clinical treatment or medical research is a challenging task. The quality of systematic review depends on the quality of individual studies and the strictness of practice. Only adopting the stringent appraisal methods including comprehensive literature search, quality assessment of individual studies, appropriate statistical analyses and creditability evaluation of effect-size estimates and biases, the confounding effects and possible biases can be maximally reduced, yielding a more accurate conclusion. Therefore, this review summarizes not only major features of systematic reviews and meta-analyses from medical fields, but also common conceptual and methodological issues encountered in the papers by medical postgrad derive a uate students, aiming to help them analyze data reasonably and select correct statistical methods to reliable conclusion.