Such diverse thinkers as Lao-Tze, Confucius, and U.S. Defense Secretary Donald Rumsfeld have all pointed out that we need to be able to tell the difference between real and assumed knowledge. The systematic review is a scientific tool that can help with this difficult task. It can help, for example, with appraising, summarising, and communicating the results and implications of otherwise unmanageable quantities of data. This is important because quite often there are so many studies, and their results are often so conflicting, that no policymaker or practitioner could possibly carry out this task themselves.Systematic review methods have been widely used in health care, and are becoming increasingly common in the social sciences (fostered, for example, by the work of the Campbell Collaboration). 

This book outlines the rationale and methods of systematic reviews, giving worked examples from social science and other fields. It requires no previous knowledge, but takes the reader through the process stage by stage. It draws on examples from such diverse fields as psychology, criminology, education, transport, social welfare, public health, and housing and urban policy, among others.The book includes detailed sections on assessing the quality of both quantitative, and qualitative research; searching for evidence in the social sciences;meta-analytic and other methods of evidence synthesis; publication bias; heterogeneity; and approaches to dissemination.

Systematic Reviews in the Social Sciences: A Practical Guide

http://europharm.pbworks.com/f/Pound_2005%255B1%255D.pdf

Resisting medicines: a synthesis of qualitative studies of medicine taking

Evaluating meta ethnography: systematic analysis and synthesis of qualitative research (poster presentation)

Background: Methods for reviewing and synthesising findings from quantitative research studies in health care are well established. Although there is recognition of the need for qualitative research to be brought into the evidence base, there is no consensus about how this should be done and the methods for synthesising qualitative research are at a relatively early stage of development.Objective: To evaluate meta-ethnography as a method for synthesising qualitative research studies in health and health care.Methods: Two full syntheses of qualitative research studies were conducted between April 2002 and September 2004 using meta-ethnography: (1) studies of medicine-taking and (2) studies exploring patients? experiences of living with rheumatoid arthritis. Potentially relevant studies identified in multiple literature searches conducted in July and August 2002 (electronically and by hand) were appraised using a modified version of the Critical Appraisal Skills Programme questions for understanding qualitative research. Candidate papers were excluded on grounds of lack of relevance to the aims of the synthesis or because the work failed to employ qualitative methods of data collection and analysis.Results: Thirty-eight studies were entered into the medicine-taking synthesis, one of which did not contribute to the final synthesis. The synthesis revealed a general caution about taking medicine, and that the practice of lay testing of medicines was widespread. People were found to take their medicine passively or actively or to reject it outright. Some, in particular clinical areas, were coerced into taking it. Those who actively accepted their medicine often modified the regimen prescribed by a doctor, without the doctor?s knowledge. The synthesis concluded that people often do not take their medicines as prescribed because of concern about the medicines themselves. ?Resistance? emerged from the synthesis as a concept that best encapsulated the lay response to prescribed medicines. It was suggested that a policy focus should be on the problems associated with the medicines themselves and on evaluating the effectiveness of alternative treatments that some people use in preference to prescribed medicines. The synthesis of studies of lay experiences of living with rheumatoid arthritis began with 29 papers. Four could not be synthesised, leaving 25 papers (describing 22 studies) contributing to the final synthesis. Most of the papers were concerned with the everyday experience of living with rheumatoid arthritis. This synthesis did not produce significant new insights, probably because the early papers in the area were substantial and theoretically rich, and later papers were mostly confirmatory. In both topic areas, only a minority of the studies included in the syntheses were found to have referenced each other, suggesting that unnecessary replication had occurred.Limitations: We only evaluated meta-ethnography as a method for synthesising qualitative research, but there are other methods being employed. Further research is required to investigate how different methods of qualitative synthesis influence the outcome of the synthesis.Conclusions: Meta-ethnography is an effective method for synthesising qualitative research. The process of reciprocally translating the findings from each individual study into those from all the other studies in the synthesis, if applied rigorously, ensures that qualitative data can be combined. Following this essential process, the synthesis can then be expressed as a ?line of argument? that can be presented as text and in summary tables and diagrams or models. Meta-ethnography can produce significant new insights, but not all meta-ethnographic syntheses do so. Instead, some will identify fields in which saturation has been reached and in which no theoretical development has taken place for some time. Both outcomes are helpful in either moving research forward or avoiding wasted resources. Meta-ethnography is a highly interpretative method requiring considerable immersion in the individual studies to achieve a synthesis. It places substantial demands upon the synthesiser and requires a high degree of qualitative research skill. Meta-ethnography has great potential as a method of synthesis in qualitative health technology assessment but it is still evolving and cannot, at present, be regarded as a standardised approach capable of application in a routinised way.Funding: Funding for this study was provided by the Health Technology Assessment programme of the National Institute for Health Research.

/pdf/evaluating-meta-ethnography-systematic-analysis-and-3wwez9e6s4.pdf

Evaluating meta-ethnography: systematic analysis and synthesis of qualitative research.

Heads and seizures, knees and toes A competitor climbs the monkey bars in front of the Sydney Harbour Bridge during the 2012 Mens’ Health Urbanathlon last month. The 10.7 km race through the Sydney CBD includes challenges such as hoisting a 10 kg sandbag and clambering over barricades. It offers a chance for sedentary office workers to get up from their chairs, with recent research in the Archives of Internal Medicine showing that sitting is a risk factor for all-cause mortality.

The Cochrane library

A fundamental aim of any systematic review is that all relevant studies should be identified and considered for inclusion. Limitations with searching bibliographic databases led the Cochrane Collaboration to search journals by hand for reports of trials. This article presents the results of a 3-year project to identify and make accessible reports of randomized trials published in European general health care journals. Overall, 21,620 reports of controlled trials were identified from119 journals from16 countries. More than three quarters (76%) were published in U.K. or German journals. Only 3,640 (17%) reports were indexed in MEDLINE as controlled trials, and 6,554 (30%) were not indexed in MEDLINE at all. Bibliographic details for all reports are available by searching The Cochrane Controlled Trials Register in The Cochrane Library. This project has ensured that a large proportion of trial reports not previously identifiable has been made accessible to those preparing systematic reviews.

The Contribution of Handsearching European General Health Care Journals to the Cochrane Controlled Trials Register

Objective: To identify all reports of randomised clinical trials in the Journal and compare our findings with reports available in Medline. Methods: We handsearched the Scandinavian Journal of Rheumatology with supplements for the years 1955-1997 to identify reports of randomised clinical trials and controlled clinical trials. Results: We identified 445 trial reports. In Medline, 134 of these trials (30%) were indexed as randomised or controlled trials; an additional 50 trials (11%) were available in Medline but were indexed differently. Thus, 261 of the trials (59%) we identified were not indexed in Medline; most of these trials were published in supplements to the Journal. Conclusion: Handsearching of medical journals for randomised trials can be a worthwhile effort. Clinicians and patients will become better informed about the value of different treatment options and researchers will reduce their risk of performing trials that are unnecessary.

Kirsten Lone Jensen

Papers

The Contribution of Handsearching European General Health Care Journals to the Cochrane Controlled Trials Register

Randomised clinical trials in the Scandinavian Journal of Rheumatology.