SUPPORT Tools for evidence-informed health Policymaking (STP) 9: Assessing the applicability of the findings of a systematic review
SUPPORT Tools for evidence-informed health Policymaking (STP) 9: Assessing the applicability of the findings of a systematic review
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DOI：
10.1186/1478-4505-7-s1-i1
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发表时间：
2009-12-16
影响因子：
4
通讯作者：
Fretheim, Atle
中科院分区：
文献类型：
--
作者：
Lavis, John N.;Oxman, Andrew D.;Fretheim, Atle
卫生系统之间的差异往往可能导致在一种环境中使用的政策或规划方案在另一种环境中不可行或可接受。或者这些差异可能会导致选项在另一种环境中无法以相同的方式工作，甚至在另一种环境中产生不同的影响。因此，决策者和支持他们的人必须面对的一个关键挑战是，需要了解关于一种选择的研究证据是否可以应用于他们的环境。系统评价通过总结在各种不同环境下进行的研究的证据，使这项任务更容易完成。然而，许多系统综述并没有对进行原始研究的实际环境的特征提供充分的描述。在这篇文章中，我们提出了一些问题来指导那些评估系统综述结果对特定环境的适用性的人。这些是：1 .这些研究是否包括在同一环境下进行的系统评价中，或者这些研究结果在不同环境或时间段内是否一致？2. 实际情况和限制因素之间是否存在重大差异，从而可能大大改变一项选择的可行性和可接受性？3. 卫生系统安排是否存在重大差异，可能意味着某一选择无法以同样的方式发挥作用？4. 即使相对有效性相同，基线条件是否存在可能产生不同绝对效果的重要差异？5. 在选项、实施、监测和评估方面可以得出什么见解？即使有合理的理由得出结论，认为一种选择的影响在特定情况下可能有所不同，但几乎总是可以从对可能的选择以及执行选择和监测与评价的方法的系统审查中得出见解。
Differences between health systems may often result in a policy or programme option that is used in one setting not being feasible or acceptable in another. Or these differences may result in an option not working in the same way in another setting, or even achieving different impacts in another setting. A key challenge that policymakers and those supporting them must face is therefore the need to understand whether research evidence about an option can be applied to their setting. Systematic reviews make this task easier by summarising the evidence from studies conducted in a variety of different settings. Many systematic reviews, however, do not provide adequate descriptions of the features of the actual settings in which the original studies were conducted. In this article, we suggest questions to guide those assessing the applicability of the findings of a systematic review to a specific setting. These are: I. Were the studies included in a systematic review conducted in the same setting or were the findings consistent across settings or time periods? 2. Are there important differences in on-the-ground realities and constraints that might substantially alter the feasibility and acceptability of an option? 3. Are there important differences in health system arrangements that may mean an option could not work in the same way? 4. Are there important differences in the baseline conditions that might yield different absolute effects even if the relative effectiveness was the same? 5. What insights can be drawn about options, implementation, and monitoring and evaluation? Even if there are reasonable grounds for concluding that the impacts of an option might differ in a specific setting, insights can almost always be drawn from a systematic review about possible options, as well as approaches to the implementation of options and to monitoring and evaluation.