Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines.

Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process.

In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain.

Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON STANDARDS FOR SYSTEMATIC REVIEWS OF COMPARATIVE EFFECTIVENESS RESEARCH
• Reviewers
• Foreword
• Preface
• Acknowledgments
• Summary
• 1. Introduction
  • COMMITTEE CHARGE
  • WHAT IS COMPARATIVE EFFECTIVENESS RESEARCH?
  • STUDY SCOPE
  • CONCEPTUAL FRAMEWORK
  • METHODS OF THE STUDY
  • CURRENT LANDSCAPE
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. Standards for Initiating a Systematic Review
  • ESTABLISHING THE REVIEW TEAM
  • RECOMMENDED STANDARDS FOR ORGANIZING THE REVIEW TEAM
  • ENSURING USER AND STAKEHOLDER INPUT
  • RECOMMENDED STANDARDS FOR ENSURING USER AND STAKEHOLDER INPUT
  • FORMULATING THE TOPIC
  • RECOMMENDED STANDARDS FOR FORMULATING THE TOPIC
  • DEVELOPING THE SYSTEMATIC REVIEW PROTOCOL
  • RECOMMENDED STANDARDS FOR DEVELOPING THE SYSTEMATIC REVIEW PROTOCOL
  • REFERENCES
• 3. Standards for Finding and Assessing Individual Studies
  • THE SEARCH PROCESS
  • RECOMMENDED STANDARDS FOR THE SEARCH PROCESS
  • SCREENING AND SELECTING STUDIES
  • RECOMMENDED STANDARDS FOR SCREENING AND SELECTING STUDIES
  • MANAGING DATA COLLECTION
  • RECOMMENDED STANDARD FOR EXTRACTING DATA
  • CRITICAL APPRAISAL OF INDIVIDUAL STUDIES
  • RECOMMENDED STANDARDS FOR ASSESSING THE QUALITY AND RELEVANCE OF INDIVIDUAL STUDIES
  • REFERENCES
• 4. Standards for Synthesizing the Body of Evidence
  • A NOTE ON TERMINOLOGY
  • RECOMMENDED STANDARD FOR ASSESSING AND DESCRIBING THE QUALITY OF A BODY OF EVIDENCE
  • QUALITATIVE SYNTHESIS OF THE BODY OF EVIDENCE
  • RECOMMENDED STANDARDS FOR QUALITATIVE SYNTHESIS
  • META-ANALYSIS
  • RECOMMENDED STANDARDS FOR META-ANALYSIS
  • REFERENCES
• 5. Standards for Reporting Systematic Reviews
  • REPORTING GUIDELINES
  • SYSTEMATIC REVIEWS PUBLISHED IN JOURNALS
  • RECOMMENDED STANDARD FOR PREPARING THE FINAL REPORT
  • RECOMMENDED STANDARD FOR REPORT REVIEW
  • RECOMMENDED STANDARD FOR PUBLISHING THE FINAL REPORT
  • REFERENCES
• 6. Improving the Quality of Systematic Reviews: Discussion, Conclusions, and Recommendations
  • IMPROVING THE SCIENCE OF SYSTEMATIC REVIEWS
  • IMPROVING THE ENVIRONMENT FOR SUPPORTING SYSTEMATIC REVIEWS
  • CONCLUSIONS AND RECOMMENDATIONS
• A Abbreviations and Acronyms
• B. Glossary
• C Workshop Agenda and Questions to Panelists
• D Expert Guidance for Chapter 2: Standards for Initiating a Systematic Review
• E Expert Guidance for Chapter 3: Standards for Finding and Assessing Individual Studies
• F Expert Guidance for Chapter 4: Standards for Synthesizing the Body of Evidence
• G Expert Guidance for Chapter 5: Standards for Reporting Systemic Reviews
• H Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist
• I Committee Biographies

This study was supported by Contract No. HHSP23320042509X1 between the National Academy of Sciences and the Department of Health and Human Services. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2011. Finding What Works in Health Care: Standards for Systematic Reviews. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.