如何写系统综述英文版Word文件下载.docx

如何写系统综述英文版Word文件下载.docx

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Traditionalclinicalreviewarticles,alsoknownasupdates,differfromsystematicreviewsandmeta-analyses.Updatesselectivelyreviewthemedicalliteraturewhilediscussingatopicbroadly.Nonquantitativesystematicreviewscomprehensivelyexaminethemedicalliterature,seekingtoidentifyandsynthesizeallrelevantinformationtoformulatethebestapproachtodiagnosisortreatment.Meta-analyses（quantitativesystematicreviews）seektoanswerafocusedclinicalquestion,usingrigorousstatisticalanalysisofpooledresearchstudies.Thisarticlepresentsguidelinesforwritinganevidence-basedclinicalreviewarticlefor 

AmericanFamilyPhysician.First,thetopicshouldbeofcommoninterestandrelevancetofamilypractice.Includeatableofthecontinuingmedicaleducationobjectivesofthereview.Statehowtheliteraturesearchwasdoneandincludeseveralsourcesofevidence-basedreviews,suchastheCochraneCollaboration,BMJ'

s 

ClinicalEvidence,ortheInfoRetrieverWebsite.Wherepossible,useevidencebasedonclinicaloutcomesrelatingtomorbidity,mortality,orqualityoflife,andstudiesofprimarycarepopulations.Inarticlessubmittedto 

AmericanFamilyPhysician,ratethelevelofevidenceforkeyrecommendationsaccordingtothefollowingscale:

levelA（randomizedcontrolledtrial[RCT],meta-analysis）;

levelB（otherevidence）;

levelC（consensus/expertopinion）.Finally,provideatableofkeysummarypoints.

AmericanFamilyPhysician 

isparticularlyinterestedinreceivingclinicalreviewarticlesthatfollowanevidence-basedformat.Clinicalreviewarticles,alsoknownasupdates,differfromsystematicreviewsandmeta-analysesinimportantways.1 

Updatesselectivelyreviewthemedicalliteraturewhilediscussingatopicbroadly.Anexampleofsuchatopicis,“Thediagnosisandtreatmentofmyocardialischemia.”Systematicreviewscomprehensivelyexaminethemedicalliterature,seekingtoidentifyandsynthesizeallrelevantinformationtoformulatethebestapproachtodiagnosisortreatment.ExamplesaremanyofthesystematicreviewsoftheCochraneCollaborationorBMJ'

ClinicalEvidence 

compendium.Meta-analysesareaspecialtypeofsystematicreview.Theyusequantitativemethodstoanalyzetheliteratureandseektoanswerafocusedclinicalquestion,usingrigorousstatisticalanalysisofpooledresearchstudies.Anexampleis,“Dobetablockersreducemortalityfollowingmyocardialinfarction?

”

Thebestclinicalreviewarticlesbasethediscussiononexistingsystematicreviewsandmeta-analyses,andincorporateallrelevantresearchfindingsaboutthemanagementofagivendisorder.Suchevidence-basedupdatesprovidereaderswithpowerfulsummariesandsoundclinicalguidance.

Inthisarticle,wepresentguidelinesforwritinganevidence-basedclinicalreviewarticle,especiallyonedesignedforcontinuingmedicaleducation（CME）andincorporatingCMEobjectivesintoitsformat.Thisarticlemaybereadasacompanionpiecetoapreviousarticleandaccompanyingeditorialaboutreadingandevaluatingclinicalreviewarticles.1,2 

Somearticlesmaynotbeappropriateforanevidence-basedformatbecauseofthenatureofthetopic,theslantofthearticle,alackofsufficientsupportingevidence,orotherfactors.Weencourageauthorstoreviewtheliteratureand,whereverpossible,ratekeypointsofevidence.Thisprocesswillhelpemphasizethesummarypointsofthearticleandstrengthenitsteachingvalue.

TopicSelection

Chooseacommonclinicalproblemandavoidtopicsthatareraritiesorunusualmanifestationsofdiseaseorthathavecuriosityvalueonly.Wheneverpossible,choosecommonproblemsforwhichthereisnewinformationaboutdiagnosisortreatment.Emphasizenewinformationthat,ifvalid,shouldpromptachangeinclinicalpractice,suchastherecentevidencethatspironolactonetherapyimprovessurvivalinpatientswhohaveseverecongestiveheartfailure.3 

Similarly,newevidenceshowingthatastandardtreatmentisnolongerhelpful,butmaybeharmful,wouldalsobeimportanttoreport.Forexample,patchingmosttraumaticcornealabrasionsmayactuallycausemoresymptomsanddelayhealingcomparedwithnopatching.4

SearchingtheLiterature

Whensearchingtheliteratureonyourtopic,pleaseconsultseveralsourcesofevidence-basedreviews（Table1）.Lookforpertinentguidelinesonthediagnosis,treatment,orpreventionofthedisorderbeingdiscussed.Incorporateallhigh-qualityrecommendationsthatarerelevanttothetopic.Whenreviewingthefirstdraft,lookforallkeyrecommendationsaboutdiagnosisand,especially,treatment.Trytoensurethatallrecommendationsarebasedonthehighestlevelofevidenceavailable.Ifyouarenotsureaboutthesourceorstrengthoftherecommendation,returntotheliterature,seekingoutthebasisfortherecommendation.

TABLE1

SomeSourcesofEvidence-BasedMedicine

AgencyforHealthcareResearchandQuality（AHRQ）,formerlyknownastheAgencyforHealthCarePolicyandResearch（AHCPR）:

ClinicalGuidelinesandEvidenceReports*

http:

//www.ahrq.gov/clinic

TheAHRQWebsiteincludeslinkstotheNationalGuidelineClearinghouse,EvidenceReportsfromtheAHRQ'

s12Evidence-basedPracticeCenters（EPC）,andPreventiveServices.TheAHCPRreleased19ClinicalPracticeGuidelinesbetween1992and1996thatwerenotsubsequentlyupdated.

AmericanCollegeofPhysiciansJournalClub（ACPJC）

//www.acponline.org/journals/acpjc/jcmenu.htm

ACPJournalClub 

evaluatesevidenceinindividualarticles.CommentarybyACPauthoroffersclinicalrecommendations.Accesstotheonlineversionof 

ACPJC 

isabenefitformembersoftheACP-ASIM,butwillbeopentoalluntilatleasttheendof2001.

Bandolier*

//www.jr2.ox.ac.uk/bandolier/

Featuresshortevaluations/discussionsofindividualarticlesdealingwithevidence-basedclinicalpractice.

CentreforEvidenceBasedMedicine（CEBM）

TheUniversityofOxford/OxfordRadcliffeHospitalClinicalSchoolWebsiteincludeslinkstoCEBMwithintheFacultyofMedicine,aCATbank（CriticallyAppraisedTopics）,linkstoevidence-basedjournals,andEBM-relatedteachingmaterials.

CenterforResearchSupport,TRIPDatabase

TheAHRQbegantheTranslatingResearchintoPractice（TRIP）initiativein1990toimplementevidence-basedtoolsandinformation.TheTRIPDatabasefeatureshyperlinkstothelargestcollectionofEBMmaterialsontheinternet,includingNGC,POEM,DARE,CochraneLibrary,CATbank,andindividualarticles.AgoodstartingplaceforanEBMliteraturesearch.

ClinicalEvidence,BMJPublishingGroup*

//www.clinicalevidence.org

SearchesBMJ'

compendiumforup-to-dateevidenceregardingeffectivehealthcare.Listsavailabletopicsanddescribesthesupportingbodyofevidencetodate（e.g.,numberofrelevantrandomizedcontrolledtrialspublishedtodate）.Concludeswithinterventions“likelytobebeneficial”versusthosewith“unknowneffectiveness.”IndividualswhohavereceivedafreecopyofClinicalEvidence 

Issue5fromtheUnitedHealthFoundationarealsoentitledtofreeaccesstothefullonlinecontent.

CochraneDatabaseofSystematicReviews*

//www.cochrane.org/

SystematicevidencereviewsthatareupdatedperiodicallybytheCochraneGroup.ReviewersdiscusswhetheradequatedataareavailableforthedevelopmentofEBMguidelinesfordiagnosisormanagement.

DatabaseofAbstractsofReviewsofEffectiveness（DARE）*

//www.crd.york.ac.uk/crdweb/

StructuredabstractswrittenbyUniversityofYorkCRDreviewers（seeNHSCRD）.Abstractsummariesreviewarticlesondiagnosticortreatmentinterventionsanddiscussclinicalimplications.

EffectiveHealthCare*

//www.york.ac.uk/inst/crd/ehcb.htm

Bi-monthly,peer-reviewedbulletinformedicaldecision-makers.Basedonsystematicreviewsandsynthesisofresearchontheclinicaleffectiveness,cost-effectivenessandacceptabilityofhealthserviceinterventions.

Evidence-BasedMedicine*

//www.evidence-

Bimonthlypublicationlaunchedin1995bytheBMJPublishingGroup.Articlesummariesincludecommentariesbyclinicalexperts.Subscriptionisrequired.

Evidence-BasedPractice 

Newsletter（including 

JFP 

Patient-OrientedEvidencethatMatters[POEM]）*

This 

newsletterfeaturesup-to-datePOEM,Disease-OrientedEvidence（DOE）,andtestsapprovedforCategory1CMEcredit.Subscriptionrequired.

InfoPOEMs

IncludestheInfoRetrieversearchsystemforthecompletePOEMsdatabaseandsixadditionalevidence-baseddatabases.Subscriptionisrequired.

InstituteforClinicalSystemsImprovement（ICSI）*

//www.ICSI.org

ICSIisanindependent,nonprofitcollaborationofhealthcareorganizations,includingtheMayoClinic,Rochester,Minn.WebsiteincludestheICSIguidelinesforpreventiveservicesanddiseasemanagement.

NationalGuidelineClearinghouse（NGC）

//www.guideline.gov/

Comprehensivedatabaseofevidence-basedclinicalpracticeguidelinesfromgovernmentagenciesandhealthcareorganizations.Describesandcomparesguidelinestatementswithrespecttoobjectives,methods,outcomes,evidenceratingscheme,andm