Systematiske oversikter og epidemiologisk forskning
DOI:
https://doi.org/10.5324/nje.v23i2.1633Sammendrag
En god helsetjeneste forutsetter god kunnskap som grunnlag for de valg som gjøres. Systematiske oversikter som sammenfatter tilgjengelig forskningsbasert kunnskap er en viktig del av beslutningsgrunnlaget, enten det er snakk om effektene av tiltak, hvorfor sykdom oppstår, diagnostikk, prognose, eller hvordan sykdom oppleves for dem som rammes.
Systematiske oversikter er blitt en vel anerkjent kilde for kunnskap om effekt av helsetiltak, med bred internasjonal enighet om metodene som bør benyttes ved utvikling av slike oversikter. Når det gjelder systematiske oversikter for å sammenfatte resultater fra epidemiologisk forskning på årsaksspørsmål er erfaringene langt mindre.
Samtidig som systematiske oversikter over epidemiologiske studier i større grad bør inngå i beslutningsprosesser, er det et betydelig behov for metodeutvikling. Dette gjelder særlig kriterier for vurdering av kvalitet på epidemiologiske studier, metoder for sammenfatning av resultater i metaanalyser og kriterier for å gradere tillit til de endelige estimatene. Publikasjonsskjevheter er en utfordring for all forskning, og det er behov for initiativ for å sikre bedre rapportering av funn fra epidemiologiske studier, blant annet publisering av studieprotokoller.
Norderhaug IN. Systematic reviews of epidemiological research. Nor J Epidemiol 2013; 23 (2): 125-130.
ENGLISH SUMMARY
In health care, good knowledge is key to sound decision making. Good management of knowledge can be achieved through systematic reviews for various questions including the effects of health care interventions, causes of disease, how to best diagnose diseases, prognosis, as well as people’s experiences from living with disease.
Systematic reviews are well recognized and valued resources to inform decisions regarding health care interventions. Furthermore there is broad international consensus on methods for conducting systematic reviews on the effects of health care interventions. Although the need for systematic reviews is recognized also for epidemiological questions, such as the causes of disease, the level of experience in this area is far less than for systematic reviews on the effects of interventions.
Thus, alongside the need for better integration of systematic reviews in epidemiology into health care decision making processes, methodological developments are needed, particularly on how to assess the quality of epidemiological studies, methods for combining the results in meta-analyses, and criteria for grading our confidence in the final estimates.
Publication bias is a problem in all research, and initiatives are needed to improve planning and reporting of epidemiological studies, such as publication of study protocols.
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