Principles in Developing and Applying Guidance. Methods Guide for Comparative Effectiveness Reviews

摘要

Comparative Effectiveness Reviews (CERs) are summaries of available scientific evidence in which investigators collect, evaluate, and synthesize studies in accordance with an organized, structured, explicit, and transparent methodology. They seek to provide decision makers with accurate, independent, scientifically rigorous information for comparing the effectiveness and safety of alternative clinical options. CERs have become a foundation for decision making in clinical practice and health policy. To play this important role in decision making, CERs must address significant questions that are relevant to patients and clinicians, and they must use valid, objective, and scientifically rigorous methods to identify and synthesize evidence, applying these methods consistently and in an unbiased and transparent manner. In this chapter, we describe the preliminary work and key principles that underlie the development of the Methods Guide for Comparative Effectiveness Reviews. The chapters in this guide describe recommended approaches for addressing difficult, frequently encountered methodological issues. The science of systematic reviews is evolving and dynamic. However, excessive variation in methods among systematic reviews gives the appearance of arbitrariness and idiosyncrasy, which undercuts the goals of transparency and scientific impartiality.