Systematic reviews to support evidence‐based medicine: how to review and apply findings of healthcare research

Systematic reviews to support evidence-based medicine: how to review and apply findings of healthcare research Khalid S. Khan, Regina Kunz, Jos Kleijnen and Gerd Antes . London : The Royal Society of Medicine Press Limited , 2003 (reprinted 2004). ISBN 1-85315-525-X . 137 pp. £18.50 . As the authors state in the preface to this book ‘As our current healthcare practice and policy increasingly relies on clear and comprehensive summaries of information collated through systematic literature reviews, it is necessary for us to understand how reviews and practice guidelines are produced’ (p. iii). This is precisely what Khalid Khan and colleagues attempt to do in Systematic reviews to support evidence-based medicine: how to review and apply findings of healthcare research. The authors describe the main principles behind systematic reviews of healthcare research and provide guidance on how reviews can be appraised, conducted and applied in practice. The book is divided into three main sections: an introduction which introduces key concepts and outlines the purpose and structure of the book; this is followed by the five major steps of undertaking a systematic review (framing questions for a review, identifying relevant literature, assessing the quality of the literature, summarizing the evidence and interpreting the findings); and then the book concludes by examining four case studies (identifying and appraising systematic reviews, reviewing evidence on safety of a public health intervention, reviewing evidence on effectiveness of therapy, and reviewing evidence on test accuracy). The target audience is health professionals and researchers, particularly in public health, epidemiology and health technology assessment. The book is primarily aimed at new systematic reviewers and therefore much of the material is introductory in nature and draws heavily on the NHS Centre for Reviews and Dissemination Report1 No. 4, Undertaking systematic reviews of research on effectiveness. CRD's guidance for carrying out or commissioning reviews. Indeed, the lead author was involved in updating this report. Unlike the CRD report, Systematic reviews to support evidence-based medicine: how to review and apply findings of healthcare research is equally relevant to health professionals and researchers simply wanting to appraise review articles, as well as those actually conducting reviews. Considerable attention has been paid to the format and structure of the book. Key messages and definitions are clearly highlighted throughout and summaries are provided at the end of each chapter for both ‘users’ and ‘doers’ of reviews. Tables, graphs and diagrams are used to enhance points made in the text. A short reading list is provided at the end which highlights the core texts in the field, but without overwhelming the reader. An extremely useful glossary of terms is also included. Finally, the book is written in an engaging style, making it more user-friendly than other more substantial texts in the field, such as Systematic reviews in health care: meta-analysis in context (Egger et al. 2001).2 It must be pointed out that Systematic reviews to support evidence-based medicine: how to review and apply findings of healthcare research is really only an introduction to systematic review methodology and offers little new to experienced reviewers, with the possible exception of the four case studies. In common with other texts in this field, the emphasis of the book is on quantitative systematic reviews. The second case study, however, uses the scenario of the safety of public water fluoridation to illustrate how some reviews need to include evidence from studies with a range of designs, i.e. not just randomised controlled trials (RCTs). In conclusion, this book provides a step-by-step guide to undertaking a systematic review, using examples from published reviews to illustrate basic principles. The book is essential reading for all new systematic reviewers, including masters and PhD level students undertaking, for example, literature review and critical appraisal modules. Systematic reviews to support evidence-based medicine: how to review and apply findings of healthcare research would therefore be a valuable addition to any healthcare library or information service.