Designing Efficient Systematic Reviews Using Economical Allocation, Creation and Synthesis of Medical Evidence

Designing Efficient Systematic Reviews Using Economical Allocation, Creation and Synthesis of Medical Evidence | RAND

Medical literature and the actions of policymakers have emphasized the importance of evidence-based medicine in recent years, but basing clinical practice on an exploding base of evidence is challenging. Systematic reviews, which are very resource-intensive, are a crucial channel in the pathway from medical literature to clinical practice.

This thesis begins by estimating the value of one systematic review, finding that synthesized evidence regarding treatments to prevent osteoporotic fractures generated a net benefit of approximately $450M. Next, the time taken to screen articles in systematic reviews is analyzed, showing that user interface changes can result in significant reductions in resource requirements. Presenting multiple articles on one screen while reviewing titles leads to a seven-fold reduction in time taken per article. Experience and mental state are also related to screening times, with abstracts reviewed at ideal session lengths requiring 33% less time than those at the beginning of a session.

To further increase the speed at which articles can be screened and decrease the cost of preparing systematic reviews, machine learning techniques allow avoidance of up to 80% of articles. When updating an existing review, savings are increased by utilizing the information present in original screening decisions to train the machine learning model. Finally, implementation issues are addressed, paying attention to technical, organizational, and institutional challenges and opportunities.

Evidence-based medicine - Wikipedia, the free encyclopedia

Evidence-based medicine (EBM) emphasizes the use of evidence from well designed and conducted research in healthcare decision-making. The term was originally used to describe an approach to teaching the practice of medicine and improving decisions by individual physicians.^[1] Use of the term rapidly expanded to include a previously described approach that emphasized the use of evidence in the design of guidelines and policies that apply to populations ("evidence-based practice policies").^[2] It has subsequently spread to describe an approach to decision making that is used at virtually every level of the healthcare system.^[3]

Whether applied to medical education, decisions about individuals, guidelines and policies applied to populations, or administration of health services in general, evidence-based medicine advocates that to the greatest extent possible, decisions and policies should be based on evidence, not just the beliefs of practitioners, experts, or administrators. It promotes the use of formal, explicit methods to analyze evidence and make it available to decision makers. It promotes programs to teach the methods to medical students, practitioners, and policy makers.

Home Center for Evidence Based Medicine - CEBM

The Centre for Evidence Based Medicine is a not-for-profit organisation dedicated to the practice, teaching and dissemination of high quality evidence based medicine to improve healthcare in everyday clinical practice.

 Evidence-based health care and systematic reviews | The Cochrane Collaboration
Evidence-based health care

• Evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors [1].
• Evidence-based clinical practice is an approach to decision-making in which the clinician uses the best evidence available, in consultation with the patient, to decide upon the option which suits that patient best [2].
• Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research [3].