P. Lina Santaguida, PhD; Mark Helfand, MD, MPH; Parminder Raina, PhD
Increasingly, consumers, clinicians, regulatory bodies, and insurers are using systematic reviews of drug interventions to select treatments and set policies. Although a systematic review cannot provide all the information a clinician needs to make an informed choice for therapy, it can help decision makers distinguish what claims about effectiveness are based on evidence, identify critical information gaps, desc ribe features of the evidence that limit applicability in practice, and address whether drug effectiveness differs for particular subgroups of patients. To improve the relevance and validity of reviews of drug therapies, reviewers need to delineate clinically important subgroups, specific aims of therapy, and most important outcomes. They may need to find unpublished trials, studies other than direct comparator (head-to-head) trials, and additional details of published trials from pharmaceutical manufacturers and regulatory agencies. In this paper, we address ways to formulate questions relevant to specific clinical therapeutic aims; discuss types of studies to include in drug efficacy and effectiveness reviews and how to find them; and describe ways to assess applicability of studies to actual practice.
Whichever triptan I get, I'm only going to get 4 of them a month. I have more migraines than that. What I want to know is, which triptan is the most reliable if you only take a half a pill, or even less, without having to take the rest of it a couple hours later? I'd rather get pretty good relief for 8 headaches than complete relief for a short time for 3 or 4 (4).
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Santaguida PL, Helfand M, Raina P. Challenges in Systematic Reviews That Evaluate Drug Efficacy or Effectiveness. Ann Intern Med. 2005;142:1066–1072. doi: 10.7326/0003-4819-142-12_Part_2-200506211-00006
Download citation file:
Published: Ann Intern Med. 2005;142(12_Part_2):1066-1072.
Cardiology, Coronary Risk Factors, Headache, Hypertension, Infectious Disease.
Copyright © 2018 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use