Report at a Glance
Improving the Quality of Systematic Reviews
The committee proposes a framework for improving the quality of the research that supports systematic reviews, including strategies for involving the right people, methods for conducting the systematic review, methods for synthesizing and evaluating evidence, and methods for communicating and using the results. Successful execution and effective use of a systematic review requires improving the science supporting the steps in the systematic review process.
In addition, the committee finds that the environment surrounding the development of systematic reviews lacks adequate funding and coordination—both of which are needed to conduct high-quality systematic reviews. Many organizations conduct systematic reviews, but typically they do not work together. The committee emphasizes the need for greater collaboration among stakeholder groups, including PCORI, government agencies, medical professional societies, researchers, and patient interest groups. Together, these groups have the potential to improve the rigor and transparency of systematic reviews, encourage standardization of methods and processes, set priorities for selection of clinical topics of interest to clinicians and patients, reduce unintentional duplication of efforts, and more effectively manage conflicts of interest.
The committee recommends that PCORI provide oversight and encourage coordination among Department of Health and Human Services (HHS) agencies to improve the research base and support the environment for systematic reviews. Improved coordination should include:
- Developing training programs for researchers, users, consumers, and other stakeholders to encourage more effective and inclusive contributions to systematic reviews of comparative effectiveness research;
- Systematically supporting research that advances the methods for designing and conducting systematic reviews of comparative effectiveness research;
- Supporting research to improve the communication and use of systematic reviews of comparative effectiveness research in clinical decision making;
- Developing effective coordination and collaboration between U.S. and international partners;
- Developing a process to ensure that standards for systematic reviews of comparative effectiveness research are regularly updated to reflect current best practice; and
- Using systematic reviews to inform priorities and methods for primary comparative effectiveness research.
Systematic reviews should be used to inform healthcare decision makers about what is known and not known about the effectiveness of health interventions. Patients expect that their doctors and other healthcare providers know what type of treatment to recommend. Yet the reality is that the evidence that informs current healthcare decisions often is incomplete and may be biased, and there are no standards in place to ensure that systematic reviews of the evidence are objective, transparent, and scientifically valid. Better-quality systematic reviews have the potential to improve the decisions made by clinicians, to better inform patient choice, and to provide a more trustworthy basis for decisions by payers and policy makers.