Blogger's Note/Opinion: gyn cancers - this topic of discussion should be of interest: Cochrane total gyn cancers reviews = #85; empty reviews = #7; because Cochrane synthesizes and analyses systematic reviews, often the results are inadequate (for patients/providers) in that studies included are: poor quality; lacking in data or are not randomized clinical trials; we often see this as 'further research is required'; many 'argue' that the value of systematic reviews in gyn cancers are dated (as discussed in this article) but part of this issue is the nature of, in particular, ovarian cancer research itself; the other 'issue' for this blogger is the number of systematic reviews which continually review reviews; (re: reviews that include Cochrane systematic reviews); there needs to be a streamlining of systematic reviews (randomized clinical trial reviews) nominating or permitting one entity/conglomerate - eg. the philosophy of meaningful use, however, therein lies system wide issues within cancer; observational studies are often not included in the reviews and Cochrane is attempting to address this issue within the parameters of the purpose and philosophy of Cochrane itself, still for quality evidence Cochrane remains the leader; note also that Cochrane has always been one of, if not the leader, in including patients/consumers - your thoughts?
PLoS ONE: Empty Reviews: A Description and Consideration of Cochrane Systematic Reviews with No Included Studies
Introduction
The
Cochrane Library is the largest and perhaps best recognized global
collection of health care evidence, currently hosting more than 4,500
systematic reviews in its Cochrane Database of Systematic Reviews (CDSR).
However, it has been reported that clinicians find Cochrane reviews of
limited relevance to practice decisions. For example, one study found
that while Cochrane reviews are highly regarded for their quality, they
are used less than other sources for clinical decision-making because of
their emphasis on methodology and rigor rather than on clinical
relevance [1].
It is not Cochrane's policy to provide guidelines for practice or policy decisions [2].
Instead, it sees itself as the provider of best quality evidence and
specifically states that guidelines go “beyond a systematic review and
require additional information and informed judgments that are typically
the domain of clinical practice guideline developers.”Systematic reviews that find no studies eligible for inclusion, commonly known as “empty reviews,” may be especially problematic for clinicians and other decision-makers. Little is known about the incidence, prevalence or variation in reporting of such reviews [3]. The little that has been written about them suggests that the reporting of implications for practice may sustain a risk for bias. With no studies meeting criteria for inclusion, these empty reviews may appear to: (1) offer no conclusions, (2) offer conclusions based on referenced excluded studies, (3) offer conclusions based on other evidence, or (4) offer conclusions not based on evidence. Thus, empty reviews may contribute to what appears to be generalized disappointment with The CDSR among some clinicians and policymakers [1], [4]........
