Medicine Mind the Gap Seminar

Whether discussing priorities for comparative effectiveness research (CER) from a funder's or researcher’s perspective, understanding knowledge gaps, or setting guidelines for care, systematic reviews of existing research hold the promise of scientifically summarizing "what works" at any point in time. However, many of us are content to use nonsystematic methods to synthesize knowledge; non-systematic methods certainly use fewer resources, and in a given field experts believe they know the literature sufficiently to avoid the investment. Yet, by using a nonsystematic approach to summarizing what is known, we are effectively applying a double standard: although we demand that the primary research studies minimize the risk of bias in their design and implementation, we accept the possibility of bias in synthesizing the primary research ("meta-bias"). We will review models of how systematic reviews are being used globally to plan, implement, and derive recommendations from CER. We will then review some of the existing challenges to using systematic reviews and methods being used to address these challenges.

Kay Dickersin, M.A., Ph.D., is Professor of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. At Johns Hopkins, she also serves as the Director for the Center for Clinical Trials and Evidence Synthesis External Website Policy, whose faculty, staff and students are involved in methodologic research related to clinical trials and evidence synthesis. Dr. Dickersin's major research interests are related to epidemiology, randomized clinical trials, systematic reviews and meta-analysis, reporting biases, trials registers, peer review, evidence-based health care, and patient-centered outcomes research. She has conducted studies in a number of important subject areas, including women's health, eyes and vision, and surgery. Dr. Dickersin’s research has involved comparing internal company documents to the published record, where she and her colleagues have found differing results. She is currently engaged in examining practical issues related to demands for “open access to trial data,” when the available data may be discordant.

Dr. Dickersin is also Director of the US Cochrane Center (USCC), one of 13 Centers worldwide participating in The Cochrane Collaboration External Website Policy. The Collaboration aims to help people make well-informed decisions about health by preparing, maintaining, and promoting the accessibility of systematic reviews of available evidence on the benefits and risks of health care. The USCC hosts Consumers United for Evidence-based Healthcare (CUE) External Website Policy. She also serves as Director of the Cochrane Eyes and Vision Review Group, US Satellite External Website Policy.

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For more information go to https://prevention.nih.gov/programs-events/medicine-mind-the-gap