Systematic reviews in health care: Systematic reviews of evaluations of prognostic variables

doi:10.1136/bmj.323.7306.224

BMJ 2001;323:224-228 ( 28 July )

Education and debate

Systematic reviews in health care

Systematic reviews of evaluations of prognostic variables

This is the last in a series of four articles

Douglas G Altman, director.

Imperial Cancer Research Fund Medical Statistics Group, Centre for Statistics in Medicine, Institute of Health Sciences, Oxford OX3 7LF

The first 150 words of the full text of this article appear below.

Prognostic studies include clinical studies of variables predictive of future events as well as epidemiological studies ofaetiological risk factors. As multiple similar studies accumulateit becomes increasingly important to identify and evaluate allof the relevant studies to develop a more reliable overall assessment.For prognostic studies this is notstraightforward.

Box 1 summarises the clinical importance of information on prognostic factors. Many of the issues discussed are also relevantto aetiological studies, especially cohort ones. Some featuresof prognostic studies lead to particular difficulties for thesystematic reviewer. Firstly, in most clinical prognostic studiesthe outcome of primary interest is the time to an event, oftendeath. Meta-analysis of such studies is rather more difficultthan that for binary data or continuous measurements. Secondly,in many contexts the prognostic variable of interest is oftenone of several prognostic variables. When examining a variableof interest researchers should consider . . . [Full text of this article]

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