Systematic reviews and lifelong diseases

doi:10.1136/bmj.325.7360.381

BMJ 2002;325:381-384 ( 17 August )

Education and debate

Systematic reviews and lifelong diseases

Heather E Elphick, lecturer ^a, Anton Tan, specialist registrar in paediatrics ^b, Deborah Ashby, professor of medical statistics ^c, Rosalind L Smyth, Brough professor of paediatric medicine ^a.

^a University of Liverpool Institute of Child Health, Alder Hey Children's Hospital, Liverpool L12 2AP, ^b Respiratory Unit, Alder Hey Children's Hospital, ^c Wolfson Institute of Preventive Medicine, Barts and The London, Queen Mary's School of Medicine and Dentistry, University of London EC1M 6B9

Correspondence to: R L Smyth r.l.smyth@liv.ac.uk

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

Systematic reviews of randomised controlled trials provide an evidence base for treatment but too often fail to give adequateinformation on long term outcomes. Elphick and colleagues discussthe limitations of the systematic review of randomised controlledtrials for patients with chronic or lifelong diseases and suggestthat long term observational studies have a place in the evaluationof the benefits and risks of treatment

Synthesis of evidence from systematic reviews of randomised controlled trials is considered the gold standard when evaluatingthe effectiveness of treatments, yet systematic reviews do notalways place as much emphasis on information about adverse effectsor safety issues. ¹ ² In people with chronic, or lifelong,diseases long term outcomes are particularly important but aremuch less likely to be evaluated in randomised controlled trials.We discuss the results of a recent systematic review of randomisedcontrolled trials of antibiotic therapy in cystic fibrosis, whichprovided . . . [Full text of this article]

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