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B4O4 | Consensus-based recommendations for investigating clinical heterogeneity in systematic reviews

Abstract text
Background: It has been argued that systematic reviews (SR) fail to inform clinical decision-making due to their results being far too general such that the findings do not apply to individual clinical cases. Also, few SRs investigate clinical reasons for heterogeneity and when they do often fail to use valid statistical or other methods. While there is some consensus on methods in SRs for investigating statistical and methodological heterogeneity, little attention has been paid to clinical aspects of heterogeneity.

Objective: To develop recommendations for investigating clinical heterogeneity in SRs.

Methods: We identified and invited potential participants with expertise in SR methodology, SR reporting, heterogeneity, statistical aspects of meta-analyses, or those who published papers on clinical heterogeneity. Three phases are being conducted: 1. Pre-meeting item generation 2. Face to face consensus meeting in the form of a modified Delphi process, and 3. Post-meeting feedback.

Results: A total of 19 participants have agreed to attend the meeting that is being held June 3-4, 2011, at the University of Michigan, USA. Currently, we are performing the pre-meeting item generation that consists of phone calls with all participants, asking them to indicate important potential recommendations that need to be discussed during the face-to-face meeting. In addition, we have extracted recommendations from two recent comprehensive methodologic reviews in the area. We are collating and cross-referencing the phone call results and the extracted data from the methodologic reviews to construct items to be discussed during the face-to-face consensus meeting in June. We anticipate that by July 2011, we will have completed a manuscript that outlines the results of this consensus meeting. This manuscript will outline the first set of consensus-based guidelines for investigating clinical heterogeneity in SRs.

Discussion: We expect that these guidelines for investigating clinical heterogeneity in SRs will improve the validity of such investigations resulting in SRs with more applicable results.
Authors
Gagnier JJ1, Morgenstern H2, Moher D3
1 Assistant Professor, Departments of Orthopaedic Surgery and Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
2 Professor, Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
3 Senior Scientist, Clinical Epidemiology, Ottawa Health Research Institute, Ottawa, Ontario, Canada
Presenting author and contact person
Presenting author: 
Joel Gagnier
Contact person: 
Joel Gagnier (Contact this person)
Date and Location
Session: 
Oral session B4O4
Date: 
Friday 21 October 2011 - 12:25 - 12:45
Location: