O que esperamos das revisões sistemáticas no futuro

Abstract

The search for critical syntheses of scientific knowledge is not new. For example, 18 th -century Scottish physician James Lind, credited with the first clinical trial in medicine 1 , stated on the cover page of his A Treatise of the Scurvy that it contained "an inquiry into the nature, causes and cure, of that disease. Together with a critical and chronological view of what has been published on the subject" 2 (p. 13-4). The first attempt to quantitatively combine the results of different health studies is attributed to Karl Pearson in an article published in 1904 on typhoid fever 3 . Three years later, Goldberger described a process that began with a literature search, followed by selection of references according to a set of criteria, and subsequent data extraction 2 . American statistician Gene V. Glass coined the term "metaanalysis" in 1976, referring to the integration of results from different studies using statistical analysis 4 . Interestingly, only in the early 1990s was a distinction made between "metaanalysis" and "systematic review": the former corresponding to the statistical method of quantitative synthesis and the latter to the process of reference selection, critical evaluation, and integration of results to minimize risk of bias.As the last item in this very brief historical approach, before systematic reviews became popular as a rigorous and valid research method, they were treated for many years as a kind of second-rate science 2 . The situation has changed, and the scientific community and decision-makers in public health now value well-conducted systematic reviews as important sources of information.In order to adjust the systematic reviews published in CSP to progress in this field, and for the journal to ensure its role in inducing scientific research, CSP will henceforth adopt some new recommendations for the reviews submitted for publication. Initially, every systematic review should have its protocol published or registered in a registry of systematic reviews, such as PROSPERO (http://www.crd.york.ac.uk/prospero/). Prospective protocol registration for systematic reviews is important because it enhances the transparency of the review process, protects against selective publication of results, and allows better scrutiny by reviewers concerning what the authors originally planned and what they actually performed. A second important aspect is that systematic reviews should be submitted in English. Submission of reviews in English is intended to optimize peer review, to the extent that it will allow inviting some of the authors of the original articles included in the manuscript to issue their reviews. We expect this to contribute to both the quality of the evaluation and greater availability of reviewers. Obviously, manuscripts in Portuguese or Spanish will also be accepted in the case of systematic reviews that relate exclusively to Brazilian or Latin American themes (for example, prevalence of a given condition in Latin America). A third relevant aspect is that the use of the STROBE ins...

Da prática baseada em evidências para a saúde coletiva informada por evidencias: revisão narrativa

“…Conforme assinalado em um estudo (23) , considerando que as intervenções em SC estão sujeitas "a um grau de complexidade superior ao das pesquisas clínicas usuais", é importante perceber algumas diferenças fundamentais entre a PBE e a SCBE: a) a unidade de análise geralmente é populacional, e não individual; b) intervenções multicomponentes complexas são, frequentemente, mais difíceis de serem descritas e caracterizadas do que intervenções simples (como o consumo de um medicamento específico em um ambiente controlado de pesquisa); c) e nem sempre os delineamentos aleatorizados e controlados são possíveis em Saúde Coletiva (23) .…”

A arte e a ciência de escrever um artigo científico de revisão

“…Third, in systematic reviews, where the assessment of risk of bias is mandatory, avoid the use of instruments such as the Newcastle-Ottawa and Downs & Black Scales, that yield numeric scores as their final parameter for the evaluation of the risk of bias in included studies. Although commonly used, such tools will often fail to identify studies at high risk of bias when a single or few critical domains are severely compromised within studies included in the review 20,21 . Several instruments are currently available that avoid the illusion of objectivity posed by numeric scores to assess risk of bias.…”