Is narrative review more useful than systematic in making health decisions?

Abstract:

The conclusion of an investigation -- 'What does it mean?' -- is the most important element of any report of an investigation which is most likely to influence the actual choices and decisions about treatment. It was one of the key questions recommended by Professor Bradford Hill, the pioneer of randomized controlled trials. Today, the burden of information in health issues related to therapy is immeasurable. But, when the quality of what is published is not proportional to the quantity, and the time available for reading is short, the most important thing is to determinate how the research was conducted. This is very important in order to select the most valid research to make a better decision. According to this, one must choose between a narrative review or a systematic review in order to answer Dr. Braford Hill's question. Public and clinical management decision making should be based on the best evidence possible with the lowest risk of bias. This is in the spirit of Descartes' expression, "looking for infallible demonstrations based in medicine". The aim of the paper is to show a comparison between a systematic review and a narrative review. Its goal is for the reader him- or herself to determine the usefulness of these types of secondary analyses, in order to make the best medical decision associated with the highest safety for the patient. Use of the human activated recombinant protein C in people with severe sepsis will be used as an example.

Año de publicación:

2010

Keywords:

• Fallacy
• Systematic Review
• Evidence based medicine
• Narrative review

Fuente:

scopus