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Systematic literature review for clinical practice guideline development
D M O'Day1, E P Steinberg, K Dickersin
1Department of Ophthalmology and Visual Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee.
Transactions of the American Ophthalmological Society
|January 1, 1993
Summary
The literature on cataract-related functional impairment is sparse and of poor quality, with few studies meeting inclusion criteria for clinical guidelines. Most available research lacks robust experimental design.
Area of Science:
- Ophthalmology
- Health Services Research
- Evidence-Based Medicine
Background:
- Cataract significantly impacts adult functional abilities.
- Clinical practice guidelines rely on high-quality literature for recommendations.
- Previous reviews have not comprehensively assessed the literature quality for cataract guidelines.
Purpose of the Study:
- To evaluate the quality and scope of published literature on functional impairment due to cataract.
- To assess the literature retrieval and analysis methods used for a specific clinical practice guideline.
- To identify gaps in the evidence base for cataract management.
Main Methods:
- Reviewed literature acquisition, identification, and quality assessment processes for 77 guideline-related issues.
- Analyzed the selection of articles from an initial pool of approximately 8,000.
- Assessed the quality of included studies based on experimental design and relevance.
Main Results:
- Less than 4% of initially identified articles were ultimately used in the guideline.
- Key topics like surgical indications and rehabilitation lacked relevant literature.
- The majority of included literature consisted of case series, with only 17 randomized controlled trials.
- Literature quality was predominantly rated as fair to poor due to flawed experimental designs.
Conclusions:
- A significant evidence gap exists for managing functional impairment from cataracts.
- The available literature is sparse and of low methodological quality.
- Further research with rigorous experimental designs is needed to inform clinical practice guidelines.