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Narrow Summaries: Syntheses

After gaining foundational knowledge from Broad Focused Summaries we are ready to drill down further looking for higher quality information on more narrowly focused clinical questions. We search for a greater depth of information in the form of Narrow Focused Summaries, the most prominent of which are Syntheses.

Syntheses are considered to be the heart and soul of the EBM movement. When they are well-done they can save us a lot of time because they perform all the steps of EBM in one place: framing focused clinical questions, finding all available evidence, evaluating and synthesizing that information so that we can apply it. There are two main types of syntheses:

Overviews (of which Meta-Analyses is a sub-type), and

Practice guidelines.

One of the main differences between each of these two types of syntheses is that overviews/meta-analyses compile the findings from individual clinical trials to provide us with summary findings and practice guidelines compile the information to provide us with summary recommendations. (For a more thorough description see the “Synthesis section” of Classification of Medical Research.)

The links in this section yield high quality syntheses from organizations and individuals with expertise in this area.

Cochrane Collaboration:
The Cochrane Collaboration is an international non-profit organization of more than 11,500 individuals working in over 90 countries. They publish the Cochrane Database of Systematic Reviews (CDSR), a growing collection of regularly updated overviews and meta-analyses (more than 2500 now), that are among the most rigorous you will find. The majority of the reviews focus on conventional medicine, but reviews on complementary and alternative medicine are available as well. Each systematic review tackles a narrow-focused clinical question, and is exhaustive in finding all the relevant clinical trials, each of which is critically evaluated. The abstracts summarizing the reviews are free and are aimed at health-care professionals. In the U.S. you need a subscription to read the entire text of the review. At the end of each abstract, free, easy to read summaries are available for patients.

National Guidelines Clearinghouse (NGC):
Developed by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality (AHRQ), in partnership with the American Medical Association (AMA) and America’s Health Insurance Plans (AHIP), this site disseminates a wide range of practice guidelines from hundreds of institutions and affiliated organizations. Links are provided to the major recommendations and, where available, to the full-text of each guideline. Many guidelines are also translated into patient handouts. These guidelines are often used by health professionals to guide their treatment decisions. The NGC home page also has a link to “Patient Resources” pointing to a list of consumer health pages from organizations like the AMA, FDA and AHIP.

The Agency for Healthcare Research and Quality (AHRQ):
AHRQ is the lead Federal agency charged with the promotion of evidence-based decision-making to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. It has a wide range of information for health professionals and consumers. It also provides access to the U.S. Preventive Services Task Force recommendations, making it one of the best resources to find information on screening and prevention. If this is what you are looking for, click on their link to “Preventive Services” under their “Clinical Information” section or “Prevention & Wellness” link under their “Consumers & Patients” section.

Narrow Summaries: Synopses

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Narrow Summaries: Syntheses