Observational evidence and strength of evidence domains case examples

BACKGROUND: Systematic reviews of health care interventions most often focus on randomized controlled trials. However, certain circumstances warrant consideration of observational evidence, and such studies are increasingly being included as evidence in systematic reviews. METHODS: To illustrate the...

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Bibliographic Details
Main Author: O'Neil, Maya E.
Corporate Authors: United States Agency for Healthcare Research and Quality, Scientific Resource Center (Portland, Or.)
Format: eBook
Language:English
Published: Rockville (MD) Agency for Healthcare Research and Quality (US) 2014, April 2014
Series:Research white papers
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
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100 1 |a O'Neil, Maya E. 
245 0 0 |a Observational evidence and strength of evidence domains  |h Elektronische Ressource  |b case examples  |c investigators, Maya O'Neil, Nancy Berkman, Lisa Hartling, Stephanie Chang, Johanna Anderson, Makalapua Motu'apuaka, Jeanne-Marie Guise, Marian McDonagh 
260 |a Rockville (MD)  |b Agency for Healthcare Research and Quality (US)  |c 2014, April 2014 
300 |a 1 PDF file (v, 12 pages) 
505 0 |a Includes bibliographical references 
653 |a Comparative Effectiveness Research 
653 |a Observational Studies as Topic 
653 |a Bias 
653 |a Review Literature as Topic 
710 2 |a United States  |b Agency for Healthcare Research and Quality 
710 2 |a Scientific Resource Center (Portland, Or.) 
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490 0 |a Research white papers 
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520 |a BACKGROUND: Systematic reviews of health care interventions most often focus on randomized controlled trials. However, certain circumstances warrant consideration of observational evidence, and such studies are increasingly being included as evidence in systematic reviews. METHODS: To illustrate the use of observational evidence, we present case examples of systematic reviews in which observational evidence was considered as well as case examples of individual observational studies and how they demonstrate various strength of evidence domains in accordance with current AHRQ Evidence-based Practice Center methods guidance. RESULTS: In the presented examples, observational evidence is used when randomized controlled trials are infeasible or raise ethical concerns, lack generalizability, or provide insufficient data. Individual study case examples highlight how observational evidence may fulfill required strength of evidence domains, such as study limitations (reduced risk of selection, detection, performance, and attrition); directness; consistency; precision; and reporting bias (publication, selective outcome reporting, and selective analysis reporting), as well as additional domains of dose-response association, plausible confounding that would decrease the observed effect, and strength of association (magnitude of effect). CONCLUSIONS: The cases highlighted in this paper demonstrate how observational studies may provide moderate- to (rarely) high-strength evidence in systematic reviews