Article type
Year
Abstract
Background: providing syntheses of evidences emphasizing the reliability of results is a cornerstone for Cochrane. Considering this concern, 'Summary of findings' tables and the GRADE approach have been added to Cochrane Reviews (CRs) over the last 10 years. This incorporation has contributed to the use of review’s findings for decision-making, connecting research and practice.
Objectives: to assess the certainty of evidence found by CRs of palliative care.
Methods: a sensitive search strategy (Table 1) was elaborated, and the results were screened independently by two authors to identify reviews about palliative care. Protocols and withdrawn reviews were excluded. Only reviews that evaluated the certainty of evidence with the GRADE approach were included. Titles, year of publication, comparisons, outcomes, and certainty of evidence were collected.
Results: Of the 585 CRs retrieved, 49 were pre-selected and of these, 17 presented 'Summary of findings' tables. The publication year ranged from 2011 to 2019, and 50 comparisons assessed 230 outcomes. Overall, for 6.5% of the outcomes, the evidence provided was of high-certainty, and for 24.7% of them, the evidence was of very low certainty (Table 2). The evidence for palliative care considering core patient-oriented outcomes were mostly of very low certainty. No CRs found high-certainty evidence for quality of life, adverse events and satisfaction with care. No CRs assessed quality of death as an outcome of 'Summary of findings' table.
Conclusions: the certainty of evidence about palliative care is very limited for most clinical conditions or interventions addressed by Cochrane Reviews.
Patient or healthcare consumer involvement: these findings reinforce the need to improve the quality of studies in palliative care. With the aging of the population and the development of life-prolonging drugs for incurable disease, it is essential to optimize the quality of studies for enhancing the certainty of the evidence around patient-oriented outcomes.
Objectives: to assess the certainty of evidence found by CRs of palliative care.
Methods: a sensitive search strategy (Table 1) was elaborated, and the results were screened independently by two authors to identify reviews about palliative care. Protocols and withdrawn reviews were excluded. Only reviews that evaluated the certainty of evidence with the GRADE approach were included. Titles, year of publication, comparisons, outcomes, and certainty of evidence were collected.
Results: Of the 585 CRs retrieved, 49 were pre-selected and of these, 17 presented 'Summary of findings' tables. The publication year ranged from 2011 to 2019, and 50 comparisons assessed 230 outcomes. Overall, for 6.5% of the outcomes, the evidence provided was of high-certainty, and for 24.7% of them, the evidence was of very low certainty (Table 2). The evidence for palliative care considering core patient-oriented outcomes were mostly of very low certainty. No CRs found high-certainty evidence for quality of life, adverse events and satisfaction with care. No CRs assessed quality of death as an outcome of 'Summary of findings' table.
Conclusions: the certainty of evidence about palliative care is very limited for most clinical conditions or interventions addressed by Cochrane Reviews.
Patient or healthcare consumer involvement: these findings reinforce the need to improve the quality of studies in palliative care. With the aging of the population and the development of life-prolonging drugs for incurable disease, it is essential to optimize the quality of studies for enhancing the certainty of the evidence around patient-oriented outcomes.
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