EBLM の進め方と問題点−系統的レビューを中心に−(3)

系統的レビュー( Systematic review )とは

西　堀　眞　弘*
　　　　　　　　　　　　　　　　　　　　　　
What is the Systematic Review ?

Masahiro NISHIBORI, MD*

Systematic reviewing provides a major backbone for evidence-based laboratory medicine(EBLM). Compared with a usual review paper, a systematic review is characterized by pursuing both the most comprehensive search for available evidence and the highest level of scientific quality. The word of ‘scientific' does not mean a scientific truth but means a reliable result proven by a scientific method. According to the best effort policy of EBM, a result including some statistical bias may be adopted as the current best evidence if better ones are not available.
In addition, EBLM requires specialized approaches because of the following reasons. (1)Many factors, such as analytical errors or lack of standardization may cause various statistical biases in the laboratory data. (2)Unlike the effectiveness of therapeutic measures that can be evaluated by comparing only two groups, there are almost infinite combinations of diagnostic tests and phases of clinical courses, and it is hardly possible to statistically match the patient group with the control group at any of those combinations. (3)Unlike medication, which has direct effects on a patient's outcome, many steps must be taken to analyze the effects of laboratory tests.
From now, more effort should be dedicated to promoting systematic reviewing in laboratory medicine.
[Rinsho Byori 51 : 678〜681, 2003]

*Clinical Laboratory, Tokyo Medical and Dental University Hospital, Faculty of Medicine, Bunkyo-ku, Tokyo 113-8519

【Key Words】systematic review(系統的レビュー)，critical appraisal(批判的吟味)，evidence-based medicine：EBM(根拠に基づく医療)，evidence-based laboratory medicine：EBLM(根拠に基づく臨床検査医学)

*東京医科歯科大学医学部附属病院検査部(〒113-8519 東京都文京区湯島1-5-45)

E-mail :mn.mlab@tmd.ac.jp