Skip to main content
Quality & Safety in Health Care logoLink to Quality & Safety in Health Care
. 2003 Aug;12(4):298–303. doi: 10.1136/qhc.12.4.298

Systematic reviews of the effectiveness of quality improvement strategies and programmes

J Grimshaw 1, L McAuley 1, L Bero 1, R Grilli 1, A Oxman 1, C Ramsay 1, L Vale 1, M Zwarenstein 1
PMCID: PMC1743751  PMID: 12897365

Abstract



 Systematic reviews provide the best evidence on the effectiveness of healthcare interventions including quality improvement strategies. The methods of systematic review of individual patient randomised trials of healthcare interventions are well developed. We discuss methodological and practice issues that need to be considered when undertaking systematic reviews of quality improvement strategies including developing a review protocol, identifying and screening evidence sources, quality assessment and data abstraction, analytical methods, reporting systematic reviews, and appraising systematic reviews. This paper builds on our experiences within the Cochrane Effective Practice and Organisation of Care (EPOC) review group.

Full Text

The Full Text of this article is available as a PDF (157.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Donner Allan, Klar Neil. Issues in the meta-analysis of cluster randomized trials. Stat Med. 2002 Oct 15;21(19):2971–2980. doi: 10.1002/sim.1301. [DOI] [PubMed] [Google Scholar]
  2. Eccles M., Grimshaw J., Campbell M., Ramsay C. Research designs for studies evaluating the effectiveness of change and improvement strategies. Qual Saf Health Care. 2003 Feb;12(1):47–52. doi: 10.1136/qhc.12.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Gotzsche P. C. Why we need a broad perspective on meta-analysis. It may be crucially important for patients. BMJ. 2000 Sep 9;321(7261):585–586. doi: 10.1136/bmj.321.7261.585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Grimshaw J. M., Shirran L., Thomas R., Mowatt G., Fraser C., Bero L., Grilli R., Harvey E., Oxman A., O'Brien M. A. Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001 Aug;39(8 Suppl 2):II2–I45. [PubMed] [Google Scholar]
  5. Grimshaw Jeremy M., Eccles Martin P., Walker Anne E., Thomas Ruth E. Changing physicians' behavior: what works and thoughts on getting more things to work. J Contin Educ Health Prof. 2002 Fall;22(4):237–243. doi: 10.1002/chp.1340220408. [DOI] [PubMed] [Google Scholar]
  6. Mowatt G., Grimshaw J. M., Davis D. A., Mazmanian P. E. Getting evidence into practice: the work of the Cochrane Effective Practice and Organization of care Group (EPOC). J Contin Educ Health Prof. 2001 Winter;21(1):55–60. doi: 10.1002/chp.1340210109. [DOI] [PubMed] [Google Scholar]
  7. Mulrow C. D. Rationale for systematic reviews. BMJ. 1994 Sep 3;309(6954):597–599. doi: 10.1136/bmj.309.6954.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Oxman A. D. Checklists for review articles. BMJ. 1994 Sep 10;309(6955):648–651. doi: 10.1136/bmj.309.6955.648. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Oxman A. D., Guyatt G. H. A consumer's guide to subgroup analyses. Ann Intern Med. 1992 Jan 1;116(1):78–84. doi: 10.7326/0003-4819-116-1-78. [DOI] [PubMed] [Google Scholar]
  10. Peto R. Why do we need systematic overviews of randomized trials? Stat Med. 1987 Apr-May;6(3):233–244. doi: 10.1002/sim.4780060306. [DOI] [PubMed] [Google Scholar]
  11. Rao J. N., Scott A. J. A simple method for the analysis of clustered binary data. Biometrics. 1992 Jun;48(2):577–585. [PubMed] [Google Scholar]
  12. Thompson S. G. Why sources of heterogeneity in meta-analysis should be investigated. BMJ. 1994 Nov 19;309(6965):1351–1355. doi: 10.1136/bmj.309.6965.1351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Whiting-O'Keefe Q. E., Henke C., Simborg D. W. Choosing the correct unit of analysis in Medical Care experiments. Med Care. 1984 Dec;22(12):1101–1114. doi: 10.1097/00005650-198412000-00005. [DOI] [PubMed] [Google Scholar]

Articles from Quality & safety in health care are provided here courtesy of BMJ Publishing Group

RESOURCES