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Evidence-based Public HealthEffectiveness and efficiency$
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Amanda Killoran and Mike P. Kelly

Print publication date: 2009

Print ISBN-13: 9780199563623

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780199563623.001.0001

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The process of systematic review of public health evidence: quality criteria and standards

The process of systematic review of public health evidence: quality criteria and standards

(p.327) Chapter 21 The process of systematic review of public health evidence: quality criteria and standards
Evidence-based Public Health

Mark Petticrew

Oxford University Press

Assessing ‘study quality’ is a key component of the systematic review process that is much contested. Systematic reviewers would argue that the purpose is to ensure that the final synthesis of evidence is based on the most robust studies; that is, those least susceptible to bias. A range of appraisal tools and checklists are often employed to ensure that attention is duly given to the main sources of bias, but to the non-initiated this approach often seems formulaic and narrowly focused, and risks privileging a few key aspects of internal validity over other important aspects of research, such as its utility and generalizability. Moreover, for critics, the process of quality assessment seems to reduce the task of reviewing evidence to a series of box-ticking exercises, as opposed to an appraisal of the usefulness of research for decision making purposes. The application of quality criteria becomes particularly difficult when reviewing public health evidence, because the range of types of evidence to be included is potentially wide. In this context, excluding studies on grounds of ‘validity’ or ‘quality’ alone may inadvertently introduce further biases. This chapter gives examples of this problem drawn from public health systematic reviews in the fields of tobacco control, transport, and physical activity. Despite such potential pitfalls, systematic reviews do need to include an assessment of the risk of bias posed by each study, without taking it to extremes. The chapter also describes some of the challenges.

Keywords:   study quality, public health evidence, quality assessment, systematic review process

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