Evidence synthesis – Literature review

Critical analysis of the medical literature is an essential prerequisite for many projects carried out in the field of health, be they academic, industrial or institutional. It is based on the synthesis of evidence from scientific publications (evidence syntesis) and grey literature (Orphanet, Scan santé, HAS, CNAM, EMA, clinical trial, Prospero, etc.).

There are different kinds of evidence syntheses, depending on the purpose of the work. The systematic review is the most complete form, both from the point of view of methodology and the exhaustiveness of the data collected. It can include a quantitative synthesis of an effect (e.g. treatment): meta-analysis of estimates, indirect comparison, or network meta-analysis. When time is constrained, an accelerated synthesis of the evidence can be provided as a rapid review of the literature. The parameters of the query are then revised: number and types of databases searched, geographical scope, time lag, nature of the data to be extracted, type of scoring (single, double adjudication), etc. Finally, the syntheses can be enriched using bibliometric techniques such as the scoping review (description of available data in terms of nature, context, characteristics and volume), or the research mapping (technique for visualizing current research in a field in order to identify target populations, treatments, geographical context and gaps).

CEMKA’s Evidence Synthesis Unit offers all these services. The wide range of methodologies used requires a multidisciplinary team with technical (methodologist, statistician, economist, etc.) and professional skills (physicians, pharmacists, epidemiologists, etc.). Within CEMKA, literature reviews are coordinated by the Medical Department, which is responsible for the methodological and scientific aspects. Depending on the type of review and the nature of the data collected, the consultants of the different departments are called upon for their expertise. In order to meet the twofold requirement of transparency and comprehensiveness, the literature reviews conducted by CEMKA comply with the best practice recommendations, in particular the PRISMA guidelines (The Preferred Reporting Items for Systematic reviews and Meta-Analyses).[1]

To meet the needs of its industrial and institutional clients, CEMKA conducts literature reviews with different objectives:

  • To assess the epidemiological context and the burden of a given disease: epidemiology (prevalence, incidence, morbidity and mortality indicators), burden (PREMs, PROMs, quality of life, cost of illness), treatments.
  • To carry out a state of the art prior to a study on medico-administrative database (SNDS), or to a public health evaluation.
  • Prepare a regulatory submission to the health authorities (CT or CNEDiMTS).
  • Calculate the target population for a drug treatment, a medical device, or a care plan.
  • Identify patient pathways within healthcare systems.
  • Document medico-economic modeling (patient characteristics, pathways, transition probability, cost of illness, quality of life, etc.).
  • Estimate the treatment effect of different therapies in a given indication.

 

[1] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Systematic reviews. 2021 Dec;10(1):1-1.

Key points

  • Technical and professional skills provided by a multidisciplinary team.
  • Specialized methodologists with solid experience in university teams.
  • Compliance with best practice guidelines to ensure transparency and completeness.
  • A wide range of deliverables: slides kit, bibliographic note, scientific article, summary tables, etc