《循证医学》Review Manager 使用介绍

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【Revman使用手册（图文版）：第一部分：建立综述】

【Revman使用手册（图文版）：第一部分：建立综述】
1.建立一个新的meta分析
双击安装好的RevMan，选择Standard模式，出现欢迎界面。

单击左上角的File，通过点击New，点击下一步，开始一项新的meta分析。

可以看到RevMan列出主要的5项功能，第一项为：干预性评价
Intervention review，第二项为：诊断试验评价Diagnostic test。

第三项为：方法学系统评价、第四项为：同类系统评价。

最后一项为：flexible review其他类型的系统评价包括：预后、质性、原型。

这里我们以第一项为例进行说明
选择：Intervention review 点击next。

选择相应的模块后，可以进行描述。

比如干预措施是什么，关心的疾病是什么，填写后点击next。

这里需要选择full review，点击下一步Finish
点击完成后，则可看到如下界面，分别为菜单栏、大纲窗口、内容窗口、指导窗口。

值得注意的是大纲窗口里的内容相当于是Cochran系统评价的各个段落标题，因此RevMan除帮助我们完成质量评价图及Meta分析图的制作，也可指导我们meta分析的撰写（点击图中的小钥匙可以展开下级菜单）。

Revman 讲义教程

方积乾.医学统计学与电脑实验.第二版.上海科学技术出版社,2001,349-350.
传统文献综述的特点
在医学研究中，传统的文献综述在处理同一问题的多个结果报道时，通常是平等（等权重方法）对待每个研究结果而得出结论。这种文献综述主要是以某类结果的文献数量的多少得出结论，一般不进行文献评价，也不考虑文献的质量。
Glass最早在教育学研究中使用了 Meta分析，而该方法现已广泛应用于医学和健康领域，尤其是针对疾病的诊断、治疗、预防和病因等问题的综合评价。
上世纪80年代末，我国医学杂志较多的介绍了该方法。其中文译名有荟萃分析，二次分析、汇总分析、集成分析等。
无论何种中文译名都有不足之处。因此，很多学者建议仍然使用“Meta分析”这一名称。
目前，随机效应模型多采用D-L法（DerSimonian & Laird法）。
关于随机效应模型（2）
D-L法是1986年，由DerSimonian 和Laird首先提出，该法不仅可用于分类变量，也适用于数值变量。其D-计L法算主方要法是见对后权：重Wi进行校正，
随机效应模型的计算
随机效应模型的合并统计量计算：
统计学异质性
通常，将Meta分析的统计学异质性简称为 “异质性”，它是以各研究之间可信区间（CI）的重合程度来度量异质性的大小；
多个研究间的CI重合程度越大，存在统计学异质性的可能性就越小，反之，各研究之间存在统计学异质性的可能性就越大。
临床异质性、方法学异质性和统计学异质性三者是相互独立又相互关联的，临床或方法学上的异质，不一定在统计学上就有异质性，反之亦然。
异质性分析的意义
Meta 分析的核心计算是合并（相加），按统计原理，只有同质的资料才能进行合并或比较等统计分析，反之，则不能。

Review Manager操作技术

• 二分类变量资料常用的分析方法有：方差倒数权重法 Inverse variance、M-H法(Mantel-Haenszel)、Peto法、D-L法（DerSimonian-Laird）
• 输入系统评价的标题 • 以针刺治疗慢性前列腺炎随机对照临床研究为例，在此输入： • 适合Meta分析的题材：Meta分析最适用于针对同一主题的 RCT文献，这类文献的综合分析结果较为可靠，单个文献的质量直接决定了Meta分析的价值。
• 选择系统评价的类型 • Full review全文，Protocol草案
•
•
• •
Dichotomous二分类变量（定性资料），录入时需要输入各组发生该事件或结局的人数与各组的总人数。 Continuous连续性变量（定量资料），录入时需要输入各组的例数，结局指标的均数及标准差。 O-E and variance期望方差法资料，罕见情况下涉及。 Generic inverse variance倒方差法资料，罕见情况下涉及。
• 点击Finish,弹出如下界面：
• 添加纳入研究 • 点击大纲面板中Studies and reference (研究和参考文献)旁边钥匙图标，再次点击References to studies（研究的参考文献）旁的钥匙图标，在Included Studies（纳入的研究）点击鼠标右键，选择Add study（添加研究）。
• 添加比较： • 在Data and analysises上点击鼠标右键，选择Add comparison • 在弹出的对Add an outcome under the new comparion,点击Continue
• 选择数据类型：
Review Manager 操作技术

系统评价与meta分析之-Review manager-Revman软件使用-水天之间 - DXY

含三个选项：Low risk，unclear risk，high risk，默认为unclear risk）； 3. 右侧栏为选择该选项的依据（Support for judgement）
水天之间
RevMan实战—纳入研究风险偏倚及图形
• 表格（Risk of bias table）更改条目：
水天之间
为结局指标添加纳入研究的对话框
水天之间
7
水天之间
RevMan实战—二分类变量meta
2014/1/3 Friday
RevMan实战—二分类变量meta
水天之间
翻转结局标注
水天之间
RevMan实战—二分类变量meta
RevMan实战—二分类变量meta
保存森林图操作
水天之间
二分类数据分析状态下，计算器的计算界面及结果
RevMan实战—“比较”和“结局指标”
RevMan实战—“比较”和“结局指标”
新加结局指标数据类型选择框
水天之间
6
新加结局指标名称及组标签
水天之间
RevMan实战—“比较”和“结局指标”
2014/1/3 Friday
RevMan实战—“比较”和“结局指标”
分析方法选择框
水天之间
分析细节对话框
水天之间
• “Data and analyses”部分为Revman软件 meta分析功能的核心也是重点，在数据分析下，有三个水平：
1. Comparison； 2. Outcome； 3. Subgroup。
水天之间
RevMan实战—“比较”和“结局指标”
• 增加Comparison同样有两种方法： • 1.鼠标左键点击大纲面板的“Data and

Review Manager操作技术

• 某中学发生一起因饮水引起的甲型肝炎爆发，经调查发现，该校部分学生有生饮自来水的习惯，34名甲肝患者中有22 人生饮自来水；而1449名健康学生中，生饮自来水的有255 人，试估计该中学甲肝发病与生饮自来水的比值比。 • 比值比OR=病例组暴露的比值/对照组暴露的比值=（22/12） /(255/1194)=8.58 • 说明说明甲肝患者生饮自来水与未生饮自来水比值是健康学生的8.58倍。
• 添加研究识别码： • 如果经过注册的临床试验有唯一的注册码。 • 这里我们不填加，继续点击Next
• 继续添加下一个研究，选择Add another study in the same section • 点击Continue,依照上述方法，继续将剩余三项研究添加进去。
• 将四项研究全部添加完成后，可以看到在Included stydies里显示出了已经添加的研究：
方差倒数权重法、 M-H法、Peto法 D-L法一般方差法、M-H 法 D-L法方差倒数权重法 D-L法
• 结果输出选项 • Totals中可以选择显示组和亚组或亚组或不显示组和亚组。 • Study confidence interval（研究置信区间）可设定计算纳入研究效应量的90%、95%、和99%的置信区间。 • Total confidence interval（总体置信区间）可设定计算总体效应量的90%、95%、和99%的置信区间。
Review Manager 软件分析结果解释
• 菱形代表合并效应量，菱形的重心是合并效应的点估计值，宽是合并效应量的置信区间。 • 需要注意：无论是二分类变量的指标OR\RR，还是连续性变量的指标WMD\SMD，若置信区间落在无效线的右侧，则表示试验组的效应量大于对照组。若某研究的置信区间落在无效线的左侧，则表示试验组的效应量小于对照组。 • 例如：本例中合并效应量落在无效线的右侧，表明试验组的效应量（针刺治疗前列腺炎的有效率）大于对照组的效应量（药物治疗前列腺炎的有效率），又因为研究为“有利事件”，所以表明试验组的实验因素会增加有利事件的发生。

Review Manager 5.2诊断性试验系统评价手册

Review Manager 5.2 Tutorialfor Diagnostic test accuracy reviewsSeptember 2012Welcome to the RevMan Diagnostic test accuracy (DTA) Tutorial. This tutorial is designed to give Cochrane review authors an introduction to the process of writing a Cochrane systematic review of the accuracy of diagnostic tests using RevMan.The tutorial does not provide all the information necessary to write a Cochrane DTA review, and does not address other types of Cochrane systematic reviews such as reviews of intervention studies or overviews of reviews. For detailed instructions on how to conduct a Cochrane DTA review, please refer to the Cochrane Handbook for Diagnostic Test Accuracy Reviews, available from the following website.Later parts of this tutorial rely on activities completed in the earlier sections, so we recommend you start working from the beginning. If you would like to skip ahead, click on the section you would like to read in the Contents list. The approximate time needed to complete this tutorial will be about three to four hours.If you have technical questions regarding RevMan software, please contact the Cochrane Information Management System team at /revman. Other questions related to preparing protocols or reviews in RevMan should be directed to the relevant Cochrane Review Group.About this tutorialThe tutorial for Cochrane diagnostic test accuracy reviews in RevMan 5 was developed by Mariska Leeflang in 2010, with assistance from the Australasian Cochrane Centre and the UK and Continental European Support Unit for diagnostic test accuracy reviews, and with funding from The Cochrane Collaboration Steering Group. The tutorial was revised in February 2011 to incorporate new features of RevMan 5.1 and in September 2012 for new features of RevMan 5.2. Please note that the results reported in this tutorial are fictional and were created by the authors for teaching purposes only. Note about using mouse right-clicksMany of the functions in RevMan that involve selecting a button on the outline pane toolbar can also be achieved by right-clicking the sub-headings in the outline pane and selecting the function from the drop-down list.PART 1 – Getting started (5)Opening your review (5)Setting up user details (6)The RevMan 5.2 interface (6)Saving a review (8)Adding authors to a review (8)Accessing the Cochrane Handbook for Diagnostic Test Accuracy Reviews (9)PART 2 – Working with text (11)Adding text to a review (11)Formatting text (11)Making changes to headings (11)Adding notes (12)Tracking changes in the text (12)Checking your spelling (13)PART 3 – Adding studies and references (15)Adding studies to a review (15)Adding references to a study (15)Editing an existing reference (17)Importing references from a text file (18)Moving references (18)Adding links to references in the text (19)Removing a link (20)Adding multiple links automatically (20)PART 4 - Tables (21)Characteristics of included studies tables (21)Patient selection (21)Index Test, Reference Standard, and Flow and Timing (22)Editing the Characteristics of included studies table (22)Adding user-defined items (23)Characteristics of excluded studies (24)Adding Footnotes to tables (25)Additional tables (25)PART 5 - Data and analyses (27)Adding tests (27)Entering data by test (28)Entering data using the calculator (29)Entering data by study (30)Assessment of methodological quality for two tests (32)Covariates (33)Analyses (35)a. Changing Forest Plot properties (36)b. Changing SROC Graph properties (37)c. Entering Externally Calculated Parameters (38)Test Comparisons (38)Paired Test Comparisons (40)Investigating heterogeneity (41)Adding a figure to your review (42)Risk of bias and applicability concerns graph and summary (43)PART 6 – Finishing the review (44)Summary of Findings tables (44)Adding an appendix (44)Validating a review (44)Submitting a review for editorial approval (45)Appendix – To convert to QUADAS-2 from QUADAS (46)PART 1 – Getting startedOpening your reviewAll Cochrane reviews are stored in Archie, The Cochrane Collaboration’s central server for managing documents and contacts details. When you have registered a review with a Cochrane Review Group, they will set up a user account for you in Archie. To work on your review, you will need to find your review online in Archie and check it out into RevMan using the My Reviews button on the toolbar. Doing this opens a new window which provides information on the location of your reviews and what the next task for your review is. In this window you can check a review outby selecting the title and pressing the Check Out button.Before going ahead it is important to make sure that RevMan is currently in‘Standard’ mode rather than ‘Non-Cochrane’ mode. ‘Non-Cochrane’ mode is a preference that allows users to specify that they are using RevMan to author reviews that will not be published in The Cochrane Library. In ‘Non-Cochrane’ mode, all Cochrane-specific functions like check in/out and connection settings to Archie are absent from the interface. To complete this tutorial you need to be in ‘Standard’ RevMan mode.1.From Tools menu on the toolbar, select Preferences which will open thePreferences window.2.Under User mode on the General tab, confirm that the Non-Cochrane modeoption is NOT checked.3.If the Non-Cochrane mode option is checked, uncheck it and press OK. Awarning will appear indicating that “Not all changes may take effect until you restart the program”. Click OK, and Exit out of RevMan and restart it.4.If the Non-Cochrane mode option is NOT checked, simply click OK.For this tutorial we will use a sample review called ‘Laboratory tests for caffeine addiction in PhD students’. Instead of checking the review out of Archie, it has been provided as an additional file with RevMan 5.2.1.From the File menu, select Open, or click the Open button on the toolbar.2.Find the folder where RevMan was installed on your computer. If you areusing Windows and accepted the default installation location, this will beC:\\Program Files\Review Manager 5. If you are using Mac OS or Linux, thetutorial files are copied to a subfolder of your home directory named‘RevMan tutorial’.3.Open the doc folder, and then the tutorial folder.4.Select the file ‘Laboratory tests for caffeine addiction in PhD students.rm5’.5.Click Open.button on the toolbar. Be aware that if you create a review yourself, you cannot check it into Archie or use it for publication inSetting up user detailsIf you will be using RevMan regularly on the same computer, you may wish to enter your user details (such as your name). RevMan will attach these user details to any editing done using track changes so that co-authors and editors can easily identify who has made the changes. Open your user details by selecting Preferences from the Tools menu. Enter your name directly or click Choose to find your details in Archie.The RevMan 5.2 interfaceWhen a review is open in RevMan 5.2, you will see there are two separate window panes that interact with each other as you navigate through the different sections of a review. The pane on the left hand side shows the outline of a review. This is referred to as the outline pane. The area on the right hand side shows all the information contained in a review. This is referred to as the content pane. The content pane will usually show the text of your review, but can also contain additional tabs for results, figures, etc.In the outline pane, you can use the key icon next to each heading to expand and collapse subheadings. In the content pane, use the symbol.RevMan allows you to change the appearance of the interface by selecting Preferences from the Tools menu and going to the Interface tab. The default Look and Feel of the interface is Metal. All screen captures presented in this tutorial display the Metal look and feel. It is also possible to set language and spelling options in the Preferences window.By default, your new review is at the protocol stage, indicating that you are planning the methods for a review. Sections of a review that are not required at the protocol stage (but will be needed later for your completed review) appear as inactive (light grey) in both the outline pane and the content pane.or review icon at the topWhen you undertake a Cochrane review, the protocol must be completed and submitted for publication before moving on to the review stage. For this tutorial, to convert the file from the protocol stage to review stage, use the following directions:1.Click the Properties button in the top-right of the content pane.2.In the Properties window, select the General tab.3.Note the automatically generated Version Number – this number will changeeach time the review is checked into Archie. Note that you do not need aseparate Review Number unless your Review Group provides one.4.Enter the Version Description ‘First draft’. When choosing a versiondescription, make sure it is brief and clearly indicates what’s different aboutthis draft, e.g. ‘Edited by [your initials]’ or ‘Methods section complete’.5.For the Stage, select Full Review.6.Click OK. Note that all of the section headings of the review are nowactivated for inclusion (there are no light grey section headings).Saving a reviewWhen you have finished working on a review from Archie, we recommend that you always save the review by checking it back into Archie using the Check In button on the toolbar. This ensures the most recent version of your review is safely stored and can always be accessed from Archie by your co-authors and editors.We recommend that you do not keep saved reviews on your computer, to avoid confusion with different versions. Be careful not to use a version of your review from your computer if a more recent version is available in Archie. If for some reason you do need to save a review to your computer, such as this tutorial review which is notfrom Archie, go to the File menu and select Save As, or click the Save button on the toolbar. You can open a saved review by going to the File menu and selecting Open, or clicking the Open button on the toolbar.RevMan also creates automatic backups of your review. See the Help menu for information on retrieving a backup file.Adding authors to a reviewFor a real review, your Review Group will add your name as an author of the review when they create the file, along with any known co-authors. You may wish to add additional authors later.There are two ways to add authors to a review:•Add an author based on their record in Archie – this option allows you to add authors who are already listed in the Archie database. You will need tohave internet access and an Archie user account for this option.•Add a local record (name only) that can be linked to Archie later – this option allows you to add authors that are not yet listed in Archie.1.In the content pane, click the icon next to the Review information headingto show further subheadings.2.Click the icon to open the Authors section. Note that three authors havealready been added to this review.3.In the outline pane, click the key icon next to Review information.4.Select the Authors heading.5.Click the Add Author button on the outline pane toolbar to open the NewAuthor Wizard.6.Select Add a local record (name only) that can be linked to Archie later. ClickNext.7.Enter your name in the First Name and Family Name fields.8.Click Finish. You will now see your name listed next to the other authors ofthe review. Note that no affiliation is available for your name. Affiliations canonly be added from records in Archie.Under the author details in both the outline and content panes you will note that a Contact person can be specified for the review. By default, this is the first author, but another person (who may or may not be an author of the review) can benominated by selecting the Contact person heading in the outline pane and clickingthe Edit Contact Person button on the outline pane toolbar. The contact personmust be listed in Archie.Accessing the Cochrane Handbook for Diagnostic Test Accuracy ReviewsFor detailed instructions on what to report in each section of your review, you canrefer to the Cochrane Handbook for Diagnostic Test Accuracy Reviews. This can beaccessed from the Help menu, or by clicking the Handbook button in the topright-hand corner of the content pane, which will open a new window that will allowyou to browse through all sections of the Handbook. A particular section of the Handbook can be opened in the new window depending on which section of the Main text you are working on.1.In the outline pane, if it is not already expanded, click the key icon next tothe Main text heading.2.Click on the word Abstract.3.In the content pane, click the Handbook button (or right click and selectHandbook). Note that the Cochrane Handbook for Diagnostic Test Accuracy Reviews window has opened at the section with guidance on what to write in the abstract of the review.4.Close the Cochrane Handbook for Diagnostic Test Accuracy Reviewswindow.PART 2 – Working with textAdding text to a reviewText can be copied and pasted from a word processor document, imported as an html file or typed directly into RevMan.1.In the content pane, if it is not already expanded, click the icon next to theBackground heading.2.Click the icon next to the Target condition being diagnosed heading. Ablank line will open under the heading.3.Click to place the cursor in the blank line and type “Caffeine addiction is acommon problem that affects productivity of PhD students, mainly due totoo much talking at the coffee machine.”Formatting textRevMan text formatting options are available from the toolbar, including bold , italics , underline , superscript , subscript , and highlighting text similar to most other word processing software. You cannot change the font or type size, as these are standard for all Cochrane reviews.The Insert Symbol button allows you to insert symbols into the text of the review, including in tables and author names. You can also insert a non-breaking space. RevMan also allows bulleted and numbered lists , including multi-level lists. Making changes to headingsRevMan includes the standard headings for a complete Cochrane review, but new headings can be added and some standard headings can be deactivated.1.In the outline pane, click the key icon next to Main text to reveal thesubheadings.2.Click the key icon next to Background.3.Click the key icon next to Clinical pathway.4.Any heading with the icon is optional and can be deactivated. Right-clickthe Alternative tests subheading and select Deactivate Heading(alternatively, select the heading Alternative test(s) then click the buttonon the outline pane toolbar and select Deactivate Heading from the dropdown menu).5.Note that the heading appears deactivated (light grey) in the outline paneand the text of the heading has been removed from the content pane.6.In the content pane, click to place the cursor at the end of the text in theTarget condition being diagnosed section and press Enter to create a newline.7.On the toolbar, you will see a drop-down box showing the text style currentlyin use. By default, text is in the Normal style. Click the drop-down arrow andselect Heading 3.8.Type the text ‘Reference standard’. Note that formatting of Heading 3 is boldand italics.9.Press Enter again. Note that the new blank line is in the Normal style again. Adding notesYou can add notes to assist in drafting the review. These notes will not appear in the published version of the review.1.In the content pane, make sure the cursor is still in the Background section.2.Click the Notes button on the outline pane toolbar (NOT the Notes buttonin the content pane). This will open the Notes window.3.Enter a note, ‘This text needs revision.’ You will see the user details youentered in the Preferences window at the beginning of the tutorial appearsat the bottom of the Notes window.4.Click the Close button to save the note and close the window.5. A yellow Note icon appears next to the relevant heading in both thecontent pane and outline pane.6.To see all the notes for a review while you are working, go to the View menuand select Notes. A separate window pane will appear below the contentpane showing the notes for each section.7.In the content pane, click to place the cursor back in the Background section.The notes area will automatically display the note you have entered in thatsection.8.Click the icon at the top left of the notes area to minimise it, or go to theView menu and select Notes to close the notes pane.9.In the content pane, click the Note icon to open the Notes window again.10.Click Delete to delete the note.Tracking changes in the textRevMan has a Track Changes system to help you manage editing in the text.1.From the Tools menu, select Track Changes, or click the Track Changesbutton on the toolbar. Note that the Track Changes button is now activated.2.In the content pane, go to the Background section and replace the word‘problem’ with the word ‘condition’. The old text will appear in red with a line through it, and the new text will appear in green.3.In the same section of the review, change the word ‘at’ to ‘by’. Leave thecursor in the text after your changes.4.From the Tools menu, select Accept or Reject Changes. This will open theAccept or Reject Changes window.5.In the window you just opened, click the Find button with the arrow pointingleft to search backwards toward the beginning of your document.6.The first change found will be the word ‘function’. The word will behighlighted in the content pane. You may need to move the Accept or Reject Changes window out of the way to see the highlighted section of text. ClickAccept to accept the change.7.RevMan will automatically find the next change and highlight the relevanttext. Click Accept again to accept the deletion of the word ‘at’.8.Reject the rest of the changes you made by clicking the Reject All button.9.Click OK.10.In the content pane, change the word ‘problem’ to ‘condition’ again.11.Hover the mouse pointer over the change. A popup message will appearshowing the user details and when the change was made.12.Right-click each change (both the added word and deleted word) and selectAccept Change.13.Turn off the Track Changes feature by clicking the Track Changes buttonon the toolbar.Checking your spellingRevMan can either check your spelling as you type, or check all the spelling in your review at the one time.1.From the Tools menu, select Preferences.2.Select the Spell Checking tab.3.Select which dictionaries you would like RevMan to use, including UK, US orCanadian English. You can select more than one dictionary if you wish.4.Click OK.5.In the content pane, create a spelling mistake by deleting an ‘m’ from theword ‘common’.6.Open the Tools menu and select the Check Spelling option. This will open theCheck Spelling window.7.Depending where your cursor was placed, RevMan may ask whether you wishto continue checking from the beginning of the document. Click Yes.8.RevMan will highlight the spelling mistake and suggest ‘common’ as thecorrect spelling. Click Change.9. A notice will appear to say that the spell check is complete. Click OK.10.Click OK again to close the Check Spelling window.11.To check spelling continuously while you type, go to the Tools menu andselect Check Spelling as You Type, or click the Check Spelling as You Type button on the toolbar.12.Delete the ‘m’ from ‘common’ again, and click to place the cursor elsewherein the text. The spelling mistake will be underlined in red.13.To correct the word, right-click it and select the correct spelling from theoptions available.PART 3 – Adding studies and referencesThere are two kinds of references that can be added to a review:•References to studies – these are references to studies that have been either included or excluded from your review. A study can have more than onereference, for example if there has been more than one published paper, or if you have received additional information from the study author.•Other references – these are any other source you would like to cite in your review, such as background articles, methodological references, software,etc.Adding studies to a reviewWhen you are ready to add included and excluded studies to your review, you will need to create a Study ID for each study, and then add the associated references. For Cochrane reviews, the Study ID is usually the name of the lead author of the main published paper and the year of publication. If you have more than one reference with the same name and year, you can add a letter to the year to differentiate them(e.g. Egberts 2001a, Egberts 2001b).1.In the outline pane, click the key icon next to Studies and references.2.Click the key icon next to the Reference to studies section. You will seethat there are already some studies included.3.Select Included studies and click the Add Study button on the outlinepane toolbar. This will open the New Study Wizard.4.Enter the Study ID ‘Dorlas 2006’ and click Next.5.From the Data source drop-down list, choose Published and unpublisheddata. Click Next.6.The year the study was conducted will appear by default as ‘2006’. Click Next.7.If your study has an ID number, such as a document ID, you can enter it hereby clicking the Add Identifier button, selecting an ID type from the drop-down list, and entering the ID.8.Click Next.9.Select Add another study in the same section and click Finish.10.Repeat steps 4-9 and add the following studies to the tutorial review:Egberts 2001Levelt 2007Smit 200611.When you have added the details for the last study, instead of step 9, selectNothing and click Finish.12.In the outline pane, click the key symbol next to Included Studies to seethe new studies listed.Adding references to a study1.In the outline pane, select the Dorlas 2006 study.2.Click the Add Reference button on the outline pane toolbar. This will openthe New Reference Wizard.3.By default, the Reference Type is set to Journal article (click the drop-downlist to see the other options available). Click Next.4.Enter the following details in the form provided (note that fields appearing inbold are mandatory):Authors: Dorlas S, Egberts DEnglish title: Questionnaires to measure caffeine addictionJournal/book/source: Journal of Addictive ResearchDate of publication: 2006Volume: 15Issue: 4Pages: 567-715.Click Next. As for a study, you will have the option to add an ID number forthe reference, such as a MEDLINE reference number.6.Click Finish. The reference will now appear in the content pane. In the outlinepane, click the key symbol next to Dorlas 2006 to see the new reference listed.Editing an existing reference1.In the outline pane, double-click the reference listed under the Dorlas 2006study (or right-click and select Edit Reference).This will open a new tab in the content pane showing all the details you entered.2.Open the Reference Type drop-down box and change the type from ‘Journalarticle’ to ‘Book’. Note that the fields have changed and some rows are nowshaded. Shaded rows will not appear in your published review.3.Change the reference information to the following (you need to scroll downto see some of these fields):Authors: Dorlas S, Egberts DJournal/book/source: Measuring caffeine addictionDate of publication: 2006Publisher Name: Grinder PressCity of publication: London4.At the bottom of the reference tab, note that the reference is displayed as itwill appear in the published review. Note that this display changes as youmake the changes to the reference. Check that the reference appearscorrectly.5.Go to the tab header and click the button next to the first author’s name toclose the reference tab (do not click the button at the top right corner asthis will close the review).Importing references from a text fileIf you have already entered your references in another program, you can avoid typing them in again by importing them from a text file. A sample text file has been provided with RevMan 5 for this tutorial.1.Go to the File menu and select Import, then References. This will open theImport References Wizard.2.Click Next.3.RevMan should automatically open the same folder we used to open thesample review: c:\\program files\review manager 5\doc\tutorial. Select the file ‘DTA Study References.txt’ and click Open.4.You will see a preview of the text file. Click Next.5.By default, RevMan Format is selected as the format of the text file (otheroptions include RIS or PubMed MEDLINE formats). Click Next.6.By default, RevMan will save references to the Classification pendingreferences section, under Other References in the outline pane. Referencesin this section will not appear in the published review (for this reason theyare shown in grey). Click Next.7.If you wish, you can assign different locations for each individual reference,or exclude specific references from the text file while importing the rest. Forthis tutorial, leave the settings as they are and click Finish.8.RevMan will report that 8 references have been imported. Click OK.9.In the outline pane, use the key icons to open the Other references sectionand then the Classification pending references section. You will see thereferences you imported.Moving referencesThere are several ways to move references to the appropriate study.1.In the outline pane, in the Classification pending references section, selectthe reference Egberts 2001.2.From the Edit menu, select Cut or click the Cut button on the toolbar.e the key icons to open the Included studies section, and open theEgberts 2001 study. An [Empty] reference has been added here. To add areference manually, you can edit the empty reference using the instructionsin the previous section.4.Select the Egberts 2001 study.5.From the Edit menu, select Paste, or click the Paste button on the toolbar.6.The reference will be deleted from the Classification pending referencessection and added to the Egberts 2001 study. Note that the [Empty]reference has gone.7.Go to Classification pending references and right-click Gunnink 2003.8.Select Move to, then Included studies. As there was no study with a namematching the reference, RevMan will automatically create a new study in the Included studies section with the ID Gunnink 2003.9.Go to the Classification pending references section and select Kanis 2007.10.Click and drag the reference to the Kanis 2007 study.11.Repeat steps 1 to 6 and 10 to move the remaining references to thecorresponding studies.12.In the outline pane, click the key icons to open the Included studiessection, and then open the Egberts 2001 study.13.Select the first reference and double-click to open the reference tab.14.In the content pane, check the This is the primary reference for the studybox.15.In the outline pane, note that the book icon beside the primary referenceappears in black , and the icons beside the other references are grey . Adding links to references in the textRather than typing citations in the text or including footnotes, RevMan allows you to include active hyperlinks to references in the text of your review.1.In the content pane, scroll up to find the Target condition being diagnosedsection.2.Click to place the cursor after the word ‘machine’.3.From the Format menu, select Insert Link, or click the Insert Link buttonon the toolbar. This will open the Insert Link window.4.From the list, select the study Gunnink 2003. Note that you can use this samemethod to link to included and excluded studies, figures, tables, sections ofthe review text and external web links.5.Click OK. You will see a blue hyperlink to the reference appear in the text.This link will be active after the review is published in The Cochrane Library.6.Add a space before the link and parentheses ( ) before and after the link, sothat it appears as “…the coffee machine (Gunnink 2003).”。

Review Manager4.2 讲义

Review Manager (RevMan)——临床医生通向Meta分析的桥梁Review Manager (RevMan)——a Bridge leading the Clinicians to Meta Analysisiseeyou1989年蒂姆成功开发出世界上第一个Web服务器和第一台Web 客户机并将他的发明命名为World wide web，由此引发了一场新的信息革命和经济革命；1972年Archie Cochrane 首次提出循证医学的思想并将系统评价的方法应用于产科领域，从而开创了一场翻天覆地的医学革命。

Meta分析正是循证医学合理配置资源和提高资源有限使用效率最有效的工具[1]。

1 Meta分析简介Meta分析的前身源于Fisher1920年“合并P值”的思想，1955年由Beecher首次提出初步的概念，1976年心理学家Glass进一步按照其思想发展为“合并统计量”，称之为Meta 分析[2]。

1979年英国临床流行病学家Archie Cochrane提出系统评价（systematic review，SR）的概念，并发表了激素治疗早产孕妇降低新生儿死亡率随机对照试验的系统评价，对循证医学的发展起了举足轻重的作用。

Meta分析国内翻译为“荟萃分析”，定义是“The statistical analysis of large collection of analysis results from individual studies for the purpose of integrating the findings.”亦即“对具备特定条件的、同课题的诸多研究结果进行综合的一类统计方法。

”[3,4] Meta 从字源来说据考证有“ Meta logic：a branch of analytic philosophy that deals with the critical examination of the basic concepts of logic ”；“ Meta mathematics：the philosophy of mathematics， especially，the logical syntax of mathematics.”其中最简洁并且一语中的的是“ Meta science:：a theory or science of science，a theory concerned with the investigation, analysis, or description of theory itself.”意为一种科学中的科学或理论，一种对原理本身进行调查、分析和描述的原理。

RevMan5使用指南-中文版

RevMan5.0使用指南前言欢迎使用RevMan指南.这个指南指导Cochrane综述作者提供如何使用RevMan完成健康干预措施的系统综述.这个指南没有提供写一篇Cochrane综述所需的所有信息，也没有探讨其他类型研究的系统综述,如诊断精确性试验（diagnostic test accuracy studies）和综述的评价(overviews of reviews）.获取如何写一篇干预措施的Cochrane系统综述的更多信息，请参考RevMan帮助（Help）菜单下的“Cochrane Handbook for Systematic Reviews of Interventions”.该使用指南的后面章节的内容是建立在前面章节基础上的，所以最好从开始看起。

如果你不想看前面章节，在目录里点击你要看的章节。

如果有关于RevMan软件的技术问题，请在www。

cc—ims。

net/RevMan联系Cochrane 信息管理系统小组（Cochrane Information Management System team）.其他关于RevMan准备方案或综述的问题,请联系有关的Cochrane评价小组（Cochrane Review Group）。

注意：该使用指南中报告的结果是假设的,数据由作者杜撰。

查询目前有关一个干预措施效果的信息，请登录www。

第一章开始综述第一节打开你的综述第二节设置用户信息第三节RevMan 5 界面第四节保存综述第五节添加综述的作者第一节打开你的综述所有的Cochrane综述都存在Cochrane协作组的网上数据库—-Archie中。

当你注册成为某个Cochrane综述小组（Cochrane Review Group）成员时，你会获得登录Archie的账户。

为了开始你的综述，你需要在Archie数据库中找到你的综述，下载在RevMan中使用，完成后再点击工具栏上的“Check Out”按钮上传综述。

Review Manager 和 GRADEprofiler的使用汇编

Review Manager 和 GRADEprofiler 的使用
武汉大学公共卫生学院流行病学 Meta 分析的方法与步骤 ...................................................................................................1 一、选题................................................................................................................................... 1 二、文献检索...........................................................................................................................1 （一）文献检索策略 ....................................................................................................... 1 （二）文献检索步骤 ....................................................................................................... 1 三、文献纳入与排除...............................................................................................................2 四、文献质量评价...................................................................................................................3 五、数据及相关信息提取 ....................................................................................................... 3 六、异质性分析.......................................................................................................................3 七、效应量选择.......................................................................................................................4 八、发表偏倚分析...................................................................................................................4 （一）如何发现发表偏倚 ............................................................................................... 4 （二）发表偏倚的控制 ................................................................................................... 5

review manager修改标准

review manager修改标准
Review Manager（也被称为RevMan）是Cochrane Collaboration的一个工具，主要用于管理、分析和报告系统评价和随机对照试验的文献综述。

在使用Review Manager 进行文献综述的过程中，有时可能需要修改一些标准以适应特定的研究需求或改进工作流程。

以下是关于如何修改Review Manager中标准的建议：
明确修改需求：首先，需要明确为何需要修改标准。

这可能是因为研究目的的变化、新的方法论要求或是为了更好地筛选文献。

更新搜索策略：如果修改涉及到文献搜索，那么需要更新搜索策略以反映新的标准。

这可能包括更改关键词、修改数据库搜索限制或调整搜索日期范围。

调整纳入和排除标准：如果修改是关于文献的纳入和排除，那么需要更新这些标准以确保它们与研究目的相一致。

这可能涉及更改研究类型、人群、干预措施、结局指标等。

重新评估文献：一旦标准被修改，需要重新评估已经纳入的文献，以确保它们仍然符合新的标准。

这可能需要重新阅读文献、提取新的数据或重新分析数据。

更新报告：任何标准的修改都需要在最终报告中明确说明。

这有助于读者理解为何会做出这些修改，以及这些修改如何影响研究结果。

持续质量改进：修改标准不应是一次性的活动，而应是一个持续的过程。

随着研究的进展和新的证据的出现，可能需要进一步调整标准。

总之，修改Review Manager中的标准需要谨慎考虑，并确保所有修改都是基于明确的研究需求和证据。

通过持续的改进和优化，可以提高文献综述的质量和可靠性。

循证医学RevMan(Review,Manager)v4.2课件免费下载

循证医学RevMan(Review,Manager)v4.2课件免费下载篇一：循证医学系统评价一、概念系统评价（Systematic review，SR）：是一种全新的文献综合方法，针对某一具体临床问题（如疾病的病因、诊断、治疗、预后），系统、全面地收集全世界所有已发表或未发表的临床研究，采用临床流行病学的原则和方法严格评价文献，筛选出符合质量标准的文献，进行定性或定量合成，得出综合可靠的结论。

是被公认为客观地评价和综合针对某一特定问题的研究证据的最佳手段。

独特的优点：良好的重复性二、Cochrane系统评价定义：Cochrane协作网成员在Cochrane协作网统一工作手册指导下，在相应Cochrane评价组编辑部指导和帮助下所完成的系统评价。

循证医学实践中最高质量的证据。

Cochrane系统评价目前主要限于RCT。

回答各类临床问题的证据“金字塔”。

Cochrane协作网：提供最佳证据的国家协作组织，旨在通过制作、保存、传播和不断更新医疗卫生各领域治疗措施的系统评价提高医疗保健干预措施的效率，帮助人们制定遵循证据的医疗决策。

三、系统评价的分类根据研究的临床问题：病因、治疗、诊断、预后等方面的系统评价根据纳入的原始研究类型不同：临床对照试验和观察性研究的系统评价根据纳入原始研究的方式：前瞻性、回顾性和累积性系统评价根据分析时是否采用统计学方法（Meta分析）：定性和定量的系统评价四、为什么要进行系统评价：1. 应对信息时代的挑战、海量信息需要整合2. 及时转化和应用研究成果、连接新旧知识的桥梁3. 提高统计效能、避免“只见树木不见森林”4. 克服传统文献综述的缺陷五、叙述性文献综述（Narrative Review，NR）：由作者根据特定的目的和需要或兴趣，收集有关的文献资料，采用定性分析的方法，对论文中阐述的研究目的、方法、结果、结论和观点等进行分析和评价，用自己的判断和观点，整理综合而成文。

Cochrane系统评价软件RevMan简介

四、未来发展与展望
随着医学和健康科学的不断发展，Cochrane快速系统评价将会更加完善和普及。未来，可以通过改进和完善Cochrane快速系统评价的方法和标准，提高其准确性和可靠性。可以进一步拓展Cochrane快速系统评价的应用领域，将其应用于不同国家和地区的研究中，为全球的医学和健康科学领域提供更加全面和准确的决策依据。
4、实时更新：Cochrane快速系统评价会随着新研究的出现而不断更新，确保其结论的时效性和准确性。
二、方法学解读
1、问题定义与目标：首先需要明确评价的目标和问题，确定所要研究的疾病或干预措施，以及评价的目标人群、结局指标等。
2、文献检索：通过全面的文献检索，收集所有相关的研究。Cochrane快速系统评价通常采用计算机辅助检索和手工检索相结合的方式，以确保检出所有相关研究。
也需要注意合理使用图形和遵循伦理规范等问题。通过正确使用RevMan和其他相关工具和方法，我们可以更好地总结和传播临床医学和其他领域的研究证据，从而为提高医疗质量和促进科学发展做出贡献。
参考内容
关键词：Meta分析，RevMan软件，学术研究，统计分析
在当今学术研究领域，Meta分析被广泛认为是有效的统计方法之一，可用于汇总和评估先前的研究结果。这种分析方法通过合并多个独立研究的结果，以提供更全面、更可靠的总体估计。与此同时，Meta分析的流程和方法也经历了不断的发展和优化。本次演示将介绍Meta分析的基本概念、优点及其在学术研究中的应用，并探讨使用RevMan软件进行Meta分析的实践方法。
3、高效可靠：CDEGS软件采用了先进的计算方法和算法，确保计算结果准确可靠。
4、兼容性好：CDEGS软件可与多种主流的工程软件进行无缝对接，如 AutoCAD、ANSYS等。

循证医学-循证医学系统综述与meta分析-循证医学meta分析

n 如果异质性较大，且假定理论效应量变化呈正态分布则应选用随机效应模型。随机效应模型因将研究间的变异因子2作为校正权重，其结果比固定效应模型结果更稳健。
Ø 固定效应模型的合并效应值 Ø 随机效应模型合并的效应值 Ø 绘制各研究的效应值和置信区间－－－－森林图（Forest Plot）
meta分析的数据类型
① 二分类变量资料按照某种属性分为互不相容的两类，
如描述临床结局时，选用存活、死亡，复发或不复发等。
② 数值变量/ 连续性变量资料如血压值、尿糖、CD4/CD8 数等，
n 其他需要收集的信息 n （重要引文、资助机构、利益冲突、
伦理审查，一些讨论和结论内容）
Cochrane 数据收集项目清单
摘自Cochrane handbook （Higgins JPT, Green S （editors）. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from .）
往往有度量衡单位，且能够精确测量。
③ 等级资料/ 有序多分类变量资料按照某种属性分为多类，类与类间有
程度或等级上差异。如疗效判定用痊愈、显效、有效、无效等表示。
④ 计数数据即同一个体在一定观察时间内可发
生多次不良事件，如心肌梗死、骨折、多次入院等。
⑤ 生存资料同时观察两类数据，即是否发生不
Cochrane协作网的异质性分类
（1）临床异质性：即参与者、干预措施、结局指标差
异所致的偏倚。（2）方法学异质性：

循证医学RevMan(Review

循证医学RevMan(Review篇一：循证医学系统评价一、概念系统评价（Systematic review，SR）：是一种全新的文献综合方法，针对某一具体临床问题（如疾病的病因、诊断、治疗、预后），系统、全面地收集全世界所有已发表或未发表的临床研究，采用临床流行病学的原则和方法严格评价文献，筛选出符合质量标准的文献，进行定性或定量合成，得出综合可靠的结论。

是被公认为客观地评价和综合针对某一特定问题的研究证据的最佳手段。

循证医学实践中最高质量的证据。

Cochrane系统评价目前主要限于RCT。

回答各类临床问题的证据“金字塔”。

六、系统评价与叙述性文献综述的区别与联系确定一篇综述为叙述性文献综述还是系统评价，主要取决于是否采用科学的方法以减少偏倚和混杂因素的影响。

RevMan4.2教程

Meta分析正是循证医学合理配置资源和提高资源有限使用效率最有效的工具[1]。

循证医学-系统评价

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7.解释系统评价的结果（讨论和结论）
❖ 论证强度：检索和采集数据的质量如何？目前此类研究是否存在方法学的局限、汇总结果的大小、方向。
❖ 明确结论：目前通过CSR是否得出某一疗法有效或无效？如果现有资料尚不足以下结论，有何趋势？进一步进行临床试验的建议。
❖ 推广意义：现在的结论是否可以在临床实践中推广此疗法？是否存在环境背景和地域差异？在推广应用时，应结合该CSR的文献纳入/排除标准，考虑其样本的代表性如何等。
特点资料搜集质量控制措施方法学不断更新反馈意见及修正
CSR 全面完善规范是及时
一般 SR 不一定全面不一定完善不一定规范
否不一定及时
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CSR的完成过程
❖ 选题及在专业评价小组注册题目 ❖ 完成研究方案(Protocol) ❖ 送专业评价小组编辑部审批 ❖ 修改 ❖ 接受发表 ❖ 完成全文 ❖ 送专业评价小组编辑部审批 ❖ 修改 ❖ 接受发表 ❖ 随时更新
❖ 各指标的均数和标准差/标准误 ❖ 事件发生率
所有数据资料均要输入系统评价管理软件
（review manager，RevMan），以进行文献结果的分析和报告。
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6.分析资料和报告结果
❖ 定性分析
❖ 定量分析前必不可少的步骤。
❖ 定量分析
❖ 同质性检验 ❖ Meta-分析 ❖ 敏感性检验
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五、系统评价的应用
❖ 科研工作的需要
❖ 例：英国国家医学研究会资助的临床试验，要求申请者回答是否已有相关的系统评价及其结论如何，并邀请系统评价的作者参与临床试验申请书的评审工作。

Cochrane系统评价及Review Manager软件简介

Cochrane系统评价及Review Manager软件简介
循证医学对证据的分级
❖ 一级证据
高质量的系统评价高质量的大型随机对照试验
❖ 二级证据
观察性研究的系统评价小型的单个随机对照试验
❖ 三级证据
高质量的队列研究和病例-对照研究
❖ 四级证据
综述和专家意见
Cochrane系统评价及Review Manager软件简介
安装
双击下载文件revman42开始安装，连续点击6次“Next”完成安装
Cochrane系统评价及Review Manager软件简介
启动
Cochrane系统评价及Review Manager软件简介
初次运行Revman
❖ 联系编号（contact ID）：每个综述者唯一的标识，最多不超过4个字符
Cochrane系统评价及Review Manager软件简介
二、系统评价的制作过程
❖ 制订课题计划书（protocol) ❖ 科学背景 ❖ 研究目的 ❖ 纳入标准和排除标准
研究类型观察对象干预措施测量指标
Cochrane系统评价及Review Manager软件简介
系统评价的制作过程
♠ 图表提供早产孕妇随机对照试验的系统评价结果。第一个试验于1972年发表，试验结果透露corticosteroid的治疗能够降低婴儿因为早产所出现的并发症。1991年，更多试验结果也陆续发表，同时也更加强这项治疗方式的说服力－可减少 30%到 50%的死亡机率。
♠ 由于直到 1989年才有相关的系统评论数据及随机对照试用被出版报导，大部份的产科医师无从得知这项治疗方法的效用，也因此许多早产儿无辜地受难及及死亡（并浪费许多无效的医疗资源）。

循证医学RevMan(Review,Manager)v4.2课件免费下载

是被公认为客观地评价和综合针对某一特定问题的研究证据的最佳手段。

循证医学实践中最高质量的证据。

Cochrane系统评价目前主要限于RCT。

回答各类临床问题的证据“金字塔”。

《循证医学》Review Manager 使用介绍

【Revman使用手册（图文版）：第一部分：建立综述】

Revman 讲义 教程

Review Manager操作技术

系统评价与meta分析之-Review manager-Revman软件使用-水天之间 - DXY

Review Manager操作技术

Review Manager 5.2诊断性试验系统评价手册

Review Manager4.2 讲义

RevMan5使用指南-中文版

Review Manager 和 GRADEprofiler的使用汇编

review manager修改标准

循证医学RevMan(Review,Manager)v4.2课件免费下载

Cochrane系统评价软件RevMan简介

循证医学-循证医学系统综述与meta分析-循证医学meta分析

循证医学RevMan(Review

RevMan4.2教程

循证医学-系统评价

Cochrane系统评价及Review Manager软件简介

循证医学RevMan(Review,Manager)v4.2课件免费下载

Revman 讲义教程