Systematic review and rapid evidence assessment of the literature methodology: The field, logistics, and challenges

Objective: At present, evidence rankings do not consider equally internal (IV), external (EV), and model validity (MV) for CAM studies. Therefore, we have developed an EV/MV-REAL-PLUS-tool for evaluating EV and MV criteria. The purpose of this presentation is to describe this model. Methods: A systematic review methodology was used to evaluate the literature on EV/MV. Pubmed search for keywords external validity, model validity, and bias-scoring from inception to Jan 2013. The research team developed the EV/MV-REAL-PLUS-tool scale based on other published EV/MV scales i.e the GAP-Scale. Results: 1131 abstracts were reviewed. We created the EV/MV-REAL-PLUS-tool scale to measure: 1) how closely the study population; 2) the institution types in the study; 3) the types of physicians in the study; 4) the role of clinician decision-making in the study; and 5) the role of patient preferences in the study resemble those in actual practice. Conclusion: Improved reporting on EV can help produce and provide information that will help guide policy makers, public health researchers, and other scientists, especially in the field of Integrative Health Care, in their selection, development, and improvement in their research-tested intervention. Overall, RCTs and pragmatic-studies with high EV have the potential to provide the most useful information about ‘real-world' consequences of health interventions. It is hoped that this novel tool which considers internal and external validity on equal footing, will better guide clinical decision making.