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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">rpcardio</journal-id><journal-title-group><journal-title xml:lang="en">Rational Pharmacotherapy in Cardiology</journal-title><trans-title-group xml:lang="ru"><trans-title>Рациональная Фармакотерапия в Кардиологии</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1819-6446</issn><issn pub-type="epub">2225-3653</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20996/1819-6446-2023-2923</article-id><article-id custom-type="edn" pub-id-type="custom">WHYFSZ</article-id><article-id custom-type="elpub" pub-id-type="custom">rpcardio-2923</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>POINT OF VIEW</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ТОЧКА ЗРЕНИЯ</subject></subj-group></article-categories><title-group><article-title>Systematic review and meta-analysis: a critical examination of the methodology</article-title><trans-title-group xml:lang="ru"><trans-title>Систематический обзор и метаанализ: критический взгляд на методологию проведения</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7717-4362</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Марцевич</surname><given-names>С. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Martsevich S.Yu.</surname><given-names>S. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Марцевич Сергей Юрьевич</p><p>Москва</p></bio><bio xml:lang="en"><p>Sergey Yu. Martsevich</p><p>Moscow</p></bio><email xlink:type="simple">sergeymartsevich@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4022-2981</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Навасардян</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Navasardyan</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Навасардян Артур Рубенович</p><p>Москва</p></bio><bio xml:lang="en"><p>Artur R. Navasardyan</p><p>Moscow</p></bio><email xlink:type="simple">bk_nar@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5358-7218</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лобастов</surname><given-names>К. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lobastov</surname><given-names>K. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лобастов Кирилл Викторович</p><p>Москва</p></bio><bio xml:lang="en"><p>Kirill V. Lobastov</p><p>Moscow</p></bio><email xlink:type="simple">lobastov_kv@hotmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-3022-7648</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Микаелян</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Mikaelyan</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Микаелян Максим Вадимович</p><p>Москва</p></bio><bio xml:lang="en"><p>Maksim V. Mikaelyan</p><p>Moscow</p></bio><email xlink:type="simple">Mimavad@yandex.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6175-8179</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Михайленко</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Mikhaylenko</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Михайленко Елизавета Вячеславовна</p><p>Москва</p></bio><bio xml:lang="en"><p>Elizaveta V. Mikhaylenko</p><p>Moscow</p></bio><email xlink:type="simple">elizavetamikhaylenko@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2224-0019</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Суворов</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Suvorov</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Суворов Александр Юрьевич</p><p>Москва</p></bio><bio xml:lang="en"><p>Alexander Yu. Suvorov</p><p>Moscow</p></bio><email xlink:type="simple">yourmedstat@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1306-1502</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Счастливцев</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Schastlivtsev</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Счастливцев Илья Вениаминович</p><p>Москва</p></bio><bio xml:lang="en"><p>Ilya V. Schastlivtsev</p><p>Moscow</p></bio><email xlink:type="simple">schastlivtsev.ilya@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5384-3795</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Джиоева</surname><given-names>О. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Dzhioeva</surname><given-names>O. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Джиоева Ольга Николаевна</p><p>Москва</p></bio><bio xml:lang="en"><p>Olga N. Dzhioeva</p><p>Moscow</p><p> </p></bio><email xlink:type="simple">dzhioevaon@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-6212-7499</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Матвеев</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Matveev</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Матвеев Виталий Владимирович</p><p>Москва</p></bio><bio xml:lang="en"><p>Vitaly V. Matveev</p><p>Moscow</p></bio><email xlink:type="simple">resp.tab@inbox.ru</email><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9261-009X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Акимова</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Akimova</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Акимова Елизавета Сергеевна</p><p>Москва</p></bio><bio xml:lang="en"><p>Elizaveta S. Akimova</p><p>Moscow</p></bio><email xlink:type="simple">akimova.liza.96@gmail.com</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6152-5693</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сытьков</surname><given-names>В В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sytkov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сытьков Валентин Вячеславович</p><p>Москва</p></bio><bio xml:lang="en"><p>Valentin V. Sytkov</p><p>Moscow</p></bio><email xlink:type="simple">val-sytkov@yandex.ru</email><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-7451-7967</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дубар</surname><given-names>Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Dubar</surname><given-names>E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дубар Эмель</p><p>Москва</p></bio><bio xml:lang="en"><p>Emel Dubar</p><p>Moscow</p></bio><email xlink:type="simple">emeldubar@rambler.ru</email><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4453-8430</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Драпкина</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Drapkina</surname><given-names>O. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Драпкина Оксана Михайловна</p><p>Москва</p></bio><bio xml:lang="en"><p>Oksana M.Drapkina</p><p>Moscow</p></bio><email xlink:type="simple">drapkina@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр терапии и профилактической медицины</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Medical Research Center for Therapy and Preventive Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>АО «БАЙЕР»; Национальный медицинский исследовательский центр терапии и профилактической медицины</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Medical Research Center for Therapy and Preventive Medicine; &#13;
AO Bayer</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГАОУ ВО Российский Национальный Исследовательский Медицинский Университет им. Н.И. Пирогова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>АО «БАЙЕР»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>AO Bayer</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I. M. Sechenov First Moscow State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ФУВ ГБУЗ МО МОНИКИ им. М.Ф. Владимирского; ООО «Сименс Здравоохранение»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>M. F.Vladimirsky Moscow Regional Research and Clinical Institute; Siemens healthineers LLC</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ФГБОУ ВО "МГМСУ им. А.И. Евдокимова" Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A. I. Evdokimov Moscow State University of Medicine and Dentistry</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>ФГБОУ ВО "МГМСУ им. А.И. Евдокимова" Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A. I.Evdokimov Moscow State University of Medicine and Dentistry</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru"><institution>ГКБ имени С.С. Юдина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>S. S.Yudin City Clinical Hospita</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>29</day><month>09</month><year>2023</year></pub-date><volume>19</volume><issue>4</issue><fpage>382</fpage><lpage>397</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Martsevich S.Yu. S.Y., Navasardyan A.R., Lobastov K.V., Mikaelyan M.V., Mikhaylenko E.V., Suvorov A.Y., Schastlivtsev I.V., Dzhioeva O.N., Matveev V.V., Akimova E.S., Sytkov V.V., Dubar E., Drapkina O.M., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Марцевич С.Ю., Навасардян А.Р., Лобастов К.В., Микаелян М.В., Михайленко Е.В., Суворов А.Ю., Счастливцев И.В., Джиоева О.Н., Матвеев В.В., Акимова Е.С., Сытьков В.В., Дубар Э., Драпкина О.М.</copyright-holder><copyright-holder xml:lang="en">Martsevich S.Yu. S.Y., Navasardyan A.R., Lobastov K.V., Mikaelyan M.V., Mikhaylenko E.V., Suvorov A.Y., Schastlivtsev I.V., Dzhioeva O.N., Matveev V.V., Akimova E.S., Sytkov V.V., Dubar E., Drapkina O.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rpcardio.online/jour/article/view/2923">https://www.rpcardio.online/jour/article/view/2923</self-uri><abstract><p>Nowadays, the pyramid of evidence is the main model of decision-making for healthcare professionals. According to this concept, data from randomized clinical trials (RCTs) are considered lower in hierarchy than data obtained from systematic reviews (SRs) and meta-analyses (MAs). However, it заменить на:is not established whether it is appropriate to rate large RCTs with hard endpoints lower than SRs and MAs that combine data from smaller RCTs of questionable quality, or even from prospective or retrospective observational studies. It is also important to consider that in addition to assessing the quality of the studies included in the SRs and MAs, it is necessary to assess the accuracy of the SRs and MAs themselves. If not rigorously conducted, they can also contain systematic errors, leading to increased risks of data manipulation. The publication covers the main stages and principles of preparing SRs and MAs, common types of systematic errors that can arise at each stage, and methods to minimize them. We believe that the tools, knowledge, and skills we offer will help practicing doctors and healthcare professionals critically assess the results obtained from SRs and MAs in terms of methodology and the mitigation of potential data manipulation risks.</p></abstract><trans-abstract xml:lang="ru"><p>Согласно современным представлениям, принцип пирамиды доказательств является основной моделью, на которую ориентируются специалисты здравоохранения при принятии решений. В рамках этой концепции, данные отдельных рандомизированных клинических исследований (РКИ) стоят ниже данных, полученных в систематических обзорах (СО) и метаанализах (МА). При этом нет ясности, насколько правомерно ставить результаты, полученные в крупном РКИ с жесткими конечными точками ниже выводов СО и МА, объединяющих данные небольших РКИ спорного качества или даже данные проспективных или ретроспективных наблюдательных исследований. Также необходимо учитывать, что помимо оценки качества входящих в СО и МА исследований, следует оценивать корректность самих СО и МА, которые при недостаточно добросовестном подходе авторов также могут содержать некоторое количество систематических ошибок, что может приводить к увеличению рисков манипуляции данными. В данной публикации отражены основные этапы и принципы подготовки СО и МА, рассмотрены основные виды систематических ошибок, которые могут возникать на каждом этапе, а также методы их минимизации. Мы верим, что предложенными нами инструменты, знания и навыки помогут практикующим врачам и всем специалистам здравоохранения критически оценивать результаты, полученные в СО и МА, с точки зрения методологии проведения и минимизации риска возможных манипуляций данными.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>систематический обзор</kwd><kwd>метаанализ</kwd><kwd>рандомизированные контролируемые исследования</kwd><kwd>пирамида доказательств</kwd><kwd>доказательная медицина</kwd><kwd>описательный обзор</kwd><kwd>систематическая ошибка</kwd><kwd>публикационная ошибка</kwd></kwd-group><kwd-group xml:lang="en"><kwd>systematic review</kwd><kwd>meta-analysis</kwd><kwd>randomized controlled trials</kwd><kwd>pyramid of evidence</kwd><kwd>evidence-based medicine</kwd><kwd>narrative review</kwd><kwd>bias</kwd><kwd>publication bias</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Авторы выражают благодарность за научную поддержку «Независимой национальной академии доказательной медицины» и «Национальному обществу доказательной фармакотерапии».</funding-statement><funding-statement xml:lang="en">The authors express their gratitude for the scientific support provided by the “Independent National Academy of Evidence-Based Medicine” and the “National Society of Evidence-Based Pharmacotherapy”.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Paul M, Leibovici L. 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