Systematic reviews of effectiveness of Public Health practice

Abstract

Background: Public Health is the main discipline involved in the prevention of avoidable deaths. To
implement interventions aimed at eliminating causes of death, and to take decisions based on evidence of
effectiveness, research summaries are needed.
Methods: To discuss the critical points for synthesizing the evidence on the effectiveness of public health
interventions, the inconsistencies between the results produced by different epidemiological study designs
and the methodological issues related to the quality of the summaries are underlined.
Results: The Randomized Controlled Trial is recognized as the best study design for the assessment of the
effectiveness of clinical practices; however, the integration of the results from non-randomized and
randomized interventions has been suggested recently. In particular this involves Public Health, where the
randomization of individuals is often impossible, and interventions are administered at different levels
(individual, group, population).
Conclusions: Systematic reviews are not common in Public Health. Methodological tools to write rigorous
summaries of the evidence from public health interventions, taking into account all possible biases, appear
to be a priority.