系統性文獻回顧（Systematic Reviews, SR）乃以實證醫學為基礎所發展延伸的研究文獻，為摒除學術傳播偏差提升該類型文獻之完整性與客觀性，醫學圖書館員會參與其中協助資料檢索與相關資訊服務。根據2017年美國醫學圖書館學會（Medical Library Association, MLA）發佈之「醫學圖書館員終身學習與成就專業能力」（MLA Competencies for Lifelong Learning and Professional Success），首次明訂SR文獻檢索及其相關知識為館員必備之專業能力。然因國內參與該研究之館員仍在少數，故本研究乃以「醫學圖書館員參與Medline所收錄的SR」為研究對象，並應用書目分析與內容分析法萃取出重要資訊，藉以瞭解其文獻特質、圖書館員角色、資料庫與檢索策略應用、學科分布及通訊作者特質，提供欲參與該研究之館員參考。
    根據研究結果歸納重點如下：（一）在文獻特質方面，自2014年至2016年間符合研究條件之文獻共有786篇，醫學圖書館員參與之文獻量有增加趨勢；為提升SR品質，應依循準則進行研究，PRISMA是最常被採用且簡易之準則；文獻發表時亦應提供完整之檢索策略與檢索過程以做為文獻品質驗證。（二）在館員角色部分，則以館員共同作者比例居多占有61.58％，其餘則為內文或致謝辭提及貢獻；（三）在資料庫運用與檢索策略部分，共出現192種資料庫，平均每篇SR會檢索5.16種以上資料庫以蒐集完整之研究資料；資料庫類型包含索摘資料庫、引文資料庫、全文資料庫及註冊資料庫，索摘資料庫則以medline及PubMed平台居冠，且通常會於Medline資料庫確立檢索詞彙與檢索策略後，再微調運用於跨資料庫檢索；（四）通訊作者分屬34個國家，以美國最多，依次為加拿大及英國。台灣則僅有二篇文獻，且館員之貢獻出現於致謝辭中；（五）本研究對象有96.07％期刊收錄於JCR中，其中高達50.66％期刊列為所屬學科領域的第一分位數。
    本研究依研究結果與發現，提出以下建議：（一）館員應應充實醫學詞彙、實證醫學及SR相關知識，並應熟悉各資料庫範圍、索引方式及檢索語法。（二）臨床人員進行SR研究時，可尋求醫學圖書館員協助或參與團隊共同進行研究，以提升研究品質。

Systematic Reviews (SR) is extended literature review based on evidence-based medicine. In order to reduce the bias on academic communication and enhance the integrity and objectiveness of such type of literature review, medical librarians will participate in service to assist the researcher in data searching and information related work. According to the "MLA Competencies for Lifelong Learning and Professional Success" published by the Medical Library Association (MLA) in 2017, for the first time, the ability of literature retrieval of systematic review, and its related knowledge, are the necessary professional qualifications for librarians. However, the number of librarians participating in the study is still a minority. Therefore, this study aims to understand the characteristics of literature review, role of librarians, pool of database and application of searching strategy, distribution of department and characteristics of corresponding author by using database on SR study from Medline database involved by medical librarians, and also applying bibliographic analysis and content analysis to extract important information. Such research might provide reference for librarians who wish to participate in the study.
The results of the study reveal that: (1) in the characteristics of literature review, a total of 786 in line with the conditions of the literature review of SR from 2014 to 2016 years. More medical librarians involved in the increasing amount of literature review of SR. In order to enhance the study quality of SR, we should follow the guidelines for research. Among them, PRISMA is the most commonly used and simple guidelines; the publication of SR should also provide a complete searching strategy and process of data searching for assurance of good searching quality. (2) In the role of librarians, the proportion of librarians as co-author occupies 61.58%; the rest of them mentioned the contribution of librarian in the text or acknowledgement. (3) In the database application and searching strategy part, 192 kinds of databases appeared. An average of 5.16 or more databases searched to collect complete SR research data. The type of database contains “Indexing & Abstracting Database”, the “Citation Index Database”, the “Fulltext Database”, and the “Clinical Register Database”. The highest data searched was on Medline and PubMed. In addition, usually we used Medline database to establish the searching terms and searching strategies, then perform fine-tuning by cross-database searching. (4) The corresponding author of all SR belongs to 34 countries, with the largest number of them is from the United States, followed by Canada and the United Kingdom. Taiwan has only two SR, and the librarian's contribution only appears acknowledgement. (5) 96.07% of the SR was included in the JCR, of which up to 50.66% of the journals listed as the first quintiles in the subjected area. 
According to the results and findings in the study, recommendations are provide as below: (1) Librarians should be proficient in the medical vocabulary, evidence based medicine, and systematic review related knowledge, and should be familiar with the scope of the databases, the indexing methods and search syntax; (2) For conducting the research of systematic review, clinical staffs can seek for the assistance of medical librarians, or participate in the team for a joint study to improve the quality of research.

第一章 緒論	1
第一節 研究背景與動機	1
第二節 研究目的與問題	4
第三節 研究範圍與限制	4
第四節 名詞解釋	5
第二章 文獻探討	7
第一節 實證醫學	7
第二節SR之定義與應用	22
第三節SR之品質監控	26
第四節 SR與系統性檢索	33
第三章 研究設計與實施	45
第一節 研究架構	45
第二節 研究方法	46
第三節 研究對象	46
第四節 研究工具	49
第五節 研究步驟	51
第四章 研究結果與討論	53
第一節 文獻特質	53
第二節 醫學次級學科領域差異	62
第三節 作者特質	66
第四節 圖書館員角色	70
第五節 資料庫及檢索策略分析	75
第六節 綜合討論	85
第五章 結論與建議	89
第一節 結論	89
第二節 建議	94
第三節 未來研究之建議	97
參考文獻	99
附錄一 PRISMA 檢查表	109
附錄二 PRISMA 流程圖	111
附錄三 DATA EXTRATION SHEET	112
附錄四JCR學科類別與本研究對象期刊數	113

表次
表2-1 ACRL「應達成目標」與2A 資料檢索課程「學習項目」對照表 ............... 16
表2-2 2017 年MLA「醫學圖書館員終身學習與成就專業能力」之「資訊服務」評估指標
........................................................................... 19
表2-3 2016 年臺灣醫學圖書館員研習課程表 .................................... 21
表2-4 敘述性綜論與SR 之差異 ............................................... 23
表2-5 SR 準則清單 .......................................................... 32
表2-6 降低檢索策略偏差 ..................................................... 33
表2-7 多種重要SR 標準建議圖書館員參與 ...................................... 34
表3-1 醫學圖書館員職稱彙整表 ............................................... 48
表3-2 資料萃取表格 ................................................................................................................... 50
表4-1 本研究納入分析篇數 ........................................................................................................ 54
表4-2 2014-2016 年SR 文獻量分布 .......................................................................................... 55
表4-3 SR 文獻撰寫準則清單及篇數 .......................................................................................... 56
表4-4 SR 準則單用與兩種並用分析 .......................................................................................... 57
表4-5 檢索總篇數與納入分析篇數之中位數 ............................................................................ 59
表4-6 檢索策略呈現方式 ............................................................................................................ 60
表4-7 未呈現檢索過程篇數 ........................................................................................................ 61
表4-8 出版量最高前20 種期刊清單與刊登篇數 ...................................................................... 62
表4-9 未收錄於JCＲ之期刊清單與SR 文獻篇數 ................................................................... 63
表4-10 IF 值10 分以上期刊清單 ............................................................................................... 64
表4-11 前十大學科領域及期刊數 .............................................................................................. 65
表4-12 期刊學科領域排行分布 .................................................................................................. 65
表4-13 作者數與篇數分布 .......................................................................................................... 66
表4-14 通訊作者所屬機構國別 .................................................................................................. 68
表4-15 臺灣醫學圖書館館員參與之SR 文獻書目資料 ........................................................... 69
表4-16 歷年圖書館員貢獻之文獻數量 ...................................................................................... 70
表4-17 館員為共同作者之人數分布 .......................................................................................... 71
表4-18 多位館員參與之SR 文獻書目資料 ............................................................................... 72
表4-19 圖書館員職稱名詞與形容詞 .......................................................................................... 75
表4-20 本研究所有使用資源清單 .............................................................................................. 75
表4-21 資料庫平台次數及百分比分析 ...................................................................................... 77
表4-22Cochrane Library 子資料庫使用次數 ............................................................................. 78
表4-23 同時檢索EMBASE 與Medline 各平台之SR 文獻數量 ............................................. 79
表4-24 特殊主題索摘資料庫 ...................................................................................................... 80
表4-25 引文資料庫 ...................................................................................................................... 80
表4-26 註冊資料庫 ...................................................................................................................... 81
圖次
圖2-1 執行實證醫學三要素 ........................................................................................................ 11
圖2- 2 實證醫學五步驟 ............................................................................................................... 13
圖2-3 中央健康保險署「發展臨床診療指引之SR 進行流程圖」 ......................................... 25
圖2-4 國民健康署「骨質疏鬆症臨床治療指引」GRADES OF RECOMMENDATION .................. 25
圖2-5 耶魯大學醫學圖書館SYSTEMATIC REVIEW SERVICE 網頁 .............................................. 36
圖2-6 快速檢索概念的4S/ 5S/6S 金字塔 .................................................................................. 39
圖2-7 研究設計概念的文獻金字塔 ............................................................................................ 41
圖2-8 PUBMED 資料庫 2010 年-2016 年SR 文獻年增量 ......................................................... 42
圖3-1 研究架構 ............................................................................................................................ 45
圖3-2 SR 檢索語法 ...................................................................................................................... 47
圖3-3 研究步驟流程圖 ................................................................................................................ 52
圖4-1 2006-2015 年MEDLINE SR 文獻量 ................................................................................... 53
圖4-2 COCHRANE INFORMATION SPECIALISTS' HANDBOOK .......................................................... 55
圖4-3 CDSR 文獻版本 ................................................................................................................ 59
圖4-4 檢索結果與實際納入分析之文獻篇數散佈圖 ................................................................ 60
圖4-5 置於附錄之檢索策略範例 ................................................................................................ 61
圖4-6 單一作者SR 文獻致謝詞 ................................................................................................. 67
圖4-7 黎巴嫩作者致謝詞 ............................................................................................................ 68
圖4-8 館員為共同作者之國家別篇數 ........................................................................................ 71
圖4-9 圖館員參與之SR 文獻及館員作者排序分析 ................................................................. 73

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