Evidence Synthesis

Past research and findings offer valuable insights if you know where to look and how to synthesize and apply the evidence. These evidence syntheses, either as standalone products or in support of guidelines, are critical to supporting decisions now, and for identifying priorities for additional research to allow even better decisions in the future.

Synthesize Evidence. Improve Decisionmaking.

The Duke Evidence Synthesis Group (Duke ESG) synthesizes evidence on the comparative effectiveness, safety, and value of prevention, treatment, and management strategies to inform and improve decisionmaking for patients, providers, and policymakers.

The utility of these syntheses is dependent not only on their underlying scientific rigor, but also on the extent to which they address the explicitly stated needs of stakeholders, avoid real or perceived conflicts of interest, and present the results clearly.

Duke ESG has a sustained record of excellence in conducting a full range of activities backed by transparent and rigorous research methods and tools.

Gillian Sanders-Schmidler

By combining multiple sources of evidence, the decision-making process is more transparent and better understood, and that benefits everyone.

Gillian Sanders-Schmidler, PhD

Duke Evidence Synthesis Group Director

The Duke Evidence Synthesis Group produces comparative effectiveness reviews on medications, devices, and other health care services with the goal of helping patients, physicians, and policymakers make better decisions about treatments. Depending on the uncertainty that exists, one or more methods may be used.



  • Where should we focus future data acquisition?
  • What future research is of most value to different decisionmakers?


  • Value-of-information analyses
  • Stakeholder engagement
  • Future research needs prioritization
  • Horizon scans



  • What do we know about the comparative safety and effectiveness of alternative strategies?
  • What are the benefits and harms of available strategies?
  • What are the limitations of existing evidence?


  • Systematic reviews of the evidence
  • Individual patient data analysis
  • Meta-analysis



  • How do we trade off possible benefits and harms?
  • How can we make our decisionmaking process transparent and understood?
  • How can we inform decisionmaking from diverse perspectives?
  • What healthcare interventions are the best value given limited resources?
  • How do alternative payment models effect the implementation and or value of interventions?


  • Decision modeling
  • Cost-effectiveness analysis
  • Benefit-harm acceptability curves
  • Shared decision making
  • Guideline development

Duke Evidence-Based Practice Center

AHRQ logo

Duke ESG is proud to once again serve as the Duke Evidence-based Practice Center (EPC) for the Agency for Healthcare Research and Quality (AHRQ).

The Duke Evidence-based Practice Center brings together the expertise necessary to develop state of the art systematic reviews and meta-analyses. The EPC advances understanding of clinical topics through 1) a thorough ascertainment of available scientific research, 2) a scientifically-driven process for evaluating available evidence, and 3) a methodologically sophisticated analysis designed to demonstrate and estimate bias. The goal of such projects is to aid in the development of clinical practice guidelines or practice improvement projects. The center is one of 13 Evidence-based Practice Centers (EPCs) nationwide designated and funded by the Agency for Healthcare Research and Quality (AHRQ).

Case Studies

Breast Cancer Screening


ADAPTABLE Trial Analysis

Duke ESG Leadership

Professor of Medicine; Duke Evidence Synthesis Group, Director; Duke Evidence-based Practice Center, Director; Duke Clinical Research Institute
Walter L. Thomas Professor Division of Clinical and Epidemiological Research, Department of Obstetrics & Gynecology; Duke University Medical Center Duke Evidence Synthesis Group, Associate Director; Duke Evidence-based Practice Center, Associate Director
Project Leader III; Evidence Synthesis Group/ Evidence-based Practice Center, Program Manager; Duke Clinical Research Institute