15 Systematic Reviews

Question 1

4 reasons to do systematic reviews

Answer 1

Response to calls to organize knowledge
Efficient way to access a specific body of research
Explore differences between studies
Reliable basis for decision making

Question 2

Evidence informed healthcare takes what 3 things into account?

Answer 2

Clinical expertise
Patient’s values
Research evidence

Question 3

Narrative vs systematic reviews

1. Question
2. Sources and searches
3. Selection

Answer 3

1. NR: broad, SR: focused clinical question
2. NR: not specified, biased, SR: comprehensive source and strategy explicitly stated
3. NR: not specified, biased, SR: criterion-based, uniformly applied

Question 4

Narrative vs systematic reviews

1. Appraisal
2. Synthesis
3. Inferences

Answer 4

1. NR: variable, SR: rigorous critical appraisal
2. NR: qualitative summary common. SR: qualitative summary plus or minus meta analyis
3. NR: sometimes evidence based, SR: evidence-based

Question 5

What are systematic reviews?

Answer 5

Synthesis of results of all available studies
Address a focused question
Use systematic and explicit methods to identify, select and appraise relevant research and collect/analyze data
Minimize potential biases at each step
They use well-defined protocol and methodological principles to attempt to reduce bias

Question 6

5 advantages of systematic reviews

Answer 6

Digest large amounts of information
Assess consistency of results
Improve ability to detect an experimental effect
Increase precision in estimate of effect
Reduce random errors

Question 7

5 potential disadvantages of systematic reviews

Answer 7

Can be difficult to read and interpret
A poor systematic review may be given greater precedence than a well conducted RCT
The inclusion of inappropriate studies can lead to drowning of important effects
Increase systematic errors
Limited by reporting quality

Question 8

Time required for a systematic review

Answer 8

6 months

1200 hours

Question 9

5 steps of a systematic review

Answer 9

Formulate the review question
Identify studies
Select studies for inclusion
Appraise included studies
Synthesize the results

Question 10

PICOS

Answer 10

Population
Intervention (exposure)
Comparison
Outcome
Study designs

Question 11

Importance of the review question (3)

Answer 11

Transparency
Minimises bias
Facilitates subsequent steps

Question 12

Which step is the key factor distinguishing systematic reviews from narrative reviews?

Answer 12

Identifying studies

Use a comprehensive literature search

Question 13

3 different analytical methods

Answer 13

Narrative synthesis
Meta-analysis
Meta regression +

Question 14

Meta-analysis

Answer 14

Statistical analysis of a collection of independent studies

Quantitative part of systematic reviews