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MED 106- RESEARCH METHODS AND ESSENTIAL MEDICAL STATISTICS > 40. SYSTEMATIC AND META-ANALYSIS STUDIES > Flashcards

40. SYSTEMATIC AND META-ANALYSIS STUDIES Flashcards

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USMLE® Step 1 flashcards
1
Q
  1. What are the aims of Evidence Based Medicine?
A

IT AIMS TO OPTIMISE MEDICAL PRACTICE:
- it aims to optimise decision making
- it does this by emphasising the use of evidence
- this evidence comes from well designed and conducted
research

MANY STUDIES:
- will have to confirm the sae results
- different literatures will have to have the same
conclusions

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2
Q
  1. How do we classify Medical Evidence?
A
  • we classify it by its scientific strength
  • only the strongest types of research can yield strong
    recommendations
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3
Q
  1. What is the Hierarchy of Evidence?
A

THIS LIST GOES FROM THE STRONGEST EVIDENCE TO THE WEAKEST:
1. Systematic Reviews
2. Randomised Control Trials
3. Cohort Studies
4. Case-Control Studies
5. Case Series and Case Reports
6. Editorials and Expert Opinions

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4
Q
  1. What are Editorials and Expert studies an example of?
A
  • they are an example of Descriptive Studies
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5
Q
  1. Which type of time-based studies provide stronger evidence?
A
  • Prospective studies
  • rather than Retrospective
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6
Q
  1. What is the advantage of High Quality Research?
A

IT HAS THE ABILITY
- to change or to improve current clinical practice

IT ENCOURAGES HEALTH CARE PROFESSIONALS
- and systems
- to use treatments that are more clinical and cost
effective

IT ENCOURAGES HOSPITALS
- to remove and stop funding practices that do not meet
the objectives

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7
Q
  1. What kind of results can Weaker Study Types bring?
A
  • they bring only weak recommendations
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8
Q
  1. What are three examples of Observational Studies?
A
  1. Cohort Studies
  2. Case Control Studies
  3. Cross-Sectional Studies
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9
Q
  1. What is a Systematic Review?
A
  • it is a review of a clearly formulated question
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10
Q
  1. What are two characteristics of Systematic Reviews?
A
  1. THEY ARE SYSTEMATIC AND EXPLICIT METHODS
    - of identifying, selecting and critically evaluate
    research
  2. THEY COLLECT AND ANALYSE DATA
    - from the studies that are included in the review
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11
Q
  1. What is Meta-Analysis?
A
  • it is an example of a Statistical Method
  • it may be used to analyse and summarise the results of
    the studies included in the Systematic Review
  • it is an optional part of the Systematic Review

WE PUT THE SYSTEMATIC REVIEW AND THE META-ANALYSIS TOGETHER:
- to create a quantitative amount to analyse

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12
Q
  1. What are the steps involved in a Systematic Review?
A
  1. FORMULATE A REVIEW QUESTION
  2. FIND THE STUDIES YOU WANT TO USE
  3. SELECT AND EVALUATE THE CHOSEN STUDIES
    - evaluate them in terms of their value
  4. SUMMARISE AND GROUP TOGETHER THE RESULTS
  5. INTERPRET AND APPLY THE RESULTS
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13
Q
  1. What is the Framework we use when we look at a Research Question?
A
  • PICOS
  • P:
  • the Types of Participants
  • I:
  • the Types of Intervention
  • this refers to the Exposure
  • C:
  • Comparators
  • O:
  • Types of Outcomes
  • S:
  • Types of studies
  • the studies can be observational or experimental
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14
Q
  1. Define: Meta-Analysis.
A
  • this is the Statistical Component of a Systematic Review

IT MAY OR MAY NOT ALWAYS BE POSSIBLE OR APPROPRIATE:
- to conduct as part of the systematic review

A META-ANALYSIS IS WHEN:
- we pool together results
- then we measure the overall and pooled association

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15
Q
  1. What does a Meta-Analysis show us?
A
  • it shows is if there is an association between the
    Exposure and the Outcome
  • this ensures that the association is not a Result of
    Chance
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16
Q
  1. What does this Logo show?
A
  • this is the Cochrane Collaboration (1993)
  • it encouraged the growth of Meta-Analysis in Medical
    Research
17
Q
  1. Why should be conduct a Meta-Analysis as part of a Systematic Review?
A
  • a single study may not give very precise results about
    the effects of a treatment

COMBINING THE RESULTS FROM SEVERAL STUDIES:
- gives us more precise estimates
- it generalises the results to different countries and
settings

18
Q
  1. List 6 reasons why Meta-Analysis is important?
A
  1. RESEARCHERS PUT LITTLE FAITH IN A SINGLE STUDY
    - that outlines the effect of a treatment
    - this is regardless of how statistically significant the
    data is
  2. IT ALLOWS US TO WRITE A NARRATIVE REVIEW
    • this reviews of the quality of the study
    • this helps to explain why the association behaved as
      it did in the study
  3. EACH STUDY
    - produces a different estimate of the magnitude
    - Meta-Analysis allows us to find an average
  4. IT HELPS RESEARCHERS TO UNDERSTAND
    - which effects have a real impact on the patient
  5. IT COMBINES THE EFFECTS FROM ALL THE STUDIES
    - this gives an overall mean effect
    - it gives generalised important statistics
19
Q
  1. What is the aim of Meta-Analysis?
A
  • to obtain the magnitude of an effect
  • and to do this with precision
20
Q
  1. What are the reasons for not performing a
    Meta-Analysis?
A
  1. THE DATA
    - is not in a suitable format
  2. THE STUDIES ARE POOR QUALITY
    - they are at risk of being biased
  3. HETEROGENEITY STUDIES
    - are not sufficiently similar
  4. HETEROGENEITY STUDIES CAN BE DIFFERENT IN:
    - the populations
    - interventions
    - outcome definitions
    - effect estimates
21
Q
  1. What is Quality Assessment?
A
  • this is the critical evaluation of the results
  • it decides what is a good or a bad study
  • it decides which study should be used more than
    others
  • it chooses a reliable study

THE CONCLUSIONS OF QUALITY ASSESSMENT:
- are based in the quality of the studies

22
Q
  1. Why are Published Effects of a treatment often biased?
A
  • the meta-analysis will only reflect what is published
  • statistically significant results are more likely to be
    published
  • this leads to high bias levels being present
23
Q
  1. Define: Publication Bias.
A
  • this is the selected publication of studies
24
Q
  1. What are some causes of Publication Bias?
A
  1. INVESTIGATORS
    - fail to report completed studies
  2. INVESTIGATORS
    - fail to report studies that show no effect
  3. INVESTIGATORS
    - can publish a limited number of small trials that only
    show benefits
  4. BAD PHARMA
    - are pharmaceutical companies that suppress
    evidence that goes against their agenda

MED 106- RESEARCH METHODS AND ESSENTIAL MEDICAL STATISTICS (43 decks)

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