Appraising Systematic Reviews Flashcards
What is a systematic review?
Method for of locating, appraising and synthesising research from primary studies
How do systematic reviews differ from literature reviews?
prepared using predefined methods
- lit reviews don’t have strict requirements
What does conducting a systematic review involve?
- research question
- determine eligibility criteria (pre-defined)
- comprehensive search to identify all relevant studies (beyond electronic searches)
- select studies based on predefined eligibility criteria
- appraise risk of bias in each study
- extract data
- synthesise results (meta-analysis)
- interpret and report results
- update review at an apropriate time
What type of reviews overlap with meta-analysis?
systematic reviews lit reviews (no strict method)
Advantages of systematic review
Adv:
- established generalisability of overall results
- makes explicit differences in results
- identifies gaps in knowledge
- guides decision making
- improves dissemination of evidence
- hasten assimilation of research into practise
Disadvantages of systematic review
can be done badly
What is the best study design to assess effectiveness of intervention?
Systematic review of RCT
What is the best source for systematic reviews
Cochrane Database
What is so good about Cochrane systematic reviews?
- rigorous standards
- editorial teams support reviews
Can systematic reviews be updated?
YES- as new studies are released
What are the checklists we use to appraise systematic reviews?
AMSTAR (Assessment of multiple systematic reviews)
- CASP (checklist for appraising reviews)
Criteria for systematic reviews
AMSTAR- check word doc
- Were the methods used to combine the findings of the study appropriate? what are you looking for?
I^2
- Was the likelihood of publication bias assessed? What are we looking for?
funnel plot or Egger regression test
- Was conflict of interest included?
acknowledged sources of support in systematic review and included studies
- can be in declarations of interest
Most common way results are presented for meta-analysis
forest plot
Interpreting funnel plot
box, line, size of box, diamond, points of edge of diamond
- Box = mean
- Line = confidence interval
- Size of box = weights
- Diamond = represents overall effect when combining info from the studies
- Points of edge of diamond = 95% confidence interval
- Spread of diamond = range
- Was an ‘a priori’ design provided?
inclusion criteria & research question established before conduct of review
- Was there duplicate study selection and data excration?
2 or more independent data extractors
- Was a comprehensive lit review performed?
2 or more electronic sources searched
- Was the status of publication (i.e. grey literature) used as an inclusion criteria?
want no exclusion based on publication status, language etc.
(no is good)
- Was there a list of studies provided?
- list of included and excluded studies provided
- Cochrane always include
- Were the characteristics of included studies provided?
data on participants, interventions, outcomes (often in table) included
- Was the scientific quality of included studies assessed and documented?
- critically appraise each study
- satisfied if ‘a priori’ methods of assessment provided
- Was the scientific quality of the included studies used appropriately in formulating conclusions?
putting less weight on studies prone to bias and more weight on studies performed well
e.g. “the results should be interpreted with caution due to poor quality of included studies.”
