Chapter 22 Flashcards

1
Q

What is a systematic review?

A

Careful compilation and summary of all publications relevant to a particular research topic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a meta-analysis?

A

It creates a summary statistic for the results of systematically identified articles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A review article in the health sciences requires:

A

1) An extensive search of the literature
2) The extraction of key information from relevant articles
3) The clear and concise presentation of this information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is one way to become an expert in the literature on a well-defined topic?

A

Writing a review article (a narrative review, systematic review, or meta-analysis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What often becomes foundational for a new research in the field?

A

Well written and comprehensive review articles, because they summarize what is known about an area of inquiry.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is more frequently cited in an individual field study:

Published review articles or the typical article? Why?

A

Published review articles, because they provide a concise summary of the literature.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the limitations of review articles?

A

1) Not all journals publish review articles, so their likelihood of publication might be lower than that of other study approaches.
2) Reviews are sometimes regarded as exhibiting less originality than other types of scholarship. Reviews are perceived to be a less rigorous form of research than projects collecting new data and/or involving statistical analysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When starting a tertiary analysis, the most important decision is:

A

The selection of a topic that is narrow enough that all the relevant publications can be acquired.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The topic may need to be modified after a preliminary search depending on:

A

The number of articles available; if a search yields only eight articles, the topic needs to be expanded. If the search yields 400 articles, the topic needs to be narrowed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

No review article can be written without:

A

Excellent library access, because EVERY relevant article must be identified and obtained during a systematic review.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Before starting a review project, a researcher should check with a University librarian regarding:

A

1) The libraries journal access policies
2) The fees that patrons may have to pay to acquire articles that are not part of the libraries collections or subscription services.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The researcher must prepare to maintain a meticulous system for:

A

Tracking articles that I’ve already been acquired, those that have been requested but not yet received, and those that need to be requested.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are narrative reviews?

A

They tell a story about a topic using evidence from the literature to support the “plot“.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Narrative reviews are intended to:

A

Convey a perspective and NOT just compile facts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Narrative reviews must be carefully organized by:

A

Theme, methodology, chronology, or some other guiding principle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When a researcher has developed a unique conceptual framework or theory that can be illustrated with examples from the literature, which kind of review may be appropriate?

A

Narrative review

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

This type of review works best when the researcher has a unique perspective on a topic and/or a particular expertise in the field that can be drawn on without using a systematic search strategy.

A

Narrative review.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are systematic reviews?

A

They use a predetermined and comprehensive searching and screening method to identify relevant articles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which type of review is designed to minimize the bias that might occur when researchers handpick the articles they want to highlight?

A

Systematic reviews.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

After the identification of a focus study question, the most important decisions in a systematic review are:

A

The selection of keywords and inclusion criteria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the goal of a systematic review search?

A

To craft a search strategy that identifies all the articles ever published on the narrow, well defined area covered by the review.

22
Q

What are the steps of a systematic review process?

A

1) Define study question
2) Define search strategy
3) Search for abstracts by keyword
4) Screen abstracts
5) Check full-text articles for eligibility
6) Extract information
7) Summarize findings
8) Write and report

23
Q

After selecting a well defined study question, the next step in a systematic review or meta-analysis is to:

A

Compose appropriate search strings.

24
Q

A helpful first task for choosing appropriate search strings is an exploration of:

A

The MeSH dictionary (available through PubMed) in order to identify the definitions of key terms as well as synonyms and related terms. (Boolean included)

25
Q

What allows for the design of a database-appropriate search string?

A

Understanding the language used by MEDLINE and other databases. (like “child” is a person 6-12 yrs old).

26
Q

What can you do to check the appropriateness of search terms?

A

Identify a handful of articles not to be relevant, then confirm that the search string captures all of these articles. If the search misses one or more, than the search strategy needs to be modified. This process must not be used to exclude disliked articles (inclusion biased).

27
Q

True or false:
A researcher is lacking fluency in other languages is an acceptable justification for including only English language articles.

A

False; that is not an acceptable justification.

28
Q

Which is better:
Using built-in limiters (Artificially limiting the number of abstracts using filters) or using study specific exclusion checklists. Why?

A

Study specific exclusion checklists, because built-in limiters often exclude many studies that would otherwise be eligible.

29
Q

What an abstract is not available or the abstract does not allow determination about an eligibility to be made, what should be done?

A

The full text of the article must be read.

30
Q

What should researchers be able to justify?

A

1) Search limiters

2) Inclusion and exclusion criteria

31
Q

What three other strategies may complement database searches?

A

1) Snowballing: Looking up every article cited by eligible articles in order to identify other articles that might be relevant but not indexed in the selected databases.
2) Gray literature: Research reports that are available to the researchers but have not been externally reviewed and formally published.
3) Hand searching: All articles in the tables of contents of selected volumes of relevant journals or scans for reports on the topic of interest.

32
Q

The methods used for expanded searches (snowballing, gray literature, hand searching) must be:

A

Disclosed in the research report, and any documents found through the supplemental search methods must meet all of the inclusion criteria.

33
Q

Once all of the eligibile articles are identified, the contents of these articles is summarized in:

A

Data extraction tables.

34
Q

Data extraction tables lists descriptive characteristics such as:

A

1) Study location
2) The years of data collection
3) The study design
4) The study population and sample size
5) The definitions used for key exposures and outcomes
6) The key findings of interest, including both quantitative results and qualitative conclusions
7) An evaluation of the quality of the study

35
Q

A data extraction table allows for:

A

Easy compilation and comparison of observations relevant to the study question.

36
Q

What kind of statistical findings should be reported?

A

Significant and insignificant findings.

37
Q

One of the primary contributions of systematic reviews to the health science literature is the ability to:

A

Identify both areas of consensus and areas of disagreement and uncertainty that need to be further examined.

38
Q

What is publication bias?

A

Occurs when articles with statistically significant results are more likely to be published than those with null results.

39
Q

What is the goal of a meta-analysis?

A

To combine into one summary statistic the results of several high-quality quantitative studies that use similar methods to collect and analyze their data.

40
Q

Which review is very restrictive in its eligibility criteria?

A

Meta-analysis

41
Q

What are the steps of a meta-analysis?

A

1) Use a systematic search strategy to identify relevant articles
2) Carefully read each study
3) Assess the quality and comparability of each study
4) Extract statistical results from each of the studies that meet all of the inclusion criteria for the meta-analysis
5) Combine comparable statistical results into one summary statistic

42
Q

The summary statistic (meta-analysis) should usually adjust for:

A

The confidence intervals of the contributing statistical measures.

43
Q

Before pooling the statistical data, the researcher must show that the results of the studies are ___.

A

Comparable

44
Q

What kind of studies can be combined into a summary statistic?

A

Homogenous studies.

45
Q

The amount of variability in the measure across studies can be examined using:

A

1) Cochran’s Q statistic for homogeneity
2) I^2 (I squared) statistic that adjusts the Q statistics based on the number of studies being pooled. (Reported as percentage from 0-100%)

46
Q

What is the effect size?

A

The estimated value of a measure, like an odds ratio or efficacy etc…

47
Q

What are the two models that can be used for creating a pooled estimate of the effect size?

A

1) Fixed effects model: When studies are homogenous

2) Random effects model: When studies are heterogenous

48
Q

The contributing studies and the summary measure for a meta-analysis are often displayed using a ____.

A

Forest plot

49
Q

A forest plot usually has:

A

1) A horizontal axis showing effect size
2) A vertical line showing the effect size that indicates no effect (such as an odds ratio of one)
3) A row for information from each included study that uses a square (or other marker) to indicate the point estimate for the effect size and uses a horizontal line to show the 95% confidence interval {Markers are often presented in different sizes to show how each study was weighted in the meta-analysis. Small markers = small sample sizes, large markers = large sample sizes}
4) A representation of the summary measure and its confidence interval, often shown using a diamond shape.

50
Q

What are the two main threats to the validity of a meta-analysis?

A

1) Poor quality of included studies

2) Publication bias

51
Q

What can eliminate studies of questionable validity?

A

The selection criteria used during the systematic review process

52
Q

How can we examine the possibility of publication bias?

A

By using a funnel plot; Part of the cone will be missing. (In this case, the pooled estimate is likely to have overestimated the true effect size).