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Reproduction and the growing child > Critical appraisal > Flashcards

Critical appraisal Flashcards

H&S

1
Q

4 steps of the process of critical appraisal

A
  1. Come up with an answerable question
  2. Search for best evidence
  3. Appraise the evidence
  4. Make a decision
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2
Q

What contributes to making a final decision?

A

Available evidence, available resources, patient preference, clinical experience

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3
Q

What does PICO stand for?

A 
P = patient, problem, population
I = intervention 
C = comparason, comparator, control
O = outcome
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4
Q

When you have a study you cannot control (e.g. about risk factors), what type of question do you use?

A

PEO question

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5
Q

What does PEO stand for?

A 
P = patient group 
E = exposure
O = outcome
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6
Q

Name 5 types of question we can have?

A
  1. Therapy
  2. Prognosis
  3. Diagnosis
  4. Aetiology
  5. Evaluation/acceptance
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7
Q

Best feasible study design for diagnosis

A

Cross-sectional analytic study

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8
Q

What is a cross-sectional analytic study?

A

Looks at data from a cross-section of a population from the same time point

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9
Q

Best feasible study design for aetiology (harm)

A

Cohort study (prospective), population-based case-control study (retrospective)

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10
Q

Best feasible study design for prognosis

A

Cohort study

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11
Q

Best feasible study design for treatment

A

RCT, systematic review (SR) of RCTs

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12
Q

Best feasible study design for evaluation

A

Qualitative research (SR or meta-analysis also possible).

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13
Q

What is a systematic review?

A

critcially appraises all available research on a particular topic.

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14
Q

Potential benefits of systematic reviews over primary individual trials

A
  • Include all available evidence to answer a question
  • Include research that is unpublished or published in non-English-language journals
  • Increase the total sample size (increases levels of certainty and precision)
  • indicate heterogeneity (variation) among studies
  • permit sub-group analysis
  • permit sensitivity analysis
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15
Q

What is a sub-group analysis?

A

Evaluation of treatment effects for a specific end point in subgroups of patients determined by a baseline characteristic

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16
Q

What is sensitivity analysis?

A

Are the results sensitive to the quality of the research? e.g. looking at top 10 studies

17
Q

What is bias?

A

systemic introduction of error into a study that can distort the results in a non-random way

18
Q

What is error?

A

difference between the average values that were obtained through a study and the true average values of the population

19
Q

error vs bias

A

Every study has some degree of error. Bias is systemic and non-random.

20
Q

4 things you should assess a research study for

A
  1. Bias
  2. Applicability
  3. Limits
  4. Values
21
Q

3 steps to the appraisal of the results of a study (questions)

A
  1. Are the results of the study valid?
  2. What are the results?
  3. Can the results apply to patient care?
22
Q

What is study validity?

A

The believability or credibility of the results. Do they represent an unbiased estimate of the treatment effect or have they been influenced in some systematic fashion?

23
Q

NNT

A

Number needed to treat

24
Q

NNH

A

Number needed to harm

25
Q

Define NNT

A

Number of patients you need to treat to prevent one additional bad outcome.

26
Q

Define NNH

A

How many persons on average need to be exposed to a risk factor over a specific period to cause harm in an average of one person who would not otherwise have been harmed

27
Q

What is generalisability of results

A

The extent to which research findings can be applied to settings other than that in which they were orignially tested

28
Q

What is particularisability

A

Can you use this evidence to inform the decisions you make about this particular patient/answer this particular question?
- How similar or patient in the study to yours?
- Can local health service provide it?
What are the benefits and costs?

29
Q

What are the 2 screening questions which, if the answer is no, the study shouldn’t continue?

A

Did the review ask a clearly-focused question

Did the review include the right type of study?

30
Q

What should a search strategy include?

A

Hand-searching, conference proceedings, contacting authors and papers in languages other than English

31
Q

Why include none English-language papers?

A

Increase population size, not including may over-state effect size as it usually excludes papers with null rsults.

32
Q

When should you combine results in a meta-analysis?

A

When studies are similar/same outcomes

33
Q

What is the line at 0 in a meta-analysis graph called?

A

Line of no effect

Reproduction and the growing child (15 decks)

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