Critical Appraisal - Systematic Reviews & Meta-Analysis Flashcards

1
Q

What is a systematic review?

A

A literature review focused on a single question with well defined criteria for review. It is the highest level of evidence.

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2
Q

What is a meta-analysis?

A

The statistical analysis aspect of systematic review - analyses combined data from multiple studies. Done using statistical software.

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3
Q

What are the purposes of a meta-analysis?

A

Increase power, resolve uncertainty, improve estimates, answer other questions (such as secondary outcomes)

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4
Q

What are the inclusion and exclusion criteria used to select studies for a systematic review?

A

The PICOT parameters plus other relevant criteria such as sample size

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5
Q

How might bias be introduced when selecting studies?

A

By selecting only studies which are in English, or by selecting only studies which have been published

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6
Q

What is the CONSORT checklist?

A

A checklist of items that should be included in a randomised trial

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7
Q

What is the Cochrane guidelines?

A

A guide which looks at various types of bias to judge whether or not the individual study accounted for it

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8
Q

What are the key statistical issues in a meta-analysis?

A

outcome, weighting and heterogeneity

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9
Q

What does the outcome look at?

A

The average of each of the studies - such as the relative risk. Can be either a relative or absolute measure.

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10
Q

What determines the weighting of each study?

A

The number of outcomes - which is usually an indirect measure of the sample size

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11
Q

Why is heterogeneity important?

A

Because only studies which are not heterogenous should be combined

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12
Q

How is the information presented in a meta-anaysis?

A

In a forest plot

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13
Q

What does the vertical line in the forest plot represent?

A

The line of null effect

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14
Q

What does the size of the square in the forest plot represent?

A

The size of each of the studies

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15
Q

What does the horizontal line in the forest plot represent?

A

The confidence interval

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16
Q

What does the diamond in the forest plot represent?

A

The pooled result of all the studies - the vertical line of the diamond shows the point estimate and the horizontal width of the diamond shows the confidence interval

17
Q

How is statistical heterogeneity determined?

A

Using a p value. If the p value is greater than 0.05 then the studies are not heterogenous so can be combined.

18
Q

How else is heterogeneity determined?

A

Subjectively in terms of the PICOT parameters