Duke Health - Module 7

Question 1

Some systematic reviews will also include a meta-analysis
* A meta-analysis mathematically pools data from …
* This allowed you to see an —

Answer 1

similar individual studies
aggregated effect

Question 2

1. Did the review address a focused clinical question?
   (3)

Answer 2

a. Patient problem
b. Intervention or exposure
c. Outcomes

Question 3

2. Was the search for relevant studies detailed and exhaustive?
   a. Search multiple appropriate article databases such as Medline, Embase, and Web of Science
   b. A minimum of — article databases is recommended

Answer 3

three

Question 4

c. Search strategies should be

Answer 4

reproducible: they should be described in the methods section and the full strategies should be included as an appendix

Question 5

d. — should be included in the search

Answer 5

Unpublished evidence (trial data, conference abstracts, or unpublished results)

Question 6

e. — at the end of included studies should also be checked

Answer 6

Cited references

Question 7

3. Was the selection of studies reproducible?
   (4)

Answer 7

a. Description of study screening and selection process
b. Explicit inclusion and exclusion criteria
c. Blinded, dual screening
d. Neutral conflict resolution

Question 8

4. Was the risk of bias of the primary studies assessed?
   a. Each included study should be appraised for —
   b. (2) tools are available for different kinds of studies

Answer 8

validity
Quality and risk of bias

Question 9

Magnitude/Precision
1. What is the magnitude of treatment effect?
2. How precise are the results?
a. The forest plot provides

Answer 9

confidence intervals for all studies, as well as for the pooled summary estimate

Question 10

To address the issue of consistency, we assess —

Answer 10

heterogeneity

Question 11

To address the issue of consistency, we assess heterogeneity

Answer 11

• Variability in characteristics between the studies in a systematic review

Question 12

• Variability may come from:
  (3)

Answer 12

o Interventions of interest
o How data was captured
o Outcomes were measured

Question 13

You can test for heterogeneity

Answer 13

• The eyeball test

Question 14

• The eyeball test
  (2)

Answer 14

o You should be able to draw a line intersecting all of the CI
* A low value indicates little difference between the studies

Question 15

Was there evidence of publication bias?
* Several tests have been developed to detect publication bias
o Requires a

Answer 15

large number of studies (>30)

Question 16

• Common tests for publication bias:
  (4)

Answer 16

o Funnel plot
o Trim and fill method
o Estimation of the chances of publication
o Examination of the evolution of the effect size

Question 17

Quality of evidence by outcomes
* Tools
(3)

Answer 17

o GRADE
o Cochrane risk of bias tool
o Newcastle-Ottawa scale