Exam 1

Question 1

What type of questions do narrative reviews answer?

Answer 1

Background questions

Question 2

Where is information for background questions found?

Answer 2

General sources (textbooks, Google, etc)

Question 3

What type of questions do systematic reviews answer?

Answer 3

Foreground questions

Question 4

Where is information for foreground questions found?

Answer 4

primary research studies

Question 5

What are the two types of systematic reviews?

Answer 5

Qualitative and quantitative

Question 6

What is a meta-analysis?

Answer 6

A quantitative systematic review - pools data from multiple RCTs

Question 7

Why are systematic reviews on the top of the EBP pyramid?

Answer 7

Lowest bias

Question 8

What are the benefits of systematic reviews?

Answer 8

Combine results from several RCTs to create “pooled effect”. Can draw generalized cause and effect from RCTs.

Question 9

Why is meta-analysis more useful than an RCT?

Answer 9

Pooled data, more power to apply to patient decision making.

Question 10

What questions should be asked when appraising a meta-analysis? (5)

Answer 10

1. Is the PICO identifiable? 2. Did they find all the best available research evidence? 3. Were all included studies critically appraised? 4. Have results been summarized in tables/plots? 5. What do the results mean?

Question 11

Where should PICO elements be found in an ideal search?

Answer 11

Title of the review

Question 12

What is the study type of choice for therapy-related foreground questions?

Answer 12

RCTs

Question 13

What is selection bias?

Answer 13

selectively choosing which studies to include in the syst. Review

Question 14

What is the first step in avoiding selection bias?

Answer 14

Systematic search methodology

Question 15

What steps should be included in systematic searching? (4)

Answer 15

1. Have transparent and thorough search strategy 2. Search Cochrane library 3. Search other major electronic databases 4. Hand searching of “grey literature”

Question 16

What is “grey literature”?

Answer 16

conference proceedings, reference lists, hard to find journals, unpublished studies

Question 17

What is a good rule of thumb to determine if results have been summarized appropriately?

Answer 17

See if two independent assesors were used to extract the data

Question 18

What table should be included in a systematic review?

Answer 18

Summary table of all included RCTs

Question 19

What should each listed RCT have a description of? (3)

Answer 19

1. Intervention used 2. Number of subjects 3. Effectiveness of therapy (including 95% CI)

Question 20

What should be included in the table describing RCTs to make the review even better? (4)

Answer 20

1. comparison intervention 2. duration of intervention 3. frequency of intervention 4. “intensity” of intervention

Question 21

What does the summary table of RCTs allow you to determine?

Answer 21

If all included studies were similar enough in design

Question 22

Why is it important that all studies be similar in design?

Answer 22

For pooling of the results

Question 23

How are results of a meta-analysis expressed?

Answer 23

Forest plot

Question 24

What is a forest plot?

Answer 24

Visual aid for summarizing data in quantitative literature

Question 25

Key components of a forest plot? (5)

Answer 25

1. Line of no effect 2. Point estimates for each study 3. Representation of size of each study 4. CIs for each study 5. Pooled effect diamond

Question 26

How are the sizes of studies represented on a forest plot?

Answer 26

Size of box

Question 27

Which side of the line of no effect favors treatment, and which side favors placebo?

Answer 27

Right side = treatment, Left side = placebo

Question 28

What does the width of the pooled effect diamond represent?

Answer 28

total CI

Question 29

What does the size of the pooled effect diamond represent?

Answer 29

Total number of patients of all RCTs

Question 30

What should you be able to interpret by looking at a forest plot?

Answer 30

Effectiveness of therapy

Question 31

Where is the exact pooled relative risk on a forest plot?

Answer 31

Center of the pooled effect diamond

Question 32

What is the exact pooled relative risk?

Answer 32

quantitative measure of how all subjects responded to the treatment

Question 33

What does it mean if CI crosses line of no effect?

Answer 33

Statistically insignificant

Question 34

What does it mean if CI does not cross line of no effect?

Answer 34

Statistically significant

Question 35

How do you look for consistency amongst RCTs with a forest plot?

Answer 35

Are most trials on same side of line of no effect? Do most CI s of included trials overlap with the CI of pooled result?

Question 36

What is the "eyeball test"?

Answer 36

Measure of heterogeneity - look to see if included trials are similar enough (on forest plot)

Question 37

How do you determine clinical significance?

Answer 37

Compare difference between treatment and control groups to an MCID if available

Question 38

What are three strategies for finding systematic reviews?

Answer 38

1. limiters/filters for syst. Reviews 2. Include syst. Review-related keywords in search string 3. know if database has special focus on syst. Reviews

Question 39

Six databases to use when looking for syst. Reviews?

Answer 39

Medline, SportDiscus, Cochrane database, PubMed, Trip, PEDRO

Question 40

What filter should you use in PubMed?

Answer 40

"Clinical Queries"

Question 41

Which database filters by color-coding?

Answer 41

TRIP database

Question 42

Which database does not have a "systematic review" filter?

Answer 42

SportDiscus

Question 43

How do you limit you search to systematic reviews if there is no filter?

Answer 43

Include variations of systematic review keywords (with or without truncation symbol)