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Evidence-Based Practice > L4 Critical Appraisal of Systematic Reviews > Flashcards

L4 Critical Appraisal of Systematic Reviews Flashcards

1
Q

core aim of reviews

A

to collect, evaluate and present the available research evidence of a topic

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2
Q

why may individual studies be misleading

A

chance or bias

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3
Q

why must the evidence base be synthesised

A

so an observer can reliably understand its implications

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4
Q

what does an increase of primary research lead to

A

an increase of reviews

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5
Q

how many types of reviews exist

A

about 25

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6
Q

types of reviews

11

A
  • Systematic review
  • Scoping review
  • Meta-analysis
  • Literature / Narrative reviews
  • Rapid reviews
  • Living reviews
  • Critical reviews
  • Overviews
  • Qualitative systematic reviews
  • State-of-the-art reviews
  • Umbrella review
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7
Q

what is a systematic review

A

A summary of all available primary research or evidence in response to a research question. A systematic review uses all existing research and is sometimes called secondary research (research on research). They are often required by research funders to establish the state of existing knowledge and are frequently used in guideline development (Clark, 2011)

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8
Q

five types of systematic reviews

A
  1. Effectiveness reviews
  2. Experiential (qualitative) reviews
  3. Costs/Economic Evaluation reviews
  4. Prevalence and/or Incidence reviews
  5. Diagnostic Test Accuracy reviews
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9
Q

describe effectiveness reviews

A
  • Most common type of systematic reviews
  • Assesses the effectiveness of an intervention
  • Widely used to inform the development of trustworthy clinical guidelines
  • Questions are developed often using the PICO format
    (Munn et al., 2018)
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10
Q

what is effectiveness

A

the extent to which an intervention, when used appropriately, achieves the intended effect

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11
Q

indications for systematic reviews

A
  • Uncover the international evidence
  • Confirm current practice/ address any variation/ identify new practices
  • Identify and inform areas for future research
  • Identify and investigate conflicting results
  • Produce statements to guide decision-making
    (Munn et al., 2018)
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12
Q

what is a scoping review

A

“exploratory projects that systematically map the literature available on a topic, identifying key concepts, theories, sources of evidence and gaps in the research.“
Canadian Institute of Health Research

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13
Q

what is a meta analysis

A

a combination of a group of studies to reach a conclusion statistically about the effect if an intervention.

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14
Q

when not to conduct a meta-analysis

A
  • Heterogeneity of studies (can also be tested statistically)
  • Poor quality of studies
  • Publication bias (selective publication of positive studies and exclusion of negative studies)
  • Small number of studies or limited sample size
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15
Q

why is a limited sample size a reason to not conduct a meta-analysis

A
  • Too few studies or studies with limited sample sizes provide less information to summarise or pool the results.
  • Can yield inaccurate, unstable or erroneous results.
  • Too few studies in the trial impede the exploration of publication bias and can confound the conclusions.
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16
Q

six steps of conducting a systematic review

A
  1. Prepare your topic
  2. Search for studies
  3. Screen studies
  4. Extract data
  5. Analyse and synthesis evidence
  6. Report findings
17
Q

high quality

Grade working group grades of evidence

A

further research is very unlikely to change our confidence in the estimate of effect

Flynn et al 2018

18
Q

moderate quality

Grade working group grades of evidence

A

further research is likely to have an important impact on our confidence in the estimate and may change the estimate

flynn et al 2018

19
Q

low quality

Grade working group grades of evidence

A

further research is likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate

20
Q

very low quality

Grade working group grades of evidence

A

we are very uncertain about the estimate

flynn et al 2018

21
Q

what does PRISMA stand for

A

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

22
Q

what is PRISMA

A

an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses

23
Q

three limitations of systematic reviews

A
  • Systematic reviews are costly and take a long time to produce. The need for good evidence is often urgent.
  • Systematic reviews answer a specific clinical question. In real life, the useful question is sometimes broader.
  • Once published, systematic reviews can quickly become out-of-date as new evidence emerges. When evidence becomes incorrect in this way, it has the potential to cause harm

Evidence-Based Practice (4 decks)

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