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Clinical Epidemiology > Lecture 10 > Flashcards

Lecture 10 Flashcards

1
Q

what study types seek to summarize the available evidence on a given topic in a comprehensive and systemic way

A
  • systematic reviews

- meta-analyses

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2
Q

systematic reviews and meta-analyses can help clarify intervention effects when ___ studies are available or when ___ evidence is apparent

A
  • only small studies are available

- conflicting evidence is apparent

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3
Q

systemic reviews also form the basis for ____

A
  • guidelines
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4
Q

in the past, content experts have often written reviews, called ____ which summarized the available information on a given topic

A
  • narrative reviews
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5
Q

how can narrative reviews be biased

A
  • depends on how the studies were chosen to be in the review
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6
Q

______ are rigorous studies that attempt to comprehensively search and review all the available literature on a given topic

A
  • systematic reviews
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7
Q

a typical systematic review will include each of the following elements:

  • formulate a focused _______
  • define admissible ______
  • search for relevant _____
  • select and _____ studies
  • synthesize the ____
  • _____ the evidence
A
  • question
  • evidence
  • studies
  • assess
  • evidence
  • interpret
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8
Q

____ refinement is an essential part of systematic reviews

A
  • topic
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9
Q

the best focus of a systematic review is a concise _______ that is generated after establishing the key questions to be addressed

A
  • PICO formatted clinical question
  • patient
  • intervention
  • comparison
  • outcome

may also include a study time, setting, and study design

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10
Q

after formulating the research question, the next task is to do what

A
  • conduct the literature search
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11
Q

what is grey literature

A
  • meeting abstracts
  • trial registries
  • unpublished data
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12
Q

systematic reviews should contain a ____ describing how studies were selected and the number of studies ______ and reasons for it

A
  • flow diagram

- excluded

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13
Q

what is the best method for systematic review studies

A
  • dual review
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14
Q

the assessment of studies for their quality is often referred to as

A
  • risk of bias
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15
Q

once the data have been extracted, investigators will need to decide whether to combine studies into pooled analysis (______) or only qualitatively describe the body of studies they have found (________)

A
  • meta-analyses

- systematic review

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16
Q

what is the “study heterogeneity”

what type of heterogeneity should be looked at

A
  • whether studies are sufficiency similar to combine
  • clinical - PICOTS
  • statistical - I^2 (variation in outcomes)
17
Q

what are methods to investigate sources of heterogeniety

two methods within this method

which is more conservative and will yield wider confidence intervals

A
  • meta-regression
  • fixed-effect
  • random-effect modelling - more conservative
18
Q

the products of meta-analysis are one of more _____

A
  • forest plots
19
Q

what is meant by each row included in a forest plot

A
  • a row for each study included
20
Q

the box in a forest plot that represents the _____ will be proportional to the size of the study

A
  • point estimate
21
Q

at the bottom of the forest plot, a summary or _____ is shown and is represented by a diamond

A
  • pooled estimate
22
Q

the vertical midpoint of the diamond represents the ______ estimate and the width of the diamond represents the _____

A
  • summary point estimate (average of all point estimates)

- width of the pooled estimate confidence interval

23
Q

the available _______ influences the weight of a systematic review or meta-analysis

A
  • evidence
24
Q

an important element of understanding and interpreting meta-analyses is to assess the overall _____ for the findings

what does this mean

A
  • strength of evidence

- how confident we should be in the overall results of the meta-analysis

25
Q

______ refers to a situation in which the published literature is systematically unrepresentative of the population of completed studies

why does this occur

A
  • publication bias

- negative studies are less likely to be published than positive studies

26
Q

publication bias can bias results of a meta-analysis ____ the null

A
  • away from
27
Q

one way to visually assess publication bias is by using a _____

A
  • funnel plot
28
Q

larger studies generally have more precise results and an effect estimate that is closest to the truth and they are typically plotted near the ____ of the funnel

A
  • top or apex
29
Q

smaller studies typically have less precision, and often over-or under-estimate the truth effect and are plotted towards the ____ of the Y axis

A
  • bottom
30
Q

what group should you be familiar with that specializes in systematic reviews and meta-analyses

A
  • Cochrane collaborative

Clinical Epidemiology (11 decks)

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