Lecture #24 - Systematic reviews Flashcards
What is a review?
A collation of information
Why are reviews done?
There is just so much information out there that we can’t cope so instead of us having to skim all the papers done - reviews are vital for bringing info together so clinicians can read them instead
What are the two main types of reviews?
Systematic reviews have a what kind of approach and it’s almost what in itself?
Narrative and systematic
Systematic have a structured approach to doing the reviews and it’s almost a research method within itself.
To answer each of these questions, what do you use?
- What are the gaps or contested concepts in the field?
- What’s the range of treatments offered for condition X and why are they used?
- Is the treatment X more effective than treatment Y (or no treatment) in population Z?
- What’s the current best practice for the treatment of condition X in population Z?
- Narrative review by an expert
- Narrative review by an expert
- RCTs address this and a systematic review of all the RCTs addressing this question would be even better
- Bring multiple reviews together and do an overview of them kinda thing
Narrative vs Systematic reviews - what’re the main differences? (cherry vs blue)
- In narrative, author can cherry pick the studies and we won’t know because in that review, it’s not expected that the selection is documented.
- Systematic reviews usually have a blue print method - it’s replicable and documented etc. Also, remember it has the bias in and bias out thing
Why are systematic reviews conducted?
- Bring together…..
- Their design ensures….
- And they’re a scientific method to ___ + _____ + ____ the results and _____ of research
- Bring together a number of separately conducted studies and synthesises their results
- Their design ensures the information isn’t treated selectively (not cherry picking the studies according to prejudice or bias of reviewer)
- And they’re a scientific method to appraise + communicate + summarise the results & implications of research
What kind of systematic review are we doing here?
What are the 7 steps of the systematic review methods?
- Reviewing effectiveness of interventions so with this one, answering “Is the treatment X more effective than treatment Y (or no treatment) in population Z?” so get as many RCTs together as you can and research
Well, look at the book
Step 1: Formation of a clear question
- What kind of question is this?
- Give an example of such a question
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Step 2: Write a protocol (blueprint) for the review
- What 9 things to state?
- Why do this?
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Step 3: Comprehensive searching
- What is the most common place to search for studies to include?
- But the problem with publication bias - so to supplement this, what two things do they do?
- The problem with missing data; explain the cherry picking situation.
- What two kinds of bias involved?
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Step 4: Screening and data extraction
- Once you’ve found the studies that meet selection criteria - have to go through what?
- How is it done? (in terms of people)
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Step 5: Risk of bias assessment
- With systematic reviews, if biased studies go in, what comes out?
- So in review what should be done?
- Of course, no study is perfect - but the author reviewing should have what?
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Step 6: Synthesis of findings
- Numeric data extracted when possible from individual trials is ____ and _____ in a _____ ______
- What is a meta analysis?
- What is a meta analysis most commonly presented as?
- Before pooling data, researchers have to what? What is this based on?
- What are the first and second most enduring criticisms of systematic reviews?
- What is the difference between heterogeneity and homogeneity?
- pooled and summarised, meta analysis
What is the difference between systematic review and meta analysis?
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Step 7: Interpretation
- State what 3 things? (5 if you include the sub things for the last one)
- One thing that should be distinguished in systematic studies is the difference between what?
3.
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