Lecture 4 - Analytical Study Design Part 2 - Systematic Reviews and Meta Analyses

Question 1

Designs that summarize the work of other studies
—Takes the results of a large numbers of primary research studies and combines them into one

—Synthesis a great deal of research!

The top two levels of the EBM pyramid
—Generally represents the strongest evidence

Both are subject to bias based on the inclusion and/or exclusion criteria

Answer 1

Systematic Reviews and Meta-analyses

Question 2

Designs that summarize the work of other studies

—Takes the results of a large numbers of primary research studies and combines them into one

Answer 2

Systematic Reviews and Meta-analyses

Question 3

Systematic Reviews and Meta-analyses

Both are subject to bias based on the ______

Answer 3

inclusion and/or exclusion criteria

Question 4

The top two levels of the EBM pyramid

—Generally represents the strongest evidence

Answer 4

Systematic Reviews and Meta-analyses

Question 5

What is the difference between a “systematic review” and a “meta-analysis”?

Answer 5

A “systematic review” is a thorough, comprehensive, and explicit way of interpreting the medical literature

A “meta-analysis” is a statistical approach to combine the data derived from several selected studies

Question 6

interpreting the medical literature

Answer 6

systematic review

Question 7

statistical approach…. to combine the date derived from several selected studies

Answer 7

meta-analysis

Question 8

Systematic Reviews and Meta-analyses:

Both are used for the development of…

Answer 8

Clinical Practice Guidelines (CPGs)

Question 9

Appraise and synthesize all the empirical evidence to answer a given research question!

Answer 9

Systematic reviews

Question 10

Methodology

State objectives and outline eligibility criteria

Search for trials that meet criteria

Establish methods for assessing methodological quality of each study

Apply eligibility criteria and justify exclusions

Assemble the most complete collection possible

Analyze results using synthesis of data

Compare alternate analyses, if necessary

Prepare a critical summary of the review

Restate aims, methods, and results

Answer 10

Systematic reviews

Question 11

Strengths of Systematic Reviews

Answer 11

Exhaustive review of the current literature and other sources

Less costly to review prior studies than to create a new study

Less time required than conducting a new study

Results can be generalized and extrapolated into the general population more broadly than individual studies

More reliable and accurate than individual studies

Considered an evidence-based resource

Question 12

Strengths of Systematic Reviews:

summary of strengths or meat and potatoes

Answer 12

Can be generalized

Evidence-based resource

Question 13

Limitations of Systematic reviews

Answer 13

Very time and labor consuming

May not be easy to combine studies

Question 14

Meta-analyses:

A method for combining pertinent study data from several selected studies that are similar enough to justify a quantitative summary to develop a single conclusion that has….

Answer 14

greater statistical power

Question 15

A statistical synthesis of the numerical results of several trials which all addressed the same research question

Answer 15

Meta-analyses

Question 16

Meta-analyses:

The conclusion is statistically stronger than any single study due to?

Answer 16

increased numbers of subjects

greater diversity among subjects

accumulated effects and results

Question 17

Strengths of Meta-anaylses:

Answer 17

Greater statistical power

Confirmatory data analysis

Greater ability to extrapolate to the general population

Question 18

Meta-analyses:

Limitations?

Answer 18

Difficult and time consuming to identify appropriate studies

Not all studies provide adequate data for inclusion and analysis

Requires advanced statistical techniques

Heterogeneity of study populations

Age, gender, etc.

Results are not always reproducible by other investigators

Subject publication Bias, Selection Bias, and Misclassification Bias

Can give a false sense of certantiy regarding the magnitude of risk

Question 19

Meta-analyses:

Limitations?

(meat and potatoes)

Answer 19

Difficult

Not all studies provide adequate data

advanced statistical techniques

heterogeneity

publication bias, selection bias, and misclassification bias