Rigorous reviews Flashcards
what is systematic review + its position on hierarchy of evidence
summary of medical literature (from multiple primary studies)
top of hierarchy as maximally informed (most evidence for causal association) + least biased (so most valid/applicable)
what are strength + weakness of systematic review
strength:
more robust/reliable conclusions than primary studies
core of EBM
weakness:
limited by availability/quality of evidence (necessary data may not be included in primary research sources)
time-consuming, needs searcher expertise
what is done before systematic review is performed
systematic review protocol needs to be published first, before conducting research
Cochrane (independent organisation) conducts systematic review for treatments
what is the systematic review protocol
1 - developed a priori that describes rationale/hypothesis/methods
2 - made publicly available before conducting research, with ammendments made obvious
3 - registered in PROSPERO (registry)
4 - checked with PRISMA (reporting checklist) to ensure high quality
what is meta-analysis
combining data from at least 2 primary research studies
to form a pooled single estimate of the effect under consideration
for meta-analysis, how is ___ presented
results
publication bias
binary variables
continuous outcomes
results shown in forest plot graph
publication bias shown in funnel plot
binary variables shown as ratios between 2 groups (case-control = odds, cohort = RR)
continuous outcomes shown as weighted mean difference between 2 groups
what criteria used for quantitative/interventional + qualitative/non-interventional meta-analysis
quantitative/interventional = PICO
population, intervention, comparison, outcome
qualitative = SPIDER
sample, phenomenon of interest, design, evaluation, research type
how to reduce bias in meta-analysis
use quality appraisal tool to form scores + set quality threshold to reject studies
