Systematic Review

Question 1

Systematic review and clinical practice guidelines are

Answer 1

pre appraised and summarized

Flaw though is that the reader must understand each of the formats

Question 2

Systematic review is a

Answer 2

secondary analysis of original studies focusing on one element or evidence based question

Question 3

What is the goal of a systematic review

Answer 3

to draw a conclusion based on the cumulative weight of the evidence on the element of interest

Question 4

Where is a good place to look for systematic reviews

Answer 4

Cochrane Collaboration library

Question 5

Types of reviews that can be found

Answer 5

Intervention benefits/harms
Diagnostic test accuracy
Prognostic outcomes
Methodology 
Qualitative

Question 6

Systematic reviews are research studies with their own

Answer 6

Designing elements:
Methods for identifying and selective studies to include
Review criteria to determine study quality
Processes for drawing conclusions from the body of evidence
Formal results section with qualitative and or statistical conclusions
- it is filtered info

Question 7

Systematic reviews that use a quantitative method for drawing conclusions are called

Answer 7

Meta-analyses

• pool data from individual studies, creating larger sample size and inc power –> important to consider publication bias
• all studies in the review have to be similar in design

Question 8

Heterogeneity

Answer 8

differences in methodology, populations, interventions, or study quality can affect whether studies should be combined

Question 9

Evidence on systematic reviews should be assessed based on

Answer 9

design and execution that may have biased results

Question 10

To avoid selection bias - review authors should

Answer 10

search all relevant electronic and print databases and collections

Question 11

Inclusion and Exclusion criteria

Answer 11

Has to be determined in advance

typically includes study design criteria, language and publication

Question 12

Results

Answer 12

summarizes the info
induces descriptive info about the evidence:
Research design
Population
Sample size
Outcomes
Interventions

Question 13

Results - quantitative

Answer 13

likelihood ratio
odds ratio
effect size
relative risk
confidence inteval

Question 14

The most useful way to determine statistical importance

Answer 14

confidence interval

Question 15

Forest plots

Answer 15

presents a variety of info about studies combined in a met-analysis and presented overall result of the data combination

Question 16

Forest Plot - line of no effect

Answer 16

direction and strength of results

Question 17

Forest plot - squares

Answer 17

mean effect of individual study

Question 18

Forest plot - diamond

Answer 18

mean effect of meta-analysis; represents the CI of the mean effect

Question 19

Forest plot - chi square

Answer 19

test for heterogeneity

Question 20

Sensitivity analysis

Answer 20

a way of evaluating whether findings would change if certain studies were removed from the analysis

Question 21

When a statistical analysis is not possible then what

Answer 21

qualitative info is presented

Vote counting, or polling each author

Question 22

If statistical importance cannot be demonstrated then

Answer 22

Study importance must be inferred from similar results in multiple studies

Question 23

3 considerations when applying evidence from systematic reviews

Answer 23

1. Appropriateness of element of interest to therapists setting and patients
2. That the subjects in the reviews resemble the patient
3. That the element of interest is compatible with patients preference and values

Question 24

Clinical practice guidelines are

Answer 24

systematically developed statements to assist in decisions about appropriate health care for specific circumstances

Question 25

Clinical practice guidelines intent is to

Answer 25

improve efficiency and effectiveness of health care and are based on current best evidence and expert judgment

Question 26

Primary producer of CPG

Answer 26

AHRQ

Question 27

GRADE - recommendations to implement a guideline “Strong For”

Answer 27

confident desirable consequences outweighs undesirable consequences

Question 28

GRADE - recommendations to implement a guideline “Weak For”

Answer 28

Less confident desired consequence outweighs

Question 29

GRADE - recommendations to implement a guideline “Weak against”

Answer 29

less confident undesired consequence outweighs desired

Question 30

GRADE - recommendations to implement a guideline “strong against”

Answer 30

highly confident undesirable consequence outweighs desired outcomes

Question 31

AGREE II

Answer 31

quantitative process for evaluating CPG

Does not address clinical validity of recommendations

Question 32

Validity of CPG needs to be assessed on

Answer 32

Currency of the element of interest
New evidence refuting previous findings
Clinical or societal changes in outcomes or care
Changes in health care resources

Question 33

Applicability of CPG is determined by

Answer 33

Factors related to condition of interest
Similarity to the patient in question
Other options available
Practice environment or setting

Question 34

Summary - Systematic reviews do what

Answer 34

synthesize info from individual studies to arrive at a conclusion based on the weight of evidence

Question 35

Summary - CPG are

Answer 35

statements to facilitate decision making and quality of care

Question 36

CAT - is it unlikely that important, relevant studies were missed

Answer 36

Methods

Question 37

CAT - were the criteria used to select articles for inclusion appropriate

Answer 37

Methods

Question 38

CAT - were the included studies sufficiently valid for the type of question asked

Answer 38

Methods

Question 39

CAT - were the results similar from study to study

Answer 39

Results