Systematic reviews

Question 1

Systemic reviews can be conducted for what

Answer 1

Any primary study design/ research question

Question 2

What is a systemic review

Answer 2

A type of literature review that uses systematic methods to collect secondary data, critically appraise research studies, and synthesize studies

Question 3

What is a systemic review designed to provide

Answer 3

To provide a complete, exhaustive summary of current evidence relevant to a research question

Question 4

Systemic reviews of what are thought to be key to evidence based medicine

Answer 4

Randomized controled trials

Question 5

Systemic reviews vs single studies

Answer 5

Save readers time

Provide reliable evidence
-By providing a unbiased comprehensive picture of body of evidence

Resolve inconsistencies

Identify gaps
-Acts a catalyst for a better designed prim. study

Identify when questions have been fully answered

Explore difference between studies

Question 6

What does a systemic review use

Answer 6

Robust methods to reduce bias in the gathering, summarizing, presenting, interpreting, and reporting of the research evidence

Question 7

What are the characteristics of a systematic review

Answer 7

1.Well formulated question

2. Comprehensive data search
3. Unbiased selection and abstraction process

4.Assessment of papers

5.Synthesis of data

Question 8

What are non-systematic reviews susceptible to and why

Answer 8

Bias

The authors may not clearly state the methodology used, and may be selective in presenting evidence to support a particular, pre-existing view

Question 9

Why are SR’s important

Answer 9

Reduce large quantities of information into manageable portions

Formulate policy and develop guidelines

Efficient use of resources

Increased power/precision in your estimates

Limit bias and improve accuracy

Question 10

What is the process of systematic reviews

Answer 10

Authors
-Two or more
-Topic expert
-Methodological expert

Study protocol
0In advance set out what they plan to do methodologically

Specific Question
-Using PICO

Search strategy.
-comprehensive and repeatable
-multiple electronic databases
-published and unpublished literature
-ideally without language restrictions

Inclusion/Exclusion criteria
Specific
Agreed in advance
Critical Appraisal
Systematic and thorough
Risk of Bias
Synthesis
Qualitative (narrative) synthesis
Quantitative pooling of data in meta-analysis,
relative precision and quality of the included studies.

Question 11

How reliable are SR’s

Answer 11

Depends
-Methodological quality of included studies
-Quality of the Systematic Review itself
-How well was the review conducted?

Question 12

Whats the exact process of SR’s

Answer 12

1. Well formulated question (PICO)
2. Comprehensive data search
3. Unbiased selection and abstraction process
4. Assessment of papers
5. Synthesis of data

Question 13

What does PICO stand for

Answer 13

Participants
-Who is the review interested in studying

Interventions (Exposure)
-What is the intervention or group of interventions of interest

Comparisons
-What will the interventions be compared to

Outcomes
-Which outcomes will tell you which intervention is most effective

Question 14

What do you do in comprehemsive data search

Answer 14

Needs to be as comprehensive as possible

Consider:
-Electronic databases

-Reference lists

-Hand searching

-English language/non-English language

-Sources of ongoing and/or unpublished studies

Question 15

What reporting bias’s are there

Answer 15

Statistically significant ‘positive’ results are:
more likely to be published
-publication bias

more likely to be published rapidly
-time lag bias

more likely to be published in English
-language bias

more likely to be cited by others
-citation bias

Question 16

How to make sure unbiased selection

Answer 16

Data extraction to a predefined data extraction form

Process should be conducted independently by at least two reviewers

Clear description of reasons for exclusion if any

Adequate description of included studies

Details of studies funding sources

Question 17

What is meant by assessment of papers and how is it carried out

Answer 17

How well the studies have been designed and conducted

Process should be conducted independently by at least two reviewers

Question 18

What can assessment of papers be used for

Answer 18

As a threshold for inclusion of studies

As a possible explanation for differences in results between trials

In sensitivity analyses

As weights in statistical analysis of the results

Question 19

What is the preffered quality assessment tool of papers

Answer 19

Component approach

-assesses relevant methodological aspects individually (e.g. randomisation, blinding, drop-outs)

Question 20

What is the problematic quality assessment tool of papers

Answer 20

Composite scales

Question 21

What does bias determine

Answer 21

The extent to which results of studies can be believed

Question 22

In a RCT what are you looking at in a risk of bias assessment

Answer 22

The sequence generation

The allocation concealment

The blinding

Incomplete outcome data

Selective outcome reporting

Other (funding source/ compliance, eg)

Question 23

In a study risk of bias table what do fill in

Answer 23

Whether there is bias in parts of studies and then you put in something like
-Unclear risk
-Low risk
-High risk

And then a sentance to support judgement

Question 24

What cab be an explanation for heterogeneity between results of different studies

Answer 24

Variation of risk of bias