Systematic reviews Flashcards

1
Q

systematic reviews are also known as

A

evidence sysntheis

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2
Q

review

A

what is there

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3
Q

synthesis

A

what does it mean

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4
Q

Lord Rayleigh

A

a victorian scientist who discovered Argon, believed it is more important to make sense of what we already know, instead of discovering new things e.g. secondary research

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5
Q

evidence synthesis brings

A

all the evidence to one place

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6
Q

how many peer reviewed articles published in 2014

A
  1. 36 mill

- one every 20 second

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7
Q

systematic review is

A

more methodical- you can see how they were done- can be replicated

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8
Q

systematic reviews give accounts of

A

the search, appraisal and synthesis methods

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9
Q

systematic also means

A

exhaustive- has ALL the info out there

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10
Q

some people say that if you don’t include all the info-

A

then you are not carrying out a systematic review

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11
Q

which statistical representation are used in systematic reviews

A

forest plots

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12
Q

forets plots show

A
  • down the far left= the trial
  • shows odd rations- depending on how far one rah plot is not he control/ treatment side of the plot
  • plots have confidence intervals
  • can make cumulative forest pots where fata from diff studies synthesis- should decrease confidence limits
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13
Q

if confidence limits are on1

A

not signif

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14
Q

if confidence limits do not spread past 1

A

then the results are significant

-

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15
Q

meta-analyses will have

A

narrower confidence intervals

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16
Q

forest plots can be used to

A

look at trial o specific topic one ra lon period of time e.g. thrombosis
e.g. is it ethical to give control, ten years after it has been proven to be the favourable treatment

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17
Q

forest plots example

A

1987- the clinical value of thrombolysis remains uncertain

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18
Q

p value

A

the probability that if this was repeated you would get the same result- significance

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19
Q

SRs in terms o hierarchy of evidence

A

at the top

  • quantitative
  • used to decide whether treatment/ diagnostic technique should be employed
20
Q

negative of SR

A

dint hel popel decide how they feel about the new treatment/ diagnostic technique- not qualitative

21
Q

Steps in a systematic review

A

1) ask the Q
2) get the stuff - search- how
3) check the study- appraisal, how
4) synthesise the stuff- what does it mean, meta-analysis
5) apply in the decision

22
Q

summary of SR

A

find- appraise- act

23
Q

when asking a q

A
  • focus on what knowledge is needed
  • identify the most important unknowns
  • not all qs are equal
24
Q

important that we use the right evidence

A

to help patient and service development

25
(1)Structuring a Q using PICO
P- population I- intervention C- control O- outcome
26
population
the kind of people you are interested in
27
Intervention
what may happen to the group
28
control
what will happen without the intervention
29
Outcome
consequences of interest to the patients
30
(2) find the evidence
- electornic bibliographic databases - not all databases are equal e. g. Meddling, EmBase, PsycIfo
31
peer reviewed articles are
vastly over respected | - may things which are peer reviewed are rubbish
32
where can you find grey 'non-peer reviewed' literature
SIGLE
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(3) Appraise the evidence
-did they find enough -what does it mean? -should you believe it? Will it help with your uncertainty? What was the Question? what si the context?
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(4) Synthesis
- depending on kind of review - different kind of synthesis for diagnosis and critical reviews - cause use forest plots
35
On forest plots systematic reviews will
have the narrowest Ci
36
Heterogeneity
level is 0.1
37
heterogeneity is
reers to variation in study outcomes between studies
38
Heterogeneity is represented by
I^2
39
I^2
how much of the variation is due to chance vs heterogeneity - between variance/ total vairance
40
low I^2
may not be a porblem
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high I^2
substantial heterogeneity
42
heterogeneity needs to be
explored- could be due to different populations/ doses
43
why may heterogeneity occur
- look for wide CIs | - studies data will disagree significantly
44
Biases
- positive Studie sage mir eliekly to be published and quicker - positive outcomes - langauge
45
funnel plot- publication bias
- larger studies have higher/ lower odds - negative studies are much less likely to be published - review will have more positive the negative outcome trials
46
funnel plots illustrate why it is important to
use unpublished literature too - showing studies with equal stand error are subjected to publication bias based on whether they yield positive or negative results
47
types of SR
- effectiveness | - epidemiological