16 Questions
What is the main purpose of a forest plot?
What is the name of the organization that provides a critical summary of randomized controlled trials?
Cochrane Organization
What is a problem that can occur in meta-analysis?
All of the above
What is the term for the graphical display of estimated results from multiple studies?
Forest plot
What is the main objective of evidence-based healthcare?
To base healthcare services and interventions on best available evidence
What is a characteristic of a systematic review?
Explicit assumptions and transparent methodology
Who is the person who criticized the medical profession for not organizing a critical summary of randomized controlled trials?
Archie Cochrane
What is the percentage of weight for the study with the odds ratio of 1.12 (1.04,1.21)?
72.9
What is the purpose of a meta-analysis?
To facilitate the synthesis of a large number of study results
What is a limitation of expert reviews in healthcare decision-making?
They are biased, subjective, and not reproducible
What is the term for a review of multiple studies that provides a comprehensive summary of the results?
Systematic review
What is the overall odds ratio in the forest plot?
1.11
What is a key aspect of a systematic review?
It is an extremely credible source of evidence
What is the purpose of a systematic literature search in a systematic review?
To identify all relevant studies on a specific topic
What is the difference between a systematic review and a meta-analysis?
A systematic review is an overview of primary studies, while a meta-analysis is a quantitative synthesis of the results of two or more primary studies
What is the purpose of decision analyses in healthcare?
To evaluate the harms and benefits of a healthcare intervention
Study Notes
Healthcare Services and Interventions
- Healthcare services and interventions should be based on the best available evidence
- Best available evidence comes from rigorously conducted research, including:
- Primary research studies (e.g. RCT)
- Literature reviews
- Decision analyses (e.g. harms and benefits, cost-effectiveness)
Systematic Reviews
- A systematic review is a credible source of evidence that:
- Asks a clearly focused question
- Has explicit statements about:
- Types of study
- Types of participants
- Types of interventions
- Types of outcome measures
- Uses a systematic literature search
- Selects and appraises materials
- Synthesizes results (possibly including a meta-analysis)
- A systematic review is explicit, transparent, and reproducible
Meta-Analysis
- A meta-analysis is a quantitative synthesis of the results of two or more primary studies that:
- Address the same hypothesis
- Use the same methodology
- The purpose of a meta-analysis is to:
- Facilitate the synthesis of a large number of study results
- Systematically collate study results
- Reduce problems of interpretation due to variations in sampling
- Quantify effect sizes and their uncertainty as a pooled estimate
Forest Plot
- A forest plot is a graphical display of estimated results from multiple scientific studies addressing the same question
- It shows the overall results, along with the results of each individual study
Example of Meta-Analysis
- A meta-analysis of RCTs of the effect of aspirin in preventing death after myocardial infarction
- The results of 7 studies are combined to show the overall effect of aspirin on mortality
Problems in Meta-Analysis
- Heterogeneity between studies
- Variable quality of the studies
- Publication bias in selection of studies
Sources of Evidence
- Systematic reviews are a key source of evidence in healthcare
- Archie Cochrane, a pioneer in evidence-based medicine, emphasized the importance of organizing and summarizing RCTs by specialty or subspecialty
Review evidence-based healthcare and the role of systematic reviews in clinical practice. Learn to interpret Forest plots and overcome common difficulties in systematic reviews.
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