Systematic Review and Meta-Analysis
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Questions and Answers

Which of the following statements about the presented observations is true?

  • They have high internal and external validity.
  • They can infer causality.
  • They are based on clinical observations. (correct)
  • They are based on empirical research findings.

    • What can be inferred about the validity of the observations?

  • Both internal and external validity are high.
  • Internal and external validity are extremely low. (correct)
  • Internal validity is high, but external validity is low.
  • Internal validity is low, but external validity is high.

    • What is a challenge in using levels of evidence?

  • Levels of evidence never change over time.
  • There is only one organization that provides levels of evidence.
  • There is no gold standard rule for levels of evidence. (correct)
  • Different organizations have the same levels of evidence.

    • Which organization's levels of evidence are mentioned in the text?

    <p>National Institute for Health and Care Excellence (NICE), Australian National Health and Medical Research Council (NHMRC), and United States Preventive Services Task Force (USPSTF)</p> Signup and view all the answers

    What is the relationship between quality of evidence and strength of recommendation?

    <p>Quality of evidence does not necessarily correspond to strength of recommendation.</p> Signup and view all the answers

    What can influence the quality of recommendation?

    <p>Quality of evidence, balance of benefits and harms, values and preferences, cost, and other factors.</p> Signup and view all the answers

    What is an example of a scenario where weak recommendations are made despite high-quality evidence?

    <p>Inoperable non-small cell lung cancer chemotherapy and radiotherapy.</p> Signup and view all the answers

    What is true about the levels of evidence provided by different organizations?

    <p>They are slightly different across different organizations.</p> Signup and view all the answers

    Why is it challenging to determine the strength of recommendation?

    <p>Because many factors, including quality of evidence, balance of benefits and harms, values and preferences, cost, and other factors, influence the strength of recommendation.</p> Signup and view all the answers

    What is the relationship between the quality of evidence and the quality of recommendation?

    <p>Weak recommendations can be made despite high-quality evidence.</p> Signup and view all the answers

    Study Notes

    Meta-Analysis

    • A component of a systematic review that involves pooling together the results to get an overall/pooled measure of the association/estimate (e.g. pooled odds ratio)
    • Increases statistical power and generalizability of the results
    • Quantifies the magnitude and direction of effects across studies, providing a more precise estimate of the overall effect size

    Cochrane Collaboration

    • An independent, international organization dedicated to promoting evidence-based healthcare by producing high-quality systematic reviews and meta-analyses of healthcare interventions
    • Website: http://www.cochrane.org

    Why Conduct a Meta-Analysis?

    • Increases statistical power: combines data from multiple studies, increasing sample size and precision
    • Increases generalizability: combines data from diverse populations and settings, increasing the applicability of the results
    • Quantifies the magnitude of effects: provides a more precise estimate of the overall effect size

    Publication Bias

    • Systematic reviews only reflect on published results
    • Statistically significant results are more likely to be published, leading to biased high estimates
    • Should be evaluated when conducting a systematic review

    Levels of Evidence

    • Based on the Oxford Centre for Evidence Based Medicine (2009)
    • Levels of evidence are categorized from 1a to 5, with 1a being the highest level of evidence

    Levels of Evidence (continued)

    • Level 1a: Systematic reviews/meta-analyses of randomized controlled trials
    • Level 1b: High-quality individual randomized controlled trials
    • Level 1c: High-quality individual non-randomized/non-controlled trials
    • Level 2a: Systematic reviews/meta-analyses of cohort studies
    • Level 2b: High-quality individual cohort studies
    • Level 3a: Systematic reviews/meta-analyses of case-control studies
    • Level 3b: High-quality individual case-control studies
    • Level 4: Case series, cross-sectional studies, and low-quality cohort and case-control studies
    • Level 5: Individual expert opinion/report, expert committee opinion/report, and clinical experiences of respected authorities

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    Description

    This quiz covers the concepts of systematic reviews and meta-analysis, including the formation of Cochrane Collaboration, pooling results, and ruling out chance findings. It also touches on the limitations of conducting meta-analysis and the importance of statistical components. Test your knowledge of these research methods!

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