Systematic Review in Research

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Questions and Answers

What is the primary purpose of appraising evidence in a systematic review?

  • To identify publication bias
  • To collect evidence from relevant databases
  • To synthesize evidence from multiple studies
  • To assess the risk of bias in individual studies (correct)

What type of bias is most likely to occur when studies with significant results are more likely to be published than studies with non-significant results?

  • Selection bias
  • Information bias
  • Confounding bias
  • Publication bias (correct)

What is the primary goal of synthesizing evidence in a systematic review?

  • To identify sources of heterogeneity
  • To appraise the quality of individual studies
  • To estimate the overall effect of an intervention (correct)
  • To identify the most effective treatment

Which of the following is a type of bias that can occur when the outcome of interest is not measured or reported consistently across studies?

<p>Indirectness (B)</p> Signup and view all the answers

What is the primary purpose of using a systematic review methodology?

<p>To synthesize evidence from multiple studies to inform decision-making (B)</p> Signup and view all the answers

What tool is commonly used to assess the risk of bias in individual studies within a systematic review?

<p>Cochrane risk of bias tool (A)</p> Signup and view all the answers

What is the primary goal of the evidence to decision framework?

<p>To make a recommendation based on the available evidence (A)</p> Signup and view all the answers

What is the primary purpose of considering the acceptability of an intervention in the evidence to decision framework?

<p>To consider the values and preferences of patients (B)</p> Signup and view all the answers

What is the primary goal of using a clear and precise recommendation in the evidence to decision framework?

<p>To ensure that the recommendation is actionable (A)</p> Signup and view all the answers

What is the primary purpose of considering the feasibility of an intervention in the evidence to decision framework?

<p>To consider the resources and infrastructure required to implement an intervention (A)</p> Signup and view all the answers

What is the primary purpose of a systematic review?

<p>To explore a specific research question (C)</p> Signup and view all the answers

Which of the following is NOT a component of the PICO framework?

<p>Study design (C)</p> Signup and view all the answers

What is the primary goal of bias assessment in a systematic review?

<p>To evaluate the quality of individual studies (B)</p> Signup and view all the answers

Which tool is used to assess the risk of bias in randomized controlled trials?

<p>ROBINS-I (D)</p> Signup and view all the answers

What is the purpose of meta-analysis in a systematic review?

<p>To combine the results of individual studies (B)</p> Signup and view all the answers

Which type of meta-analysis is used to compare multiple interventions?

<p>Network meta-analysis (D)</p> Signup and view all the answers

What is the purpose of the GRADE approach in a systematic review?

<p>To evaluate the quality of the evidence (A)</p> Signup and view all the answers

What is the purpose of visual inspection in a systematic review?

<p>To identify sources of heterogeneity (B)</p> Signup and view all the answers

Which of the following is a type of study design?

<p>Randomized controlled trial (B)</p> Signup and view all the answers

What is the purpose of appraising the evidence in a systematic review?

<p>To evaluate the quality of the evidence (A)</p> Signup and view all the answers

What is the most suitable type of study to use in this scenario?

<p>Systematic review (A)</p> Signup and view all the answers

What is the primary purpose of using a systematic review in this case?

<p>To identify all relevant studies on the topic (A)</p> Signup and view all the answers

What is the primary advantage of using a search strategy like (pregnan* AND appendicit*) AND (treatment OR management)?

<p>It increases the specificity of the search (C)</p> Signup and view all the answers

What is a potential limitation of relying on a single consultant's opinion in this scenario?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary purpose of using a risk of bias tool in this scenario?

<p>To assess the quality of individual studies (A)</p> Signup and view all the answers

What is the primary advantage of using an artificial intelligence (AI) system in this scenario?

<p>It can reduce the time and effort required to analyze the evidence (A)</p> Signup and view all the answers

What is the primary limitation of relying on a textbook in this scenario?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary advantage of using a systematic review in informing treatment decisions?

<p>It provides a comprehensive overview of the available evidence (B)</p> Signup and view all the answers

What is the primary purpose of assessing the quality of individual studies in a systematic review?

<p>To reduce the risk of bias in the results (D)</p> Signup and view all the answers

What is the primary advantage of using a systematic search strategy in this scenario?

<p>All of the above (D)</p> Signup and view all the answers

Flashcards

Appraising Evidence

Assess the risk of bias in individual studies.

Publication Bias

Studies with significant results are more likely to be published.

Synthesizing Evidence

To estimate the overall effect of an intervention.

Indirectness Bias

Outcome not measured or reported consistently across studies.

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Systematic Review Purpose

To synthesize evidence from multiple studies to inform decision-making.

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Cochrane Risk of Bias Tool

Assess the risk of bias in individual studies.

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Evidence to Decision Framework Goal

To make a recommendation based on the available evidence.

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Acceptability of Intervention

To consider the values and preferences of patients.

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Clear and Precise Recommendation Goal

To ensure that the recommendation is actionable.

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Feasibility of Intervention

To consider the resources and infrastructure required to implement an intervention.

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Systematic Review Purpose

Explore a specific research question.

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NOT a PICO Component

Study design.

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Bias Assessment Goal

To evaluate the quality of individual studies.

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ROBINS-I

Tool to assess bias in randomized controlled trials.

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Meta-Analysis Purpose

To combine the results of individual studies.

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Network Meta-Analysis

Compare multiple interventions.

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GRADE Approach

Evaluate the quality of the evidence.

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Visual Inspection Purpose

Identify sources of heterogeneity.

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Study Design Type

Randomized controlled trial.

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Appraising the Evidence

To evaluate the quality of the evidence.

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Most Suitable Study Type

Systematic review

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Systematic Review Purpose

To identify all relevant studies on the topic

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Search Strategy Advantage

It increases the specificity of the search

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Relying on Consultant's Opinion

All of the above

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Risk of Bias Tool Purpose

To assess the quality of individual studies

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Advantage of AI system

It can reduce the time and effort required to analyze the evidence

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Relying on Textbook

All of the above

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Advantage of Systematic View

It provides a comprehensive overview of the available evidence

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Assessing Study Quality Purpose

To reduce the risk of bias in the results

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Systematic Search Advantage

All of the above

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Study Notes

Systematic Review

  • A systematic review is a summary of evidence on a specific topic
  • It involves a systematic search, collection, and synthesis of evidence, as well as appraisal of evidence
  • May include meta-analysis, network meta-analysis, time-to-event meta-analysis, and IPD meta-analysis

PICO

  • PICO stands for Patient (population), Intervention (exposure), Comparator (control), and Outcome(s)
  • Used to formulate a specific research question

Evidence Appraisal

  • Risk of bias: assessing the methodological quality of individual studies
  • Inconsistency: assessing the variability in results across studies
  • Indirectness: assessing the extent to which the results of the studies can be generalized to the population of interest
  • Imprecision: assessing the degree of uncertainty in the results of the studies
  • Publication bias: assessing the potential for selective reporting of results

GRADE

  • A system for grading the quality of evidence and strength of recommendations
  • Quality of evidence: very low, low, moderate, or high
  • Strength of recommendations: strong or weak

Case Scenario

  • A 32-year-old pregnant woman in the 9th week of pregnancy presents with pain and tenderness in the right lower abdominal fossa
  • The patient has acute uncomplicated appendicitis and the attending suggests watchful waiting
  • The doctor is unsure of the right course of action and needs to search for evidence

Searching for Evidence

  • Use a specific search strategy, such as (pregnan* AND appendicit*) AND (treatment OR management)
  • Search for systematic reviews, a type of study that provides a summary of evidence on a specific topic

Evidence to Decision

  • A framework for making decisions based on evidence
  • Consider the benefits and risks (or burden) of an intervention
  • Consider the overall certainty of the evidence
  • Consider the patients' values and preferences
  • Consider the acceptability, feasibility, and resources required for the intervention

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