crp 5.3 systematic review

8/2/2019 Crp 5.3 Systematic Review

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SYSTEMATIC REVIEWSYSTEMATIC REVIEWSYSTEMATIC REVIEWSYSTEMATIC REVIEW

Community Research ProgramCommunity Research Program

Medical Faculty of North SumatraMedical Faculty of North Sumatra


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Systematic Review (SR)Paper that summarizes other papers

Known as: Review article Systematic review

Meta analysis


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Definition An overview of primary studies that

used explicit (objectives, material,and methods) and reproduciblemethods


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Systematic review Systematic in : Gathering relevant articles

Appraising the articles

The difference between SR and Metaanalysis is:

In SR, there is no formal statistical analysis

In Meta analysis, there is


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Integrative literature

Review article

Systematic review

Meta analysis


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Integrative literatureReview article

Systematic review

Meta analysis


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Methodology for

systematic review of RCT


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When systematic review isundertaken, not only must the search

for relevant articles be thorough andobjectives but the criteria used toreject articles as flawed must be

explicit and independent of theresults of those trials


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The most enduring and usefulsystematic review, notably those

undertaken by the CochraneCollaboration are regularly updated toincorporate new evidence


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Advantages Explicit methods limit bias in identifying andrejecting studies

Conclusions are more reliable and accurate

because of methods used Large amounts of information can be assimilatedquickly by healthcare providers, researches, andpolicymakers

Delay between research discoveries andimplementation of effective diagnostic andtherapeutics strategies may be reduced


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Advantages Results of different studies can be formally

compared to establish generalisability of finding

and consistency (lack of heterogeneity) of results Reasons for heterogeneity (inconsistency inresults across studies) can be identified and newhupotheses generated about particular subgroups

Quantitative systematic reviews (metaanalysis)increases the precision of the overall result


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Evaluating Systematic

Review

Validity

Important

Applicability


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Validity (Methods)

Questions: Is it a systematic review of randomized

trials of the treatment youre interestedin?

Does it include a methods section thatdescribes: Finding and including all the relevant trials? Assesing their individual validity?

Were the results consisten from study tostudy?


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Important (Results)Odds ratio to NNTs OR

RRR CER

PEER

NNTs


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Applicability (Discussions)YES to all Do they really make biologic and clinical sense? Is the qualitative difference both clinically

(beneficial for some useless or harmful forothers) and statistically significant?

Was this difference hypothesised before thestudy began (rather than the product of dredgingthe data), and has it been confirmed in other,independent studies?

Was this one of just a few subgroup analusescarried out in this study?


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Thank you

crp 5.3 systematic review

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