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# which of the following statements is not true of the conduct of systematic reviews?

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### James

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## Multiple Choice Quiz

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## Multiple Choice Quiz

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## 641 Quiz Flashcards

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## 641 Quiz

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What does a p-value of 0.08 mean?

A. There are 8 chances in 100 that the finding is true

B. There are 8 chances in 100 that the finding is a chance variation

C. There are 8 chances in 10 that the finding is true

D. There are 8 chances in 100 that the finding is biased.

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B. There are 8 chances in 100 that the finding is a chance variation (refer to pg. 107 in book)

This is my educated guess

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Which statement about systematic reviews (SRs) is not true?

a. SR is another name for a literature review

b. At the onset of conducting an SR, a decision can be made to exclude studies based on quality, research design, or years of publication

c. One type of SR is an integrative research review

d. The goal of SRs is to reach conclusions that represent the findings of a body of individual studies

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a. SR is another name for a literature review

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### Terms in this set (35)

What does a p-value of 0.08 mean?

A. There are 8 chances in 100 that the finding is true

B. There are 8 chances in 100 that the finding is a chance variation

C. There are 8 chances in 10 that the finding is true

D. There are 8 chances in 100 that the finding is biased.

B. There are 8 chances in 100 that the finding is a chance variation (refer to pg. 107 in book)

This is my educated guess

Which statement about systematic reviews (SRs) is not true?

a. SR is another name for a literature review

b. At the onset of conducting an SR, a decision can be made to exclude studies based on quality, research design, or years of publication

c. One type of SR is an integrative research review

d. The goal of SRs is to reach conclusions that represent the findings of a body of individual studies

a. SR is another name for a literature review

Which of the following questions is part of appraising the credibility of an integrative research review?

A. What topic or question did the integrative research review address?

B. Was the search for study reports comprehensive and unbiased?

C. Is the size of the clinical effect large enough to make a difference in patient well-being?

D. Are there any reasons why the conclusions might not apply to your setting?

B. Was the search for study reports comprehensive and unbiased?

Which of the following is not a major determinant of the credibility of a conclusion of an integrative research review?

A. The number of studies with similar findings

B. The quality of the studies addressing the issue

C. The journal in which the IRR was published

D. The quality of the synthesis across studies

C. The journal in which the IRR was published

In evaluating the applicability of the findings of an integrative research review to your setting, which of the following is a major determinant?

A. Whether only high quality studies were included

B. Whether the objectives of the review were clear

C. Whether the patient samples in the studies were similar to the setting where you are considering using the findings

D. Whether a comprehensive search for study reports was conducted

C. Whether the patient samples in the studies were similar to the setting where you are considering using the findings

How are the conclusions of an integrative research review reached?

A. By statistically combining findings from individual studies

B. By cross-study comparisons and logical reasoning

C. By polling experts in the field

D. By focusing on the findings of large studies

B. By cross-study comparisons and logical reasoning

What is the minimum number of studies for an integrative research review?

A. 2 B. 5 C. 10 D. 30 2

Which of the following is not a criterion that should be used when appraising the credibility of the conclusions of an integrative research review?

A. Findings are consistent across several studies

B. Explicit criteria were used for study inclusion and exclusion.

C. The reviewer has conducted a study about the question or topic

D. A comprehensive search was conducted

C. The reviewer has conducted a study about the question or topic

Which of the following statements is not true of the conduct of integrative research reviews?

a. It is best done by one person to control conflicting views

b. It can lead to conclusions based on findings from studies with diverse designs

c. Adhering to widely accepted methods reduces bias

d. Findings represent conclusions arrived at across studies

a. It is best done by one person to control conflicting views

The scope of an integrative review refers to which of the following?

a. The databases searched

b. The clarity of the purpose statement

c. The narrowness or broadness of the purpose statement

d. The rigor of the data synthesis

c. The narrowness or broadness of the purpose statement

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## Systematic Reviews: What Do You Need to Know to Get Started?

Can J Hosp Pharm. 2015 Mar-Apr; 68(2): 144–148.

doi: 10.4212/cjhp.v68i2.1440

PMCID: PMC4414076 PMID: 25964686

## Systematic Reviews: What Do You Need to Know to Get Started?

Theresa L Charrois

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## INTRODUCTION

The cornerstone of clinical research on interventions is generally considered to be the randomized controlled trial (RCT).1 However, in topic areas where the number of patients is limited or the evidence is conflicting, systematic reviews offer the benefit of collating evidence from a variety of sources.1,2 A systematic review attempts to bring together all available evidence on a specific, clearly defined topic. Moreover, in areas where a number of large-scale trials have had similar results, a systematic review that includes meta-analysis of the data can help researchers to find a population estimate for the overall effect of the intervention.

In the hierarchy of evidence, systematic reviews of randomized trials offer the highest level of evidence.1 The strongest inferences can be drawn if the systematic review is well conducted and includes methodologically sound RCTs with consistent results. In making treatment decisions, the highest quality of evidence should be sought, but well-conducted systematic reviews may not always be available.

This article provides a concise overview of the steps in a systematic review, with a focus on systematic reviews of RCTs. For more in-depth discussion of issues that go beyond the scope of this article, readers are directed to other resources.2,3

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## DISTINCTION BETWEEN SYSTEMATIC REVIEWS AND META-ANALYSES

One of the most common errors in understanding systematic reviews is the perception that they are interchangeable with meta-analyses. “Systematic review” is the overarching term for studies that collate available evidence related to a directed clinical question.2,4 A meta-analysis is a review in which statistical methods are employed to collate the numeric data from the primary studies. For various reasons, not all systematic reviews can combine the available data to generate summary numeric results; however, all systematic reviews should employ stringent methods to summarize the available research.

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## STUDY QUESTION

As in any type of research, a clear clinical question is needed for a systematic review. The question should state the patient group of interest, the intervention being investigated, the control or comparator group, and the outcomes of interest.1,2 For example, if you were interested in conducting a systematic review of the effectiveness of new agents (e.g., gliptins) in the treatment of diabetes mellitus, you would need to clearly define your target population and specify whether you are considering studies that compare gliptins with other antidiabetic agents or studies that compare gliptins just with placebo. If you neglect to define each of these parameters a priori, you will have problems in determining which studies should be included and which should be excluded from your systematic review. Table 1 provides an example of how to define the question.

### Table 1.

Example of Components in Posing a Relevant Clinical Question

Component of Question Example

Patient population Patients with poorly controlled type 2 diabetes mellitus

Intervention Gliptins (all agents)

Control Placebo

Outcomes Change in A1C, hypoglycemic episodes

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A1C = glycated hemoglobin.

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## INCLUSION AND EXCLUSION CRITERIA

Just as an RCT requires that the investigator specify criteria for deciding which patients will be included in the study, a systematic review requires that the investigator define, at the proposal-writing stage, clear criteria for deciding which studies will be included. For example, will you limit your review to English-language studies? Will you include only RCTs, or will you accept other study designs? What outcomes will meet your inclusion criteria—will you include only hard clinical end points (e.g., admissions to hospital, deaths), or will you also consider surrogate end points (e.g., laboratory values)? The decisions about inclusion and exclusion criteria should relate directly to the defined research question. In the example given in Table 1, you might want to consider what is meant by “poorly controlled” (e.g., defined in terms of glycated hemoglobin [A1C] or other clinical markers) and whether there is a specific age range you want to investigate (e.g., between 18 and 75 years). You might also decide whether studies must have a minimal methodologic quality to be considered for inclusion, particularly in terms of the study designs that you will consider acceptable, according to your area of study. RCTs represent the optimal study design; however, not all clinical questions can be answered by an RCT, so you may also need to include observational study designs, depending on the topic.

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## LITERATURE SEARCH

A systematic review is only as good as the data on which it is based, that is, the primary studies. To ensure that the widest scope of primary research is identified, a thorough and complete search of the literature is needed. The best way to accomplish this is to have help from a librarian with expertise in the area of systematic reviews in defining the search terms, search strategies, and databases to be used. The rule of thumb for a systematic review literature search is that more than 2 databases should be used. For the casual reader, the databases that should be used for a particular systematic review can be difficult to judge, but generally databases beyond just MEDLINE should be searched. Ideally, articles in languages other than English should be included, and there should be an attempt to find unpublished research and research that has not been formally published in a journal. This “grey literature” is the most difficult to find. Grey literature has been defined as “that which is produced on all levels of government, academics, business and industry in print and electronic formats, but which is not controlled by commercial publishers”.5 It can include reports, theses, conference proceedings, technical specifications and standards, noncommercial translations, bibliographies, technical and commercial documentation, and official documents not published commercially (such as government reports).5 The instantaneous nature of the Internet has led to a proliferation of this type of literature, but the challenge lies in finding it. Searching the websites of agencies and organizations that may be involved in the area of interest is a reasonable way to start. Grey literature repositories and gateways have evolved and offer another method for researchers to find primary evidence not available in the peer-reviewed literature.5 Again, searching for grey literature can be much easier with the help of a librarian.

Source : www.ncbi.nlm.nih.gov

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James 5 month ago

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