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