Reviews and guidelines

Question 1

Types of reviews

Answer 1

Narrative review- traditional, lacks structure, opinion driven

Scoping- broad research, used to map and summarise broad literature

Systematic- answer a specific question by identifying studies to meet criteria

Meta-analysis- a type of systematic review and generation of new data from primary studies

Rapid- accelerated forms of evidence aiming to provide timely and relevant info while speeding up traditional systemic review

Question 2

Steps in critical appraisal of reviews

Answer 2

1. Planning- methods, questions.
2. Search databases
3. Screening
4. Evaluate research quality
5. Analyse data
6. Communicate and write review

Question 3

Steps involved in development of reviews

Answer 3

1. State objective and review and outline eligibility
2. Search for trials that meet criteria
3. Assess quality and characteristics of trials
4. Apply criteria and justify exclusions
5. Analyse results of RCTs using statistical synthesis of data
6. Interpret results
7. Critical summary of review, state aims, describe materials and results
8. Give implications for research and practise

Question 4

Bias involved in synthesis of reviews

Answer 4

Language bias
Selection bias
Publication bias

Question 5

Process of developing a meta-analysis

Answer 5

Formulate a research question
Search literature
Select studies
Extract data
Assess quality
Forest plot
Heterogeneity assessment
Grade, interpret, and conclude

Question 6

What is a forest plot

Answer 6

Graphical representation of results of multiple studies that investigate research question
Visually compare results of different studies and determine consistent effect

Black squares- odds ratio of individual studies
Horizontal lines- 95% CI
Area of black square- weight of each trial
Solid vertical line- no effect
Diamond- overall treatment effect summary

Question 7

Types of guidelines

Answer 7

Evidence based guidelines- systematic process to develop recommendations

Consensus based guidelines- expert experience to develop recommendations

Evidence + consensus based- mix to cover steps without experience

Question 8

guideline development process

Answer 8

1. Identify therapeutic area
2. Form guideline development group
3. Systematically review evidence
4. Formulate clinical statements
5. Grade evidence
6. Develop recommendations and pilot run
7. External review and implement recommendations
8. Revise/update

Question 9

Critical appraisal tools

Answer 9

AGREE
Appraisal of guidelines for research and evaluation

Scope and purpose of a guideline
Stakeholder involvement
Rigour development
Clarity of presentation
Application
Editorial independence

Question 10

PRISMA

Answer 10

Preferred reporting item for systematic reviews and meta analysis (PRISMA)
Title, abstract, intro, methods, results, discussion, funding

Question 11

Evidence rating in guidelines

Answer 11

SORT - strength of evidence recommendation taxonomy

NHMRC grading system