IMED2003 Study Guide - Midterm Guide: Systematic Review, Meta-Analysis, Osteoarthritis
12 Jan 2019
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Document Summary
Not always a reliable indicator of the level of risk of bias. Eg: limitations vary from study to study. Not all rcts can achieve the same low level of bias. Meta-analyses using data heavily affected by limitations could be rated down accordingly. Similarly high-quality data can be obtained from non-randomized observational studies. (eg. benefits of hip replacement in patients with osteoarthritis) ** there should be flexibility to upgrade" or downgrade" evidence levels based on the quality of evidence! To first evaluate the credibility of a systematic review. Then evaluate the quality of the evidence it presents. Eg: can"t compare a meta-analysis of well conducted rcts with low risk of bias with a meta-analysis of observational studies with considerable bias, so they can"t all be lumped together at the top of the pyramid! Hence: remove systematic reviews and meta-analyses from the top of the pyramid. And use these as tools ( lens ) to evaluate and apply the evidence.
