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IMED2003 Study Guide - Midterm Guide: Systematic Review, Meta-Analysis, OsteoarthritisPremium

2 pages23 viewsSpring 2018

Integrated Medical Sciences
Course Code
Kellie Bennett
Study Guide

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IMED2003: Revision 10 Notes
Study design definitions:
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!
Challenging it:
Current ‘popular’ suggestion”
To first evaluate the credibility of a systematic review
Then evaluate the quality of the evidence it presents
Eg: cant 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 cant all be lumped together at the top of
the pyramid!
HENCE: Remove systematic reviews and meta-analyses from the top of the
And use these as tools (“lens”) to evaluate and apply the evidence
SUMMARY: Evaluating the Evidence:
When it comes to finding our evidence, we cant simply be an observer
We need to actively participate in the process;
Understand the research question
Understand/evaluate the design applied to answer that question
Look for limitations and bias
Assign a level of validity to the study, place a hierarchy
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