Systematic Reviews, Meta Analysis, Critically Appraised Topics & Paper
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effect size
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unit less number we are able to calculate that estimates strength of treatment effect - provides indication of clinical meaningfulness
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Cohens d interpretation of effect sizes
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> 0.8 = strong 0.5 - 0.8 = moderate 0.2 - 0.5 = small < 0.2 = weak - can range from negative to positive - negative is just as strong as positive effect size
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confidence interval
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set of values for the parameter being estimated that are plausible - level of interval = 95% (most common)
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confidence interval inerpretation
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- if CI includes 0 (including pos. and neg.) = non significant result, no difference b/t 2 groups - if CI doesn't include 0 (all pos. or all neg.) = significant result
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systematic review
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one paper that reviews many different previously published papers and trying to make recommendation based on result of those papers
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components of systematic review
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- title page - abstract - background - objectives - methods - results - discussion - conclusions - references - tables and figures
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meta-analysis
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subtype of systematic review *All meta-analyses are systematic review, but all systematic reviews are not meta-analyses* - Meta-analysis combines the effects from multiple studies to give a single estimation of the overall effect
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what a meta analysis is not
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not a simple average of magnitude of effects across all the included studies
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meta analysis conti...
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provides weighted average of treatment effect
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what contributes to weighting
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sample size - large sample = greater weighing variance - incertainty - lower variance = more certain = greater weighting
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components of meta analysis
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- subjects - must have strict inclusion and exclusion criteria - individual study characteristics must be similar for inclusion
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what can meta analysis answer?
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- what is direction of effect? - what is the size of effect? - is the effect consistent?
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meta analysis advantages
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- Allows for single quantitative estimate from results pooled across multiple studies - Increases statistical power and provides a more precise estimate of the treatment effect
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meta analysis limitation
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must make sure that all included studies asked the same clinical question
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critically appraised topics
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- provide a reader friendly source of evidence for practicing clinicians to help guide their clinical decision making - Critical review and summary of 3-4 studies, each directed at answering a specific clinical question
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difference between CAT and systematic review
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level of rigor - CAT provides lower level evidence but easy to read
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critically appraised paper
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critical review and summary of a single study - longer than abstract shorter than article - usually done for high level of evidence papers
