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Content-Location: file:///C:/F009C636/Research_synthesis_Gulmezoglu_2006_files/pres.xml
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Content-Type: text/xml; charset="utf-8"
Research synthesi=
s
Metin Gülmezoglu M.D., Ph.D&#=
13;
Department of Reproductive He=
alth
and Research
World Health Organization
=
;
Training Course in Reproductive Health / Sexual Health
Research
Geneva 2006
What is research synthesis?
oThe process th=
rough
which two or more research studies are assessed =
w=
ith the
objective of summarizing the evidence relat=
ing to
a particular question.
Why do we need
research synthesis?
<=
span
class=3DB1B style=3D'position:absolute;left:-5.77%'>nthe quality of
research is very variable
<=
span
class=3DB1B style=3D'position:absolute;left:-6.43%'>nmost studies a=
re too
small
What is the sc=
ience
of
research synthesis?
research synthesis?
The medical re=
view
article:
state of the science.
[Mulrow. Ann Int Med, 1987]
&= nbsp;
"Current medical reviews do n= ot routinely use scientific methods to ide= ntify, assess, and synthesize information."
state of the science.
[Mulrow. Ann Int Med, 1987]
&= nbsp;
"Current medical reviews do n= ot routinely use scientific methods to ide= ntify, assess, and synthesize information."
Research synth=
esis
is required for which types of research?<=
/div>
o Risk factors=
: Factors predisposing women to
chronic pelvic pain: systematic review. Latthe P,
Mignini L, Gray R, Hills R, Khan K. =
BMJ
2006
o Aetiology: Mignini L, Villar J, Khan K. Mapping the theories =
of =
preeclampsia:
the need for systematic reviews of mechanisms of =
the
disease. AJOG 2006
o Screening/diagnostic tests:Selman TJ, Luesley DM, Acheson N, Khan KS, Mann CH. A systematic review of the
accuracy of diagnostic tests for inguinal
lymph node status in vulvar cancer.
Gynecol Oncol. 2005
o Prevalence/incidence studies: <=
span
lang=3DEN-GB style=3D'font-family:Verdana;mso-ascii-font-family:Verdana;
font-size:57%'>Say L, Donner A, Gülmezoglu AM, Taljaard M, Piaggio G. The prevalence of stillbirths=
: a
systematic review. Reproductive Health 2006&#=
13;
oEffects of practices:=
Hofmeyr
GJ, Walraven G, Gulmezoglu AM, Maholwana B, Alfirevic Z, Vil=
lar
J.Misoprostol to treat postpartum =
=
haemorrhage:
a systematic review. BJOG 2005
=
<=
span
style=3D'font-size:57%;color:#0066FF'>oBasic science
research: Horn J et al. Nimodip=
ine
in animal model experiments of focal
cerebral ischaemia. Stroke 2001
Gynecol Oncol. 2005
Why is research
synthesis important?
oPatients (and =
the
public more generally) suffer directly and i=
ndirectly
oPolicymakers,
practitioners, and patients have inadequate informatio=
n t=
o guide
their choices among alternatives
oLimited resour=
ces
for health care and new research are used inefficiently=
The science of
research synthesis
o<=
/span>S=
ystematic
reviews
n=
p=
rotocol
development
n=
c=
ritical
appraisal
n=
m=
eta-analysis
o<=
/span>U=
pdating/electronic
publication
“Reviews=
”
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oWhy do we need reviews?
=
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oTraditional (narrative) reviews
=
;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oSystematic reviews
<=
span
class=3DBB style=3D'position:absolute;left:-6.02%'>oA “review” is a retrospective study=
What constitut=
es a
systematic review?
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oClearly formul=
ated
question
o<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oSelecting
studies
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oCritical
appraisal
<=
span
style=3D'visibility:hidden'>o
What is a systematic review?
oA review of a clearly formulated question that uses systematic and explicit methods to identify, select and critically appraise <=
span
style=3D'position:absolute;top:43.5%;left:12.35%;width:80.52%;height:6.0%'=
>relevant research, and to collect and analyse data from the studies that are included in the review.
oStatistical methods (meta-analysis) may or may not be used to analyse and summarise the results of the included studies.
<=
span
style=3D'font-size:87%;visibility:hidden'>o
Review protocol
oSystematic rev=
iews
are research projects
oSystematic rev=
iews
are retrospective studies
oProtocol prepa=
ration
allows ‘a priori’ decisions
oTo obtain feed=
back
and criticism for the review before it is finalised <=
/span>
Sections of a protocol
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oCover sheet=
3;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oBackground
=
;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oObjectives
=
;
<=
span
style=3D'color:#0066FF'>oSelection criteria
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oSearch strateg=
y
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oMethods=
Selection criteria
o=
Types
of studies
n=
RCTs,
placebo-controlled etc.
o=
Participants
n=
sex,
age groups, community vs hospital
o=
Interventions
n=
Treatment
vs nothing? Placebo?
n=
Treatment
vs another treatment
o=
Outcomes
n=
Substantive
outcomes vs surrogate outcomes
n=
Outcomes
important for decision-making
n=
Outcomes
important for users (consumers)
Sections of a protocol
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oCover sheet=
3;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oBackground
=
;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oObjectives
=
;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oSelection
criteria
<=
span
style=3D'color:#0066FF'>oSearch strategy
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oMethods=
Search strategy
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oSearch terms
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Content-Transfer-Encoding: quoted-printable
Content-Type: text/html; charset="windows-1252"
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>odatabases
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>ohandsearching
<=
span
style=3D'visibility:hidden'>o
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oexpert help usually needed
Sections of a protocol
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oCover sheet=
3;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oBackground
=
;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oObjectives
=
;
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oSelection
criteria
<=
span
class=3DBB style=3D'position:absolute;left:-6.51%'>oSearch strateg=
y
<=
span
style=3D'color:#0066FF'>oMethods
Methods
oH=
ow will
you decide to include or exclude a stud=
y from
the review (critical appraisal)?
n=
A=
priori
description
n=
D=
uplicate
assessments
n=
Q=
uality
assessment
n=
M=
issing
data
Sections of a systematic review
=
oCover sheet=
3;
=
oBackground
=
;
=
oObjectives
=
;
=
oSearch strateg=
y
=
oMethods
=
o<=
/span>Description of studies
o<=
/span>Methodological quality of included studies
o<=
/span>Results
o<=
/span>Discussion
o<=
/span>Conclusions
n<=
/span>Implications for practice
n<=
/span>Implications for research
o<=
/span>Acknowledgements
o<=
/span>Conflict of interest
What is a meta-analysis?
oThe use of statistical techniques in a s=
ystematic
review to integrate the results of the
included studies. Also used to refer =
to
systematic reviews that use meta-analysis.
<=
span
style=3D'visibility:hidden'>o
1977
![](3D"slide0039_image007.png")
![](3D"slide0039_image008.png")
% =
47 less
=
Corticosteroid
treatment for women in preterm labour: =
effects
on neonatal death
External cephalic ver=
sion
Conclusions
oR=
esearch
synthesis is an essential component of
decision-making for
n=
R=
esearch
n=
P=
ractice
n=
P=
olicy
Useful resources
oWHO Reproducti=
ve
Health Library www.rhlibrary.com
oCochrane
Collaboration web site (<=
p:onmouseclick
hyperlinktype=3D"url" href=3D"http://www.cochrane.org/"/>http://www.cochrane.org<=
/span>)=
oNetting the
evidence: (http://www.shef.ac.uk/~schar=
r/ir/nett <=
p:onmouseclick
hyperlinktype=3D"url" href=3D"http://www.shef.ac.uk/~scharr/ir/netting/"/=
>ing/)
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