PENN CENTER FOR EVIDENCE-BASED PRACTICE. Introduction to Systematic Reviews and Meta-Analyses Craig A Umscheid , MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Penn Center for Evidence-based Practice Senior Associate Director, ECRI-Penn AHRQ EPC
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PENN CENTER FOR EVIDENCE-BASED PRACTICE
Introduction to Systematic Reviews and Meta-Analyses
Craig A Umscheid, MD, MSCE, FACP
Assistant Professor of Medicine and Epidemiology
Director, Penn Center for Evidence-based Practice
Senior Associate Director, ECRI-Penn AHRQ EPC
TEACH Level II Workshop 4
August 8th, 2013
You’re the CMO of a moderate sized hospital in Upstate NY, 100s of miles from a quarternary care hospital, and you hear about the below patient from the Director of your MICU:
Statistical pooling of the results of individual studies
Aims to produce a single estimate of treatment effect
BMJ. Volume 315. November 22, 1997.
Intervention or exposure
Scherer. CDSR. 2007.
Ioannidis. JAMA. 1998.
No Publication Bias Publication Bias
Linde, Lancet, 1997
Umscheid. CID. 2013.
Moher et al. Control ClinTrials. 1995.
Nurmohamed. Lancet. 1992.
-Studies with more “events” get greater weight
-Not just a simple average
Colditz, JAMA, 1994
BMJ VOLUME 327 6 SEPTEMBER 2003 p557-60
Search identified 8 studies
7 studies: no effect
1 study: large effect
Why do you think 1 study was not pooled with the others?
General Systematic Review Resources
Resources for Systematic Reviews Examining Harm
Resource for Systematic Reviews Examining Diagnostic Tests
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