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WhatistheDifferencebetween ASYSTEMATIC REVIEWANDAMETA- ANALYSIS? AnAcademicpresentation by Dr.NancyAgnes,Head,TechnicalOperations, Pubrica Group: www.pubrica.com Email:sales@pubrica.com
TODAY'S DISCUSSION InBrief Introduction Thestagesofsystematicreview Why don't all systemic reviews use meta-analysis? Whatdoes meta-analysis do? What are the other ways to synthesize evidence? Conclusion AboutPubrica
INBRIEF Thetermssystematicreviewandmeta-analysisarealsoused interchangeably.Eachtermreferstoresearchaboutthestudy,but thereare significant variationsbetween them. Asystematicreviewisapartoftheworkthatposesastudyquestion andthenrespondsbysummarisingtheevidencethatsatisfies a collectionof pre-determined requirements. A meta-analysis, a statistical implement for combining the results of many trials to produce an average outcome, is used in some systematic reviewwriting to present theirfindings. In addition, meta-analysis provides value because it can provide a more accurate estimation of a treatment's impact than looking at each study separately.
INTRODUCTION Asystematicreviewis amethodofcollecting, evaluating,andsynthesizingevidencetoaddress a well-definedquestionthatiscomprehensive, systematic,and clear. A meta-analysis is a statistical method for integrating numericaldatafromdifferentstudiesinto asingle report. Only a systematic review should ever be used to performa meta-analysis. Systematicreviewsandmeta-analysescombineand analyze data from various studies on related research subjects to present findings. In recent years, systematic reviews and meta-analyses have become common in variousfields,including anesthesiology. Contd...
Theseresearchapproachesareeffectivetoolsforovercomingthechallengesoflarge-scale randomizedcontrolled trials. However, systematic reviews and meta-analyses, including studies with biases or inappropriately measured quality of evidence, may lead to misleading results. As a result, different standards for conductingsystematic review evaluationsand meta-analyses have been proposed to standardize themfurther and improve their quality.
Systematicevaluationsaredistinguishedbytheireffortstoeliminatebiasatalllevelsofthereview process.The followingare the stepsinvolved in undertakinga review: Identifyyourissueand,preferably,registerthetitleofyourproposedstudy. Specifyandpublishyoursuggestedapproachasaprotocolinadvance. Conductasystematicliteraturequest. Reviewyoursearchresultsagainstyourpre-determinedselectioncriteriatofindstudiesthat shouldbe included. Evaluatetheconsistencyofthestudiesdiscovered Compiletheproof,whichmayormaynotincludeameta-analysis. Maketheanalysispublicbypublishinganddisseminatingit. Keepthestudyuptodateasnewinformationbecomesavailable.
THESTAGESOFSYSTEMATIC REVIEW A research question and a protocol or research plan are the foundations of a systematic analysis. Using a compassionatesearchapproach,aresearchteam looksforstudies toaddressthe issue. The recovered studies are then screened for eligibility (thisisdonebyatleasttwopeopleworking independently).Thereviewersthenextractthe relevant data and determine the validity of the studies that have been included. Finally, the research team synthesizesthedatafromthevariousstudies (possiblyusingmeta-analysis)andpresentsthe findings.
Identifytheresearchquestion Defineinclusionandexclusioncriteria Searchforstudies Selectstudies Extractdata Assessquality Synthesizeandpresentresults
Thestagesofsystematicreview Systematic Review and meta-analysis Casereports e c Cohortstudies In Vitro Research n e d i Randomized controlleddouble blindtest Ideas, editorials, opinions Ev f o y Casecontrol studies Animal Research Caseseries t i l a u Q
A systematic review gathers all relevant research on a specific subject and design, then summarises and analyses their findings. The quality of studies is assessed during the systematic review phase, andthe researchfindings arestatistically meta-analyzedbased ontheir quality. Ameta-analysisisamethodofinterpretingandintegratingvariousaccurate,analytical,and empirical results. A meta-analysis is usually performed on randomized controlled trials (RCTs) with a highdegree of evidenceto obtain more accuratefindings.
WHYDON'TALLSYSTEMATIC REVIEWSUSEMETA-ANALYSIS? The accuracy of an impact estimation can be improved with meta-analysis. However, it can be deceiving if done withdatathatarenotequallyidenticalorwithlow methodological consistency (for example, because the studyparticipantswerenotproperlyrandomized). As a result, meta-analysis isn't always sufficient, and many systematic reviews don't involve it. Even if there is no meta-analysis in the review, it can still synthesize study data to create something more valuable than the sumof its parts.
WHATDOESMETA- ANALYSISDO? Meta-analysisproducesamoreaccuratetreatment impactcalculation.Theevaluationcommittee determined the most appropriate type of effect size basedonthekindofresultsandmeasuresunder consideration. The odds ratio, risk ratio, weighted mean difference, and standardized mean difference are standard effect sizesin systematicreviews. For example, a forest map, such as the one shown below, is used to represent the effects of writinga meta-analysis paper.
Figure:ForestplotsdisplaytheestimatedresultsfromagroupofstudiesplusasummaryFigure:Forestplotsdisplaytheestimatedresultsfromagroupofstudiesplusasummary
Subgroupanalysisormeta-regressionwasusedinseveralmeta-analysiswriting services. Thesestrategiesareusedtoinvestigateafactor(suchastheageoftheresearchparticipant)that canaffect the treatment-intervention relationship. Topreventbias,plansforanalyzingdatausingthesetechniquesshouldbeexplainedandjustified beforelooking atthe data,preferably duringthe research planor protocollevel. Subgroupanalysisandmeta-regression,likemeta-analysis,areonlyhelpfulinsuchsituations.
WHATARETHEOTHER WAYSTOSYNTHESIZE EVIDENCE? Systematic reviews combine research data in various ways to arrive at a comprehensive picture of the proof. Meta-analysisis amathematicalsynthesistechnique. The results of several studies are combined using terms in a narrative synthesis. All systematic reviews, including thosethatusemeta-analysis,arelikelytoinclude a narrative synthesis component, which summarises the evidencein words. However,narrativesynthesisaimstoclarifythe gathereddata,forexample,byexaminingsimilarities and differences between study findings and investigating potentialexplanationsforthosesimilaritiesand differencessystematically.
CONCLUSION Suppose the validity of research is not adequately assessed, or properprotocolisnotstrictlyfollowedwhenconducting a systematicreview or meta-analysis. In that case, the findings can be biased, and the outcomes can be wrong. When systematic reviews and meta-analyses are properly applied, they can produce powerful results that are usually only possible with large-scale clinical trials, which are challenging to conductin individual studies. The number of systematic reviews and meta-analyses will continue to rise as our understanding of evidence-based medicine improves and its relevance is better understood. However, blind acceptance of both meta-analyses can be harmful, so we suggest that their findingsbeviewedcritically basedona betterunderstanding.
ABOUTPUBRICA Pubrica'sresearchteamcreatesscientificandmedical researcharticlesthatclinicalmeta-analysisexpertsand authorscan useas a resource. Pubrica medical writers assist you in writing and editing the introduction by informing the reader of any flaws or blank spotsintheselectedstudyfield.Ourprofessionals understand the framework that follows the broad topic, the difficulty, and the backdrop before moving on to a particular topicto presentthe hypothesis.
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