Evidence based practice Test 4a systematic review


1. A systematic review is an overview of all

One answer only.
   publications on the subject
   studies on a subject which arrive at a certain conclusion
   primary studies on the subject which produce negative results
   primary studies on the subject using an explicit and reproducible methods
   primary studies on the subjects using any methods


2. A meta-analysis

Choose 3 of the following options.
   is synonymous of a systematic review
   can be performed without a systematic review
   involves statistically combining the results of two or more primary studies
   can be performed with studies addressing different hypotheses
   follows every systematic review
   often increases the precision of the estimate of treatment effects compared with primary studies


3. Which of the following are features of a good systematic review?

Choose 3 of the following options.
   addresses a broad and vague clinical question
   provides clear eligibility criteria for inclusion of primary studies
   focuses on one database (e.g. Medline)
   searches for unpublished studies
   includes studies published in foreign languages
   includes all randomised controlled trials irrespective of whether randomisation was concealed


4. Which of the following are appropriate data sources for a systematic review for treatment effectiveness?

Choose 4 of the following options.
   The Times
   Cochrane controlled clinical trials register
   University theses
   Reference lists in primary studies
   World wide web search engines
   CINAHL
   Nursing Times
   Hospital Doctor


5. In a Forest Plot (i.e. “blobbogram”),

Choose 3 of the following options.
   each “dot” represents the estimated treatment effect for each primary study
   the “diamond” at the bottom of the chart represents the result of the study with the highest treatment effect
   one can determine the presence or absence of clinical heterogeneity
   one can determine the presence or absence of statistical heterogeneity
   the study with the longest line represents the one demonstrating the highest treatment effect
   the study with the shortest line usually has a large number of study subjects


6. In a Forest Plot (i.e. “blobbogram”), each pair of lines overlap.

Choose 2 of the following options.
   A vertical line can be drawn to intersect with each of the lines
   There is a low degree of statistical heterogeneity
   There is a high degree of clinical heterogeneity
   The meta-analysis is not valid


7. The following factors contribute to clinical heterogeneity

Choose 2 of the following options.
   the age of the study subjects
   the size of the treatment effects
   the confidence intervals for the treatment effects
   the countries in which the studies were carried out


8. The following are important factors determining whether the results of a systematic review and meta-analysis can be applied to your patient (rather than whether the study is valid).

Choose 2 of the following options.
   whether the studies are weighted
   the ages of the study subjects and your patient
   the outcomes used in the studies and the ones important to your patient
   whether unpublished studies were included


9. You decide to apply the results of a meta-analysis to your patient. The pooled odds ratio of the meta-analysis is 0.5. You estimated from past experience that the risk of your patient having a bad outcome if no treatment is given is 0.1 (10%). Estimate the number needed to treat (NNT).

One answer only.
   1
   11
   21
   31
   41
   61
   81
   101
   cannot be estimated