spph 516 methods for systematic reviews in health research · spph 516 – methods for systematic...

SPPH516

MethodsforSystematicReviewsinHealthResearch

CourseDescriptionFall2017

SchoolofPopulationandPublicHealthUniversityofBritishColumbia

SPPH516–MethodsforSystematicReviewsinHealthResearch Dr.L.Puil,Fall2017CourseDescription

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SPPH516

MethodsforSystematicReviewsinHealthResearchCourseOutline

2017Time: Tuesdays,9:00am-12:00p.m.Term: Firstclass:September12,2017

Lastclass:December5,2017 NoclassSept5(SPPHorientation)ClassLocation: UBCPointGreycampus

SchoolofPopulationandPublicHealthRoom:B1512206HealthSciencesMall

Instructor: Dr.LorriPuil,MDPhDCo-instructor: Ms.MimiDoyle-Waters,MA,MLISTeachingAssistant HéctorA.VelásquezGarcíaOfficeHours: Informallabtime1/2hourbeforeand1/2hourafterthe

classinB151:officehoursarealsoavailablebyappointmentGeneralInformation: Coursecontact:Dr.LorriPuil

E-mail:[email protected]:604-827-5064orMimiDoyle-WatersE-mail:[email protected]:604-875-4111extension61176orTA:Dr.Héctor A. Velásquez García E-mail:[email protected]


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COURSEOUTLINE

Date Week SessionTopic InstructorSept.6 SPPHorientationsession–noclass Sept12 1 Reviewsyllabus,assignmentsandcourseexpectations

Unit1:Whatmakesareview‘systematic’?Judgingthestrengthofresearchevidence.

LorriPuil

Sept19

2 Unit2:Elementsofasystematicreview,thingstoconsider;toolstoassessthequalityofasystematicreviewUnit3:Developingaresearchquestion,settinginclusionandexclusioncriteria;scopingtheliterature.StudentreviewteamsformedAssignment#1handedout–researchquestions

LorriPuilLorriPuilMimiDoyle-Waters

Sept26 3 Unit4:Literaturesearchtechniques;developingasearchstrategy.

MimiDoyle-Waters

Oct3 4 Unit5:DevelopingasystematicreviewprotocolUnit6:Applyinginclusionandexclusioncriteria,selectingstudies,resolvingdisagreement.Assignment#2handedout–draftsearchstrategy

LorriPuil

Oct3 Draftresearchquestion–Assignment#1due Oct10 5 Unit7:Data,StatisticsandMeta-AnalysisI

Continuousanddichotomousoutcomes;Dataextraction;Meta-analysisconcepts;RevMan.Assignment#3handedout–systematicreviewprotocol

LorriPuil

Oct17 6 Unit8:Data,StatisticsandMeta-analysisIITopoolornottopool?Fixed-effectandrandom-effectsmodels;Heterogeneity;Subgroupandsensitivityanalyses.

LorriPuil

Oct17 Draftsearchstrategy–Assignment#2due Oct24 7 Unit9:Criticalappraisalofclinicaltrials-riskofbias,other

qualityassessmentofRCTs;UsingtheCochraneRiskofBiastoolforRCTs;Incorporatingriskofbiasassessmentintosystematicreviews.

AaronTejaniLorriPuil

Oct31 8 Unit10:GRADEandsummaryoffindingstables;Formulatingconclusionsandcompletingyourreview;Exercise:GRADEsummaryoffindings.

LorriPuil

Nov7 9 Unit11:Criticalappraisalofasystematicreview;SpecialTopic:RIATinitiativeandothertrends.

PennyBrasherLorriPuil

Nov7 Systematicreviewprotocol–assignment#3due Nov14 10 Unit12:Knowledgetranslation,policyperspectiveand

healtheconomics;SpecialTopic:Genderandequityinsystematicreviews.

StirlingBryanLorriPuil

Nov21 11 Unit13:Non-randomized(observational)studydesigns;SystematicreviewofobservationalstudiesandtheCochraneriskofbiastoolforobservationalstudies.

ColinDormuthLorriPuil

Nov28 12 Reviewteampresentations Puil&Doyle-WatersDec5 13 SpecialTopic:Indirectcomparisonsandnetworkmeta-

analysis;Coursewrap-up.

MirSohailFazeliLorriPuil

Dec15 Draft3-trialpreliminaryreview–Assignment#4due CLASSLOCATION:RoomB151,SchoolofPopulationandPublicHealth,2206HealthSciencesMall,UBC.


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InterestedParticipants

§ Graduatestudents§ Physiciansandotherhealthprofessionalsinterestedinsystematicreviewmethods.

Purpose

Thepurposeofthiscourseistointroducestudentstosystematicreviewmethodologysothattheywilldevelopanunderstandingofthekeycomponentsofareviewandacquirethekeyskillsneededtocarryouttheirownreviews.MainObjectivesforStudents

§ Tobecomefamiliarwithdifferenttypesofsystematicreviews§ Toidentifyhealthresearchorclinicalquestionsforwhichtherearenoexisting

high-qualitysystematicreviews§ Tolearnappropriatemethodologyforprotocoldevelopmentandthestepsneeded

tocompleteasystematicreview§ Tobecomefamiliarwithmethodsforsearchingthepublishedliteratureandalso

forretrievingunpublishedliterature,andtounderstandthedifferencebetweenascopingsearchandaprimaryliteraturesearch

§ Todevelopskillsincriticalappraisalofclinicalstudiesandtoapplyriskofbiastoolswithinsystematicreviews

§ Tobeintroducedtostatisticaltechniquesrequiredformeta-analysisanddatasynthesis

§ TobecomefamiliarwithmethodsforassessingandinterpretingevidencewithinsystematicreviewsincludingtheGRADEframework.

FacultyDescriptions

LorriPuil,MD,PhDDr.PuilisaseniormemberoftheTherapeuticsInitiativeDrugAssessmentWorkingGroupintheDept.ofAnesthesiology,Pharmacology&Therapeutics,FacultyofMedicine,UBC.Shehasextensiveexperienceleadingsystematicreviewsofhealthcareinterventionsforprovincial,nationalandinternationalpolicymakers(e.g.,thefederalCommonDrugReview;theUSAgencyforHealthcareResearchandQuality).AnEditorofCochraneHypertension,andamemberoftheCochraneEquityMethodsGroup,Dr.PuilobtainedherMDfromtheUniversityofTorontoandhasspecialtytrainingininternalmedicine,hematologyandclinicalpharmacology.SheholdsaPhDfromtheUniversityofTorontoinsignaltransduction,anareaapplicabletotheanalysisofnoveltherapeuticssuchastargetedmoleculesandbiologics.Dr.Puil’sresearchinterestsincludethesafetyandeffectivenessofprescriptiondrugsandcomplexinterventions,pharmaceuticalregulatorypolicy,andresearchsynthesismethods.MimiDoyle-Waters,MA,MLISMs.Doyle-WatersisthelibrarianfortheCentreforClinicalEpidemiologyandEvaluation(C2E2).Shehasworkedonavarietyofsystematicreviewsoverthelast10years,for


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exampleSARS,influenza,herpeszoster,nursestaffing,emergingzoonoses,arthritisandseveralCochranereviews.ThroughC2E2shealsoprovidesconsultingservicestoresearchersinterestedindevelopingmeasurementinstruments,systematicreviewprotocolsandsearches.GuestFaculty:PennyBrasher,PhDDr.BrasherisaSeniorResearchScientistatC2E2andanassociatememberoftheDepartmentofStatisticsatUBC.SheisaStatisticalEditorfortheCanadianJournalofAnesthesiaandhasservedonseveralgrantreviewcommitteesandethicsboards.Dr.Brasher'sresearchinterestsincludeclinicalresearchmethodology,secondaryuseofadministrativedataandstatisticaleducation.

AaronTejani,PharmDDrTejaniisaclinicalassistantprofessorwithUBC’sFacultyofPharmaceuticalSciencesandamemberoftheFraserHealthResearchEthicsBoard,theBCMedicalAssociation’sGuidelinesandProtocolsAdvisoryCommittee,andaneditorforCochraneHypertension.Hisinterestsincludecriticalappraisalofthebiomedicalliteratureandknowledgetranslationactivities.Heconductssystematicreviewsandmeta-analysesofhealthcareinterventionswiththeTherapeuticsInitiative’sDrugAssessmentWorkingGroup.DrTejaniholdsaBScinpharmaceuticalsciencesfromUBCandaPharmDfromCreightonUniversity(Omaha,Nebraska).

ColinDormuth,ScDDr.ColinDormuthisanAssociateProfessorintheDepartmentofAnesthesiology,Pharmacology&Therapeutics,UBC,andco-principalinvestigatorfortheBCsiteoftheCanadianNetworkforObservationalDrugEffectStudies(DSEN-CNODES).Hehas20yearsofexperienceusingadministrativehealthcaredatabasestoevaluatedrugsafety,pharmaceuticalpolicychangesandphysicianprescribingbehaviour.Dr.DormuthholdsSc.D.andS.M.degreesinepidemiologyfromHarvardUniversity,anM.A.ineconomicsfromtheUniversityofVictoria,andaB.A.ineconomicsfromtheUniversityofManitoba.StirlingBryan,PhDDr.BryanisHeadoftheCentreforClinicalEpidemiology&EvaluationandProfessorintheSchoolofPopulationandPublicHealth.Forover20yearshehasbeenauniversity-basedpracticinghealtheconomistwithextensiveengagementtothepolicyanddecision-makingworld.Hehastaughthealtheconomicstoundergraduateeconomistsandmedicaltrainees,topostgraduatehealtheconomicsstudentsandtohealthsectorprofessionals.HisresearchtrackrecordrevealsalongstandinggoalofinformingpolicyandpracticeandsincehisrelocationtoCanadain2008,hehascontinuedafocusonpolicy-relevantresearch.Hiscurrentposition,sponsoredbyVancouverCoastalHealth,seeshimworkingalongsidepolicycolleaguesinoneofBC’slargestregionalhealthauthorities.


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MirFazeli,MD,PhD(c)Dr.FazeliisaphysicianandaPhDcandidateintheExperimentalMedicineProgramintheDepartmentofPediatrics,UBC.Heistrainedasaclinicalepidemiologistandhismainfieldofexpertiseincludesresearchmethodologyandclinicaltrialswithafocusonmeasuringtheactivityoftheautonomicnervoussystem,systematicreviewandmeta-analysisofrandomizedcontrolledtrials,andimplementationandevaluationofcomplementaryandalternativemedicineinterventions.TeachingAssistant:HéctorA.VelásquezGarcía,MDMSMPHDr.ValasquezGarciaisaprimarycarephysician(UniversidaddelRosario,Bogotá,Colombia),withtraininginMedicalInformatics(MS,UniversityofCalifornia,Davis)andPublicHealth(MPH,EpidemiologyandBiostatistics,JohnsHopkinsBloombergSchoolofPublicHealth).HeiscurrentlyaPhDCandidateatSPPH;thefocusofhisresearchiscancerepidemiologyandcausalinferenceinobservationalstudies.InstructionFormatStudentswillbeintroducedtosystematicreviewmethodsviaavarietyoftopicsrelatedtoeachcomponentofasystematicreview,forexample,questionformulation,theprocessofdevelopingasearchstrategy,applicationofstudyinclusionandexclusioncriteria,dataextraction,assessmentofriskofbias,andmeta-analysisofstudyresults.Oncestudentshavecompletedthiscoursetheywillhavesufficientknowledgetoparticipateinasystematicreview.Studentswilllearntousethefollowingsystematicreviewsoftware:ReviewManager(RevMan)(meta-analysisandriskofbias),GRADEpro/GDT(summaryoffindingstables)andCovidence(studyscreening).Courseassignmentsincludebothindividualandgroupworkandwillbuildtowardsteamdevelopmentofadraftsystematicreviewprotocolandapartialsystematicreview.Feedbackoneachassignmentaimstocontributetodevelopmentofsubsequentcomponentsofthedraftreview.Thecourseisorganizedinto13weekly,3-hoursessions.Inaddition,thecourseinstructorswillbeavailabletomeetinformallywiththestudentstoaddressquestionsanddiscusstheirresearchtopicandreviewprotocols.Thisincludesoptionallabtimefrom8:30amto9ampriortotheclass(search-relatedQ’s),and12:00pmto12:30pm(anyQ’s)aftereachclass.Additionalofficetime,meetingsandtutorialsareavailableonappointment.ScopeofthisCourseThefocusofthiscourseissystematicreviewsinvolvingclinicalandpolicyquestionsthatareaddressedprimarilythroughrandomizedcontrolledtrials(RCTs).Systematicreviewsofobservationalstudieswillalsobecoveredinthecourse.StudentsareencouragedtocarryoutareviewthatincludesRCTevidenceinordertobuildanexperiencebasebeforeaddressingmorecomplexdesignsbutmayincludeotherquantitativestudydesignsifappropriatetotheirtopic.Interventionsusingqualitativemethodsarebrieflydiscussedbutthecourseisnotdesignedtoprovidein-depthdetailonsystematicreviewsofqualitativeormixedmethodsstudies.


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Eachyear,thecoursealsocoverstwoorthreespecialtopicsorinnovations.Thesetopicsmaychangefromyear-to-yearorsubsequentlybeincorporatedintothecorecurriculum.PrerequisitesStudentsshouldhavebasicunderstandingofhealthresearchdesign/methodologyandanintroductoryunderstandingofmedicalstatistics.TherearenocourserequisitesforstudentsenrolledinSPPHmaster’sandPhDprograms.Studentsinothergraduateprogramsmayenrollwithpermissionfromtheinstructor.ResearchTopicStudentswillselectaninitialresearchquestionappropriatetoasystematicreview.Thesequestionswillbeusedasabasisforthedevelopmentof‘reviewteams’oftwotothreestudents,whowillworktogethertocarryouteachstageofadraftsystematicreview.Eachmemberofareviewteamwillhaveprimaryauthorshipandresponsibilityforasectionofthereview,butallteammembersareexpectedtoprovidesubstantivecontributionstotheentirereview.AssignmentsCourseassignmentswillcomprisethedifferentstagesofareview:1)developmentofaresearchquestionandscopingsearch;2)developmentofaliteraturesearchstrategy;3)developmentofasystematicreviewprotocolincludingplansformeta-analysis;and4)a3-studydraftreviewwithcriticalappraisal.Studentswillalsopresentabriefsummaryoftheirtopicinaclasspresentation.FullassignmentdetailsandguidancewillbepostedinCanvasduringtheterm.StudentEvaluationStudentswillreceiveindividualgradesonparticipationandonthesectionofAssignment#4onaspecificclinicalstudy.Therestoftheassignmentswillbecarriedoutasresearchteams,withasinglegradeforallmembersofateam.

Evaluation

§ Participationandpreparationforclass(includesclassdiscussionsonreadings)[individualgrade] 10%

§ Assignment#1–Researchquestion[teamgrade] 10%§ Assignment#2–Draftsearchstrategy[teamgrade] 10%§ Assignment#3–Protocol[teamgrade] 25%§ Assignment#4–Draft3-studyresults

o Individualgrade 20%o Teamgrade 20%

§ Assignment#5–TeamPresentation[teamgrade] 5%

UBC/SPPHgradingdetailsarelocatedinAppendixAattheendofthesyllabus.


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CourseTextbooksandCoreMaterialsStudentsarenotrequiredtobuytextbooksforthiscourse.Twoon-linemanualsprovidecorecoursematerialsandareavailableintheKeyCourseResourcesmoduleinCanvas.Individualchapterswillbelinkedtospecificcourseweeksandmodules.Studentsareencouragedtoaccessatleastoneoftheseon-lineorviaCanvasandrefertothemthroughoutthecourse.

1. TheCochraneHandbook.

• Forthissemester,the2017updatedchaptersoftheCochraneHandbook(version5.2.0)areavailableinCanvas.HigginsJPT,ChurchillR,ChandlerJ,CumpstonMS(editors),CochraneHandbookforSystematicReviewsofInterventionsversion5.2.0(updatedJune2017).Individualchaptersthathavenotyetbeenupdated(2011version)arealsoavailableinCanvas.

• Alternatively,studentsmayconsulttheonlineCochraneHandbook(2011):HigginsJPT,GreenS.CochraneHandbookforSystematicReviewsofInterventions.CochraneCollaboration.Version5.1.0[updated2011March]Availableforbrowsingat:handbook.cochrane.org/

2. CentreforReviewsandDissemination.SystematicReviews.CRD'sguidanceforundertakingreviewsinhealthcare.York,UK:NHSCentreforReviewsandDissemination;2009.www.york.ac.uk/crd/guidance/

Thefollowingtextbookisrecommendedasanadditionalresourceandmaybereferredtoinspecificsectionsofthecourse:

• EggerM,SmithGD,AltmanDG,editors(2008).Systematicreviewsinhealthcare:meta-analysisincontext.[monographonline].London:BMJPublishingGroup.Availableon-lineviaUBCConnect.

• The2001printeditionofthisbookisalsoavailableinWoodwardLibrary.Callnumber:WA20.5.S9882001C.1.

3. Software

§ Reviewmanager(RevMan5.3.5)softwarewillbeusedinthecourse(availablefreeofcharge):

o Downloadat:http://tech.cochrane.org/revman/download§ GRADEprowillbeusedforGRADEevidencetablesandsummaryoffindingtables.

o SignupforaGRADEproaccountonline(availablefreeofcharge)at:https://gradepro.org

§ AccesstoCovidence(tobeusedforscreeningonly)willbemadeavailablethroughtheclass.


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AdditionalGeneralReferencesThefollowingaretwomethodsreferenceshavebeenmadeavailableinCanvasasfurtherresourcesbutarenotrequiredreading.

• BorensteinM,HedgesLV,HigginsJPT,RothsteinHR(2009)IntroductiontoMeta-Analysis,Chichester,UK:JohnWiley&SonsLtd.Availableon-lineviaUBCConnect.[moredetailonstatisticaltechniques]

• AgencyforHealthCareResearchandQuality(AHRQ)MethodsforEffectivenessandComparativeEffectivenessReviews(lastupdated2015).Chapters5to16maybeusefulforspecificmethodstopics.

OtherResources(forinterestonlyunlessspecifiedinclass)InCanvas,wehavealsoprovidedresourcematerialforsearching,qualityassessmenttoolsandreportingguidanceforbothsystematicreviewsandprimarystudies.Instructorswillidentifyspecificitemsasneededduringthecourse.


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Thecompletesyllabus,includingclasspreparation,handoutsandassignments,willbemadeavailabletostudentsviaCanvas.Thefollowingprovidesanoverviewofeachweeklysessionandissubjecttochange.

Week1OverviewofSystematicReviews;LevelsofResearchEvidence

Dr.LorriPuil

September12,2017Objectives:

§ Tounderstandwhythereisanevolvingscienceofresearchsynthesis§ Toknowhowtodistinguishbetweenanarrativeandasystematicreview§ Toappreciatethespectrumofdifferenttypesofsystematicreviews§ Tounderstandtherelativestrengthandapplicabilityofvariousresearchdesigns§ Reviewsyllabus,assignmentsandcourseexpectations§ Begintoformresearchteams

RequiredReadings1) EggerM,DaveySmithG,O’RourkeK.Rationale,potentials,andpromiseofsystematic

reviews.In:Systematicreviewsinhealthcare:meta-analysisincontext.Pages3-21.(coursetextbook;availableon-lineviaCanvas)

2) GreenhalghT.Assessingthemethodologicalqualityofpublishedpapers.BMJ1997Aug2;315(7103):305-8.

SupplementaryReadingsandResourcesWeek1§ CookDJ,MulrowCD,HaynesRB.Systematicreviews:synthesisofbestevidencefor

clinicaldecisions.AnnInternMed1997;126:376-80.(A‘classic’paper)Generalclassificationofsystematicreviews:§ TriccoAC,TetzlaffJ,MoherD.Theartandscienceofknowledgesynthesis.JClin

Epidemiol2011Jan31;64(1):11-20.§ StrausSE,KastnerM,SoobiahC,AntonyJ,TriccoAC.Introduction:Engaging

researchersondeveloping,using,andimprovingknowledgesynthesismethods:aseriesofarticlesdescribingtheresultsofascopingreviewonemergingknowledgesynthesismethods.JClinEpidemiol2016May31;73:15-8.

Specifictypesofreviews§ ChouR,HelfandM.Challengesinsystematicreviewsthatassesstreatmentharms.Ann

InternMed2005Jun21;142(12Part2):1090-9.§ LokeYK,PriceD,HerxheimerA,CochraneAdverseEffectsMethodsGroup.Systematic

reviewsofadverseeffects:frameworkforastructuredapproach.BMCMedResMethodol2007Jul5;7:32.


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§ AltmanDG.Systematicreviewsofevaluationsofprognosticvariables.BMJ2001;323:224-228.

§ DeeksJJ.Systematicreviewsinhealthcare:Systematicreviewsofevaluationsofdiagnosticandscreeningtests.BMJ2001;323:157-162.

§ ElliottJH,TurnerT,ClavisiO,ThomasJ,HigginsJP,MavergamesC,GruenRL.Livingsystematicreviews:anemergingopportunitytonarrowtheevidence-practicegap.PLOSMed2014Feb18;11(2):e1001603.

§ RileyRD,LambertPC,Abo-ZaidG.Meta-analysisofindividualparticipantdata:rationale,conduct,andreporting.BMJ2010Feb5;340:c221.

§ KhanguraS,KonnyuK,CushmanR,GrimshawJ,MoherD.Evidencesummaries:theevolutionofarapidreviewapproach.SystRev2012Feb10;1(1):10.


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Week21. IntroductiontoElementsofaSystematicReview

2. QuestionDevelopmentandBackground;SettingInclusionandExclusionCriteria

Dr.LorriPuil

September19,2017

Objectives:§ Toobtainanoverviewoftheelementsofasystematicreview§ Tobeawareoffeaturesthatdeterminethequalityofasystematicreview§ TounderstandthePICOScomponentsofaclinicalresearchquestion§ Toexploretheappropriatelevelofprecisionneededforaninformativeand

relevantsystematicreviewquestion§ Toexploreframingofresearchquestionsfromapatienthealthperspective§ Tounderstandhowinclusionandexclusioncriteriaaresetinrelationtothereview

questionRequiredReadings1) EggerM,DaveySmithG.Principlesofandproceduresforsystematicreviews.In:

SystematicReviewsinHealthCare:Meta-analysisincontext.Pages23-42.Thisprovidesanoverviewoftheelementsofsystematicreviews.

2) RichardsonWS,WilsonMC,NishikawaJ,HaywardRSA.Thewell-builtclinicalquestion:Akeytoevidence-baseddecisions.ACPJournalClub1995;123(Nov-Dec,12).

3. Scopingtheliterature

Ms.MimiDoyle-WatersSeptember19,2017

Objectives:

§ Tounderstandthemeaningandimportanceofscopingtheliteratureasitpertainstoasystematicreviewprotocolorgrantapplication

§ Tobecomefamiliarwithmethodsonscopingtheliterature§ Toplanascopingsearchwhileconsideringappropriatedatabases,subject

headingsandkeywords


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RequiredReadings1) AromatarisE,RiitanoD.Constructingasearchstrategyandsearchingforevidence.A

guidetotheliteraturesearchforasystematicreview.AmJNurs2014May;114(5):49-56.

2) BoothA.Unpackingyourliteraturesearchtoolbox:onsearchstylesandtactics.HealthInfoLibrJ2008Dec;25(4):313-7.

SupplementaryReadings&AdditionalResourcesWeek2Qualityassessmentofsystematicreviews§ SheaB,GrimshawJ,WellsG,BoersMetal.DevelopmentofAMSTAR:Ameasurement

tooltoassessthemethodologicalqualityofsystematicreviews.BMCMedResMethodol2007;7:10.

§ WegewitzU,WeikertB,FishtaA,JacobsA,PieperD.ResumingthediscussionofAMSTAR:Whatcan(should)bemadebetter?BMCMedResMethodol2016Aug26;16(1):111.

§ SheaB,ReevesBC,WellsG,ThukuM,HamelC,MoranJ,MoherD,TugwellP,WelchV,KristjanssonE,HenryD.AMSTAR2:acriticalappraisaltoolforsystematicreviewsthatincluderandomisedornon-randomisedstudiesofhealthcareinterventions,orboth.BMJ2017;358:j4008

§ WhitingP,SavovićJ,HigginsJP,CaldwellDM,ReevesBC,SheaB,DaviesP,KleijnenJ,ChurchillR.ROBIS:anewtooltoassessriskofbiasinsystematicreviewswasdeveloped.JClinEpidemiol2016Jan31;69:225-234.

§ RiskofBiasinSystematicReviews(ROBIS)tool.http://www.bristol.ac.uk/population-health-sciences/projects/robis/

§ ScottishIntercollegiateGuidelinesNetwork.MethodologyChecklist1:SystematicReviewsandMeta-analyses.Notesforcompletionofchecklist.Availableat:http://www.sign.ac.uk/checklists-and-notes.html

§ HigginsJPT,LassersonT,ChandlerJ,ToveyD,ChurchillR.MethodologicalExpectationsofCochraneInterventionReviews.Cochrane:London,2016.

§ WhitlockEP,LinJS,ChouR,ShekelleP,RobinsonKA.Usingexistingsystematicreviewsincomplexsystematicreviews.AnnInternMed2008;148:776-782.

Developingresearchquestionsandscopingtheliterature§ O’ConnorD,GreenS,HigginsJPT(editors).Chapter5:Definingthereviewquestion

anddevelopingcriteriaforincludingstudies.In:HigginsJPT,GreenS(editors),CochraneHandbookforSystematicReviewsofInterventions.Version5.1.0[updatedSeptember2011].TheCochraneCollaboration,2011.

§ PICOandFormulatingtheClinicalQuestion:AGuidedExercise.NYUSchoolofMedicine.EhrmanMedicalLibrary.

§ WeinfeldJM,FinkelsteinK.Howtoansweryourclinicalquestionsmoreefficiently.FamPractManag2005;12(7):37-41.

§ CounsellC.Formulatingquestionsandlocatingprimarystudiesforinclusioninsystematicreviews.AnnInternMed1997Sept1;127(5):380-387.


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Week3LiteratureSearchTechniques:DevelopingaSearchStrategy

Ms.MimiDoyle-WatersSeptember27,2016

Objectives:

§ Tounderstandmethodsfordevelopingacomprehensivesearchtemplatetofindprimarystudies

§ Tounderstandthecomponentsofasearchprotocolwhichwillhelpyoutofindallorthemajorityofrelevantprimarystudies

RequiredReadingsYourtwomaincoursereadingshavesectionsthatarehighlyrelevanttothissessiononcarryingoutaliteraturesearch.1) LefebvreC,ManheimerE,GlanvilleJ.Chapter6:Searchingforstudies.In:HigginsJPT,

GreenS(editors).CochraneHandbookforSystematicReviewsofInterventions.Version5.1.0[updatedMarch2011].TheCochraneCollaboration,2011.

2) CentreforReviewsandDissemination.SystematicReviews.CRD'sguidanceforundertakingreviewsinhealthcare.2009.http://www.york.ac.uk/crd/guidance/.Chapter1,Section1.3UndertakingtheReview(PDF:pages16-22).

SupplementaryReadings&AdditionalResourcesWeek3§ McGillUniversity.SystematicReviews.SearchingforStudies.

http://wikisites.mcgill.ca/systematicreview/index.php/Searching_for_Studies§ CADTH.FindingtheEvidence:LiteratureSearchingToolsinSupportofSystematic

Reviews.https://www.cadth.ca/resources/finding-evidence§ CADTHPeerReviewChecklistforSearchStrategies.

https://www.cadth.ca/media/is/Peer_review/CADTH%20Peer%20Review%20Checklist%20for%20Search%20Strategies_e.pdf

§ MUHCTAUMembers.Guidelinesforsystematicliteraturesearch,version2.0.Montreal(Canada):TechnologyAssessmentUnit(TAU)oftheMcGillUniversityHealthCentre(MUHC);October4,201317pp.Availablefrom:https://www.mcgill.ca/tau/files/tau/muhc_tau_search_v2.0.pdf

§ CADTH.GreyMatters:apracticalsearchtoolforevidence-basedmedicine.http://www.cadth.ca/en/resources/finding-evidence-is/grey-matters.

HandoutsareavailableinCanvasfordevelopingyoursearches.Seethemodule(folder)SearchingResources.


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Week41. Developingasystematicreviewprotocol

Dr.LorriPuil

October3,2017Objectives:

§ Toframethesystematicreviewresearchquestion§ Tounderstandtherationaleforadetailedresearchprotocolbeforeasystematic

reviewiscarriedout§ TobecomefamiliarwitheachcomponentofaCochranereviewprotocol

RequiredReadings1) HigginsJPT,GreenS(editors).Chapter4:Guidetothecontentsof

Cochraneprotocolandreview.In:HigginsJPT,GreenS(editors).CochraneHandbookforSystematicReviewsofIntervention.Version5.1.0[updatedMarch2011].TheCochraneCollaboration,2011.Availablefrom:handbook.cochrane.org/orCentreforReviewsandDissemination.SystematicReviews.CRD'sguidanceforundertakingreviewsinhealthcare.2009.http://www.york.ac.uk/crd/guidance/Chapter1,Section1.2TheReviewProtocol(PDF:pages6-15).

2) MoherD,ShamseerL,ClarkeM,GhersiD,LiberatiA,PetticrewM,ShekelleP,Stewart

LA.Preferredreportingitemsforsystematicreviewandmeta-analysisprotocols(PRISMA-P)2015statement.SystRev2015Jan1;4(1):1.

2. Applyingeligibilitycriteriaandselectingstudies

Dr.LorriPuilOctober3,2017

Objectives:

§ Tobefamiliarwithhowto‘operationalize’inclusioncriteriaforareview§ Toconsiderandmeasurethereproducibilityofdecisionsaboutwhatresearchto

includeinyourreview§ Tobecomefamiliarwithonetypeofsoftwarethatcanbeusedtoscreen

(Covidence)§ Tounderstandtheapproachneededto‘countandaccount’forstudiesin

systematicreviewsandtoconstructaPRISMAflowdiagram(eitherinCovidenceorRevMan)

§ Toconsiderthepotentialimpactofpublicationandreportingbias


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§ Toconsiderwaysofimprovingthereliabilityofthedatayoucollectandanalyzeforyourteamprotocolsandsystematicreviews.

RequiredReadings1) HigginsJPT,DeeksJJ(editors).Chapter7:Selectingstudiesandcollectingdata.In:

HigginsJPT,GreenS(editors),CochraneHandbookforSystematicReviewsofInterventions.Version5.1.0[updatedMarch2011].TheCochraneCollaboration,2011.Availablefrom:handbook.cochrane.org/orCentreforReviewsandDissemination.SystematicReviews.CRD'sguidanceforundertakingreviewsinhealthcare.2009.http://www.york.ac.uk/crd/guidance/Chapter1,Section1.3UndertakingtheReview,1.3.2Studyselection(PDFpages23-27).

SupplementaryReadings&AdditionalResourcesWeek4Protocoldevelopment § ShamseerL,MoherD,ClarkeM,GhersiD,LiberatiA,PetticrewM,ShekelleP,Stewart

LA.Preferredreportingitemsforsystematicreviewandmeta-analysisprotocols(PRISMA-P)2015:elaborationandexplanation.BMJ2015Jan2;349:g7647.

§ BoothA,ClarkeM,DooleyG,GhersiD,MoherD,PetticrewM,StewartL.ThenutsandboltsofPROSPERO:aninternationalprospectiveregisterofsystematicreviews.SystRev2012Feb9;1(1):1.

§ BoothA.PROSPERO’sprogressandactivities2012/13.SystRev2013Dec11;2(1):1.§ Analyticframeworks:AndersonLM,PetticrewM,RehfuessE,ArmstrongR,UeffingE,

BakerP,FrancisD,TugwellP.Usinglogicmodelstocapturecomplexityinsystematicreviews.ResSynthMethods2011Mar1;2(1):33-42.

§ AlsoprovidedinCanvasisafolderofprotocolsamples.Applyingeligibilitycriteriaandselectingstudies§ DoshiP,JonesM,JeffersonT.Rethinkingcredibleevidencesynthesis.BMJ

2012;344:d7898.§ MeadeMO,RichardsonWS.Selectingandappraisingstudiesforasystematicreview.

AnnInternMed1997Oct1;127(7):531-7.


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Week51. Data,StatisticsandMeta-analysisI-IntroductionDichotomousandcontinuousmeasures;dataextraction;

meta-analysisconcepts


Objectives:

§ Toknowwhymeta-analysisisusedratherthansimpledatapooling§ Tounderstandkeymeasuresofeffectfordichotomousandcontinuousoutcomes

andhowtochoosewhichmeasuretoapply§ Tobeabletodescribethedifferencebetweenriskandodds§ Tobecomefamiliarwithhowadatacollectionformisdevelopedforextracting

informationfromstudyreportsClassPreparation:Studentswillbeaskedtoreadareviewandbepreparedtodiscusshowindividualtrialswerecombined.ThearticletoreadwillbeprovidedinCanvas.RequiredReadings1) DeeksJJ,HigginsJPT,AltmanDG(editors)onbehalfoftheCochraneStatistical

MethodsGroup.Chapter9:Analysingdataandundertakingmeta-analyses.In:HigginsJPT,ChurchillR,ChandlerJ,CumpstonMS(editors),CochraneHandbookforSystematicReviewsofInterventionsversion5.2.0(updatedJune2017),Cochrane,2017.Availablefromwww.training.cochrane.org/handbook.orCentreforReviewsandDissemination.SystematicReviews.http://www.york.ac.uk/crd/guidance/.Chapter1,Section1.3UndertakingtheReview,Section1.3.5DataSynthesis(PDF:pages45-76).

2) ScottI,Interpretingrisksandratiosintherapytrials.AustPrescriber2008;31(1):12-16.


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2. RevManIntroduction

Dr.LorriPuil

October10,2017

RevManwillbeintroducedthroughoutthecourse,startinginthissession,viain-classexercises.Objectives:

§ TounderstandthecomponentsofReviewManager(RevMan)andhowitmaybeusedtocompletevarioussystematicreviewsteps

§ TobecomefamiliarwiththeuseofRevManthroughin-classexercisesandassignments

§ Toobtainanoverviewofthekeycomponentsinasystematicreviewprotocolandafullsystematicreview

NoRequiredReadings

SupplementaryReading&AdditionalResourcesWeek5§ ExamplesofdataextractionformsareinCanvas.§ AhandoutonanalyzingcontinuousoutcomesisinCanvas.§ TheRevManUser

Guide:http://community.cochrane.org/sites/default/files/uploads/inline-files/RevMan_5.3_User_Guide.pdf

§ RevManCalculator:http://training.cochrane.org/resource/revman-calculator(usefultobeawareof).

§ DeeksJ,HigginsJ.2010.StatisticalAlgorithmsinRevMan-inCanvas.


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Week6Data,StatisticsandMeta-AnalysisII

Topoolornottopool?Heterogeneity;Subgroupandsensitivityanalyses;Unitofanalysisissues

Dr.LorriPuil

October17,2017Objectives:

§ Tounderstandunderlyingassumptionsoffixed-effectandrandom-effectsmodelsofmeta-analysis

§ Tobefamiliarwiththeconceptsofstatisticalandclinicalheterogeneity,andhowheterogeneitymaybeexplored(subgroupandsensitivityanalyses;meta-regression)

§ Toconsiderpotentialsourcesoferrorandbiasinextractingandpoolingdata§ Tounderstandhowfunnelplotsmaybeusedtoassess‘smallstudyeffects’and

potentialpublicationbiasRequiredReadings

1) DeeksJJ,HigginsJPT,AltmanDG(editors).Chapter9:Analysingdataandundertakingmeta-analyses.In:HigginsJPT,GreenS(editors).CochraneHandbookforSystematicReviewsofInterventions.Version5.1.0[updatedMarch2011].TheCochraneCollaboration,2011.Availablefrom:handbook.cochrane.org/orCentreforReviewsandDissemination.SystematicReviews.2009http://www.york.ac.uk/crd/guidance/.Chapter1,Section1.3.5Datasynthesis(includingthenarrativeandquantitativesectionsofthechapter)(PDF:pages45-76).

SupplementaryReadings&AdditionalResourcesWeek6Forestplots

§ SedgwickP.Howtoreadaforestplotinameta-analysis.BMJ2015Jul24;351:h4028.

SubgroupAnalyses§ SunX,BrielM,BusseJW,YouJJ,AklEA,MejzaF,BalaMM,BasslerD,MertzD,

Diaz-GranadosN,VandvikPO.Credibilityofclaimsofsubgroupeffectsinrandomisedcontrolledtrials:systematicreview.BMJ2012Mar15;344:e1553.


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Funnelplots

§ Sterne,JA,EggerM,SmithGD.Systematicreviewsinhealthcare:Investigatinganddealingwithpublicationandotherbiasesinmeta-analysis.BMJ2001;323:101-105.

§ SterneJA,SuttonAJ,IoannidisJP,TerrinN,JonesDR,LauJ,CarpenterJ,RückerG,HarbordRM,SchmidCH,TetzlaffJ.Recommendationsforexaminingandinterpretingfunnelplotasymmetryinmeta-analysesofrandomisedcontrolledtrials.BMJ2011Jul22;343:d4002.

§ ThorntonA,LeeP.Publicationbiasinmeta-analysis:itscausesandconsequences.JClinEpidemiol2000Feb;53(2):207-216.

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Week7Introductiontocriticalappraisalofindividualstudies

UsingtheCochraneRiskofBiastool

Dr.AaronTejaniandDr.LorriPuilOctober24,2017

Objectives:

§ Tobecomefamiliarwithmethodologicaldetailsthatarerequiredtojudgequalityofthestudiesincludedinasystematicreview

§ Toknowthemainelementsofinternalandexternalvaliditytoconsiderwhenassessingandapplyingclinicaltrialresults

§ TodevelopfamiliaritywithapplyingtheCochraneriskofbiastoolforRCTs§ Tounderstandwhyqualityassessmentisneededinsystematicreviews

Preparationforthisclass:Studentswillbeaskedtoreadatrialandtobepreparedtodiscussitindetail.Thetrialwillbeassignedlaterintheterm.RequiredReadings1) JuniP,AltmanDG,EggerM.Chapter5.Assessingthequalityofrandomisedcontrolled

trials.In:SystematicReviewsinhealthCare:Meta-analysisincontext.2) RothwellP.Externalvalidityofrandomisedcontrolledtrials:“Towhomdotheresults

ofthistrialapply?”Lancet2005;365:82-933) HigginsJPT,AltmanDG,SterneJAC(editors).Chapter8:Assessingriskofbiasin

includedstudies.In:HigginsJPT,ChurchillR,ChandlerJ,CumpstonMS(editors),CochraneHandbookforSystematicReviewsofInterventionsversion5.2.0(updatedJune2017),Cochrane,2017.Availablefromwww.training.cochrane.org/handbook.

SupplementaryReadings&AdditionalResourcesWeek7

Riskofbiasassessmentforrandomizedcontrolledtrials§ CASPRandomisedcontrolledtrialchecklist.

http://media.wix.com/ugd/dded87_40b9ff0bf53840478331915a8ed8b2fb.pdf§ HigginsJP,AltmanDG,GøtzschePC,JüniP,MoherD,OxmanAD,SavovićJ,Schulz

KF,WeeksL,SterneJA.TheCochraneCollaboration’stoolforassessingriskofbiasinrandomisedtrials.BMJ.2011Oct18;343:d5928.

Empiricalevidenceofbias§ LundhA,LexchinJ,MintzesB,SchrollJB,BeroL.Industrysponsorshipandresearch

outcome.CochraneDatabaseofSystematicReviews2017,Issue2.Art.No.:MR000033.DOI:10.1002/14651858.MR000033.pub3

§ BerkmanND,SantaguidaPL,ViswanathanM,MortonSC.TheEmpiricalEvidenceofBiasinTrialsMeasuringTreatmentDifferences.MethodsResearchReport.


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(PreparedbytheRTI-UNCEvidence-basedPracticeCenterunderContractNo.290-2007-10056-I.)AHRQPublicationNo.14-EHC050-EF.Rockville,MD:AgencyforHealthcareResearchandQuality;September2014.

§ EggerM,JuniP,BartlettC,HolensteinF,SterneJ.Howimportantarecomprehensiveliteraturesearchesandtheassessmentoftrialqualityinsystematicreviews?Empiricalstudy.HealthTechnolAssess.2003;7(1):1-76.

§ WoodL,EggerM,GluudLL,SchulzKF,JuniP,AltmanDG,GluudC,MartinRM,WoodAJ,SterneJA.Empiricalevidenceofbiasintreatmenteffectestimatesincontrolledtrialswithdifferentinterventionsandoutcomes:meta-epidemiologicalstudy.BMJ2008Mar13;336(7644):601-605.

Examplesofcriticalappraisalofindividualtrials§ ErvitiJ.Denosumabinosteoporosisrelatedfractures.Acriticalappraisalofthe

FREEDOMtrial.DrugsandTherapeuticsBulletin,NavarraSpain.2012MarchApril;20(2):1-8.

§ ScottIA,GreenbergPB.Cautionarytalesintheclinicalinterpretationoftherapeutictrialreports.InternMedJ2005


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Week8GRADEandsummaryoffindingstables

Formulatingconclusionsandcompletingyourreview


Objectives:

§ TobecomefamiliarwithuseoftheGRADEsummaryoffindingstable§ Tolearntoapplyoutcome-specificevidenceratingsacrossstudies§ Toconsiderhowtotranslatesystematicreviewresultsintorelevantconclusions

RequiredReadings1) SchünemannHJ,OxmanAD,HigginsJPT,VistGE,GlasziouP,AklE,GuyattGHon

behalfoftheCochraneGRADEingMethodsGroupandtheCochraneStatisticalMethodsGroup.Chapter11:Completing‘SummaryofFindings’tablesandgradingtheconfidenceinorqualityoftheevidence.In:HigginsJPT,ChurchillR,ChandlerJ,CumpstonMS(editors),CochraneHandbookforSystematicReviewsofInterventionsversion5.2.0(updatedJune2017).Cochrane,2017.Availablefromwww.training.cochrane.org/handbook.

2) SchünemannHJ,OxmanAD,VistGE,HigginsJPT,DeeksJJ,GlasziouP,AklE,GuyattGH

onbehalfoftheCochraneApplicabilityandRecommendationsMethodsGroup.Chapter12:Interpretingresultsanddrawingconclusions.In:HigginsJPT,ChurchillR,ChandlerJ,CumpstonMS(editors),CochraneHandbookforSystematicReviewsofInterventionsversion5.2.0(updatedJune2017).Cochrane,2017.Availablefromwww.training.cochrane.org/handbook.

SupplementaryReadings&AdditionalResourcesWeek8§ GuyattGH,OxmanAD,VistGEetal.GRADE:whatis“qualityofevidence”andwhyisit

importanttoclinicians?BMJ2008;336:995-998.§ GuyattG,OxmanAD,AklEA,KunzR,VistG,BrozekJ,NorrisS,Falck-YtterY,Glasziou

P,JaeschkeR,RindD.GRADEguidelines:1.Introduction—GRADEevidenceprofilesandsummaryoffindingstables.JClinEpidemiol2011Apr30;64(4):383-94.

§ GRADEguidelineseriesintheJournalofClinicalEpidemiology2011-2015.Availableat:https://gradepro.org/guidelines-development(scrolldowntoJCEseries).

§ McMasterUniversityon-lineGRADEvideoseries.Availableat:https://cebgrade.mcmaster.ca/


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Week9

1. CriticalAppraisalofaSystematicReview

Dr.PennyBrasherNovember7,2017

Objectives:

§ Tobefamiliarwithassessmentofthequalityandriskofbiasintheconductofasystematicreviewandmeta-analysis.

§ Toreviewarandomizedtrialforriskofbiasandextractthedatapertinenttothequantitativesynthesisforthereview'sprimaryoutcome.

§ Tobeofassistancetoyoubothasbackgroundtoyourownsystematicreviewsandtheassessmentoftheresearchliterature.

Preparationforthisclass:Studentswillbeaskedtoreadandcritiqueasystematicreviewandoneofthetrialsincludedinthatreview.Thearticleswillbelistedlaterinthetermandpairsofstudentswillbeassignedtoeachtrial.RequiredReadingsThesystematicreviewandtrialsforthereviewwillbeprovidedlaterintheterm.2.SpecialTopic:RIAT-RestoringInvisibleandAbandonedTrials

andotherRecentTrends

Dr.LorriPuilNovember7,2017

Objectives:

§ Tobeawareofrecentinitiativestorestoretrialsandothertrends§ Tobeawareofthedifferencesbetweenclinicalstudyreportsandpublicationsand

todiscussexamplesofreportingbias§ Toknowthereasonswhysystematicreviewauthorslookfordatasourcesbeyond

publicationsNoRequiredReadings


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SupplementaryReadings&AdditionalResourcesWeek9Criticalappraisalofasystematicreview

§ ScottishIntercollegiateGuidelinesNetwork(SIGN)CriticalAppraisalNotesandChecklistsandNoteshttp://www.sign.ac.uk/methodology/checklists.html

§ CriticalAppraisalSkillsProgramme(CASP)SystematicReviewchecklisthttp://www.hello.nhs.uk/documents/CAT7-Systematic_Review.pdf

RIATinitiativeandotherrecenttrends• DoshiP,JonesM,JeffersonT.Rethinkingcredibleevidencesynthesis.BMJ

2012;344:d7898• SharmaT,GuskiLS,FreundN,GøtzschePC.Suicidalityandaggressionduring

antidepressanttreatment:systematicreviewandmeta-analysesbasedonclinicalstudyreports.BMJ2016Jan27;352:i65.

• LeNouryJ,NardoJM,HealyD,JureidiniJ,RavenM,TufanaruC,Abi-JaoudeE.RestoringStudy329:efficacyandharmsofparoxetineandimipramineintreatmentofmajordepressioninadolescence.BMJ2015Sep16;351:h4320.


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Week101. KnowledgeTranslation,PolicyPerspectiveandHealth

Economics

Dr.StirlingBryanNovember14,2017

Objectives:

§ Toconsidermodelsofknowledgeuse§ Toexplorewhattypesofknowledgeshouldchangepolicyandpractice§ Tounderstandhowsystematicreviewsareusedineconomics

RequiredReadings1)TugwellP,RobinsonV,GrimshawJ,SantessoN.Systematicreviewsandknowledgetranslation.BullWorldHealthOrgan.2006Aug;84(8):643-51.http://www.who.int/bulletin/volumes/84/8/05-026658.pdf2)ChambersD,WilsonPM,ThompsonCA,HanburyA,FarleyK,LightK.Maximizingtheimpactofsystematicreviewsinhealthcaredecisionmaking:asystematicscopingreviewofknowledge-translationresources.MilbankQ.2011Mar;89(1):131-56.

2. Specialtopic:Sex,GenderandEquityinSystematicReviews


Objectives:

§ Tounderstandtheinterrelatedconceptsof‘sex’,and‘gender’,andtheirimportanceinthecontextofhealthcare

§ Tobeawareofmethodsthatcanbeusedtoconsidersex,genderandequityinsystematicreviews

§ Toconsider“towhomdoestheevidenceapply”?RequiredReadings1) Doull,M.,RunnelsV.,Tudiver,S.,Boscoe,M.Appraisingtheevidence:applyingsex

andgenderbasedanalysis(SGBA)toCochranesystematicreviewsoncardiovasculardiseases.JWomen’sHealth.2010;19(5):997-1003.


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SupplementaryReading&AdditionalResourcesWeek10Knowledgetranslation,policyperspectiveandhealtheconomics

§ MoatKA,LavisJN,WilsonMGetal.Twelvemythsaboutsystematicreviewsforhealthsystemspolicymakingrebutted.JHealthServResPolicy2013;18:44–50

§ Website:http://ktcanada.net/Genderandequityinsystematicreviews

§ KriegerN.Genders,sexes,andhealth:whataretheconnections—andwhydoesitmatter?InternationalJournalofEpidemiology.2003Aug1;32(4):652-

§ Anadditionalreadinglistwillbemadeavailableinclass.


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Week11ObservationalStudiesinSystematicReviews

Dr.ColinDormuth


Dr.Dormuthwillcoverthefirsttwoobjectivesbelow.Dr.Puilwillfurtherdiscusswhentousenon-randomizedstudiesinsystematicreviews(objective2)andwillcovertheassessmentofriskofbiasinnon-randomizedstudies(objective3).Objectives:

§ Tobecomefamiliarwithmajorconceptsinobservationalstudiesandtheirmeta-analysisincludingdataextraction,dataanalysis,bias,andheterogeneity

§ Toconsiderwhentousenon-randomizedstudiesinasystematicreview§ Tobecomefamiliarwithtoolstoassessriskofbiasinnon-randomizedstudies,

includingROBINS-I,theCochraneRiskofBiasToolforNon-randomizedStudiesofInterventions

RequiredReadings1) EggerM,SchneiderM,DaveySmithG.Spuriousprecision?Meta-analysisof

observationalstudies.BMJ.1998;316(7125):140-4.2) StroupDF,BerlinJA,MortonSC,etal.Meta-analysisofobservationalstudiesin

epidemiology:aproposalforreporting.Meta-analysisOfObservationalStudiesinEpidemiology(MOOSE)group.JAMA.2000Apr19;283(15):2008-12.

Supplementaryreading&AdditionalResourcesWeek11Observationalstudiesandmeta-analysis

§ DormuthCR,HemmelgarnBR,PatersonJM,JamesMT,TeareGFetal.,CanadianNetworkforObservationalDrugEffectStudies(CNODES).Useofhighpotencystatinsandratesofadmissionforacutekidneyinjury:multicenter,retrospectiveobservationalanalysisofadministrativedatabases.BMJ2013;346:f880doi:10.1136/bmj.f880.

§ DormuthC,FilionK,PatersonJM,JamesMT,TeareGFetal.,fortheCanadianNetworkforObservationalDrugEffectStudies(CNODES)Investigators.Highpotencystatinsandtheriskofnewdiabetes:multicentre,observationalstudyofadministrativedatabases.BMJ2014;348:g3244doi:10.1136/bmj.g3244.

§ FilionKB,AzoulayL,PlattRW,DahlM,DormuthCRetal.,fortheCNODESInvestigators.Amulticenterobservationalstudyofincretin-baseddrugsandheartfailure.NewEnglJMed2016;374:1145-1154.

§ DormuthCR,FilionKBPlattRQ.Likelihoodratiometa-analysis:newmotivationandapproachforanoldmethod.ContemporaryClinicalTrials2016;47:259-265.


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Assessmentofriskofbiasofnon-randomizedstudies

§ SterneJAC,HernanMA,ReevesBC,SavovicJ,BerkmanNDetal.ROBINS-I:atoolforassessingriskofbiasinnon-randomisedstudiesofinterventions.BMJ216;355:i4919doi:101136/bmj.i4919.

§ ROBINS-Itool–Availableat:https://sites.google.com/site/riskofbiastool/§ SandersonS,TattID,HigginsJP.Toolsforassessingqualityandsusceptibilityto

biasinobservationalstudiesinepidemiology:Asystematicreviewandannotatedbibliography.IntJEpidemiol2007;36:666-676.

§ OthertoolstoassessthequalityofobservationalstudiesareavailableintheQualityAssessmentToolsmoduleinCanvas.


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Week12StudentReviewTeamPresentations

November28,2017

Eachteamwillpresenttheirresearchtopicinabriefclasspresentation.DetailsandthepresentationschedulewillbeprovidedinCanvas.

Week13

1. SpecialTopic:IndirectComparisonsandIntroductionto

NetworkMeta-analysis

Dr.MirFazeliDecember5,2017

Networkmeta-analysishasbecomeapopularanalyticaltooltouseinordertodrawconclusionsaboutcomparativeeffectivenessofhealthcareinterventionsbasedonbothdirectandindirectevidence.Thisintroductionprovidesanoverviewonwhenandhownetworkmeta-analysisisused,whatisinvolved,andtheirstrengthsandlimitations.Objectives:

§ Tobeawareoftheunderlyingassumptionsofnetworkmeta-analysis,andtheirlimitationsandstrengths

§ Tobeabletoreadanetworkmeta-analysisandcritiqueit.Requiredreadings1) MillsEJ,IoannidisJP,ThorlundK,etal.Howtouseanarticlereportingamultiple

treatmentcomparisonmeta-analysis.JAMA2012;308(12):1246-1253. Supplementaryreadings&AdditionalResourcesWeek13§ SalantiG.Indirectandmixed-treatmentcomparison,network,ormultiple-treatments

meta-analysis:manynames,manybenefits,manyconcernsforthenextgenerationevidencesynthesistool.ResSynthMethods2012Jun1;3(2):80-97.

§ CiprianiA,HigginsJP,GeddesJR,SalantiG.Conceptualandtechnicalchallengesinnetworkmeta-analysis.AnnInternMed2013Jul16;159(2):130-7.


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§ SalantiG,DelGiovaneC,ChaimaniA,CaldwellDM,HigginsJP.Evaluatingthequalityofevidencefromanetworkmeta-analysis.PLOSOne2014Jul3;9(7):e99682

§ HuttonB,SalantiG,CaldwellDM,ChaimaniA,SchmidCH,CameronC,IoannidisJP,StrausS,ThorlundK,JansenJP,MulrowC.ThePRISMAExtensionStatementforReportingofSystematicReviewsIncorporatingNetworkMeta-analysesofHealthCareInterventions:ChecklistandExplanationsPRISMAExtensionforNetworkMeta-analysis.AnnInternMed2015Jun2;162(11):777-84.

2. CourseWrap-upandDiscussion

Dr.LorriPuilDecember5,2017

Some of the main concepts of the course will be highlighted and discussed in the context of the class assignments.


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AppendixASPPHCourseGradingadaptedfrom:Pratt,D.GraduateCourseGradingPolicy,UBCDepartmentofEducationStudies.Numericandlettergradeswillbeassignedasfollows:ALevel(80%to100%)Thiscategoryofachievementistypifiedbyworkthatmeetsthehighestexpectationsasoutlinedbelow.A+isfrom90%to100%:Itisreservedforexceptionalworkthatgreatlyexceedscourseexpectations.Inaddition,achievementmustsatisfyalltheconditionsbelow.Aisfrom85%to89%:Amarkofthisordersuggestsaveryhighlevelofperformanceonallcriteriausedforevaluation.ContributionsdeservinganAaredistinguishedinvirtuallyeveryaspect.Theyshowthattheindividualsignificantlyshowsinitiative,creativity,insight,andprobinganalysiswhereappropriate.Further,theachievementmustshowcarefulattentiontocourserequirementsasestablishedbytheinstructor.A-isfrom80%to84%:Itisawardedforgenerallyhighqualityofperformance,noproblemsofanysignificance,andfulfillmentofallcourserequirements.BLevel(68%to79%)Thiscategoryofachievementistypifiedbyadequatebutunexceptionalperformance.ItisdistinguishedfromAlevelworkbyoneormoreproblems,forexample:asignificanterrorinunderstanding,superficialrepresentationoranalysisofkeyconcepts,orlackofcoherentorganizationorexplanationofideas.ThelevelofBworkisjudgedinaccordancewiththenatureofproblemsdemonstrated.B+isfrom76%to79%,Bisfrom72%to75%,andB-isfrom68%to71%.CLevel(55%to67%)Thiscategoryofachievementistypifiedbylessthanadequateperformanceatthegraduatelevel,andisdistinguishedfromBlevelworkbymultipleproblems,including:significanterrorsinunderstanding,superficialrepresentationoranalysisofkeyconcepts,and/orlackofcoherentorganizationorexplanationofideas.ThelevelofCworkisjudgedinaccordancewiththeseverityoftheproblemsdemonstrated.C+isfrom64%to67%,Cisfrom60%to63%,andC-isfrom55%to59%.Note:Allassignmentsaredueonthedatesnoted.Intheabsenceofapre-arrangedextensiontotheduedateordocumentedmedicalcircumstances,studentshandinginalateassignmentwillincurapenaltyof10%oftheallottedassignmentgradeforeachdayaftertheduedate.Also,lateassignmentsmaymeandelaysinmarking.FurtherinformationonUBCpolicywillbeprovidedinCanvas.

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