Critical Appraisal of Systematic Reviews
Introduction
Systematic reviews are meant to locate and summarize ALL existing valid evidence on a topic.
If the systematic review contains all the valid randomized controlled trials on a topic, then it can be the HIGHEST grade evidence available on that topic.
In general, when you're "hunting" for an answer to a clinical question, it's best to start with a database of systematic reviews - such as the Cochrane Database of Systematic Reviews or the Database of Abstracts of Reviews of Effectiveness.
For more detailed information on any of these concepts, go to the Cochrane Handbook Section on Review Methods
Video Tutorial
Learning Objectives
Describe the purpose and scope of a systematic review
Define meta-analysis and distinguish from systematic review
List and identify the important validity concepts for systematic reviews
comprehensive search for evidence
publication bias
explicit inclusion/exclusion criteria
explicit assessment of the quality of included studies
assessment of heterogeneity
qualitative
quantitative
Identify and interpret the following components of the results of the review:
Forest plot
point estimate
relative risk
odds ratio
risk difference
number needed to treat
confidence interval
Heterogeneity assessment
"eyeball" test
chi-square and p-value
I-square test
sensitivity analysis
Tables of included and excluded studies
Recall and identify generalizability concerns
comparison of study populations and treatment populations
exploration of heterogeneity and sensitivity analysis
interpretation of generic "effect size" as an outcome