Did this review address a focused clinical question?
Were the criteria for article inclusion appropriate?
Is it unlikely that relevant studies were missed?
Was the validity of the included studies appraised?
Were the assessments of studies reproducible?
Were the results similar from study to study?
What are the overall results of the review?
How precise are the results?
Can the results be applied to my patients?
Were all clinically important outcomes considered?
Are the benefits worth the harms and costs?
A Systematic Review is a concise summary of the best available evidence that addresses a sharply defined clinical question
A Meta-analysis is a systematic review that uses quantitative methods to summarize the results.
The test of homogeneity gauges whether it is reasonable to combine the results of individual studies; it asks if the differences in treatment effect from study to study are greater than one would expect as a result of chance alone.
For meta-analyses of therapy, the results are interpreted as in for articles on therapy:
Outcome
+ - Risk of Outcome:
Treated (Y) a b Y = a/(a+b)
Control (X) c d X = c/(c+d)
Absolute Risk Reduction:
ARR = X – Y
Relative Risk or Risk Ratio:
RR = Y/X
NNT = 1/ARR = 1(X-Y)
· meta-analysis (pt) or review (pt)
[see ACP J Club 1996 May-June; A12-A13]