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Title How to conduct systematic reviews and meta-analyses
Course number 2790
Programme Folkhälsovetenskap
Language English
Credits 3.0
Date 2017-10-09 -- 2017-10-25
Responsible KI department Institutionen för mikrobiologi, tumör- och cellbiologi
Specific entry requirements Students need to have a basic knowledge of biostatistics and epidemiology (e.g. understanding risk ratios and odds ratios).
Purpose of the course Meta-analyses are becoming the gold standard method of reviewing and summarising the scientific literature, and they have contributed greatly to the current body of scientific knowledge. This course aims to introduce the concepts and procedures of systematic reviews and meta-analyses, and will help applicants to get started with their own study.
Intended learning outcomes After completion of the course the students should be able to: 1) Understand and demonstrate the value, principles and the different concepts related to systematic reviews and meta-analyses, in particular compared to other types of studies (incl. narrative reviews, original research); 2) Identify the strengths, limitations and pitfalls of systematic reviews and meta-analysis; 3) Independently formulate study hypotheses, and plan and generate a study protocol to perform a systematic review and meta-analysis, justifying the selection of the eligible studies and statistical methodology; 4) Apply basic methods of meta-analyses; 5) Critically reflect on other students individual project work and provide feedback in a scientifically constructive way (peer-review); 6) Interpret and critically evaluate scientific studies relevant to the course content.
Contents of the course The course is designed for PhD students, in particular those who are at an early stage of their research education, and those with an interest in conducting systematic reviews and meta-analysis. The content of the course is as follows: 1) Basic concepts in systematic reviews and meta-analyses, 2) strengths, problems and limitations of systematic reviews and meta-analyses, 3) How to write a study protocol for a systematic review, 4) How to perform a systematic literature search (including a practical seminar organised by Karolinska Institutet library), 5) Data-extraction and quality assessment of included studies, 6) Statistical methods used in meta-analyses and interpretation, 7) Examination. This is a hands-on course, covering theoretical concepts and discussion of strengths, limitations and problems of systematic reviews and meta-analyses. We will also discuss publication guidelines, strategies to identify eligible studies, quality assessment of research papers, how to use Endnote to facilitate the systematic search, and different statistical methods.
Teaching and learning activities Interactive lectures, seminars, individual article review, group discussions, practical sessions (one on systematic literature search, one on statistical methods) and homework tasks will be used. The course focuses on active learning, i.e. putting knowledge into practice and critically reflecting upon the knowledge, rather than memorising facts. Therefore, much of the focus of the course is on the individual project where students are required to develop a full study protocol including several important aspects covered in the lectures, peer assessment, article reviews and group discussions. Students will also peer-review each other's projects and this will form the basis for the final examination seminar. Throughout the course, the students will work on an individual project and will have to peer-review the project of another student. Further, students will critically review and discuss relevant scientific articles. There will be several group discussions with other students and experienced teachers, with a focus on peer-assessment (discussing each other's projects), and the lectures are interactive allowing for critical discussions.
Compulsory elements Compulsory attendance includes the scheduled lectures and seminars. Absence will need to be replaced by individual assignments following discussion with the course co-ordinator, e.g. article reviews, with written or oral follow-up. Attendance is also compulsory for the examination, which includes discussion of the study protocol of each student + opposition for another student.
Examination To pass the course the student must actively participate in the lectures and group seminars and pass the examinations: 1) Individual project work: To develop a written comprehensive yet concise study protocol including several important aspects as discussed during the course; 2) Peer-review of other students¿ projects followed by an oral presentation of their own project and opposition of other students projects during the group examination; 3) Critically review scientific articles relevant to the course content.
Literature and other teaching material Course literature (mandatory)

1. Berlin JA, Golub RM. Meta-analysis as evidence: Building a better pyramid. JAMA 2014:312(6):603-605. PubMed PMID: 25117128 Before course starts
2. Systematic Reviews in Health Care: Meta-analysis in context (2nd edition, 2008, Egger et al ¿ First edition was from Charmers and Altman 1995, BMJ publishing group):
(http://ije.oxfordjournals.org.proxy.kib.ki.se/content/31/3/697.1)
(free online as e-book via KI library)
Chapter 1: Introduction: Before course starts
Chapter 3: Problems and limitations in conducting systematic reviews: Before Tuesday
Chapter 9: Why and how sources of heterogeneity should be investigated: Before Thursday

3. Introduction to meta-analysis. (2009, Borenstein et al) (free online as e-book via KI library)
(http://onlinelibrary.wiley.com.proxy.kib.ki.se/book/10.1002/9780470743386)
Part 3 - Fixed-effect versus random-effects models (complete): Before Wednesday
Part 4 - Heterogeneity: chapter 15,16: Before Thursday
Part 9 - Meta-analysis in context (complete): Before Friday

4. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting
items for systematic reviews and meta-analyses: the PRISMA statement. J Clin
Epidemiol. 2009 Oct;62(10):1006-12. doi: 10.1016/j.jclinepi.2009.06.005. Epub
2009 Jul 23. PubMed PMID: 19631508. Before Tuesday

5. Sanderson S, Tatt ID, Higgins JP. Tools for assessing quality and
susceptibility to bias in observational studies in epidemiology: a systematic
review and annotated bibliography. Int J Epidemiol. 2007 Jun;36(3):666-76. Epub
2007 Apr 30. Review. PubMed PMID: 17470488. Before Tuesday


To read for literature seminars:

1. Machado GC, Maher CG, Ferreira PH, Pinheiro MB, Lin CC, Day RO, McLachlan AJ, Ferreira ML. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ 2015 Mar 31;350:h1225. doi: 10.1136/bmj.h1225. PMCID: PMC4381278. PMID: 25828856.

2. De Bruijn KM, Arends LR, Hansen BE, Leeflang S, Ruiter R, van Eijck CH. Systematic review and meta-analysis of the association between diabetes mellitus and incidence and mortality in breast and colorectal cancer. Br J Surg. 2013 Oct;100(11):1421-9. doi: 10.1002/bjs.9229. Review. PubMed PMID: 24037561.

Suggested reading (optional)
1. Cochrane handbook (free online) (http://handbook.cochrane.org/)

2. Systematic Reviews. CRD's guidance for undertaking reviews in health care (2009). Centre for Reviews and Dissemination, University of York. ISBN 978-1-900640-47-3. www.york.ac.uk/inst/crd/index_guidance.htm (free to download online): discussion of different types of systematic reviews (clinical tests, public health interventions)

Number of students 18 - 25
Selection of students Selection will be based on 1) the relevance of the course syllabus for the applicant¿s doctoral project (according to written motivation), 2) date for registration as a doctoral student (priority given to earlier registration date). A basic understanding of epidemiology and bio-statistics is recommended, so please state relevant experience and which epidemiology/biostatistics courses you completed (written motivation).
More information The course will start with one intense week (5 full days) of mandatory lectures, discussions and practical sessions (09 Oct-13 Oct). Oct 18th (morning) there will be an ""open house"" to get direct feedback from the supervisors on your study project (attendance optional). Oct 25 (morning) is the exam, which is again mandatory. The course also requires preparation at home.
Additional course leader
Latest course evaluation Course evaluation report
Course responsible Nele Brusselaers
Institutionen för mikrobiologi, tumör- och cellbiologi
0761516212
nele.brusselaers@ki.se

CTMR - Nobelsvag 16 - KISolna

17177
Stockholm
Contact person Anna Sidorchuk
Institutionen för klinisk neurovetenskap
08-524 800 14
Anna.Sidorchuk@ki.se

Gävlegatan 22

17177
Stockholm


Nele Brusselaers
Institutionen för mikrobiologi, tumör- och cellbiologi
0761516212
nele.brusselaers@ki.se

CTMR - Nobelsvag 16 - KISolna

17177
Stockholm