Course catalogue doctoral education - HT20

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Title How to conduct systematic reviews and meta-analyses
Course number 2790
Programme Folkhälsovetenskap
Language English
Credits 3.0
Date 2016-10-24 -- 2016-11-09
Responsible KI department Institutionen för molekylär medicin och kirurgi
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 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.
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):
(free online as e-book via KI library)
Chapter 1 (read before course starts), 3 and 9.

3. Introduction to meta-analysis. (2009, Borenstein et al) (free online as e-book via KI library)
Part 3, 4 and 9.

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.

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.

To read for literature seminars:

1. Malik VS, Pan A, Willett WC, Hu FB. Sugar-sweetened beverages and weight gain
in children and adults: a systematic review and meta-analysis. Am J Clin Nutr.
2013 Oct;98(4):1084-102. doi: 10.3945/ajcn.113.058362. Epub 2013 Aug 21. Review.
PubMed PMID: 23966427; PubMed Central PMCID: PMC3778861.

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) (

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. (free to download online): discussion of different types of systematic reviews (clinical tests, public health interventions)
Number of students 20 - 25
Selection of students Preference will be given to students early on in their PhD education, and where the benefits of this course will be greatest. Date of registration as a PhD student, suitability of PhD project, and the motivation to attend the course given will be used in the selection process.
More information The course will take place during a 2.5 week period, at Widerströmska Huset, Karolinska Institutet, Solna. The majority of lectures and seminars are scheduled during the first week. During the second week of the course, the students are expected to work on their individual projects, and have the opportunity to get individual feedback on their project during the ""open office"". The examination will take place during the third week, with an oral exam based on the project work (own project + opposition of the project of one of the other students). As the course entails 3 HEC, it requires 2 weeks of full-time work. Emphasis is on the application of knowledge gained during the course to the student's own research and planned studies.
Additional course leader
Latest course evaluation Course evaluation report
Course responsible Nele Brusselaers
Institutionen för mikrobiologi, tumör- och cellbiologi

CTMR - Nobelsvag 16 - KISolna

Contact person Kalle Mälberg
Institutionen för molekylär medicin och kirurgi

Elizabeth Arkema
Institutionen för medicin, Solna