Professional Documents
Culture Documents
TITLE:
Example 2: Over the last decade, the possible association between underarm
deodorants/antiperspirants use and breast cancer risk has raised important
interest in the scientific community.
OBJECTIVE:
Example 2: The objective of our systematic review is to estimate the pooled risk
of deodorants/ antiperspirants use for breast cancer.
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Faculty of Medicine Ain Shams University MFA
METHODOLOGY:
- Types of studies
- Types of participants
Example: Participants will be adults or children (over the age of 2 years) with a
diagnosis of asthma.
- Types of interventions
1) Lung function (FEV1, % predicted FEV1, diary and clinic PEFR and PEFR
variability).
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Faculty of Medicine Ain Shams University MFA
Search strategy for identification of studies
Example 1: An initial search will be carried out using the Cochrane Airways
Group Asthma RCT register. Additional and separate searches will be carried
out on MEDLINE (1966-2017), EMBASE (1980-2017), PUBMED and also on all
relevant respiratory journals that are available as electronic data bases.
Review articles and bibliographies of each RCT identified will be searched for
additional references that may contain further RCTs. Personal contact with
colleagues, collaborators and other trialists working in the field of asthma will be
made to identify other published and unpublished relevant studies.
OR
When two or more papers were based on an identical study, the paper that
principally investigated the relationship between breast cancer and deodorants
use was used.
OR
Our review will include studies published in Arabic, English and French.
OR
We will consider studies in English, French and Spanish and no attempts were
made to locate any unpublished studies.
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Faculty of Medicine Ain Shams University MFA
Methods of the review
Abstracts of articles identified using the search strategy above will be viewed,
and articles that appear to fulfil the inclusion criteria will be retrieved in full. Data
on at least one of the outcome measures must be included in the study.
Each article identified will be reviewed and categorised into one of the following
groups:
-included: RCT or CCT that meets the described inclusion criteria and those
where it is impossible to tell from the abstract, title or MESH headings;
When there will be a doubt, a second reviewer will assess the article and a
consensus will be reached.
- Data extraction
OR
A copy of each paper identified will be obtained, and relevant data will be
abstracted by the first reviewer (M.K.M.E.) for a quantitative overview. The odds
ratio and the country where the study was carried out will also be ascertained.
In case of discrepancies or when the information presented in a study is
unclear, abstraction by a second reviewer (F.M.F.I.) will be sought to resolve
the discrepancy.
- Statistical considerations
Outcomes from included trials will be combined using the Review Manager
software.
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Faculty of Medicine Ain Shams University MFA
a) Age (children or adults)
b) Asthma severity
OR
Data will be abstracted from every study in the form of a risk estimate and its
95% confidence interval (CI). Pooled risk estimate will be obtained by weighing
each study by the inverse variance of the effect measure on a logarithmic scale.
When a risk estimate and its 95% confidence interval were not available from
the article, we calculated unadjusted values from the published data of the
article, using the Epi Info 6 computer program version 6.04d.
This approach to pooling the results assumes that the study populations being
compared are similar and hence corresponds to a fixed effect analysis. The
validity of pooling the risk estimates will be tested (test of homogeneity) using a
chi-square test (Fleiss, 1993). A violation of this test implies that the studies
being grouped differ from one another. In the presence of significant
heterogeneity of the effect measure among studies being compared, we will
perform a random effect analysis that is based on the method described by
DerSimonian and Laird (1986). The random effect analysis accounts for the
interstudy variation. Because the test of homogeneity has low power, we will
report the figures of the random effect analysis even with the absence of
significant heterogeneity.
All statistical analysis for pooling the studies will be performed on the STATA
statistical Software, release 14.0 (Stata Crop. 2015, College Station, Texas,
USA).
. Fleiss JL. The statistical basis of meta-analysis. Stat Methods Med Res
1993;2(2):121-45.
A funnel plot is a simple scatter plot of the intervention effect estimates from
individual studies against some measure of each studys size or precision.
REFERENCES:
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Faculty of Medicine Ain Shams University MFA