Systematic Review & Meta-Analysis Flashcards

In meta-analysis, the trim-and-fill method is used to:

Answer: Impute missing effect sizes from unpublished studies to correct for publication bias

The trim-and-fill method estimates and imputes potentially missing studies to produce an adjusted pooled effect corrected for funnel plot asymmetry.

A systematic review searching only MEDLINE and PubMed without grey literature is most at risk for which bias?

Answer: Publication bias

Restricting searches to major indexed databases omits unpublished or informally published studies, which tend to show null results, inflating apparent effect sizes.

Which effect size measure is most commonly used to pool continuous outcomes across studies in a meta-analysis?

Answer: Standardized mean difference (SMD)

The SMD (e.g., Cohen's d, Hedges' g) enables pooling of continuous outcomes measured on different scales across studies.

GRADE methodology in systematic reviews evaluates certainty of evidence across how many domains that can downgrade quality?

Answer: 5

GRADE uses five downgrading domains: risk of bias, inconsistency, indirectness, imprecision, and publication bias.

A Galbraith plot in meta-analysis is an alternative diagnostic tool used to visualize:

Answer: Heterogeneity and potential outlier studies

The Galbraith (radial) plot plots standardized effect estimates against their precision, helping identify studies contributing to heterogeneity.

When conducting a meta-analysis of diagnostic test accuracy, which pair of statistics is typically pooled?

Answer: Sensitivity and specificity

Sensitivity (true positive rate) and specificity (true negative rate) are the primary metrics pooled in diagnostic meta-analyses using bivariate models.

Which component of the PICO framework specifies the alternative against which an intervention is evaluated?

Answer: Comparison

The Comparison element defines the control or alternative treatment (e.g., placebo, standard of care) against which the intervention is contrasted.