SYSTEMATIC REVIEWS AND META-ANALYSIS Syllabus

340.606.01 | AY 2013-2014 - 3rd Term | 6 Credit(s)
MWF 3:30:00 PM
  • Contact Information
    Faculty
    Kay Dickersin
    Tianjing Li
  • Course Learning Objectives

    Upon successfully completing this course, students will be able to:

    • Perform a systematic review and meta-analysis addressing an epidemiologic or clinical research question
    • Formulate a focused research question
    • Conduct a comprehensive search for relevant research
    • Assess study quality and abstract the data
    • Evaluate heterogeneity of the evidence
    • Synthesize and assess the study results both qualitatively and quantitatively
    • Interpret the results and construct a report
    • Describe the various analytic approaches used in meta-analysis
    • Describe the challenges associated with performing and interpreting systematic reviews
  • Course Description
    Presents basic methods in qualitative and quantitative meta-analysis, including formulating a hypothesis that can be addressed via meta-analysis, methods for searching the literature, abstracting information, and synthesizing the evidence. Quantitative methods include Bayesian and likelihood approaches to meta-analysis.
  • Intended Audience
    Masters and doctoral students in Epidemiology or Clinical Investigations.
  • Methods of Assessment

    Course Work and Important Dates

    Course activity

    Contribution to Grade

    Due

    Submission via

    Vote on topics for class project

     

     

    -

    Thursday, January 23; by 8:00 am

    Survey link on CoursePlus.

    Quiz 1

     

    3%

    Sunday, January 26 by 11:59 pm

    CoursePlus Quiz Generator

    Quiz 2

     

    3%

    Tuesday, January 28 by 11:59 pm

    CoursePlus Quiz Generator

    Research questions for class project

     

    -

    Wednesday, January 29 by 11:59 pm

    CoursePlus DropBox

     

    Attend informationist office hours

     

    -

    Friday, January 31

    -

    Search strategy for PubMed

     

    -

    Monday, February 3, by 3:00 pm

    CoursePlus DropBox

    Search strategies for other databases

     

    -

    Wednesday, February 5, by 3:00 pm

    CoursePlus DropBox

    Quiz 3

     

    3%

    Thursday, February 6, by 11:59 pm

    CoursePlus Quiz Generator

    Quiz 4

     

    3%

    Thursday, February 13, by 11:59 pm

    CoursePlus Quiz Generator

    Mid-term paper

     

    20%

    Thursday, February 20, by 12:00 pm

    CoursePlus DropBox

    Quiz 5

     

    3%

    Tuesday, March 4, by 11:59 pm

    CoursePlus Quiz Generator

    Final presentation

    -

    Monday, March 10, by 2:00 pm OR Wednesday, March 12, by 2:00 pm

    CoursePlus DropBox

    Peer evaluation

     

    5%

    Friday, March 14 by 5:20 pm

    Paper forms

    Final paper

     

    60%

    Sunday, March 16 by 11:59 pm

    CoursePlus DropBox


    Grading

    • Quiz 1: This open-book quiz will count towards 3% of your grade. The quiz will include 5 multiple-choice questions and will be based on all materials covered during the course until and inclusive of Online Lecture 1 - Finding the evidence – Reporting bias.
    • Quiz 2: This open-book quiz will count towards 3% of your grade. The quiz will include 5 multiple-choice questions and will be based on materials covered during Online Lecture 2 - Finding the evidence – Searching principles.
    • Quiz 3: This open-book quiz will count towards 3% of your grade. The quiz will include 5 multiple-choice questions and will be based on materials covered during Online Lecture 3 - Minimizing metabias in a systematic review.
    • Quiz 4: This open-book quiz will count towards 3% of your grade. The quiz will include 5 multiple-choice questions and will be based on materials covered during Online Lecture 4 - Planning your meta-analysis.
    • Midterm evaluation: The midterm paper (protocol for your systematic review) will count towards 20% of your grade.
    • Quiz 5: This open-book quiz will count towards 3% of your grade. The quiz will include 5 multiple-choice questions and will be based on all meta-analysis materials covered during the course until and inclusive of Online Lecture 5 - Network meta-analysis methods in addressing comparative effectiveness research questions.
    • Peer evaluation: Each student will grade each of the other students in their group. Peer evaluation will count towards 5% of your grade, and will be through an online anonymous survey tool. We will provide a rubric for peer evaluation.
    • Final evaluation: The final paper (final report of your systematic review) will count towards 60% of your grade.
    • Attendance: We take attendance very seriously and keep track of it. Your review group depends on your full participation in lectures and group work. If you need to be absent for more than 2 class sessions, please talk to the instructors. In the past, we have found that students who attended all sessions gained the most from more in-depth interaction with the teaching team.

    Functioning of Groups

    We will form groups such that each will be made up of students with different skills (e.g., clinical, content area, methodological expertise, statistical expertise). All students must contribute equally and each student must participate in the various steps of the systematic review. For example, each student must be involved in identifying relevant studies from the database searches, screening, data extraction, and statistical analysis. Students work towards class projects as groups. However, the quizzes, mid-term paper (protocol), and final paper (write up of completed systematic review) are each student’s individual work. If a student wishes to include in his/her paper(s) certain analyses that others in the group do not wish to include, that student may go ahead and include them in his/her paper(s). Please see the section below on the Academic Ethics Code for details on what content may and may not be identical among students in the same group.

    Resources to Help Write Your Mid-Term and Final Papers

    Instructions and “Points to cover in paper” will be available to help you check for completeness, but your papers should use standard systematic review reporting standards that we will discuss. The text in your mid-term paper (protocol) should consist of no more than 10 pages (double-spaced). The text in your final paper should consist of no more than 20 pages (double-spaced) and the main tables and figures may be presented in an additional 5 to 10 pages (single-spaced). We are looking for quality, not quantity!

    Group Presentations

    During the last week of the course, each group will present its systematic review in a short 6-minute oral presentation to the class. To ensure conciseness, we will ask that your class presentation use a template that we will provide. Each presentation will be followed by up to 10 minutes of Q&A and discussion with the teaching team and the rest of the class.

  • Prerequisites
    340.601 or 340.751 and 140.622.
  • Required Text(s)


    Readings / Textbooks

    Required Readings:

    1.    Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0, updated March 2011) – accessible free of charge online at http://www.cochrane-handbook.org.

    2.    Institute of Medicine. Finding what works in health care: standards for systematic reviews. March 23, 2011 – available for download as PDF free of charge online at: http://www.iom.edu/Reports/2011/Finding-What-Works-in-Health-Care-Standards-for-Systematic-Reviews.aspx.

    3.    Chandler J, Churchill R, Higgins J, Tovey D. Methodological standards for the conduct of new Cochrane Intervention Reviews. Version 2.2. 17 December 2012 – available for download as PDF free of charge online at:

    http://www.editorial-unit.cochrane.org/sites/editorial-unit.cochrane.org/files/uploads/MECIR_conduct_standards%202.2%2017122012.pdf

     

    Reference/Optional Readings:

    4.    Alex J. Sutton, Keith R. Abrams, David R. Jones, Trevor A. Sheldon and Fujian Song, Methods for Meta-analysis in Medical Research. Wiley, Chichester, U.K., 2000.

    5.    Systematic Reviews in Health Care. Egger et al., BMJ Books, 2001.

    6.    We will post to the online library on CoursePlus selected journal articles and book chapters to serve as additional reference/optional readings.

    A copy each of the textbooks listed in items 1 and 4 will be available on reserve in the Welch Library 1st floor Reference Desk. 

     

    Software

    Required:

    1.    EndNote© x7 (previous versions also work) for reference management.

    2.    STATA 13© (previous versions also work) for data analyses. Download all meta-analysis related modules. Instructions for downloading the modules will be provided.

     

    Other Useful Software:

    1.    Review Manager 5.2.7 (RevMan 5.2©): Developed by the Cochrane Collaboration; available for free download and use for non-commercial purposes from http://ims.cochrane.org/revman/download. Tutorials for using RevMan are available through the software’s website as well as through CoursePlus.

    2.    Adobe® forms for developing data extraction forms;

    3.    Microsoft Access® for data management.

    Additional Resources

     

    ·         Informationists from the Welch Library will be available to assist with searches at class sessions and by appointment. Each group is required to set up and attend an Office Hours appointment with an informationist by Friday January 31, 2014 to develop search strategies for their systematic review.

    ·         This course does not focus on systematic reviews of diagnostic test accuracy studies. However, two online lectures on diagnostic test accuracy studies by Dr. Milo Puhan are available as optional resources on CoursePlus.

  • Course Schedule

    Please see the course Session for a full list of dates and items for this course.

  • Academic Ethics Code

    Students enrolled in the Bloomberg School of Public Health of The Johns Hopkins University assume an obligation to conduct themselves in a manner appropriate to the University's mission as an institution of higher education. A student is obligated to refrain from acts which he or she knows, or under the circumstances has reason to know, impair the academic integrity of the University. Violations of academic integrity include, but are not limited to: cheating; plagiarism; knowingly furnishing false information to any agent of the University for inclusion in the academic record; violation of the rights and welfare of animal or human subjects in research; and misconduct as a member of either School or University committees or recognized groups or organizations.

    Academic Ethics Code Specific to the Course

    JHSPH Academic Ethics Code: All students are expected to follow the JHSPH Academic Ethics Code, which is available at http://apps4.jhsph.edu/academicethics/.

     

    Academic Ethics Specific to This Course and Related to Your Class Project: We will be checking your individual submissions (mid-term and final papers) for violations of the JHSPH Academic Ethics Code as well as the below-mentioned details. Violations will be pursued per procedures established by JHSPH.

     

    Any content in your mid-term or final paper that was obtained from other sources must be appropriately attributed. See JHSPH Academic Ethics code for details. We intend to use plagiarism detection software to check overlapping text fragments and indications for plagiarism.

     

    (I)            Writing your mid-term paper (protocol for your systematic review):

    The following sections may be identical across all students in the group:

    ·         Title;

    ·         Objective;

    ·         Search strategies used for different databases (the actual search strings used to search the databases); and

    ·         Data items that will be extracted.

     

    Since all students in a group will conduct the same systematic review, the following sections (and additional sections that may be included) can contain similar information but each student must independently write the sections using his/her own words:

    ·         Details of research question (e.g., types of participants, types of interventions/ exposures, types of comparisons, types of outcomes);

    ·         Details of literature search;

    ·         Method used to screen search results;

    ·         Risk of bias assessment;

    ·         Data extraction; and

    ·         Data analysis including assessment of heterogeneity and reporting biases, etc. Although some data analyses will be common across students in a group, some students may choose to specify and conduct additional analyses that differ from others in the group.

     

    (II)          Writing your final paper (final report of your systematic review):

    As long as your mid-term paper does not contain content that isn’t appropriately attributed, you may use in your final paper text from your mid-term paper for the following sections after appropriate edits:

    ·         Background/Introduction; and

    ·         Methods.

     

    The following items may be identical in final papers across all students within a group:

    ·         Search strategies used for different databases (the actual search strings used to search the databases);

    ·         Objective;

    ·         Data items that will be extracted;

    ·         Tables with results of your systematic review in the main paper and Appendix;

    ·         Figures with results of your systematic review in the main paper and Appendix.

     

    All other parts of the final paper must be written independently by each student using their own words with appropriate attribution for content obtained from other sources. Students may discuss and exchange ideas with students within the group, with students in other groups, and/or with the teaching team. However, students are expected to write independently, using their own words.

     

     

    Item

    Rule

    Title

    can be identical

    Objectives

    can be identical

    Study inclusion/exclusion criteria

    Type of studies

    Types of participants

    Types of interventions/comparisons

    Types of outcome measures

         Time points

    should be written in detail in your own words

    Search strategies used for different databases

    actual search strings used should be identical

    Items to be extracted

    should be written in detail in your own words

    Items to be used for assessing risk of bias

    should be written in detail in your own words

    Measures of treatment effect

    should be written in detail in your own words

    Evidence tables

    should be identical

    Risk of bias figure

    should be identical

    Forest plots

    should be identical, unless you decide to do additional analyses

     

     

    (III)         Circulating protocol/mid-term and final paper to other students

    Students are not allowed to circulate their mid-term and final papers to others during the course. Doing so makes the student vulnerable to violations of the Academic Ethics Code.

     

    We encourage students to raise any questions related to academic ethics related to writing the mid-term and final papers. Please bring them up in class or email the instructors and/or teaching assistants with any questions.

  • Welcome Message

    Our goal is for students to experience conducting a systematic review as part of an interdisciplinary team. Our approach is geared towards providing a practical learning experience. An actual, high quality, systematic review could not typically be completed in an 8-week period. Therefore, although we teach students what would be required to complete a high quality review, we do not expect the class exercise to result in a publishable manuscript. That said, we are delighted when students elect to continue the work they have started in class to undertake a publishable manuscript.

    The course is organized into 23 class sessions, comprising a mix of eight in-class lectures, five online lectures, five in-class discussions, three in-class exercises, and dedicated in-class group time for work leading to the systematic review. The five online lectures are each followed by an online quiz and in-class discussion.  

  • Course topics

    See Syllabus

  • Teaching Assistants

    The teaching assistants for this course:

    Ian Saldanha (Lead TA)

    Email: isaldanh@jhsph.edu

     

    Tsung Yu

    Email: tsyu@jhsph.edu

     

    Diana Lock

    Email: dlock@jhsph.edu

  • Disability Support Services
    If you are a student with a documented disability who requires an academic accommodation, please contact the Office of Student Life Services at 410-955-3034 or via email at dss@jhsph.edu.