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Review article
Systematic review
Meta analysis

Integrative Literature
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• SYSTEMATICALLY

• SYSTEMATICALLY

• SYSTEMATICALLY
Bastian, Glasziou, Chalmers (2010) 75 Trials and 11Systematic Reviews a Day: How Will We Ever Keep Up? PLoS Med 7(9)
 2500000
5,000?
per day
Medical Articles per Year

2000000

1500000

1000000 1,500
55 per per day
500000
day
0
Trials MEDLINE BioMedical
Streptokinase for Myocardial Infarction
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sumber IDENTIFIKASI
informasi

METODOLOGI
SELEKSI
PENELITIAN

MEMINIMALKAN
ABSTRAKSI
ERROR & BIAS

ANALISA

LANGKAH-LANGKAH DALAM MELAKUKAN META ANALISA ( Okin, 1996 )

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 Potentially relevant
RCTs (n= ..)

n RCTs excluded with reason

RCTs retrieved for more

detailed information (n= ..)
n RCTs excluded with reason

Potentially appropriate
RCTs (n= ..)

n RCTs excluded with reason

RCTs in meta-analysis (n=..)

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Meta-analysis of RCTs with nominal outcome

Study I 1992
Study II 1994
Study III 1995
Study IV 1995
Study V 1996
Study VI 1997
Study VII1 1999
Study VIII 2000
Combined
0.1 10

OR = 1
Favor drug Favor placebo
Meta-analysis of RCTs, numerical outcome

Study I 1992
Study II 1994
Study III 1995
Study IV 1995
Study V 1996
Study VI 1997
Study VII1999
Study VIII 2000
Combined
-0.3 +0.3
Xe-xc=0
Favor drug Favor placebo
FOREST PLOT
•The label tells you what the comparison and outcome
of interest are
FOREST PLOT

Each study has an ID

FOREST PLOT
The data for each trial are here, divided into
experimental and control groups
 FOREST PLOT
This is the % weight given to each study in the pooled analysis
 FOREST PLOT
•Results from each trial are also given numerically
 FOREST PLOT
The size of the block for each study is proportional to the % weight.
The horizontal line represents the confidence interval.
 FOREST PLOT
The label above the graph tells you which statistic has been used
FOREST PLOT
Take care to read the labels –
things to the left do not always mean the treatment
is better than the control
FOREST PLOT
•The pooled analysis is given a diamond shape –
• The widest bit is located on the point estimate
and the horizontal width in the confidence interval.
•Does the confidence interval cross the line of no effect?
 FOREST PLOT
Results of the pooled analysis are also given numerically
 FOREST PLOT
Test for heterogeneity
The result of a Z test with a p value are also given
for the overall effect
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