Course syllabus for Systematic Review and Meta-Analysis

Systematisk litteraturöversikt och meta-analys

Specific entry requirements

A Bachelor's degree or a professional degree equivalent to a Swedish Bachelor's degree of at least 180 credits in public health science, healthcare or other relevant social sciences subject area. And proficiency in English equivalent to English B/English 6.

That the student has completed courses with approved results equivalent of 45 credits at the Master's Programme in Public Health Sciences, specialisation Public Health Epidemiology.

Outcomes

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 apply these in practice, by working on an individual project.

At the end of the course the students should be able to:

• 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);
• Identify the strengths, limitations and pitfalls of systematic reviews and meta-analysis;
• 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;
• Apply basic methods of meta-analyses;
• Critically reflect on other students individual project work and provide feedback in a scientifically constructive way (peer-review);
• Interpret and critically evaluate scientific studies relevant to the course content.

Content

The content of the course is as follows:

• Basic concepts in systematic reviews and meta-analyses,
• strengths, problems and limitations of systematic reviews and meta-analyses,
• How to write a study protocol for a systematic review,
• How to perform a systematic literature search (including a practical seminar organised by Karolinska Institutet library),
• Data extraction and quality assessment of included studies,
• Statistical methods used in meta-analyses and interpretation,
• 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, how to use Endnote to facilitate the systematic search, Excel for data-management, and different statistical methods and programs.

Systematic review and meta-analysis, 3.0 credits

Grading scale: VU

Teaching methods

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.

Examination

• Individual project work: To develop a written comprehensive yet concise study protocol including several important aspects as discussed during the course;
• 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;
• Critically review scientific articles relevant to the course content. To pass the course, the student has to show that all intended learning outcomes have been reached.

Compulsory participation
Compulsory attendance includes the scheduled workshops and group sessions, as well as the exam. One is required to come well prepared for each seminar (see reading list). 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.
Attendance is also compulsory for the examination, which includes discussion of the study protocol of each student + opposition for another student.

The course coordinator assesses if and, in that case, how absence can be compensated. Before the student has participated in all compulsory parts or compensated absence in accordance with the course coordinator's instructions, the student's results for each respective part will not be registered in LADOK.

Limitation of number of occasions to write the exam
The student has the right to write the exam six times. If the student has not passed the exam after four participations he/she is encouraged to visit the study advisor.

The number of times that the student has participated in one and the same examination is regarded as an examination session. Submission of a blank examination is regarded as an examination. An examination for which the student registered but not participated in will not be counted as an examination.

If there are special grounds, or a need for adaptation for a student with a disability, the examiner may decide to deviate from the syllabus's regulations on the examination form, the number of examination opportunities, the possibility of supplementation or exemptions from the compulsory section/s of the course etc. Content and learning outcomes as well as the level of expected skills, knowledge and abilities may not be changed, removed or reduced.

Transitional provisions

Examination will be provided during a time of two years after a possible cancellation of the course. Examination can take place according to an earlier literature list during a time of one year after the date when a major renewal of the literature list has been made.

Other directives

Course evaluation will be carried out in accordance with the guidelines established by the Committee for Higher Education.
The course language is English.

Literature and other teaching aids

Mandatory literature

• Systematic reviews: practical information on how to conduct systematic literature searches:, Karolinska Institutet library, https://kib.ki.se/en/search-evaluate/systematic-reviews *
• Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement., Moher, D; Liberati, A; Tetzlaff, J; Altman, DG, Institutionen för folkhälsovetenskap, http://www.prisma-statement.org/, PRISMA: http://www.prisma-statement.org/ (flowchart, checklist and PRISMA statement: 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). *
• Introduction to meta-analysis, Borenstein, Michael; Hedges, Larry V.; Higgins, Julian P. T.; Rothstein, Hannah R., Chichester : Wiley, 2009 - online resource (xxix, 421 s). ISBN: 9780470743379, LIBRIS-ID: 12049433, Table of Contents / Abstracts, Part 3 - Fixed-effect versus random-effects models (complete)
  Part 4 - Heterogeneity: chapter 15,16
  Part 9 - Meta-analysis in context (complete) *
• PRESS Peer Review of Electronic Search Strategies: 2015 guideline statement., McGowan, J; Sampson, M; Salzwedel, DM; Cogo, E; Foerst, V; Lefebvre, C, Journal of Clinical Epidemiology, July 2016 *
• PRISMA for systematic review protocols (PRISMA-P), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) website, PRISMA-P:
  http://www.prisma statement.org/Extensions/Protocols.aspx
  The PRISMA-P checklist will be used for journal club and examination (opposition *
• Meta-analysis and the science of research synthesis, Gurevitch, J.,; Koricheva, J.,; Nakagawa, S.; Stewart, G., Nature international journal of science, 2018 Nature 555, 175-182, Nature 555, 175-182 *
• Viswanathan, M. et al., Recommendations for assessing the risk of bias in systematic reviews of health-care interventions, Journal of Clinical Epidemiology, 2018 Volume 97, May 2018, Pages 26-34, https://www.sciencedirect.com/science/article/pii/S0895435617310661 *

Recommended literature

• Higgins, JPT, Cochrane Handbook for Systematic Reviews of Interventions, Green, S, 2018 Länk till KIB, Ingår i: Cochrane library, New York : Wiley-Interscience, 1998- ISSN: 1465-1858, LIBRIS-ID: 4382362, 6ed (2018) Free online http://handbook.cochrane.org/
• Egger, Matthias.; Smith, George Davey.; Altman, Douglas G., Systematic reviews in health care: meta-analysis in context, 2nd ed. : London : BMJ, c2001. - xviii, 487 p. ISBN: 9780470693926, LIBRIS-ID: 11905513, Table of Contents / Abstracts,