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"methodology"

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Conclusions (2 of 2)

Presentation: Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Testing for the Evaluation of Musculoskeletal Complaints in Pediatric Populations

Keywords: antinuclear antibody | clinical assessment | connective tissue disease | cyclic-citrullinated peptide | inflammatory arthritis | rheumatoid factor | serological tests | study limitations | methodology

This slide includes a table with two columns and three rows. Column 1, row 1: high. Column 2, row 2: High confidence that the evidence reflects the true effect. Further research is very unlikely to change our confidence in the estimate of effect. Column 1, row 2: moderate. Column 2, row 2: Moderate confidence that the evidence reflects the true effect. Further research may change our confidence in the estimate of effect and may change the estimate. Column 1, row 3: low. Column 2, row 3: Low confidence that the evidence reflects the true effect. Further research is likely to change our confidence in the estimate of effect and is likely to change the estimate. Column 1, row 4: insufficient. Column 2, row 4: Evidence is either unavailable or does not permit estimation of an effect. There is a footnote at the bottom that includes the following references: Guyatt GH, et al. BMJ 2008;336:924-6; Owens DK, et al. J Clin Epidemiol 2010;63:513-23; Samson DJ, et al. AHRQ Comparative Effectiveness Review No. 20. Available at: http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=447.

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Rating the Strength of Evidence From the CER: A Modification of the GRADE Methodology

Presentation: Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer

Keywords: evidence rating | comparative effectiveness review

To determine the strength of the evidence resulting from the systematic review, researchers used the methodology of the University of Connecticut/Hartford Hospital Evidence-Based Practice Center for grading, which is based on the GRADE (Grading of Recommendations, Assessment, DEvelopment) system of the Cochrane Collaboration. This system uses four required domains — risk of bias, consistency, directness, and precision — for assessments. All assessments were made by two investigators who resolved disagreements through discussion. The strength of evidence pertaining to each key question was classified into three broad categories or grades:
1. High means that there are consistent results from good quality clinical trials. Further research is very unlikely to change the conclusions.
2. Moderate means that findings are supported, but further research could change the conclusions.
3. Low means that there are very few clinical trials, or existing trials are flawed.

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Rating the Strength of Evidence From the CER: A Modification of the GRADE Methodology

Presentation: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and/or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Patients With Stable Ischemic Heart Disease and Preserved Left Ventricular Systolic Function

Keywords: effective health care | GRADE | strength of evidence | comparative effectiveness

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Introduction

Presentation: Considerations for Statistical Analysis in Observational Comparative Effectiveness Research

Keywords: comparative effectiveness | statistical methods | analysis

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Model Selection

Presentation: Considerations for Statistical Analysis in Observational Comparative Effectiveness Research

Keywords: model selection

Extracting the Data. Who should extract the data? Domain experts versus methodologists. What extraction method should be used? Single or double independent extraction followed by reconciliation versus single extraction and independent verification. Should data extraction be blinded (to authors, journal, results)?

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Extracting the Data

Presentation: Data Extraction

Keywords: quality assessment | methodology | data extraction

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Rating the Strength of Evidence From the CER: A Modification of the GRADE Methodology

Presentation: Effectiveness of Recombinant Human Growth Hormone (rhGH) in the Treatment of Patients with Cystic Fibrosis

Keywords: CF | HGH | human growth hormone | recombinant human growth hormone | rhGH | Strength of Evidence | cystic fibrosis

Four Required Domains: Consistency Scores. Only three possible scores for consistency: Consistent (i.e., no inconsistency). Inconsistent. Unknown or not applicable (single study cannot be assessed). Meta-analysis: Use appropriate tests, such as Cochran’s Q test or I<sup2</sup> statistics.

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Four Required Domains: Consistency Scores

Presentation: Grading Strength of Evidence

Keywords: consistency score | Evidence-based Practice Center | methodology | strength of evidence | meta-analysis | heterogeneity

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Goals for the User’s Guide

Presentation: Introduction to the User’s Guide for Developing a Protocol for Observational Comparative Effectiveness Research

Keywords: collaboration | patient-centered outcomes research | study protocol | comparative effectiveness

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Results of the Systematic Review: Evaluation of Diagnostic Methods (1 of 4)

Presentation: Non-surgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness

Keywords: cotton swab test | cough stress test | cytometry | diagnosis | mixed incontinence | pad test | pelvic examination | postvoid residual volume | sacral nerve 2 | sacral nerve 4 | stress incontinence | urge incontinence | urgency incontinence | urine culture | urodynamics | urinary incontinence

Alt text:
Results: Additional Sensitivity Analyses. Give the results of additional analyses, such as sensitivity or subgroup analyses and meta-regressions. Include the results of additional analyses to facilitate a better understanding of heterogeneity. Example 1: “[B]enefits of chondroitin were smaller in trials with adequate concealment of allocation compared with trials with unclear concealment (P for interaction = 0.050), in trials with an intention-to-treat analysis compared with those that had excluded patients from the analysis (P for interaction = 0.017), and in large compared with small trials (P for interaction = 0.022).”

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Results: Additional Sensitivity Analyses

Presentation: Reporting the Review

Keywords: methodology | subgroup analysis | risk of bias

Presenting Popular Studies Is Not Enough. One evaluation compared the results of popular studies against others with populations and methodologies that were similar or superior. Evaluation of 45 studies published from 1993 to 2000 in journals with high impact factors that reported positive findings and were cited more than 1,000 times. Results were compared against other studies with the same comparators by employing populations and methodologies that were similar or superior. Opposite/null findings or much more dramatic effects were found 31 percent of the time. Eighty-three percent of nonrandomized studies and 23 percent of randomized controlled trials were subsequently contradicted.

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Presenting Popular Studies Is Not Enough

Presentation: Searching for Relevant Studies

Keywords: systematic review | comparator | population | methodology

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