{"id":1135,"date":"2015-07-21T20:32:57","date_gmt":"2015-07-21T19:32:57","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc\/?p=1135"},"modified":"2015-07-15T13:13:10","modified_gmt":"2015-07-15T12:13:10","slug":"there-are-many-ways-to-truss-a-duck","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2015\/07\/21\/there-are-many-ways-to-truss-a-duck\/","title":{"rendered":"There are many ways to truss a duck"},"content":{"rendered":"

\"28bd690e07e27d7dfba01e0fc55a63f4\"<\/a>And there are lots of ways to do ‘synthesis’ of evidence within a systematic review<\/a>. We’ve gone on – at length – about meta-analysis<\/a> and described qualitative synthesis with meta-ethnography<\/a>, but in a new paper in the Archives<\/a> we see how a narrative combination of quantitative research studies with a qualitative framework\u00a0to understand them can allow us to see where the trees lie\u00a0in the wood [insert alternative\u00a0forestry based metaphor if preferred].<\/p>\n

This group of authors decided to examine the safety netting tools after discharge from the paediatric emergency \/ urgent care department.<\/p>\n

Taking a FAST approach<\/a>, we can show that they have<\/p>\n

F – found a lot of studies<\/a> –<\/p>\n

(As with many reviews where the ‘thing of interest’ is not a pharmacologically codable intervention, a very broad sweep with connected, spiderlike acquisition of information is most effective.)<\/p>\n

A – assessed them using a risk of bias tool<\/a> –<\/p>\n

(While the risk of bias of randomised trials is well worked out – we have a whole series of posts <\/a>on these elements \u00a0and can be acronymed\u00a0as RAMbo<\/a> – there are greater difficulties in other areas, like diagnosis<\/a> and prognosis<\/a>. This paper used a version of a generic observational studies risk of bias score to given an overview of how reliable the answers might be.)<\/p>\n

S – synthesised the information<\/a> –<\/p>\n

(This is the really interesting section. They visually grid the risk of bias against study number and ‘direction’ of answer for categories of particular question \/ sub-question.<\/p>\n

\"F3.medium\"<\/a><\/p>\n

What you can’t see is the ‘weight’ of each study – n=16 will be the same sized circle as n=673 – but this is meant to be impressionistic. It’s a feel for where it sits,\u00a0rather than conclusive proof of anything.)<\/p>\n

(And they do a nice textual job actually explaining it.)<\/p>\n

T – talk about transferability \/ utility<\/a> –<\/p>\n

(What’s really clear is that lots of people have fiddled with this concept in lots of different ways and not fundamentally bashed out a strong basis for any approach, let alone any specific approach. Many things can be said and a citation found to underpin those statements. Whatever the truth is – if there is one – it’s not clear yet.)<\/p>\n

 <\/p>\n

Such a paper really helps us see where what we might suggest is founded on good intention not always good solid evidence.<\/p>\n

– Archi<\/p>\n","protected":false},"excerpt":{"rendered":"

And there are lots of ways to do ‘synthesis’ of evidence within a systematic review. We’ve gone on – at length – about meta-analysis and described qualitative synthesis with meta-ethnography, but in a new paper in the Archives we see how a narrative combination of quantitative research studies with a qualitative framework\u00a0to understand them can […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[79],"tags":[],"class_list":["post-1135","post","type-post","status-publish","format-standard","hentry","category-archimedes"],"yoast_head":"\nThere are many ways to truss a duck - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2015\/07\/21\/there-are-many-ways-to-truss-a-duck\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"There are many ways to truss a duck - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"And there are lots of ways to do ‘synthesis’ of evidence within a systematic review. 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