Train the Trainer Course book - Cochrane Public Health Group

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………………………………………………………………………………………………………… 6 How are the results presented and Yes Can’t tell No what is the main result? Consider: – how the results are expressed (eg. odds ratio, relative risk, etc.) – how large this size of result is and how meaningful it is – how you would sum up the bottom-line result of the review in one sentence ………………………………………………………………………………………………………… 7 How precise are these results? Yes Can’t tell No Consider: – if a confidence interval were reported. Would your decision about whether or not to use this intervention be the same at the upper confidence limit as at the lower confidence limit? – if a p-value is reported where confidence intervals are unavailable ………………………………………………………………………………………………………… 8 Can the results be applied to the local population? Yes Can’t tell No Consider whether: – the population sample covered by the review could be different from your population in ways that would produce different results – your local setting differs much from that of the review – you can provide the same intervention in your setting ………………………………………………………………………………………………………… 9 Were all important outcomes considered? Yes Can’t tell No Consider outcomes from the point of view of the: – individual – policy makers and professionals – family/carers – wider community ………………………………………………………………………………………………………… 10 Should policy or practice change as a result Yes Can’t tell No of the evidence contained in this review? Consider: – whether any benefit reported outweighs any harm and/or cost. If this information is not reported can it be filled in from elsewhere? ………………………………………………………………………………………………………… 136
FACILITATOR’S GUIDE Time required 1 hour (10 minute discussion, 50 minutes exercise) Learning topics - Guidelines for publishing systematic reviews - Appraising the quality of a systematic review Summary of activity Lecture – Powerpoint slides Exercise in groups – critical appraisal of a systematic review Description of supporting materials 1) Critical appraisal paper to be included in course materials. “DiCenso A, Guyatt G, Willan A, Griffith L. Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials. BMJ 2002;324:1426-34”. 2) CASP critical appraisal checklist for systematic reviews. 3) Rapid responses to the article in BMJ (optional) Further reading (if required) 1. Oxman AD, Cook DJ, Guyatt GH for the Evidence-Based Medicine Working Group. Users’ guide to the medical literature. VI. How to use an overview. Evidence-based Medicine Working Group. JAMA 1994;272:1367-71. Instructions to facilitator There are very few slides for this unit – use your knowledge or the critical appraisal checklist to discuss or review the components of a good systematic review. Review the past two days to provide examples to participants of the steps of the systematic review process. Highlight that these are the same steps that are appraised. The appraisal exercise utilises the quality appraisal checklist developed by the Critical Appraisal Skills Programme. The crib sheet for the appraisal exercise is attached. The exercise should highlight to participants everything that they have been covered throughout the two days, i.e. the need for a clear question, comprehensive search, critical appraisal, etc. Issues for further discussion: 1) Are single factor interventions limited in their capacities to address the complex, multiple, and ongoing influences of parents, peers, health service providers, schools, socioeconomic conditions, religion, and the media which shape the values, beliefs and attitudes determining sexual risktaking? For example, the multi-factor intervention included in the review was the most effective intervention. 2) Was it the right decision to only include RCTs in this review? What would be the value of including other study designs? i.e, compare to the other systematic review which showed positive results, and included non-RCTs. The RCTs in this review had flaws (only 8 of 22 studies scored over 137
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TRAIN-THE-TRAINER HANDBOOOK Two-day
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Contents Introduction .............
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Additional reading: Textbooks: Oliv
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2) ONCE REGISTRATIONS HAVE BEEN REC
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OUTLINE OF TWO-DAY WORKSHOP 9:00am
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Unit One: Background to Systematic
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Reviews of clinical interventions v
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FACILITATOR’S GUIDE Time required
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Unit Two: International Systematic
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Unit Three: Resources Required Lear
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Formulate review question Establish
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Unit Four: Developing a Protocol Le
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Establish an Advisory Group whose m
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Unit Five: Asking an Answerable Que
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To investigate both the implementat
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Process evaluations: these studies
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REFERENCES 1. Oliver S. 1997. Explo
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FACILATOR’S GUIDE Time required:
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Unit Six: Finding The Evidence Lear
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CA38392 (NCI) Language English Entr
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Where to locate studies a) Electron
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ADDITIONAL READING Harden A, Peersm
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45. "Diet-Fat-Restricted"/ all subh
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Brunton G, Harden A, Rees R, Kavana
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1. Start with the primary concept,
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5. Because adolescent has no narrow
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12. Complete searches 8-12 and 13-2
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Unit Seven: Data Abstraction Learni
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Introduction of bias into the condu
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population on gender, age, or educa
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5) Data collection methods As highl
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These data provide important inform
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11. Green J, Tones K. Towards a sec
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QUALITY ASSESSMENT TOOL FOR QUANTIT
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G) ANALYSIS (Q1) Is there a sample
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DICTIONARY for the Effective Public
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Page 100 and 101: calculation? Yes Partially No (Q2)
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Page 104 and 105: RATE THIS SECTION Strong Moderate W
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Page 108 and 109: Pope C, Mays N. Qualitative Researc
Page 110 and 111: Screening Questions 1 Was there a c
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Page 116 and 117: A Checklist for Evaluating Evidence
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Page 120 and 121: Where studies are more homogenous,
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Page 126 and 127: esulting from some community interv
Page 128 and 129: Reviewers should use the RE-AIM mod
Page 130 and 131: Economic efficiency Harms Economic
Page 132 and 133: 9. Swerrissen H, Crisp BR. The sust
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Train the Trainer Course book - Cochrane Public Health Group

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