Train the Trainer Course book - Cochrane Public Health Group

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2 points out of the possible 4 points for quality); including high quality experimental evidence (from non-RCTs) may be advisable. 3) The PICO question is not P- adolescents, I – primary prevention C- no intervention O- delay in initiation of sexual intercourse, consistent use of birth control, avoidance of unintended pregnancy The PICO questions is P- adolescents, I – primary prevention using theory based interventions C- standard practice or care (only a few interventions are compared to no intervention in the review) O- delay in initiation of sexual intercourse, consistent use of birth control, avoidance of unintended pregnancy. Therefore, the first line of the discussion of the article is too strong and does not reflect what the review was actually answering “..show that primary prevention strategies do not delay the initiation of sexual intercourse or improve use of birth control among young men and women”. Note: There are a number of rapid responses to this article in the BMJ. They can be found on-line when printing out the article of the systematic review. Participants have found it useful to look at these rapid responses (especially as many think the study is very high quality and useful for decision-making). 138
Systematic review – critical appraisal exercise DiCenso A, Guyatt G, Griffith WL. Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials. BMJ 2002;324:1426-34. Screening questions 1. Did the review address a clearly focused research question? HINT:A research question can be 'focused' in terms of - the population studied - the intervention given - the outcomes considered Yes. Population – children 11-18 years Intervention – Primary pregnancy prevention programmes – sex education classes, school based clinics, family planning clinics, community based programmes. Control: NOTE: Comparison is conventional sex education, comparison is not no intervention. This review is only measuring the difference between the two, and is in fact comparing theory-led approaches to conventional approaches. It is not answering the question of sex education versus no education. 2. Did the review include the right type of studies? HINT: These would - address the review's research question - have an appropriate study design Detailed questions 3. Did the reviewers try to identify all relevant studies? HINT:Look for - which bibliographic databases were used - follow up from reference lists - personal contact with experts - search for unpublished as well as published studies Outcomes – delay in sexual intercourse, consistent use of birth control, avoidance of unintended pregnancy Probably not Although the effectiveness of interventions is best measured using RCTs, this review could have benefited from including high quality nonrandomised controlled trials. This type of intervention would normally be measured using non-RCTs (in ‘real-life’) in most countries, and high quality non-RCTs in this review could contribute more than poorly-designed RCTs. Therefore, this review should have included both kinds of studies. The authors could have separated the results for non-RCTs and RCTs to see if the inclusion criteria made any difference to the final results. Yes. Searched databases from 1970 to December 2000. Used: McMaster Teen Project database Electronic databases, conference papers Dissertation abstracts Reviewed content lists of journals 139
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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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(i) (ii) If the study was reported
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