Dr Huseyin Naci COW 3.01

This course is available on the MSc in Global Health, MSc in Health, Population and Society and MSc in International Health Policy. This course is available as an outside option to students on other programmes where regulations permit.

This course is relevant to all students with an interest in the health and social care interventions. 

Evidence review and synthesis methods (such as systematic reviews and meta-analyses) are increasingly used to evaluate the relative benefits and harms of healthcare interventions. In situations where direct, head-to-head comparisons of interventions do not exist, researchers also increasingly perform indirect comparisons (e.g., network meta-analyses) of two or more interventions to address comparative effectiveness questions. A broad range of decision making bodies across the health care sector (including health technology assessment bodies, drug and medical device licensing agencies, biopharmaceutical industry, and hospitals) need individuals equipped with the methods of reviewing and synthesising the existing body of evidence by performing systematic reviews and meta-analyses.

This course will be focused on the principles of reviewing and synthesising the existing body of literature. The course will have three components. The first will provide the rationale for adopting a systematic approach for evidence review and synthesis. It will equip students with the methods to undertake risk of bias assessments of randomised and non-randomised studies. The second component will focus on the quantitative synthesis of multiple studies in meta-analysis. The third component will discuss the opportunities and challenges of using evidence for decision-making. 

The intended learning outcomes of this course will be the following:

• Describe the rationale for adopting a systematic approach to literature review
• Define the principal threats to validity both in individual studies and collections of studies
• Critically evaluate the quality of randomised and non-randomised studies in oral and written form
• Assess heterogeneity in a collection of studies
• Design and perform a systematic review and meta-analysis evaluating a health care intervention in a group setting
• Describe the opportunities and challenges of using systematic review and meta-analysis findings for decision making

15 hours of lectures, 7 hours and 30 minutes of seminars and 3 hours of computer workshops in the LT. 2 hours of lectures in the ST.

Students on this course will have a reading week in Week 6, in line with departmental policy. 

Formative assessment:

• Systematic review and meta-analysis protocol (submitted as a group) - feedback provided by course instructor
• Peer review of risk of bias assessments (groups to provide feedback to each other based on suggested areas to emphasise by course instructor)
• Peer review of meta-analysis dataset and statistical analysis plan (groups to provide feedback to each other based on suggested areas to emphasise by course instructor)

Cochrane Handbook for Systematic Reviews of Inter ventions (version 5.1.0, updated March 2011).

Institute of Medicine. Finding what works in health care: standards for systematic reviews. 23 March 2011.

Sutton AJ et al. Methods for Meta-analysis in Medical Research. Wiley, Chichester, UK, 2000.

Cook DJ. Systematic reviews: synthesis of best evidence for clinical decisions. Annals of internal medicine 1997;126(5):376–80.

Higgins, Julian PT, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Bmj 343 (2011): d5928.

Project (70%, 3000 words) in the Week 11.
Presentation (30%) in the ST.

Summative assessment:

• Systematic review and meta-analysis report resembling an original article submission to a peer-reviewed journal (70%)
• Poster presentation of findings to a hypothetical decision maker (30%)