In the first 2 articles in this series, we highlighted the following issues that we as readers consider when interpreting a systematic review: a well-formulated, clinically relevant question; a comprehensive search to identify relevant trials; and an assessment of the quality of the included trials. Another crucial issue in the interpretation of a systematic review is how the authors synthesized the evidence. As discussed in the first article in this series, data can be synthesized using qualitative and quantitative methods. As with any other aspect of a systematic review, readers are in a better position if they can understand and, if desired, can replicate how the authors synthesized the evidence and made their conclusions.
Algorithm of statistical choices available to systematic reviewers.
Graphic representation (Forrest plot) of the results of a meta-analysis evaluating the effectiveness of an endoscopic intervention for bleeding peptic ulcer (from Chalmers and Lau26). Left side represents a meta-analysis of the individual trials arranged according to the date of their publication. Right side represents the same trials combined using cumulative meta-analysis.
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