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MCC 2011 - Slide 24

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European School of Oncology
European School of Oncology
Saúde e medicinaEducação
1 de 26
Systematic review and meta-analysis NNT NNH, setting up a protocol Theo Wiggers Cascais, February 16 th ,2011
[object Object],[object Object],[object Object],[object Object]
This lecture ,[object Object],[object Object],[object Object]
The meaning of the name ? Professor Archibald Leman Cochrane (1909 - 1988) Director of the new Medical Research council’s Epidemiology Research Unit, Cardiff
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The Principles of The Cochrane Collaboration
Number of reviews
[object Object],[object Object],The Cochrane Library
The Cochrane Library ,[object Object],[object Object],[object Object],[object Object],[object Object]
52 collaborative review groups http://www.cochrane-net.org/openlearning Cochrane Colorectal Cancer Group www.cccg.cochrane.org
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Cochrane Colorectal Cancer Group
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Cochrane Colorectal Cancer Group
[object Object],[object Object],[object Object],The three key components of a question for a systematic review Start with the preparation of a protocol followed by a review
[object Object],[object Object],[object Object],[object Object],[object Object],Search strategies
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Components a systematic review
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],What does allocation concealment mean?
[object Object],[object Object],When do we perform a meta-analysis ?
Forest plot
Forest plot
Do we always need a Randomized Controlled Trial? and a subsequent meta-analysis
Do we always need a Randomized Controlled Trial? Hazardous journeys Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials Gordon C S Smith, Jill P Pell BMJ VOLUME 327 20–27 DECEMBER 2003 Update 2006 next update to be expected?? We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute .
Do we always need a Randomized Controlled Trial? Prospective cohort studies preferable as part of a national audit program can bring strong and valid proof. For example in the Nordic audit report the same reduction of local recurrences after TME and 5x5 Gray are observed as in the Dutch and UK study
Number Needed to Treat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Number Needed to Harm ,[object Object],[object Object],[object Object],Incidence of incontinence Radiotherapy 50% Surgery 40%
Making a protocol(1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Making a protocol(2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thank you for your attention

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MCC 2011 - Slide 24

  • 1. Systematic review and meta-analysis NNT NNH, setting up a protocol Theo Wiggers Cascais, February 16 th ,2011
  • 2.
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  • 4. The meaning of the name ? Professor Archibald Leman Cochrane (1909 - 1988) Director of the new Medical Research council’s Epidemiology Research Unit, Cardiff
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  • 9. 52 collaborative review groups http://www.cochrane-net.org/openlearning Cochrane Colorectal Cancer Group www.cccg.cochrane.org
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  • 19. Do we always need a Randomized Controlled Trial? and a subsequent meta-analysis
  • 20. Do we always need a Randomized Controlled Trial? Hazardous journeys Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials Gordon C S Smith, Jill P Pell BMJ VOLUME 327 20–27 DECEMBER 2003 Update 2006 next update to be expected?? We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute .
  • 21. Do we always need a Randomized Controlled Trial? Prospective cohort studies preferable as part of a national audit program can bring strong and valid proof. For example in the Nordic audit report the same reduction of local recurrences after TME and 5x5 Gray are observed as in the Dutch and UK study
  • 22.
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  • 26. Thank you for your attention