Pharmacoepidemiology Course:
Meta-analyses are foundational to deriving evidence based medicine. They provide an efficient means of being able to assimilate data from various sources and provide an overall estimate of effect. For this assignment you will summarize data from a meta-analysis related to COVID 19.
In the search box for PubMed
put in these terms: meta analysis, Covid 19 Obesity
On the right hand side check free full text for text availability and in article type check meta-analysis
Select one of these articles and summarize the findings. Be sure to define the following terms in your writing and include citations for the definitions from either a textbook or a peer reviewed journal article. (You should include citations in the text while you are writing and order them chronologically so that your first reference is denoted by a superscript and you second reference is denoted by a superscript 2. Also at the end you are to provide a reference list with valid references formatted according to NLM formatting. A web address alone is not sufficient for a reference list. You should have at least four references for this section).
Provide definitions for the following terms and provide a description of what their purpose is within meta-analysis:
Forest plot
Funnel plot
Random effects
Fixed effects
Heterogeneity
Effect size
As part of the assignment, you will evaluate the quality of the article using the Amstar 2 tool (Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomized or non-randomized studies of healthcare interventions, or both. BMJ 2017; 358:j4008.). You must select 5 of the 16 criteria in the Amstar tool and discuss whether the article you select does or does not meet the criteria you select. Although you must describe at a minimum 5 criteria, you can earn an additional point and a half on the assignment for additional paragraphs that you write beyond the minimum of 5, given that they are well written and thorough. For each of your explanations, you must write a paragraph at least three sentences long that discusses if the criteria was fully met, not met at all, or partially met. (here is an example article that uses the Amstar 2 to evaluate some articles: Zhang, Xiu-jie MDa; Song, Yingqian BSa; Jiang, Tongtong MSb; Ding, Ning BSa; Shi, Tie-ying MSa,∗ Interventions to reduce burnout of physicians and nurses, Medicine: June 26, 2020 – Volume 99 – Issue 26 – p e20992 doi: 10.1097/MD.0000000000020992)
Also as a part of the assignment, you will be required to rate the overall confidence in the results of the meta-analysis as detailed in Box 2 of the Shea et al. article). You will have to write a detailed explanation regarding why you chose a high, moderate, low, or critically low confidence in the review. As a part of your explanation, identify and discuss whether there are any critical flaws in the review you have chosen.
Part 2: (no less than 2 pages 1.5 spacing, Arial size 11 font and 1 inch margins (this is in addition to the reference page)
Screening for disease is important in health care to determine who may or may not have disease and to allocate health care resources accordingly. However screening instruments may in some cases be incorrect in their classification of whether or not an individual has disease.
For one part of this assignment provide definitions for the following terms within your writeup:
Sensitivity
Specificity
Positive Predictive Value
Negative Predictive Value
False Positive
False Negative
For the next part of the assignment, identify two of the tests that have been used to screen individuals for COVID 19. For each of them write a paragraph that provides the sensitivity and specificity of the instruments you have chosen. Also you should identify which one you feel is the better choice of instrument to use from a public health perspective and provide a justification.
For the last part of the assignment choose one of the tests and assume that you are a public health pharmacist working in a clinic that has screened 671,370 people for COVID-19. Assume that the true prevalence of COVID-19 at the time of screening is 2.8%. Provide the numbers of individuals that would fit into the following categories and show your work:
True positive
False positive
True negative
False negative
Within this section you should have at least two references and follow the formatting as in the first section using in text citations and providing a reference list at the end in NLM format.
1st Section Not addressed Partially Accomplished Fully Accomplished
Section 1
Forest plot description 0 2 3
Funnel plot description 0 2 3
Random effects description 0 2 3
Fixed effects description 0 2 3
Heterogeneity description 0 2 3
Effect size description 0 2 3
Forest plot description 0 2 3
Paragraph 1 rating article according to 1st Amstar Criteria chosen 0 5 10
Paragraph 2 rating article according to 2nd Amstar Criteria chosen 0 5 10
Paragraph 3 rating article according to 3rd Amstar Criteria chosen 0 5 10
Paragraph 4 rating article according to 4th Amstar Criteria chosen 0 5 10
Paragraph 5 rating article according to 5th Amstar Criteria chosen 0 5 10
Correctly classify confidence as high, moderate, low, or critically low confidence 0 5 10
Thoroughness and correctness of discussion of critical flaws present or absent in article 0 5 10
Minimum number of references 0 4 8
Peer reviewed references 0 2 3
Adheres to length guidelines 0 2 3
Citations included in text ordered chronologically 0 2 3
Appropriate references at end of document styled correctly for all references (references at end in a appropriate format such as NLM) 0 2 3
Section 2
Sensitivity Description 0 2 3
Specificity Description 0 2 3
Positive Predictive Value Description 0 2 3
Negative Predictive Value Description 0 2 3
False Positive Description 0 2 3
False Negative Description 0 2 3
Description of screening test 1 sensitivity 0 4 8
Description of screening test 1 specificity 0 4 8
Description of screening test 2 sensitivity 0 4 8
Description of screening test 2 specificity 0 4 8
Description of which test is better and justification 0 5 10
Correct number of true positives in scenario of people tested 0 5 10
Correct number of false positives in scenario of people tested 0 5 10
Correct number of true negatives in scenario of people tested 0 5 10
Correct number of false negatives in scenario of people tested 0 5 10
Work shown in scenario of people tested 0 8 16