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Meta-Analysis Elective

  1. Rotation Faculty
    Matt Vassar, Ph.D.
    918-561-8492 (office)

    Office Hours by appointment

  2. Required Class Meetings

    Required Class Meeting Times and Room Location
    Times: TBD
    Location: TBD

  3. Required Text

    Leandro, G. (2005). Meta-analysis in Medical Research: The handbook for the understanding and practice of meta-analysis. BMJ Books

    There will be a copy of this book in the librar

  4. Rotation Description

    Meta-analysis is the process of combining the results from independent studies in order to examine an overall effect.  Meta-analytic procedures are becoming increasing popular in medical research, as findings from individual clinical trials are combined to examine the clinical effectiveness of healthcare interventions. The purpose of this rotation is to introduce the student to meta-analysis as well as to guide the student through the process of conducting a meta-analysis.  Students will choose a line of research related to their area of interest within their desired area of specialization.  Rotation components will consist of didactic lectures related to understanding of the procedure itself, the interpretation of results from meta-analytic studies, the review of relevant academic literature, the selection of inclusion criteria for research studies, the calculation of effect size statistics, and the utilization of meta-analysis software. 

  5. Why This Rotation is Important

    The student will benefit from this rotation in many ways.  First, in selecting candidates, residency programs look favorably at those who have completed research within areas of clinical interests.  The final outcome of this rotation is a completed meta-analysis suitable for conference presentation or publication.  Students are to select a research topic within their desired area of specialization which will ultimately strengthening the candidate’s residency application. 

  6. Rotation Outline
    1. Planning a Meta-Analysis
      1. Defining the outcomes
      2. Choosing the characteristics of the trials that one wants to select
      3. Finding and evaluating the articles
      4. Statistical procedures
      5. Interpretation of results
    2. Bias in Meta-Analytic Research
      1. Sampling bias
      2. Selection bias
      3. Within study bias
      4. Other biases
    3. Statistical Procedures
      1. Fixed effects models
      2. Random effects models
    4. Working Procedures
      1. Accuracy of the data
      2. Evaluation of the numeric output for each trial
      3. Evaluation of the pooled effect
      4. Additional considerations on heterogeneity
      5. Quantifying heterogeneity: the I2 index
      6. Tests for publication bias
      7. Number needed to treat (NNT)
      8. Graphical representations
    5. How to Read, Evaluate, and Present a Meta-Analysis
      1. The reading and evaluation of meta-analysis
      2. The presentation of meta-analysis results
    6. How to Use the Meta-analysis software
  7. Objectives
    1. By the end of this rotation, the student will be able to:
      • Utilize library databases in the retrieval of studies or clinical trials for the student’s meta-analysis project.
      • Evaluate an article/clinical trial using the QUOROM checklist
      • Evaluate publication bias using both Light and Pillemer’s funnel plot and Klein’s equation.
      • Identify appropriate uses of fixed and random effects models, especially in relation to the student’s individual project.
      • For fixed effects models, calculate the difference of percentage (i.e., absolute risk reduction), the standard error of the difference, and the 95% confidence interval for each study included in the student’s meta-analysis.
      • Calculate the global outcome (weighted mean) D, its 95% confidence interval, and the chi-square test for heterogeneity
      • For fixed effects models, calculate an odds ratio using the Mantel-Haenszel and Peto methods.
      • For random effects models, calculate an odds ratio using the DerSimonian-Laird method.
      • Discuss the differences between Cochrane’s Q and the I2 index of heterogeneity
      • Explain Number Needed to Treat (NNT).
      • Interpret a Forest plot, a Galbraith plot, an a l’Abbe plot, a funnel plot, and a sub-group analysis plot
      • Properly evaluate a published meta-analysis using Leandro’s 10 points rule
      • Properly convey results (and graphical output) of the student’s meta-analysis in the form of a written manuscript
      • Master the functionality of the meta-analysis software, including creating a new metanalysis file, adding/modifying individual trials, select trials for analysis, calculate appropriate statistics, and create graphs and plots.
      • Formally present the finished meta-analysis before a panel of researchers.

  8. Methods of Instruction

    Class meetings will consist of a variety of teaching methods including lecture, discussion, in-class assignments, problem solving, coding, and a presentation.  If you have a disability that you suspect may require individual accommodation, please contact the instructor immediately.

  9. Course Requirement Description
    1. Completed Manuscript

      Each student will complete a meta-analysis to be written in the form of a manuscript acceptable for peer review.  The manuscript will be evaluated on clarity of writing, presentation of data, and overall quality.

    2. Oral Presentation

      Each student will develop and deliver an oral presentation (20 minutes in length) to a panel of researchers.  Students will use PowerPoint slides to augment their presentation.  Feedback will be provided in writing and verbally from the instructor and panel.

    3. Quality Assessment Assignment

      Each student will conduct 1 clinical trial quality assessment using QUORUM.

    4. Meta-Analysis Critique

      Each student will select 1 published meta-analysis study to critique.  Student will critically evaluate the methodology and results of the study. 

    5. Class Attendance and Participation

      Students are expected to attend all regularly scheduled classes and remain in class once instruction has started.  Students are expected to complete assignments on time, maintain proper decorum during class, and contribute consistently and positively to class discussions.  Failure to demonstrate these profession-related skills may compromise a student’s course grade.

  10. Evaluation of Student Performance/Course Grading

    The course is offered for S/U credit.  A course grade of “Satisfactory” will be awarded if all course assignments have received a grade of satisfactory, if attendance has been consistent, if class participation has been satisfactory, and if a grade of satisfactory has been received in both course areas (lecture and projects).

    Students are responsible for all course content and are responsible for completing all assignments on time.  Failure to submit assignments on time will result in an assignment grade of “Unsatisfactory”.

  11. Course Expectations
    1. Late or Missed Assignments
      Assignments must be handed in on time.  Grades on assignments that are turned in late will be lowered by one half of a grade for the first day it is late; zero points will be given if turned in more than one day late.
    2. What to do in case of illness
      An unexcused absence will result in zero points assigned for the assigned lecture presentations, in class activities/assignments for that day and may result in the receipt of an unsatisfactory grade for the course.  An unexcused absence for the lecture portion of the rotation can only be granted by the rotation coordinator, Matt Vassar.  If you are too ill to come to class, you must contact Matt Vassar PRIOR to that class.  If you are hospitalized or require emergency treatment, you may have a family member or a significant other make contact on your behalf.  Notifying a secretary is insufficient.  You must obtain direct permission from the rotation coordinator to be absent from a required activity.
    3. Student Professionalism

      Students in this course are expected to exhibit professionalism, which includes the following:

      1. Reliability and dependability in attending, preparing for, and participating in course activities.
      2. Communicate respectfully, articulately, and confidently in course activities
      3. Engage in active learning
      4. Put your peers needs above your own in the active learning environment
      5. Accept and apply constructive feedback about your performance in the course
      6. Behave in an ethical manner with regard to academic conduct (see “Academic Integrity” section of the syllabus below)
      7. Demonstrate a desire to exceed expectations (i.e., minimal standards and requirements for tasks, assignments, and responsibilities)

        (Adapted from Hammer, DP, Berger, BA, Beardsley, RS, Easton, MR. Excellence series papers: Students’ professionalism. American Association of Colleges of Pharmacy, 2003).

    4. Academic Integrity

      Students are expected to work independently on individual (versus group) assignments and papers.  The use of plagiarism (occurs when another person’s work is used or copied without proper acknowledgment) is also dishonest and a violation of academic integrity.

    The university policies regarding violations of academic integrity will be strictly enforced.  Please consult the University regulations and policies (http://osu.okstate.edu/acadaffr/aa/academicintegrity.htm) for further discussion of violations to academic integrity and the penalties that may incur.