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Evidence-Based Practice Quiz
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Which statement best describes a key difference between a systematic review and a meta-analysis?
- A A meta-analysis is a qualitative synthesis of included studies, whereas a systematic review is a quantitative pooling of their results You picked ✕
- B A systematic review is registered in advance, whereas a meta-analysis can be conducted without a predefined protocol You picked ✕
- C A systematic review is a secondary analysis of existing studies, whereas a meta-analysis is a form of primary research You picked ✕
- D A systematic review can include clinically varied studies, whereas a meta-analysis pools results from studies similar enough to combine You picked ✓
- E A meta-analysis can be performed when the primary studies are clinically incompatible, whereas a systematic review is limited to describing them You picked ✕
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The answer is D: A systematic review can include clinically varied studies, whereas a meta-analysis pools results from studies similar enough to combine
Explanation
Why D is correct
See Evidence-Based Practice. Option D is correct. A systematic review is an overview of primary studies done using explicit and reproducible methods, meaning that the way the studies were found and judged is clearly stated so someone else could repeat it. It can include a broad range of studies, even those with greater clinical heterogeneity, which means the patients, treatments or outcomes differ between studies. A meta-analysis is a quantitative synthesis of the results of two or more primary studies that addressed the same hypothesis in the same way. It combines the numbers, so it needs studies that are similar enough to be pooled. Meta-analysis therefore often forms part of a systematic review, but not every systematic review contains one: if the studies are too different to combine, the review simply describes and appraises them. Both approaches aim to reduce bias and give a more complete picture than any single study, but both depend on the quality of the studies they include, which is why the phrase rubbish in, rubbish out is used. Meta-analysis also follows a formal protocol that sets out in advance which studies will be included.
- Systematic review: An overview of primary studies using explicit and reproducible methods, which can include clinically varied studies.
- Meta-analysis: A quantitative synthesis of the results of two or more primary studies that addressed the same hypothesis in the same way.
- Relationship: Meta-analysis often forms part of a systematic review, but not every systematic review contains one.
Why the other options are incorrect
- A. A meta-analysis is a qualitative synthesis of included studies, whereas a systematic review is a quantitative pooling of their results: This option reverses the usual methods. Meta-analysis is the quantitative pooling of effect estimates, whereas a systematic review can be reported in words, numbers or both. Your answer
- B. A systematic review is registered in advance, whereas a meta-analysis can be conducted without a predefined protocol: This option is wrong because both systematic reviews and meta-analyses should be guided by a protocol written before the work begins, so a meta-analysis is not conducted without one. Your answer
- C. A systematic review is a secondary analysis of existing studies, whereas a meta-analysis is a form of primary research: This option misclassifies meta-analysis as primary research. Both systematic reviews and meta-analyses are secondary research methods, because they analyse data from existing primary studies rather than collecting new data. Your answer
- E. A meta-analysis can be performed when the primary studies are clinically incompatible, whereas a systematic review is limited to describing them: This option is wrong because meta-analysis requires enough clinical similarity, while a systematic review can describe and appraise studies that are too different to combine. Your answer
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