Refining Key Questions: Interactive Case Study Quiz C. Michael White, PharmD, FCP, FCCP Professor and Director University of Connecticut / Hartford Hospital Evidence-based Practice Center Speaker has no actual or potential conflicts of interest in relation to this activity

Interactive Case Quiz: Instructions Open this presentation as a slideshow. This will activate the hyperlinks. When you come to a decision slide, choose the Red Box corresponding to the correct choice. If you are correct, you will be directed forward in the case. If you are incorrect, you will be directed back to the decision slide to choose again. – – Click on forward hyperlinks (Red Boxes) to proceed through the case based on your responses – – Click on the home hyperlink (Blue House Icon) to go back to the last correct step in the series

Participation Quiz: Question 1 All of the following statements about key questions in a systematic review are true except one; select the incorrect statement. They guide the literature search, inclusion and exclusion criteria, and types of data synthesized and reported. They must be clear, precise, and relevant to stakeholders. They are devised after the results of all relevant studies are known and pooled with other like studies. Whitlock EP, Lopez SA, Chang S, et al. Identifying, selecting, and refining topics. Rockville, MD: Agency for Healthcare Research and Quality. Methods guide for comparative effectiveness reviews; 2009 Apr.

They Guide All Subsequent Steps This is a true statement. Key questions guide many subsequent steps in the systematic review process. [Click on Blue Box to Go Back]

Clear, Precise, and Relevant This is a true statement. Key questions need to be clear, precise, and relevant. [Click on Blue Box to Go Back]

Devised Post-Hoc Good job! Key questions need to be devised before the results of studies are extracted and pooled. The key questions should drive the data to be extracted and pooled, not be driven by them. [SELECT RED BOX]

Participation Quiz: Question 2 An understanding of PICOTS and the analytic framework is needed before clear, concise, and relevant key questions can be written. Which of the following terms is correctly defined? P=Prospective I=Intervention C=Cohort study

P = Prospective This is incorrect. P stands for population, which the systematic review seeks to study. [Click on Blue Box to Go Back]

I = Intervention Good job! The I stands for intervention, the intervention that is being assessed in the systematic review. [SELECT RED BOX]

C = Cohort Study This is incorrect. The C stands for comparator, the group or groups being compared to the intervention. [Click on Blue Box to Go Back]

Participation Quiz: Question 3 Key informants are representatives of stakeholders who volunteer to provide input into a systematic review. Which of the functions do they provide? Aid in formulating key questions that address real-world dilemmas Provide context to help discern content area and applicability Ensure transparency in the process

All of the Above Key informants perform all three vital function – – Formulating key questions that address real- world dilemmas – – Providing context to help discern content area and applicability – – Ensuring transparency in the process functions [SELECT RED BOX]

Participation Quiz: Question 4 Which of the following groups are not considered key informants in the Effective Healthcare Program? Clinicians Patients Researchers

Clinicians Clinicians such as physicians, pharmacists, and nurses are key informants in the Effective Healthcare Program. [Click on Blue Box to Go Back]

Patients Patients are key informants in the Effective Healthcare Program. [Click on Blue Box to Go Back]

Researchers Good job! Researchers develop data that goes into projects conducted as part of the Effective Healthcare Program but they are not considered key informants. Key informants include clinicians, patients, and health care decisionmakers. [SELECT RED BOX]

Participation Quiz: Question 5 Which of the following is true of public comments germane to the topic refinement process? Allows all interested parties to comment on any topic refinement projects they like Is restricted to members of the public selected by AHRQ to provide feedback Allows all interested parties to comment on a particular topic, but the number of topics they can respond to is restricted

Open to All, No Restrictions Good job! Interested people can comment on as many projects as they would like. This ensures transparency and relevancy. [SELECT RED BOX]

The Public Is Carefully Selected This is incorrect. Interested people can comment on as many projects as they would like. This ensures transparency and relevancy. [Click on Blue Box to Go Back]

Open to All, But Limited Number of Projects This is incorrect. Interested people can comment on as many projects as they would like. This ensures transparency and relevancy. [Click on Blue Box to Go Back]

Conclusions These five questions summarize the importance of key questions in the systematic review process. Key informants should reflect stakeholders interest in the topics to ensure relevance and transparency. Public comment is a final check of relevance and ensures transparency.