®etailed.instructi.ons ® read all before commencing the assessment ‘
Please download the-followkg two articles:..
Please download the following two articles:
?Beattie AH, Prach.AT, Baxter JP, Pennington CR. A:raridomised controlled trial evaluating the use of
entera’I nutritional supplements postoperatively in malnourished surgical patients. Gut 2000; 46:813-
818. A randomised controlled trial-evaluating the use of supplements supplements postoperatively
in.malnourished surgical patients’-‘PubMed (nih.gov)
Smith~TR,. Cawood AL, Walters ER;. Guildford. N, Stratton R.I. Ready-made oral.nutritional supplements ..
improve nutritional outcomes and reduce. health care use= a randomised trial.inoldermalnourished
pe’opl’e.in’primary carp. Nutrients 2020; 12, 511 Nutrients I Free Full-Text 1. Ready.-Made.-Oral Nutritional
Supplements Improve Nutritional Outcomes and Reduce Health Care Use-A Randomised Trial in .Older.
Malnourished People. in.PrimaryCare* I HTML(mdpi.com)
2. Assess these two studies using the Cochrane risk of bias to and complete the tables below providing your
assessment together with reasons for your answers. For blinding of.outcome assessment and incomplete
outcome data; you should make.separate assessments.for ri,ortality and weight change (use-the categories. in the
table below), ,
Template for quality- assessrrient
Study name:
Low/unclear/high Reason
Random sequence
generation..,
-.Allocation concealment,
Blinding of participants
and personnel
Blinding of outcome
assessment:
mbrtality .
Blinding of outcome’
assessment:
weight change
f
Incomplete outcome
data:,
mortality
_ Incomplete outcome
data:
weight,cliange ^’ `
low/unclear/high _risk.of bias
Selective reporting
Other bias
Template for quality assessment (low/unclear/higli risk of bias)
Study name: .
Low/unclear/high Reason
Random sequence
generation
Allocation concealment _
Blinding of participants
and personnel
Blinding of’outcome
assessment:
mortality
Blinding of outcome
assessment:
weight change
Incomplete outcome
data:
mortality
Incomplete outcome
data:
weight change
Selective. reporting
.Other bias ‘
3. Extract relevant data for these two studies for the outcomes:
® Mortality at.six rhonths
® Weight change (kg) at six.moriths
If these time points are not available you should use the data-for the closest available time to six months, even ifthis is of short duration. You are not required to complete full data. extra ction’tables for these studies.
® Data may need to,be extracted or estimated frommarious parts of a paper including the.text, tables or
figures
® ‘If a study does not report standard deviations (SD) you may.need to estimate these using another
method.. Please see the course materials or the Cochrane Handbook. More than one approach is
possible.
• The terms intention to_treat (ITT) and per protocol (PP) can have.different meanings in different.
contexts. In Smith 2020 an ITT analysis includes all participants where a statistical imputation has been
used to estimate data for those who.dropped out of the study. The PP analysis only included the
participants that were followed up’and provided data. We will accept results for’either if justified’.
4. Add the results of the Beattie and Smith studies to the two meta-analyses-you set up in Revman during the
meta-analysis practical. For each outcome you-should now have data for up to seven studies,
5. Assuming that these seven studies were the.o.nly ones.found to be eligible for inclusion in the systematic
review of nutritional`supplementation for older people, write a short structured report below (maximum 1000.
words excluding tables and figures). The report should be submitted within this word.document and only.
include.the.items listed below; you should not include other aspects.such*asbackground to the topic; search
strategies, characteristics of included studies or references. For each item you can see the’total mark available…..
A brief description of the ‘methods you used to carry out steps 2-4. above with justification for the
meta-analysis methods used. (14 marks —up td 10 marks for detail of methods and up to 4 marks for
command of English/standard of presentation)
b) Risk-of bias assessment for the Beattie and Smith studies comprising risk of bias tables`above. (these
can be cut and pasted to this section of the report).. Give reasons for your answers. (36. marks —1 mark
for each correct answer, 1 mark for each appropriate reason)..
Data extraction tables for weight change and mortality. You may include comments/footnotes if
appropriate. (20 marks —1 mark per value provided e.g. one mark per mean value; one mark per SD
value, one mark p’e’r ‘N value)
d). Forest plots for the updated meta-analyses. (10 marks)
A full description of the results of the meta-analyses and your conclusions. ‘.What is the overall
evidence for the benefit or harm of this intervention and would.you recommend it to clinicians working
in this area? Describe the size, direction, precision and statistical significance of each result and explain
how confident you are in the’results obtained. Remember to focus on.the overall result and not on
individual studies. (16. marks — 2 marks relate’to magnitude/reliability, 2 marks relate to importance,
4 marks relate to heterogeneity, 4 marks relate to reliability, 4 marks relate to command of
English/standard of presentation).