RevMan 5 app based software - Dr. Vyaktika Shree.pptx

revman a software for statstics

1. Introduction to RevMan 5 Dr. Vyaktika Shree 3 rd Year Junior Resident Department of Pharmacology and Therapeutics King George’s Medical University, Lucknow, UP, India- 226003 Email: [email protected] 07-03-2025 Dr. Vyaktika Shree 1

2. RevMan 5 (Review Manager 5) was the last desktop-based version of Cochrane’s systematic review software. Allows users to perform meta-analyses, generate forest plots, and assess risk of bias in systematic reviews. 07-03-2025 Dr. Vyaktika Shree 2

3. Step-by-Step Guide to Using RevMan 5 07-03-2025 Dr. Vyaktika Shree 3

4. Install and Open RevMan 5 07-03-2025 Dr. Vyaktika Shree 4

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12. Outline Pane 07-03-2025 Dr. Vyaktika Shree 12

13. Content Pane 07-03-2025 Dr. Vyaktika Shree 13

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42. When to choose- OR/RR Feature Risk Ratio (RR) Odds Ratio (OR) Use in RCTs, Cohort Studies Case-Control When to use Common events (≥10%) Rare events (<10%) 07-03-2025 Dr. Vyaktika Shree 42

43. When to choose- FE/RE Model Criteria Fixed-Effect Model Random-Effects Model Heterogeneity (I²) Low (<40%) High (>40%) Population Similarity Studies are homogeneous Studies are heterogeneous Weighting Larger studies get more weight Weight is more balanced Confidence Interval Narrow (more precise) Wide (more conservative) 07-03-2025 Dr. Vyaktika Shree 43

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48. How to Interpret the Forest Plot: Diamond shape → Overall treatment effect Squares & Lines → Individual study results & confidence intervals Heterogeneity (I² Value) → Measures variability across studies 07-03-2025 Dr. Vyaktika Shree 48

49. Components of a Forest Plot Study Names (Left Column) Lists the included studies, usually identified by the first author and year of publication. 07-03-2025 Dr. Vyaktika Shree 49

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51. Effect Size & Confidence Interval (Middle Section) Each study is represented by a square and a horizontal line: Square : The point estimate (e.g., mean difference, odds ratio). Size of the Square : Weight of the study (larger squares indicate studies with higher precision, typically due to larger sample sizes). Horizontal Line : Confidence interval (typically 95% CI), indicating the uncertainty around the estimate. 07-03-2025 Dr. Vyaktika Shree 51

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53. Diamond (Summary Estimate) Located at the bottom, representing the overall pooled effect size. Center of the Diamond : Combined effect estimate. Width of the Diamond : Confidence interval for the pooled estimate. 07-03-2025 Dr. Vyaktika Shree 53

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55. Vertical Line (Reference Line) This line represents no effect (e.g., an odds ratio of 1 in binary outcomes, a mean difference of 0 in continuous outcomes). If the confidence interval crosses this line, the study’s result is not statistically significant . 07-03-2025 Dr. Vyaktika Shree 55

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57. Heterogeneity Refers to the variation in study results beyond what is expected by chance. Indicates how much the treatment effects differ across studies and whether pooling them together is appropriate. 07-03-2025 Dr. Vyaktika Shree 57

58. How is Heterogeneity Measured? Chi-Square Test (Chi² / Cochran’s Q Test) Tests if variability in study results is due to chance. P < 0.05 → Significant heterogeneity (studies differ significantly). P > 0.05 → No significant heterogeneity. 07-03-2025 Dr. Vyaktika Shree 58

59. 2. I² Statistic (Higgins & Thompson Test) Quantifies the percentage of total variation due to heterogeneity (not chance). I² < 25% → Low heterogeneity (studies are similar). I² 25-50% → Moderate heterogeneity. I² > 50% → High heterogeneity (large differences between studies). 07-03-2025 Dr. Vyaktika Shree 59

60. How to Handle Heterogeneity? If low heterogeneity (I² < 50%) , a fixed-effect model is used. If moderate or high heterogeneity (I² > 50%) , a random-effects model is preferred. Subgroup analysis or sensitivity analysis can help explore sources of heterogeneity. 07-03-2025 Dr. Vyaktika Shree 60

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64. Summary of RevMan 5 Workflow Step Action 1. Setup RevMan 5 Open RevMan 5 & create a new review 2. Define PICO Enter research question details 3. Add Studies Enter study details & outcome data 4. Risk of Bias Assessment Evaluate study quality 5. Perform Meta-analysis Run effect size calculations & forest plot 6. Export Results Save & report findings 07-03-2025 Dr. Vyaktika Shree 64

65. THANK YOU 07-03-2025 Dr. Vyaktika Shree 65