Psych CASC / OSCE · foundations — advanced EBM and evidence synthesis
Advanced journal club facilitation — CASC/teaching station
Teaching/communication station: explain forest plots, prediction intervals, publication bias, GRADE, and NMA rankings in accessible language without intimidation or uncritical acceptance.
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Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar leading a 10-minute advanced journal club with a junior doctor, pharmacist, and nurse practitioner. The paper is a random-effects meta-analysis of antidepressants with high I-squared, an asymmetric funnel plot, and a GRADE summary rating moderate-to-low certainty. A consultant has asked whether the team should switch the ward default SSRI based on a network ranking figure in the discussion section.
Station brief
Format. Teaching/communication station, approximately 8–10 minutes. Facilitate, do not monologue. Check understanding. [4]
Candidate instructions. Help the team interpret the meta-analysis at an advanced but accessible level: forest plot and prediction interval, heterogeneity, funnel asymmetry, GRADE certainty vs recommendation strength, and why an NMA ranking should not automatically rewrite ward defaults. Close with a practical team action. [1][5][6]
References8ShowHide
- [1]Riley RD, Higgins JPT, Deeks JJ Interpretation of random effects meta-analyses BMJ, 2011.PMID 21310794
- [2]Higgins JP, Thompson SG, Deeks JJ, Altman DG Measuring inconsistency in meta-analyses BMJ, 2003.PMID 12958120
- [3]Sterne JAC, Sutton AJ, Ioannidis JPA, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials BMJ, 2011.PMID 21784880
- [4]Guyatt GH, Oxman AD, Vist GE, et al; GRADE Working Group GRADE: an emerging consensus on rating quality of evidence and strength of recommendations BMJ, 2008.PMID 18436948
- [5]Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations BMJ, 2008.PMID 18467413
- [6]Mills EJ, Ioannidis JPA, Thorlund K, Schünemann HJ, Puhan MA, Guyatt GH How to use an article reporting a multiple treatment comparison meta-analysis JAMA, 2012.PMID 23011714
- [7]Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R Selective publication of antidepressant trials and its influence on apparent efficacy N Engl J Med, 2008.PMID 18199864
- [8]Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis Lancet, 2018.PMID 29477251