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Idiopathic Pulmonary Fibrosis (IPF) as the name suggests is a progressive disorder with no known aetiology. It is characterised by the thickening of the alveoli due to scarring resulting in cough. It is known to primarily occur in older adults over 60 years of age. The findings of IPF have a known association of Usual Interstitial Pneumonia (UIP) (Raghu et al., 2011; Kawano-Dourado & Kairalla, 2013; Wells, 2013). It has been deemed that the prognosis is generally poor when UIP has been confirmed (King et al., 2001b). The median survival rate of IPF is 50%, typically around two years after diagnosis (Raghu et al., 2011; King et al., 2001b).
Idiopathic Pulmonary Fibrosis (IPF) as the name suggests is a progressive disorder with no known aetiology. It is characterised by the thickening of the alveoli due to scarring resulting in cough. It is known to primarily occur in older adults over 60 years of age. The findings of IPF have a known association of Usual Interstitial Pneumonia (UIP) (Raghu et al., 2011; Kawano-Dourado & Kairalla, 2013; Wells, 2013). It has been deemed that the prognosis is generally poor when UIP has been confirmed (King et al., 2001b). The median survival rate of IPF is 50%, typically around two years after diagnosis (Raghu et al., 2011; King et al., 2001b).
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address the suitability and appropriateness of the research design whereas the external<br />
validity is used to address the appropriateness of the research questions considered. In this<br />
regard, the examination of internal and external validity reduces or eliminates the risks of<br />
bias. According to Leandro (2004), proper emphasis should be laid upon the assessment of<br />
risks so as to eliminate underestimation or overestimation of the size of the effects which<br />
leads to false negative or false positive conclusions. The risk of bias also aids in<br />
understanding the heterogeneity between the selected studies.<br />
Several methods and tools are used to address the risks of bias in meta-analysis<br />
wherein the most commonly used instrument is the checklist which uses specific questions or<br />
scales. The summary of each question and the summative scores are acquired in the end after<br />
completing the checklist. The <strong>Review</strong> Manager software which is developed by the Cochrane<br />
collaboration is constructed for the examination of RCTs and is utilised for the present<br />
research.<br />
3.5 Data Extraction<br />
With the inclusion and exclusion criteria set, the researcher/ investigator collects the<br />
detailed data which is based on specific characteristics such as the country, the population of<br />
the study, the year of research, the efficacy of pirfenidone with NAC, the types of outcomes<br />
from combined therapy, the study design, age and so on. Relevant information associated<br />
with conducting the meta-analysis are acquired from the studies satisfying the inclusion and<br />
exclusion criteria.<br />
3.6 Meta- analysis Using <strong>Review</strong> Manager (Rev Man 5.3)<br />
From the studies selected, data were compiled together and examined using a<br />
statistical analysis software called <strong>Review</strong> Manager (Rev-Man 5.3) which was developed<br />
based on collaboration with Cochrane for the management of meta-analysis conducted with<br />
systematic review (Higgins & Green, 2011). Rev-Man 5.3 is further used for the research as a<br />
tool to examine and manage data with ease.<br />
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