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Systematic Reviews

A guide to conducting systematic reviews at the University of the Sunshine Coast

What is a Systematic Review?

A systematic review is a summary of the medical literature that uses explicit methods to perform a comprehensive literature search and critical appraisal of individual studies and that uses appropriate statistical techniques to combine these valid studies. (CEBM).

Key characteristics of a systematic review are:

  • a clearly stated set of objectives with pre-defined eligibility criteria for studies
  • an explicit, reproducible methodology
  • a systematic search that attempts to identify all studies that would meet the eligibility criteria
  • an assessment of the validity of the findings of the included studies, for example through the assessment of risk of bias
  • a systematic presentation, and synthesis, of the characteristics and findings of the included studies. (Cochrane Handbook for Systematic Reviews of Interventions, 2008, p. 6)

Meta-analysis is a systematic review process that uses quantitative methods to synthesize and summarize the results.
Meta-synthesis is a systematic review process that synthesises a number of qualitative studies to reveal new understandings

 

Shamseer, L., & Moher, D. (2015). Planning a systematic review? Think protocols.  Retrieved from BioMed Central blog:https://blogs.biomedcentral.com/bmcblog/2015/01/05/planning-a-systematic-review-think-protocols/

 

The Equator Network  develops and provides Reporting Guidelines for all types of studies 

Related review types and review processes

Scoping review – an overview of a broad field; can show research gaps. Can be an ideal first review for any research project.

Read this excellent overview

Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 13(3), 141-146. doi:10.1097/XEB.0000000000000050

Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K., Colquhoun, H., Kastner, M., . . . Straus, S. E. (2016). A scoping review on the conduct and reporting of scoping reviews. BMC Medical Research Methodology, 16, 15. doi:10.1186/s12874-016-0116-4

Colquhoun, H. (2016 May). Current best practice for the conduct of scoping reviews, (Powerpoint slides) Presented at Impactful Biomedical Research: Achieving Quality and Transparency. Available from: http://www.equator-network.org/wp-content/uploads/2016/06/Gerstein-Library-scoping-reviews_May-12.pdf

Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. doi:10.1080/1364557032000119616

[Reporting Guideline PRISMA-ScR is currently under development by the Equator Network (2017)].

Protocol – a stated intention to perform a review; detailing purpose, methods, search strategies, databases and exclusion criteria.
Register the protocol with PROSPERO https://www.crd.york.ac.uk/PROSPERO/
Use PRISMA-P guidelines to develop the protocol

Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., . . . Group, P.-P. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ, 349, g7647. doi:10.1136/bmj.g7647

 Rapid review – when there is not the time to execute a full SR; but without compromising quality
Beware of methodology issues...
Tricco, A. C., Antony, J., Zarin, W., Strifler, L., Ghassemi, M., Ivory, J., . . . Straus, S. E. (2015). A scoping review of rapid review methods. BMC Medicine, 13, 224. doi:10.1186/s12916-015-0465-6

Schünemann, H. J., & Moja, L. (2015). Reviews: Rapid! Rapid! Rapid! …and systematic. Systematic Reviews, 4(1), 4. doi:10.1186/2046-4053-4-4

Evidence map – a visual summation of existing evidence
Miake-Lye, I. M., Hempel, S., Shanman, R., & Shekelle, P. G. (2016). What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Systematic Reviews, 5, 28. doi:10.1186/s13643-016-0204-x

Example based on an SR of SRs
Solloway, M. R., Taylor, S. L., Shekelle, P. G., Miake-Lye, I. M., Beroes, J. M., Shanman, R. M., & Hempel, S. (2016). An evidence map of the effect of Tai Chi on health outcomes. Systematic Reviews, 5(1), 126. doi:10.1186/s13643-016-0300-y

Realist review – how and why complex social interventions work
Gough, D. (2013). Meta-narrative and realist reviews: guidance, rules, publication standards and quality appraisal. BMC Medicine, 11, 22. doi:10.1186/1741-7015-11-22

Pawson, R., Greenhalgh, T., Harvey, G., & Walshe, K. (2005). Realist review - A new method of systematic review designed for complex policy interventions. Journal of Health Services Research and Policy, 10(SUPPL. 1), 21-34. doi:10.1258/1355819054308530

 

Note: There are many other types of review. Those above and others are identified and discussed here:

Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information and Libraries Journal 26(2), 91-108. doi:10.1111/j.1471-1842.2009.00848.x

Similiarities and Differences Between Systematic and Traditional (Narrative) Literature Reviews

Reproduced from: Bettany-Saltikov, J. (2010). Learning how to undertake a systematic review: Part 1. Nursing Standard, 24(40): 47-55.

  Systematic Review Narrative Review
Question Focused on a single question Not necessarily focused on a single question, but may describe an overview
Protocol A peer review protocol or plan is included No protocol is included
Background Both provide summaries of the available literature on a topic
Objectives Clear objectives are identified Objectives may or may not be identified
Inclusion and Exclusion Criteria Criteria stated before the review is conducted Criteria not specified
Search Strategy Comprehensive search conducted in a systematic way Strategy not explicitly stated
Process of Selecting Articles Usually clear and explicit Not described in a literature review
Process of Evaluating Articles Comprehensive evaluation of study quality Evaluation of study quality may or may not be included
Process of Extracting Relevant Information Usually clear and specific Not clear or explicit
Results and Data Synthesis Clear summaries of studies based on high quality evidence Summary based on studies where the quality of the articles may not be specified. May also be influenced by the reviewer's theories, needs and beliefs
Discussion Written by an expert or group of experts with a detailed and well grounded knowledge of the issues

 

Recommended reading on SR methodology theory and application

 

Saltikov, J., & Fernandes, T. (2010). Learning how to undertake a systematic review: Part 1. Nursing Standard, 24(50), 47-55; quiz 56. Retrieved from http://ezproxy.usc.edu.au:2048/login?url=http://search.proquest.com/docview/751264535?accountid=28745

 

Bettany-Saltikov, J. (2010). Learning how to undertake a systematic review: Part 2. Nursing Standard, 24(51), 47-56; quiz 58, 60. Retrieved from http://ezproxy.usc.edu.au:2048/login?url=http://search.proquest.com/docview/751267350?accountid=28745

 

Saltman,D., Jackson,D., Newton, P.J. & Davidson, P.M. (2013). In pursuit of certainty: Can the systematic review process deliver? BMC Medical Informatics and Decision Making, 13, 25. doi:10.1186/1472-6947-13-25
http://www.biomedcentral.com/1472-6947/13/25/abstract

 

Petticrew, M. (2009). Systematic reviews in public health: Old chestnuts and new challenges [Editorial]. Bulletin of the World Health Organization, 87(3), 163. doi: 10.2471/BLT.09.063719 . Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654648/  (Good argument for the role of SRs where there is no single clinical question).

 

 

How to Books

Free guides for systematic reviewers

Acknowledgement

Special thanks to Debbie Booth and the University of Newcastle Library for permission to reuse and modify most of the information on this guide.

The original U of N guide can be viewed here.


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