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What is a Systematic Review?

What is a systematic review?

A systematic review is a type of literature review that follows certain standards and guidelines. The review involves a rigorous, well documented, transparent, and reproducible search and selection process, where researchers are attempting to gather and synthesize all evidence that answers a specific clinical question.

 

What is required?

  1. A team: A systematic review cannot be completed by 1 person.
  2. Time: Systematic reviews typically take 12 to 18 months to complete.
  3. A clear question: Systematic reviews are geared to answer clearly defined clinical questions.
  4. Comprehensive Literature Searches: With a systematic review you are attempting to find and synthesize all relevant information with a reproducible search.

 

Where do I start?

 

Standards & Guidelines

There a variety of standards and guidelines geared towards conducting and writing systematic reviews. Some publishers may require that certain guidelines and/or standards are followed.

Parts of a Systematic Review

Systematic Reviews contain 5 major parts with many steps in each of those sections. Use the table below to learn more about these specific steps and tools that can help you through the review process.

Prefer a visual flowchart? Check out: A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research.

PREPARING FOR YOUR SYSTEMATIC REVIEW

Steps

Tools & Resources

Tips & Examples

Formulate your question using PICO  Cochrane Handbook ch. 3  

Determine if there is already a review on this topic

PubMed Clinical Queries,  Cochrane, or PROSPERO

If a systematic review already exists or is in process, then conducting an additional review may result in publication challenges.

Create and register a protocol

Checklist: PRISMA-P
Where to register: PROSPERO, OSF, or Research Registry

Define your inclusion and exclusion criteria

Cochrane Handbook 3.3

Example: Include only randomized controlled trials and Exclude publications not in English

Identify 3 to 10 “gold standard” articles (GSAs)

 

These are ideal articles that you want for your review.

Identify databases for search

A-Z Database List

FINDING THE SEARCH TERMS

Subject heading frequency analysis of gold standard articles

Yale MeSH Analyzer

Use subject explosion when fitting.

Term Harvesting

WordFreq or SearchRefinery

Include synonyms and acronyms.

Create search string 1

Combine terms with Boolean operators and add in advanced searching features: truncation, proximity searching, field codes, and wild cards.

Example: (diabet* OR (MH "Diabetes Mellitus+")) AND (obes* OR (MH "Obesity+") OR overweight* OR (MH "Overweight+")) AND (((old* OR elderly OR geriatric OR aged) N3 (wom?n OR female*)) OR ((MH "Aged+") AND (MH "Female")))

Test search string 1 against gold standard articles, if GSAs are not found modify the search string

 

Translate search string to remaining databases

Polyglot Search, Peer Review of Electronic Search Strategies, or Systematic Review Information Retrieval Checklist

Remember controlled vocabulary will and advanced search features may vary between databases.

RUNNING THE SEARCH

Run all database searches on the same day

 

Note date ran and the number of results from each database.

Search for grey literature, hand searching, etc. (if applicable)

SpiderCite

SCREENING & SELECTING STUDIES

Deduplicate Results

Citation managers, or Rayyan

EndNote, Zotero and RefWorks have the ability to detect duplicates. Note number of duplicates removed!

Title & Abstract Screening

Rayyan, Screenatron, or Disputatron

Use a minimum of two independent reviewers.

Full text Screening

HSL ILLiad (if necessary)

Use a minimum of two independent reviewers.

Quality & Risk of Bias Assessment

DistillerSR, Cochrane Risk of Bias Tool, CEBM Critical Appraisal Tools, or NIH Study Quality Assessment Tools

Document the Process

PRISMA & Cochrane Handbook 4.5

SYNTHESIZING DATA & WRITING REVIEW

Extract data

Cochrane Handbook 5 or Data Extraction Template (Cochrane Review Group)

Have two reviewers complete the data extraction and develop a plan for resolving conflicts. Determine the data you need to collect, ideal method to collect this data, and a tool to organize data. Finally run a pilot and adjust if necessary.

Synthesize findings (Qualitative or Quantitative)

Write & Publish Review

PRISMA checklist & EQUATOR Network

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