Once you have determined that the systematic review is the appropriate method for your topic and gathered your team - you are ready to begin.
As a reminder - Systematic reviews require a team and it is important to include the right people. It is recommended that teams include:
Individuals can fill more than one role, however, one person cannot fill all roles --> remember it takes a team!
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Formulate your question using PICO or other appropriate framework |
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Determine if there is already a review on this topic |
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Define your inclusion and exclusion criteria |
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Identify 3 to 10 “gold standard” articles (GSAs) |
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Identify databases for search |
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Create and register a protocol |
The main component of this initial part is to clearly define your research question. This is essential to developing and gathering terms. It can be helpful to formulate your topic using PICO(TT). This framework can help you develop a specific and answerable clinical question.
| PICO Format | Definition & Questions to Consider |
| P | Patient, Population, or Problem What are the characteristics of the patient or population? What is the condition or disease in which you are interested? |
| I | Intervention or Exposure What do you want to do with this patient (e.g. treat, diagnose, observe)? |
| C | Comparison or Intervention (if appropriate) What is the alternative to the intervention (e.g., placebo, different drug, surgery)? |
| O | Outcome What are the relevant outcomes (e.g., morbidity, death, complications)? |
| T | Type of Clinical Question Diagnosis, Etiology/Harm, Therapy, Prognosis, Prevention |
| T | Type of Study Design to Answer the Question What would be the best study design/methodology (systematic review, RCT, cohort study, case control, etc.) |
Of course PICO(TT) is not suitable for all research questions. Other frameworks include:
If you are conducting a specific type of systematic review it may be worth selecting one of the following frameworks:
(Information was adapted and taken from: Munn, Z., Stern, C., Aromataris, E., Lockwood, C., & Jordan, Z. (2018). What kind of systematic review should i conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. BMC Medical Research Methodology, 18(1), 5-5. https://doi.org/10.1186/s12874-017-0468-4)
| Review Type | Aim | Question Format |
|---|---|---|
| Effectiveness | To evaluate the effectiveness of a certain treatment/therapy. | Population, Intervention, Comparison, Outcomes (PICO) |
| Experimental | To investigate the experience or meaningfulness of a particular phenomenon. | Population, Phenomena of Interest, Context (PICo) |
| Costs/Economic Evaluation | To determine the costs associated with a treatment/therapy in terms of cost effectiveness or benefit. | Population, Intervention, Comparison, Outcomes, Context (PICOC) |
| Prevalence and/or Incidence | To determine the prevalence and/or incidence of a certain condition. | Condition, Context, Population (CoCoPop) |
| Diagnostic Test Accuracy | To determine how well a diagnostic test works in terms of sensitivity and specificity. | Population, Index Test, Reference Test, Diagnosis of Interest (PIRD) |
| Etiology and/or Risk | To determine the association between particular exposures/risk factors and outcomes. | Population, Exposure, Outcome (PEO) |
| Expert opinion/policy | To review and synthesize current expert opinion, text, or policy on a certain phenomenon. | Population, Intervention or Phenomena of Interest, Context (PICo) |
| Psychometric | To evaluate the psychometric properties of a certain test, normally to determine how the reliability and validity of a particular test. | Construct of interest or the name of the measurement instrument, Population, Type of measurement instrument, Measurement properties |
| Prognostic | To determine the overall prognosis for a condition, the link between specific prognostic factors and an outcome and/or prognostic/prediction models and prognostic tests. | Population, Prognostic Factors (or models of interest), Outcome (PFO) |
| Methodology | To examine and investigate current research methods and potentially their impact on research quality. |
Types of Studies, Types of Data, Types of Methods, Outcomes (SDMO) |
If there is already a review on your topic, it may prove difficult to get your systematic review published. If a review already exists on the topic, ask how does your review add to or differ from these existing reviews. Explore the resources below to determine the existence of current reviews:
Common categories:
Common categories:
*** Exclusion criteria are exceptions to the inclusion not just the opposite of the inclusion criteria***
Gold standard articles (GSAs) are those ideal types of studies that you want to include in your review. Gather 3 to 10 of these articles - you will use these to help determine your keywords and controlled vocabulary.
Remember these articles need to adhere to your inclusion/exclusion criteria.
Cochrane Handbook for Systematic Reviews considers CENTRAL, MEDLINE, and Embase as three of the most important databases to use in your review. Although many databases overlap in content, you need to search multiple databases to be as comprehensive as possible. Make sure to choose subject databases that are appropriate to your topic. Commonly used databases include:
REMEMBER: PubMed can be used in place of Medline (as it includes the references in the Medline database) but it SHOULD NOT be used in addition to Medline.
By creating and registering a protocol, you are setting out guidelines, reducing bias, and increasing transparency and reproducibility. There are many options for where to register your protocol:
