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Systematic Reviews & Library Assistance

The First Steps of your Review

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:

  1. Systematic review methods expert
  2. Librarian
  3. Topic Expert --> at least 2
  4. Statistician (if performing a meta-analysis)
  5. Writer(s)
  6. Project Coordinator

Individuals can fill more than one role, however, one person cannot fill all roles --> remember it takes a team!

Preparing for your Systematic Review

Formulate your question using PICO

Determine if there is already a review on this topic

Define your inclusion and exclusion criteria

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

Identify databases for search

Create and register a protocol

Step 1: Formulate your question with PICO

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 Description
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:

  • SPICE: setting, population (or perspective), intervention, comparison, evaluation
  • PEO: population (or problem), exposure, outcomes
  • SPIDER: sample, phenomenon of interest, design, evaluation, research type

Step 2: Determine if there is already a review on your topic

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:

Step 3: Define your inclusion & exclusion criteria

Inclusion criteria is all of the components that studies must contain to be included in your review.


Exclusion criteria are the components that make a study ineligible for the review.

Common categories:

  • Inclusion criteria:
    • Demographic information (age, gender, race, etc.)
    • Language
    • Presence of appropriate condition
  • Exclusion criteria:
    • Comorbidities
    • Publication Type
    • Date

Step 4: Identify "Gold Standard" Articles

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.

Step 5: Identify databases for search

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 databases that are appropriate to your topic. Commonly used databases include:

Step 6: Create & Register a Protocol

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:

Tools to assist with protocol creation:

University of Cincinnati Libraries

PO Box 210033 Cincinnati, Ohio 45221-0033

Phone: 513-556-1424

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