Systematic Review

(Advanced Course: Module 6 Appendix)

13 December 2018
 The material for this appendix is part of:

Performing systematic reviews in

resource-limited
Performing settings
systematic reviews in
resource-limited settings
Sarah Young and Erin Eldemere
May May
19, 201819,
MLA2018 MLA Annual
Annual Conference, Conference,
Atlanta GA
Atlanta GA

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 Archie Cochrane, 1979
A Scottish doctor who promoted the
use of randomized controlled trials to
improve medical care.
"It is surely a great criticism of our
profession that we have not
organised a critical summary, by
specialty or subspecialty, adapted
periodically, of all relevant
randomised controlled trials."

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 What is a systematic review?
“…a scientific investigation that focuses on a
specific question and uses explicit, pre-
specified scientific methods to identify, select,
assess, and summarize the findings of similar
but separate studies.”

Source: “Finding What Works in Health Care”, Institute of Medicine,

Available from https://www.ncbi.nlm.nih.gov/books/NBK209518/

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 Systematic review vs. traditional lit review
Review stage Narrative review
Review question Question is broad and terms
are not well-defined
Study selection Convenience sampling and
biased selection
Quality assessment None
Synthesis Qualitative and narrative;
vote-counting may be used
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Systematic review
Question is specific; terms
and protocol are defined in
advance
Exhaustive searches with
pre-defined criteria applied
for selection by more than
one reviewer
Selected studies assessed for
risk of bias and study quality
Sometimes quantitative,
including meta-analysis with
risk of bias considered
 In general, a systematic review aims
to decrease bias and increase
reproducibility and transparency.

They provide guidance for practice

and policy-making, and identify gaps
in knowledge and a need for research.

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Bias in research synthesis

Adapted from Campbell Collaboration training slides

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Bias in research synthesis
Review methods bias

Publication bias

Outcome reporting bias

Negative results Positive results

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Bias in research synthesis

Negative results Positive results

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Bias in research synthesis

Negative results Positive results

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Bias in research synthesis

Negative results Positive results

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Types of systematic review questions

• The effectiveness of a treatment or intervention

• The rate, prevalence or trends of occurrence of
a condition
• The correlation or association of factors
• The accuracy of a diagnostic test
• The reliability or validity of a method or
measure

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 Define the question

Search and screen for studies

Assess study quality

Extract and combine data

Discuss and conclude findings

Disseminate results

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 Define the question

Search and screen for studies

Assess study quality

Extract and combine data

Discuss and conclude findings

Disseminate results

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 Complex contexts Define the question

Lack of expertise and access Search and screen for studies

Lack of multiple reviewers

Assess study quality

Lack of expertise Extract and combine data

Discuss and conclude findings

Lack of funding Disseminate results

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 SR steps and librarian’s role

Develop SR Protocol Perform Search Initial Screening

Refine research question
Identify
Identify sources for searching
Research
Develop search strategy
Question
Define inclusion/exclusion criteria
Develop grading rubric
Run database searches Screen titles/abstracts
Search grey literature Independent reviewers determine
Yes/No/Maybe
Hand search journals and websites
Yes/Maybe carry through
Calls to listservs or known researchers if any

Grading
Write up of SR Eligibility Screening
Analysis and Assess quality of evidence in
Librarian assists in write- Synthesis included articles Screen abstracts/full text for
up of methods section Librarian can provide support for inclusion/exclusion criteria
rubric documentation Record reasons for exclusion

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 Resources to learn more
• Margaret Foster’s Webinar Series:
https://nnlm.gov/scr/professional-development/systematic-review-
series

• John’s Hopkins Coursera Course: Intro to Systematic Review and

Meta-Analysis:
https://www.coursera.org/learn/systematic-review

• Campbell Collaboration Training Resources:

https://www.campbellcollaboration.org/research-resources/training-
courses.html

• Cochrane Interactive Learning(free access to income-eligible countries):

 https://training.cochrane.org/interactivelearning

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Resources to learn more

Updated 2018 12
13 December 2018