Lecture 5 (Systematic Reviews)

true or false: if a paper is a systematic review, it will be high quality

false; many systematic reviews are poor quality. always appraise the research

4 reasons for conducting a SR (KNOW)

● Provide a synthesis of knowledge on a topic and can support the development of new research
● May identify issues in a research area and call for new research to
be completed.
● May address questions that otherwise could not be answered by individual studies (with a meta-analysis, power of combining and interpreting data from numerous studies).
● Can generate or evaluate theories about how or why phenomena occur

Systematic Reviews vs. Cochrane Reviews (2) (KNOW)

● "A Cochrane Review is a systematic review of research in health
care and health policy that is published in the Cochrane Database of
Systematic Reviews."
● "A SR attempts to identify, appraise and synthesize all the empirical
evidence that meets pre-specified eligibility criteria to answer a
specific research question."

Systematic Reviews: definition

Rigorously defined process to search, select, appraise, synthesize and report the findings from quality research studies

Key components of Systematic Reviews (5) (KNOW)

• Multiple authors
• Process starts with a focused question with clearly defined inclusion and exclusion criteria
• An exhaustive search is completed using numerous databases with
a detailed search algorithm.
• Follows a defined process for appraising research studies for inclusion/exclusion.
• Provides a summary report of high-quality research to support decision-making and using the best evidence (Reporting with PRISMA guidelines)

Conducting a quality SR with or without MA may take _____ years or more.

two

4 red flags for systematic reviews

-only 1-2 authors
-only searched one database
-not reporting with PRISMA guidelines
-only include poor quality data

SR Team should include people with a mix of expertise, including: (5)

• Content/Topic expertise,
• Methodological expertise,
• Statistical expertise,
• Policy,
• Librarian.

Systematic Reviews with meta-analysis (3)

• Combines the results of two or more SRs and conducts further statistical tests on the combined data.
• SRs must have "near the same" hypothesis and methods (study variables & population) for a synthesis.
• The combination of studies needs to be of "good" quality (Computing an "average effect" from poor data is not appropriate.)

Typical steps in a SR (KNOW) (10)

1. Formulate the problem with a research question or hypothesis
2. Define inclusion and exclusion criteria
3. Conduct database searches in at least two but typically at least
three or more databases.
4. Evaluation of study quality by at least TWO INDEPENDENT REVIEWERS using a respected assessment tool. Any non-agreement in ratings is discussed between reviewers until a consensus is reached, or a third reviewer may be involved in resolving the disagreement.
5. Extract and code the data following predetermined criteria. (Two or
more independent reviews are involved.)
6. If appropriate, the effect size is calculated, and further data analysis
is done. If not appropriate or not planned, a narrative analysis of the
data is presented.
7. Assessing bias in the included studies (tools are available to use).
8. Synthesizing/Interpreting the data.
9. Making recommendations for practice, policy, and/or further research.
10. Reporting for knowledge translation.

PROSPERO (KNOW)

an international database of prospectively registered systematic reviews in health and social care, welfare, public health, education, crime, justice, and international development, where there is a health-related outcome

Registration of the SR Protocol on PROSPERO (5)

• Provides the SR protocol publicly available to others on a registered
website
• Openly declares the process to be followed to conduct the SR
• Avoids duplication by other research teams
• Adheres to the gold standard for SRs, following a strategic and
rigorous review process
• Cochrane reviews must register a protocol with PROSPERO

Reporting a SR (7)

To ensure the usefulness of the SR, authors need to accurately and
thoroughly report:
• Why the SR was completed?
• What was done? What were the steps followed?
• What were the findings?
• The gold standard is to follow the PRISMA guideline to report an SR;
however, numerous published guidelines exist.
• Many journals demand that a reporting guideline be used.

PRISMA (3) (KNOW)

● Guideline for reporting a SR
● PRISMA (2020) is a 27-item checklist
● Increases credibility of the review and facilitates EBDM.

Cochrane Database of SRs (CDSR) (KNOW) (2)

-Cochrane SRs involve meta analysis.
-The CDSR includes Cochrane reviews
(systematic reviews) and protocols for Cochrane reviews as well as editorials and supplements (THESE REVIEWS WILL BE VERY HIGH QUALITY)

Joanna Briggs Institute (3) (KNOW)

● based in Australia
● Roots connected to nursing but evolved for all health professions.
● a global organisation promoting and supporting evidence-based decisions
that improve health and health service delivery