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Data entered into RevMan, such as study data, analysis data, and additional information including
search results, citations of included and excluded studies, and risk of bias assessments are
automatically made available for download from Cochrane Reviews published on the Cochrane
Library. Where meta-analysis is not possible, any other synthesis methods used should be described
explicitly, including the rationale for the methods selected. PRISMA 2020 Flow Diagrams The flow
diagram depicts the flow of information through the different phases of a systematic review. Other
materials may be available via the articles listed on the EQUATOR website. Guides and manuals
Training and support The discussion section is written to help readers interpret the results of a
review. Examples of effect measures include the odds ratio (OR), risk ratio (RR) and risk difference
(RD) for dichotomous data; the mean difference (MD) and standardized mean difference (SMD) for
continuous data; and hazard ratio for time-to-event data. Filling this gap has been one of the aims of
our team since 2011. One key difference between a review protocol and a completed review is that
the Methods section in a protocol should be written in the future tense. They involve a
comprehensive search to locate all relevant published and unpublished work on a subject; a
systematic integration of search results; and a critique of the extent, nature, and quality of evidence
in relation to a particular research question. If a similar review has been published previously, the
Introduction should explain the need for an update, e.g. there may have been new, large studies
published since the last review. Step 2: Develop a protocol A protocol is a document that contains
your research plan for the systematic review. In addition to summarizing the effects of interventions,
review authors should also summarize the results of any subgroup analyses (or meta-regression),
sensitivity analyses, and assessments of the risk of bias due to missing results (if performed) that are
relevant to each synthesis. If an article isn’t available online or through your library, you may need to
contact the authors to ask for a copy. The structured question forms the basis of the search strategy.
Software reviews are a “quality improvement processes for written material”. For details about
carrying out systematic reviews, see the Guides and Standards section of this guide. The best
reviews synthesize studies to draw broad theoretical conclusions about what a literature means,
linking theory to evidence and evidence to theory. Abstracts should be targeted primarily at
healthcare decision makers (clinicians, consumers and policy makers) rather than just to researchers.
Other published protocols as well as Cochrane Review protocols appear in the Cochrane
Methodology Register, a part of the Cochrane Library. Description of the intervention and how it
might work: A description of the experimental intervention(s) should place it in the context of any
standard or alternative interventions, remembering that standard practice may vary widely according
to context. They provide expectations for the general methodological approach to be followed from
designing the review up to interpreting the findings at the end. The most important difference is the
goal: rather than answering a specific question, a scoping review explores a topic. It is important
therefore that they can be read as stand-alone documents. Keep it short: Many journals recommend
keeping your plain language summary less than 250 words. Account Number: 8991-0002-76 (Peso
Checking Account). A chronological compilation of studies The reason for conducting a literature
review is to: Literature Reviews: An Overview for Graduate Students While this 9-minute video
from NCSU is geared toward graduate students, it is useful for anyone conducting a literature
review. Step 7: Write and publish a report The purpose of writing a systematic review article is to
share the answer to your research question and explain how you arrived at this answer. Simplicity
and clarity are also vital to readability. Rica, Cambodia, Malaysia, Italy, Macau, Singapore, and
Thailand. Typically, an expert in a topic will qualitatively summarize and evaluate previous work,
without using a formal, explicit method.
It is helpful to specify which authors were involved in each of the following tasks: conception of the
review; design of the review; co-ordination of the review; search and selection of studies for
inclusion in the review; collection of data for the review; assessment of the risk of bias in the
included studies; analysis of data; assessment of the certainty in the body of evidence; interpretation
of data, and writing of the review. Software reviews are a “quality improvement processes for
written material”. Any automated processes, software tools or crowdsourcing used to support
selection should be noted. In particular, unless vote counting based on the direction of effect is used
explicitly, authors should avoid the inadvertent use of vote counting in text (e.g. “the majority of
studies found a positive effect”) ( Cumpston et al 2023 ). Such a contribution would take the
relevance of qualitative research one step higher. Richard Peacock, Clinical Librarian Archway
Healthcare Library Ziba Nadimi, Outreach and Information Skills Librarian Camden Primary Care
Trust Adapted presentation originally produced by Helen Goodman- Library Manager, Cassel
Hospital. The methods are repeatable, and the approach is formal and systematic: Formulate a
research question Develop a protocol Search for all relevant studies Apply the selection criteria
Extract the data Synthesize the data Write and publish a report Although multiple sets of guidelines
exist, the Cochrane Handbook for Systematic Reviews is among the most widely used. This is an
open-access article distributed under the terms of the Creative Commons Attribution License (CC
BY). Judgements about the domains that determine the certainty of evidence should be described in
the results or discussion section and as part of the 'Summary of findings' table.. (as measured by the
international normalized ratio (INR)) and an increased risk of bleeding (Levine et al 2004). These
sections correspond to the same sections in a completed review, and further details are outlined in
Section III.3. The required reporting items have been incorporated into a template for protocols for
Cochrane Reviews, which is available in Cochrane’s review production tool, RevMan (see the
RevMan Knowledge Base ). Measures of the treatment effect: The effect measures used by the
review authors to describe results in any included studies or meta-analyses (or both) should be
stated. A systematic review is best deployed to test a specific hypothesis about a healthcare or public
health intervention or exposure. Only the main findings and conclusion should be reported in the
Abstract in order to the core message to be understood easily and quickly. A recent editorial
accepted that qualitative research should be included in systematic reviews, but pointed to a
“daunting array of theoretical and practical problems.” 1 This article presents an approach to
combining qualitative and quantitative research in a systematic review. The Analyses supplementary
material has a hierarchical structure, presenting results in forest plots or other table formats, grouped
first by comparison, and then for each outcome assessed within the comparison. Goals for Today.
Discuss basic characteristics and processes of evidence-based education. From PRISMA. See the
EQUATOR network for more guidelines for reporting health research. Two people should do this
step independently, and the third person will resolve any disagreements. Two of you will
independently read the studies and decide which to include in your review based on the selection
criteria you established in your protocol. Today’s Class. Meta-Analysis. Meta-Analysis. What is it?.
Meta-Analysis. What is it usually used for. Any software tools used in data collection should be
cited, as well as any checklists such as TIDieR for the description of interventions ( Hoffmann et al
2017 ), TIDieR PHP for population health and policy interventions ( Campbell et al 2018 ), or
TACIT for identifying conflicts of interest ( ). MJP and JEM took and consolidated notes from the
development meeting. Implications for research: This section of a Cochrane Review is often used by
people making decisions about future research, and review authors should try to write something that
will be useful for this purpose. The PRISMA checklist The Preferred Reporting Items for Systematic
Reviews and Meta-Analysis (PRISMA) is a 27-item checklist used to improve transparency in
systematic reviews. They are quite happy for the information that is not available in the printed
manuscript to be provided as supplementary materials in appendices. Shared Topic: Adherence to
Antiretroviral therapy (ART) for HIV in Zambia. The following publication has been used to supply
annotated examples of the abstract, introduction, discussion and conclusion. It offers an appropriate
balance between three components: an objective framework, which includes the selection, inclusion,
and appraisal of studies; a rigorously scientific approach to data analysis; and the necessary
contribution of the researcher’s subjectivity in the construction of the final work. The response
document may in fact be longer than the manuscript itself in some circumstances. Systematic reviews
What is it and why do we need them.
Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety.
Review authors should describe eligibility criteria for participants, including any restrictions based on
age, diagnostic criteria, location and setting. Analysis: Involves critically evaluating and
summarizing key findings, methodologies, and debates found in academic literature. For each listed
outcome or outcome domain, it should be clear which specific outcomes, measures or tools will be
considered together and combined for the purposes of synthesis. It may be helpful to consider tools
that have been designed to assess the risk of bias in systematic reviews (such as the ROBIS tool
(Whiting et al 2016)) when writing this section. Today’s content. What is meta-analysis, when and
why we use meta-analysis, Examples of meta-analyses benefits and pitfalls of using meta-analysis.
The question needs to be about a topic that’s previously been studied by multiple researchers. The
subsequent paragraph should address the interpretation of the findings in relation to other previously
published reviews on the same topic. Help support the objectives of: Project management Systems
engineering Verification and validation Configuration management Quality assurance. This phase is
complete when an initial assumption about the relationship between studies can be made. They also
collected data about possible sources of bias, such as how the study participants were randomized
into the control and treatment groups. Select Databases and Grey Literature Sources For steps 3 and
4, it is advisable to consult a librarian before embarking on this phase of the review process. What
other evidence would you like to have?. SC.8.N.1.1, SC.8.N.1.3, SC.6.N.1.1, SC.7.N.1.1.
Experiment vs Investigation. The first round of screening can consume 1 hour per screener for every
100-200 records. Also, comprehensively describing the eligibility criteria applied, sources consulted,
analyses conducted, and post-hoc decisions made, can reduce uncertainties in assessments of risk of
bias in the review findings ( Whiting et al 2016 ). Without a strong, and clear results section that
brings together all pertinent, and relevant information of your review, you will be less likely to draw
meaningful conclusions and start thought-provoking discussions. The code is then combined with
others in a theme named “The experience of distress.”. The protocol is created following whatever
guideline you select. They’re narrow in scope: they only answer the precise research question. For
reviews using network meta-analysis, a range of figures and table formats may be appropriate to
present both the network of evidence and the results of the analysis. Authors should avoid
overstating the conclusion of the review, especially e.g. in situations when data from observational
studies are pooled together with randomised trials and there is significant heterogeneity in the
results. Consider including a Plain Language Summary (PLS) when you publish your systematic
review. There is a need for both researchers and commissioners to be able to distinguish between
these methods and to select which method is most appropriate to their situation. Learn More About
DistillerSR (Article continues below) Why Is The Synthesis Of Results In A Systematic Review
Important. Beware that the Abstract needs to be able to standalone, being fully interpretable without
the need for referring to the main article text. If using the template, authors should consider carefully
the methods that are appropriate for their specific review and adapt the template where required.
Evidence-Based Health Care. “The integration of best research evidence with clinical expertise and
patient values to facilitate clinical decision making”. The readability of Cochrane Reviews should
compare to that of a well-written article in a general medical journal. It helps add power to the
conclusions you draw and gives less room for others to discount or discredit your interpretations.
Eligibility criteria for interventions and comparators should be stated also, including any criteria
around delivery, dose, duration, intensity, co-interventions and characteristics of complex
interventions.
Your paper will also include a PRISMA chart that is an image of your research process.? Click an
item below to see how it applies to Step 8: Write the Review. We plan to disseminate the research
widely, including to community participants in evidence synthesis organisations. Indeed, the
subjective coconstruction inherent to most of qualitative methods seems especially close to the
psychiatric clinical meeting. Meta-analysis of yield QTL on maize chromosomes 5 and 6. Guidelines:
Often endorsements of an official govt agency Consensus Statements. We recommend existing
PRISMA extensions 47 49 50 51 52 53 71 72 be updated to reflect PRISMA 2020 and advise
developers of new PRISMA extensions to use PRISMA 2020 as the foundation document. Family
members’ experience of seeking help for first-episode psychosis on behalf of a loved one: a meta-
synthesis of qualitative research. They should be included in the psychiatric common research toolkit
to become better recognized by clinicians and mental health professionals. Journal of Clinical
Epidemiology 2016; 69: 225-234. Systematic Reviews and Meta-analysis: Understanding the Best
Evidence in Primary Healthcare. These checklists are intended to improve the quality of reporting of
systematic reviews and peer reviewers often refer to these resources when assessing your papers.
More detailed assessments, including the consensus responses to each signalling question and
comments to support each response, can be made available as an additional file in a publicly
available data repository. Finfgeld, D.L. (2003). Metasynthesis: The state of the art- so far. Original
authors of metaethnography were trained in grounded theory, a qualitative method developed in the
social sciences, laying on conceptual coding combine to construct a new theory. It should be
explicitly stated whether they will be synthesized together as a single outcome (depression), or
presented as a series of separate syntheses for each tool. The paper provides different orientations of
meta-synthesis, as well as a step-by-step guide in conducting a meta-synthesis. Finally, extensions to
the PRISMA 2009 statement have been developed to guide reporting of network meta-analyses, 49
meta-analyses of individual participant data, 50 systematic reviews of harms, 51 systematic reviews
of diagnostic test accuracy studies, 52 and scoping reviews 53; for these types of reviews we
recommend authors report their review in accordance with the recommendations in PRISMA 2020
along with the guidance specific to the extension. However, a scoping review isn’t a type of
systematic review. See Chapter 10 for more information on investigating heterogeneity. TCH has
received personal fees from Elsevier outside the submitted work. For example, a review of a multi-
component public health intervention promoting healthy lifestyle choices, focusing on reduction in
smoking prevalence, might legitimately exclude studies that do not measure any smoking outcomes.
For example, clearly describing the interventions assigned in the included studies can help users
determine how best to deliver effective interventions in practice ( Hoffmann et al 2017 ). Full
guidance and a template are available as online supplementary material to this chapter. Review
authors should avoid repeating all the results of the synthesis, but be careful to ensure that all
summary statements made in the Discussion are supported by and consistent with the results
presented elsewhere in the review. These items cover all aspects of the manuscript, including title,
abstract, introduction, methods, results, discussion, and funding. Declarations of interest: Toby
Lasserson and Ella Flemyng are employees of Cochrane. Authors may be helpful to readers by
identifying factors that are likely to be relevant to their decision making, such as the relative value
of the likely benefits and harms of the intervention, participants at different levels of risk, or resource
issues. Here, we look to answer those questions by exploring what synthesis of results in a systematic
review is, and why it is important to understand how to write it. Review purpose of a Systematic
Review Types of systematic review Best question for each study type Process of designing a
systematic review. Download figure Open in new tab Download powerpoint We recommend authors
refer to PRISMA 2020 early in the writing process, because prospective consideration of the items
may help to ensure that all the items are addressed.
Bibliographic, word-processing, spreadsheet, and statistical software. Simplicity and clarity are also
vital to readability. A systematic review is a labor-intensive team effort. For RoB 2, these tables can
be generated in RevMan, and summaries of risk of bias assessments can also be added to forest plots
presenting the results of meta-analysis. It is a necessary step to guide research toward vital issues that
need to be investigated. 3 Reasons to Connect Systematic Reviews and Meta Analysis Getting
Started Guides and Standards Review Protocols Databases and Sources Randomized Controlled
Trials Controlled Clinical Trials Observational Designs Tests of Diagnostic Accuracy Software and
Tools Where do I get all those articles. Declarations of interest: Toby Lasserson and Ella Flemyng are
employees of Cochrane. PRISMA 2020 provides the main reporting items for new Cochrane
Reviews. Learn More About DistillerSR (Article continues below) Why Is The Synthesis Of Results
In A Systematic Review Important. By highlighting differences, an author starts a narrative that can
investigate why those differences have occurred and what that could mean. However, too much
explanation can detract from the readability of a review. Quick overview of the process: Steps and
resources from the UMB HSHSL Guide. Account Number: 8991-0002-76 (Peso Checking Account).
If particular journals were handsearched, this should be noted. These checklists are intended to
improve the quality of reporting of systematic reviews and peer reviewers often refer to these
resources when assessing your papers. Rica, Cambodia, Malaysia, Italy, Macau, Singapore, and
Thailand. The Webinar will run for two consecutive days July 15-. Precise writing means drafting the
text with accuracy especially with respect to the methodological and statistical aspects. Where there
is relevant content from other reporting guidelines, we reference these guidelines within the items in
the explanation and elaboration paper 41 (such as PRISMA-Search 42 in items 6 and 7, Synthesis
without meta-analysis (SWiM) reporting guideline 27 in item 13d). Metaethnography, as well as
Thematic Synthesis, takes place in six or seven steps from data collection to text coding and finally
writing the synthesis. These data must be extracted and presented in a way that enables readers to
form their own opinions about the studies included. When Boyle and Tang disagreed about whether
a study should be excluded, they discussed it with Varigos until the three researchers came to an
agreement. There are tools like the PRISMA 2020 checklist and PRISMA Statement provide
guidance as to what to include in a review. Surveys of the transparency of published systematic
reviews suggest that many elements of systematic reviews could be reported better. To inform
possible revisions to the guideline, it would also be valuable to conduct think-aloud studies 70 to
understand how systematic reviewers interpret the items, and reliability studies to identify items
where there is varied interpretation of the items. We encourage readers to submit evidence that
informs any of the recommendations in PRISMA 2020 (via the PRISMA statement website: ).
NOTE: We only request your email address so that the person you are recommending the page to
knows that you wanted them to see it, and that it is not junk mail. If relevant, any tools or checklists
used (such as ROB-ME, ) should be cited.See Chapter 13 for a description of methods for assessing
risk of bias due to missing results in a synthesis. This link opens in a new window Contact a Librarian
Ask a Librarian Definition: A literature review is a systematic examination and synthesis of existing
scholarly research on a specific topic or subject. There are tools like the PRISMA 2020 checklist and
PRISMA Statement provide guidance as to what to include in a review. PRISMA for Abstracts:
Reporting Systematic Reviews in Journal and Conference Abstracts. In: Higgins JPT, Thomas J,
Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors).
MJP is supported by an Australian Research Council Discovery Early Career Researcher Award
(DE200101618) and was previously supported by an Australian National Health and Medical
Research Council (NHMRC) Early Career Fellowship (1088535) during the conduct of this research.
Not long ago, CINAHL was the most important database for finding qualitative research, but as
qualitative research proliferates in medical research, more and more qualitative articles are referenced
in MEDLINE ( 33 ) and EMBASE. With a systematic review reporting guidelines should be
followed that help you identify what should be included in each section of the review. All steps and
decisions made need to be documented. Both our presentation and our discourse are influenced by
our aim: to answer clinical questions by suggesting specific actions or considerations for care; the
discussion and the answers are intended to be useful for the readers of our article, as well as for us (
23 ). Registering your protocol means submitting it to a database such as PROSPERO or
ClinicalTrials.gov. Step 3: Search for all relevant studies Searching for relevant studies is the most
time-consuming step of a systematic review. By reporting the systematic review findings in a
succinct manuscript, accompanied with details transparently and completely presented in
supplementary files, the data collated can be accurately presented to ensure that critical appraisal and
assimilation of evidence into practice is facilitated. It may also be helpful to seek assistance for this
task, such as asking someone with experience in writing in plain language for a general audience for
help, or seeking feedback on the draft summary from a consumer or someone with little knowledge
of the topic area. III.3.3 Background and Objectives Well-formulated review questions occur in the
context of an already-formed body of knowledge. This question must be broad enough to be of
interest but small enough to be manageable ( 5, 23 ) and has already been explored by enough
studies ( 30 ). Each comment will need to be itemised with an appropriate response and any change
in the manuscript highlighted in order for the editor to be able to be easily assess and track the
changes made to the manuscript. Giving a summary of data from studies is acceptable only when
comparisons are being made. Over the past decade, advances in systematic review methodology and
terminology have necessitated an update to the guideline. Systematic reviews: Structure, form and
content Topic selection and planning. Preferred reporting items for systematic reviews and meta-
analyses: the PRISMA statement. The PRISMA 2020 statement: an updated guideline for reporting
systematic reviews. Syst Rev. 2021;10(1):89. PRISMA 2020 Checklist Standards for reporting
systematic reviews In: Institute of Medicine. This link opens in a new window Contact a Librarian
Ask a Librarian Definition: A literature review is a systematic examination and synthesis of existing
scholarly research on a specific topic or subject. As each database has its own thesaurus terms, and
as keywords encompasses different meanings in each discipline ( 36 ), the keywords were specific
for each one. Qualitative syntheses require not only a systematic approach to collecting, analyzing,
and interpreting results across multiple studies, but also to develop overarching interpretation
emerging from the joint interpretation of the primary studies included in the synthesis ( 10, 11 ). In
our study ( 22 ), we emphasized an original point in the relationship that was no found in any result
from each primary study: the difficulty of professionals and parents to understand and cope with
suicide as an obstacle to the care of the suicidal adolescent. The principal limitations were
methodological (with our method, the access to participants’ data is partial), and in the sampling (we
didn’t take in consideration the influence of gender on the experience of suicidal behavior).
Cochrane’s Methodological Expectations of Cochrane Intervention Reviews (MECIR) detail
standards for the conduct of Cochrane Reviews of interventions. Two people should do this step
independently, and the third person will resolve any disagreements. The Abstract also needs to be
standalone, representing an independent summary that can be fully understood without the need for
reading the full paper. They can provide syntheses of the state of knowledge in a field, from which
future research priorities can be identified; they can address questions that otherwise could not be
answered by individual studies; they can identify problems in primary research that should be
rectified in future studies; and they can generate or evaluate theories about how or why phenomena
occur. The implications for clinical practice and future research should then be described here as
well. Readers may not have English as their first language. For each listed outcome or outcome
domain, it should be clear which specific outcomes, measures or tools will be considered together
and combined for the purposes of synthesis. Your Research Proposal. I. Introduction A. Problem
statement B. Sources of support: Authors should acknowledge grants that supported the review, and
other forms of support, such as support from their university or institution in the form of a salary.
The Background section should address this context, including a description of the condition or
problem of interest.