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Developing a
Systematic Review
Fiona Morgan
STEP 1
Develop a protocol
Focused question
PICO/PECO• Population/Problem• Intervention or Exposure• Comparator/Control• Outcome(s)
And…
• Study design• Languages• Publication status• Years
STEP 2
Searchthe
Literature
Search the Literature
• Search a range of relevant databases – Medline, Embase, Cochrane, Cinahl, Web of
Knowledge, ASSIA, PsycINFO, Childdata, Ageline, Social Care Online, Scopus
• Report search terms used– Indexed terms and keywords
• Sufficient range of years
Search the literature
Snowballing• Key journals
– Hand/e-TOCs searching
• Unpublished research– Experts/Manufacturers/Trial registers
• Non-journal literature – Websites
• Reference lists
STEP 3
Select studies for Inclusion
STEP 4
Quality assessment/Risk of bias
Included studies
• A priori inclusion criteria– Identified in protocol
• Selection– Title and abstract– Full text
• Independently in duplicate– Reduction of error and bias
• Checklist/form
Quality Assessment
• Identify best available evidence• Detect risk of bias• Completed independently in duplicate
– Reduces error and bias
• Tools– Critical appraisal checklists– Cochrane risk of bias
STEP 5
Data extraction
Data extraction
Develop and test form• Clear process• Confirmed understanding
Process:• Independently in duplicate
– Reduces error and bias
STEP 6Meta-
analysis or
narrative synthesis
Meta-analysis?
• Needs statistician input– Specify proposed methods in protocol
• Heterogeneity – How significant?
• Narrative synthesis
Step 7
Present findings
Present findings
• Balanced and impartial summary• Interpret the results• Contextualise• Identify limitations
And…
disseminate findings
UsefulResources
Available via Cardiff University resources as an e-Book
Available online
http://www.cochrane-handbook.org/