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• Unpublished research– Experts/Manufacturers/Trial registers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/