Systematic Review

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A systematic review requires minimum of 2 people, not including the librarian, to complete. 3 or more team members is recommended to help resolve disputes during the screening phase, and to help reduce the individual workload of each team member. 

These tutorials were developed at the UNC Health Science Library

• General Introduction to Systematic Review Methodology

• Developing Research Questions

• Developing a Review Protocol and Creating Your Team

• Overview of Literature Searching for Systematic Reviews

• Screening Studies

• Quality Assessment, Data Extraction, and Writing the Review

Guidelines for clinical intervention or comparative effectiveness reviews: 

• Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020).

Guidelines for non-clinical reviews: 

• JBI Manual for Evidence Synthesis

Guidelines for the Social Sciences:

• Campbell Collaboration Evidence Synthesis

PRISMA and its extensions are REPORTING guidelines only. They do provide guidance in how a systematic review is conducted.

The PRISMA guidelines list the elements that are to be reported in the final manuscript of a systematic review. Reporting according to PRISMA ensures that all of the elements needed to report a reproducible review are present. 

• PRISMA-P (Protocols)

PRISMA-P is to facilitate the development and reporting of systematic review protocols

• PRISMA 2020 Checklist

  The PRISMA Checklist is a tool you can use to make sure you are including everything required by PRISMA in your final report.

• PRISMA 2020 Explanation and Elaboration

  This article goes into detail about what is required for each element of PRISMA, and provides examples to guide your own writing.

• PRISMA-S (Search)

A reporting checklist to ensure that the search strategy is documented in a comprehensive and reproducible manner

• PRISMA Flow Diagrams

  The flow diagram depicts the flow of information through the different phases of a systematic review. It maps out the number of records identified, included and excluded, and the reasons for exclusions. Different templates are available depending on the type of review (new or updated) and sources used to identify studies.

• Additional PRISMA extensions

The use of PRIMSA extensions for a systematic review should be documented within the methods section and each cited as a reference. 

Example of documentation: This systematic review was conducted according to the JBI manual for systematic reviews and reported according to the PRIMSA 2020 guidelines. 

The purpose of a systematic review is to answer a specific research question. Research question frameworks, such as PICO, can help you to focus and develop the research question as well as identify the primary search terms. 

When formatting your question using the PICO format, consider: 

• Demographic variables can include: age, gender, ethnicity, socioeconomic status in addition to health status. 
• Comparison is not always an element within the PICO format.
• Outcomes measure a positive impact on the patient/population/problem and should be measurable
• Using the PICO format to develop a searchable & answerable question will provide the elements needed to obtain the best evidence from rigorous studies with statistically relevant findings. 

Inclusion and Exclusion Criteria: 

• Developed to define the parameters of the research question
• Determine the limits of the evidence synthesis
• Exclusion criteria must be justified
• All criteria are presented and defined within the methods section with the search strategy

Examples of Inclusion and Exclusion Criteria:

• Date: generally the search for evidence in a systematic review is run for the entirety of the databases existence. However, it the review is being completed to update a previous study, the run date will begin when the last study ended. 
• Exposure of Interest: (as designated in the research question) If the review is specifically interested in the outcome related to a specific exposure, only studies evaluating that exposure will be included within the review. 
• Geographic location: Global, within the United States, urban or rural, colleges or universities, etc. 
• Language: Commonly a review will limit the studies included to those written in English due to translation issues. 
• Participants: (as designated in the research question) In systematic reviews, the participant criteria are very specific and restricted to age, ethnicity, race, socioeconomic status, past medical history, etc. 
• Reported outcomes: Critically appraised objective outcomes specifically related to the research question
• Setting: Clinical, hospital, lab, school, community, etc. 
• Study design: For quantitative reviews, the search will be limited to randomized control trials; For qualitative reviews, the researchers will determine the study designs included. An umbrella review will only include systematic reviews. 
• Type of publication: Determines if the review will include only peer reviewed evidence, grey literature, dissertations, conference abstracts and papers, etc.

What are exemplar articles?

Exemplar articles provide a foundational example of the type of studies to be included within the systematic review. These articles meet the eligibility criteria and answer the PICO question. 

Why are exemplar articles required? 

These types of articles provide the guidance for the search strategy development and the screening process. 

How do I acquire exemplar articles? 

Exemplar articles can be acquired through literature review. For assistance, please contact your subject librarian