Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews

Objectives Involvement of patients, health professionals, and the wider public (‘stakeholders’) is seen to be beneficial to the quality, relevance and impact of research and may enhance the usefulness and uptake of systematic reviews. However, there is a lack of evidence and resources to guide researchers in how to actively involve stakeholders in systematic reviews. In this paper, we report the development of the ACTIVE framework to describe how stakeholders are involved in systematic reviews. Methods We developed a framework using methods previously described in the development of conceptual frameworks relating to other areas of public involvement, including: literature searching, data extraction, analysis, and categorization. A draft ACTIVE framework was developed and then refined after presentation at a conference workshop, before being applied to a subset of 32 systematic reviews. Data extracted from these systematic reviews, identified in a systematic scoping review, were categorized against pre-defined constructs, including: who was involved, how stakeholders were recruited, the mode of involvement, at what stage there was involvement and the level of control or influence. Results The final ACTIVE framework described whether patients, carers and/or families, and/or other stakeholders (including health professionals, health decision makers and funders) were involved. We defined: recruitment as either open or closed; the approach to involvement as either one-time, continuous or combined; and the method of involvement as either direct or indirect. The stage of involvement in reviews was defined using the Cochrane Ecosystem stages of a review. The level of control or influence was defined according to the roles and activities of stakeholders in the review process, and described as the ACTIVE continuum of involvement. Conclusions The ACTIVE framework provides a structure with which to describe key components of stakeholder involvement within a systematic review, and we have used this to summarize how stakeholders have been involved in a subset of varied systematic reviews. The ACTIVE continuum of involvement provides a new model that uses tasks and roles to detail the level of stakeholder involvement. This work has contributed to the development of learning resources aimed at supporting systematic review authors and editors to involve stakeholders in their systematic reviews. The ACTIVE framework may support the decision-making of systematic review authors in planning how to involve stakeholders in future reviews.

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Interventions improving health professionals’ practice for addressing patients’ weight management behaviours: systematic review of reviews

Health Promotion International ◽

10.1093/heapro/daaa039 ◽

2020 ◽

Cited By ~ 1

Author(s):

Bahareh Yazdizadeh ◽

Ruth Walker ◽

Helen Skouteris ◽

Ellinor K Olander ◽

Briony Hill

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Systematic Reviews ◽

Health Professionals ◽

Data Extraction ◽

System Level ◽

Training Interventions ◽

Cochrane Database ◽

Physical Activity Advice ◽

Diet And Physical Activity

Abstract Health professionals require education and training to implement obesity management guidelines and ultimately impact on the health outcomes experienced by their patients. Therefore, a systematic review of systematic reviews that evaluated interventions designed to change the practice of health professionals when addressing diet and physical activity with their patients was conducted. MEDLINE Complete; Cochrane database of systematic reviews; PsycINFO; CINAHL Complete; Global Health; Embase; INFORMIT: Health Subset; Health System Evidence and RX for change were searched in March 2019, with no date or language limits. Identified references underwent screening, full-text analyses and data extraction in duplicate. The search identified 15 230 references. Five systematic reviews that provided a narrative syntheses of a combined 38 studies were included. Health professional participants generally reported being satisfied with the training interventions. Heterogeneity between and within included reviews, non-controlled designs of individual studies and low quality of evidence at an individual study level and review level made it difficult to draw firm conclusions regarding what interventions are most effective in changing health professionals’ knowledge, skills, self-efficacy, attitudes and practice. However, similar gaps in the literature were identified across included reviews. Key areas that could be addressed in future interventions including organization and system-level barriers to providing advice, health professionals’ attitudes and motivation and weight stigma have been highlighted. Health professionals and patients could be more involved in the planning and development of interventions that work towards improving diet and physical activity advice and support provided in healthcare.

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Rapid reviews: definitions and uses

Medwave ◽

10.5867/medwave.2021.01.8090 ◽

2021 ◽

Vol 21 (01) ◽

pp. e8090-e8090

Author(s):

Luis Tapia-Benavente ◽

Laura Vergara-Merino ◽

Luis Ignacio Garegnani ◽

Luis Ortiz-Muñoz ◽

Cristóbal Loézar Hernández ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Clinical Epidemiology ◽

Decision Makers ◽

Limited Time ◽

Rapid Reviews ◽

Health Decision ◽

Principal Value ◽

Time Frames

This article is the first in a collaborative methodological series of narrative reviews on biostatistics and clinical epidemiology. This review aims to present rapid reviews, compare them with systematic reviews, and mention how they can be used. Rapid reviews use a methodology like systematic reviews, but through shortcuts applied, they can attain answers in less than six months and with fewer resources. Decision-makers use them in both America and Europe. There is no consensus on which shortcuts have the least impact on the reliability of conclusions, so rapid reviews are heterogeneous. Users of rapid reviews should identify these shortcuts in the methodology and be cautious when interpreting the conclusions, although they generally reach answers concordant with those obtained through a formal systematic review. The principal value of rapid reviews is to respond to health decision-makers’ needs when the context demands answers in limited time frames.

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How Objective are Systematic Reviews? Differences between Reviews on Complementary Medicine

Journal of the Royal Society of Medicine ◽

10.1177/014107680309600105 ◽

2003 ◽

Vol 96 (1) ◽

pp. 17-22 ◽

Cited By ~ 39

Author(s):

Klaus Linde ◽

Stefan N Willich

Keyword(s):

Systematic Reviews ◽

Review Process ◽

Selection Process ◽

Data Extraction ◽

Herbal Medicines ◽

Extraction Methods ◽

Inclusion Criteria ◽

Literature Searching ◽

Assessment Data ◽

Methodological Aspects

Systematic reviews are considered the most reliable tool to summarize existing evidence. To determine whether reviews that address the same questions can produce different answers we examined systematic reviews of herbal medicine, homeopathy, and acupuncture taken from a previously established database. Information on literature searching, inclusion criteria, selection process, quality assessment, data extraction, methods to summarize primary studies, number of included studies, results and conclusions was compared qualitatively. Seventeen topics (eight on acupuncture, six on herbal medicines, three on homeopathy) had been addressed by 2–5 systematic reviews each. The number of primary studies in the reviews varied greatly within most topics. The most obvious reason for discrepancies between the samples was different inclusion criteria (in thirteen topics). Methods of literature searching may have contributed with some topics but the equivalence of the searches was difficult to assess. Differences were frequently observed in other methodological aspects, in results and in conclusions. This analysis shows that, at least in the three areas examined, systematic reviews often differ considerably. Readers should be aware that apparently minor decisions in the review process can have major impact.

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Covidence and Rayyan

Journal of the Medical Library Association JMLA ◽

10.5195/jmla.2018.513 ◽

2018 ◽

Vol 106 (4) ◽

Cited By ~ 11

Author(s):

Liz Kellermeyer ◽

Ben Harnke ◽

Shandra Knight

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Review Process ◽

Data Extraction ◽

Health Sciences ◽

The Other ◽

Free Alternative ◽

Other Hand ◽

Minimalist Approach

Health sciences librarians from two institutions conducted an assessment of Covidence, a subscription-based systematic review tool, and Rayyan, a free competitor, for abilities, strengths, and limitations. Covidence mirrors the multiphase review process, including data extraction, directly in its design. Rayyan, on the other hand, does not easily mirror this process and really only aids with the reference screening phases. Rayyan takes a minimalist approach, placing more of the logistical and workflow burden on the users themselves. Many of the peripheral features (e.g., highlighting, tagging, etc.) are comparable. Covidence works well and is well suited for more rigorous systematic reviews, where methodology must be adhered to and documented at each stage. In spite of some limited functionality and clunky features, Rayyan is a good free alternative for article screening and works as a viable upgrade from a workflow using only EndNote and/or Excel.

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How to do a systematic literature review

South African Journal of Physiotherapy ◽

10.4102/sajp.v56i1.544 ◽

2000 ◽

Vol 56 (1) ◽

pp. 3-6 ◽

Cited By ~ 4

Author(s):

M. Papadopoulos ◽

P. Rheeder

Keyword(s):

Systematic Review ◽

Literature Review ◽

Systematic Literature Review ◽

Systematic Reviews ◽

Health Professionals ◽

Making Choices

Physiotherapists, whether serving individual patients or populations, always have to sought to base their decisions and actions on the best possible evidence. In making choices, health professionals may benefit from structured summaries of the options and outcomes, systematic reviews of the evidence and recommendations regarding the best choices. The aim of this paper is to present guidelines on how to conduct a systematic review. The structure and content of a systematic review are being discussed, following a step-by-step approach.

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PRISMA2020: an R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis

10.1101/2021.07.14.21260492 ◽

2021 ◽

Author(s):

Neal R Haddaway ◽

Matthew J Page ◽

Christopher C Pritchard ◽

Luke A McGuinness

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Science Communication ◽

Review Process ◽

Evidence Synthesis ◽

R Package ◽

Web Based ◽

Shiny App ◽

Data Files ◽

Flow Diagrams

Background Reporting standards, such as PRISMA aim to ensure that the methods and results of systematic reviews are described in sufficient detail to allow full transparency. Flow diagrams in evidence syntheses allow the reader to rapidly understand the core procedures used in a review and examine the attrition of irrelevant records throughout the review process. Recent research suggests that use of flow diagrams in systematic reviews is poor and of low quality and called for standardised templates to facilitate better reporting in flow diagrams. The increasing options for interactivity provided by the Internet gives us an opportunity to support easy-to-use evidence synthesis tools, and here we report on the development of tools for the production of PRISMA 2020-compliant systematic review flow diagrams. Methods and Findings We developed a free-to-use, Open Source R package and web-based Shiny app to allow users to design PRISMA flow diagrams for their own systematic reviews. Our tools allow users to produce standardised visualisations that transparently document the methods and results of a systematic review process in a variety of formats. In addition, we provide the opportunity to produce interactive, web-based flow diagrams (exported as HTML files), that allow readers to click on boxes of the diagram and navigate to further details on methods, results or data files. We provide an interactive example here; https://driscoll.ntu.ac.uk/prisma/. Conclusions We have developed a user-friendly suite of tools for producing PRISMA 2020-compliant flow diagrams for users with coding experience and, importantly, for users without prior experience in coding by making use of Shiny. These free-to-use tools will make it easier to produce clear and PRISMA 2020-compliant systematic review flow diagrams. Significantly, users can also produce interactive flow diagrams for the first time, allowing readers of their reviews to smoothly and swiftly explore and navigate to further details of the methods and results of a review. We believe these tools will increase use of PRISMA flow diagrams, improve the compliance and quality of flow diagrams, and facilitate strong science communication of the methods and results of systematic reviews by making use of interactivity. We encourage the systematic review community to make use of these tools, and provide feedback to streamline and improve their usability and efficiency.

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Pre-arrest and intra-arrest prognostic factors associated with survival after in-hospital cardiac arrest: systematic review and meta-analysis

BMJ ◽

10.1136/bmj.l6373 ◽

2019 ◽

pp. l6373 ◽

Cited By ~ 9

Author(s):

Shannon M Fernando ◽

Alexandre Tran ◽

Wei Cheng ◽

Bram Rochwerg ◽

Monica Taljaard ◽

...

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Prognostic Factors ◽

Systematic Reviews ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Research Strategy ◽

Primary Analysis ◽

Hospital Cardiac Arrest

Abstract Objective To determine associations between important pre-arrest and intra-arrest prognostic factors and survival after in-hospital cardiac arrest. Design Systematic review and meta-analysis. Data sources Medline, PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews from inception to 4 February 2019. Primary, unpublished data from the United Kingdom National Cardiac Arrest Audit database. Study selection criteria English language studies that investigated pre-arrest and intra-arrest prognostic factors and survival after in-hospital cardiac arrest. Data extraction PROGRESS (prognosis research strategy group) recommendations and the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist were followed. Risk of bias was assessed by using the QUIPS tool (quality in prognosis studies). The primary analysis pooled associations only if they were adjusted for relevant confounders. The GRADE approach (grading of recommendations assessment, development, and evaluation) was used to rate certainty in the evidence. Results The primary analysis included 23 cohort studies. Of the pre-arrest factors, male sex (odds ratio 0.84, 95% confidence interval 0.73 to 0.95, moderate certainty), age 60 or older (0.50, 0.40 to 0.62, low certainty), active malignancy (0.57, 0.45 to 0.71, high certainty), and history of chronic kidney disease (0.56, 0.40 to 0.78, high certainty) were associated with reduced odds of survival after in-hospital cardiac arrest. Of the intra-arrest factors, witnessed arrest (2.71, 2.17 to 3.38, high certainty), monitored arrest (2.23, 1.41 to 3.52, high certainty), arrest during daytime hours (1.41, 1.20 to 1.66, high certainty), and initial shockable rhythm (5.28, 3.78 to 7.39, high certainty) were associated with increased odds of survival. Intubation during arrest (0.54, 0.42 to 0.70, moderate certainty) and duration of resuscitation of at least 15 minutes (0.12, 0.07 to 0.19, high certainty) were associated with reduced odds of survival. Conclusion Moderate to high certainty evidence was found for associations of pre-arrest and intra-arrest prognostic factors with survival after in-hospital cardiac arrest. Systematic review registration PROSPERO CRD42018104795

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Clinical handover and handoff in healthcare: a systematic review of systematic reviews

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzaa170 ◽

2020 ◽

Author(s):

Melissa Desmedt ◽

Dorien Ulenaers ◽

Joep Grosemans ◽

Johan Hellings ◽

Jochen Bergs

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Data Extraction ◽

Implementation Process ◽

Healthcare Setting ◽

Well Being ◽

Role Playing ◽

Included Study ◽

Clinical Handover ◽

Review Team

Abstract Purpose The purpose of this systematic review is to appraise and summarize existing literature on clinical handover. Data sources We searched EMBASE, MEDLINE, Database of Abstracts of Reviews of Effects and Cochrane Database of Systematic Reviews. Study selection Included articles were reviewed independently by the review team. Data extraction The review team extracted data under the following headers: author(s), year of publication, journal, scope, search strategy, number of studies included, type of studies included, study quality assessment, used definition of handover, healthcare setting, outcomes measured, findings and finally some comments or remarks. Results of data synthesis First, research indicates that poor handover is associated with multiple potential hazards such as lack of availability of required equipment for patients, information omissions, diagnosis errors, treatment errors, disposition errors and treatment delays. Second, our systematic review indicates that no single tool arises as best for any particular specialty or use to evaluate the handover process. Third, there is little evidence delineating what constitutes best handoff practices. Most efforts facilitated the coordination of care and communication between healthcare professionals using electronic tools or a standardized form. Fourth, our review indicates that the principal teaching methods are role-playing and simulation, which may result in better knowledge transfer to the work environment, better health and patients’ well-being. Conclusions This review emphasizes the importance of staff education (including simulation-based and team training), non-technical skills and the implementation process of clinical handover in healthcare settings.

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Assessment of humoral and cell-mediated immune responses to pertussis vaccination: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2018-028109 ◽

2019 ◽

Vol 9 (6) ◽

pp. e028109 ◽

Cited By ~ 1

Author(s):

Funbi Akinola ◽

Rudzani Muloiwa ◽

Gregory, D Hussey ◽

Violette Dirix ◽

Benjamin Kagina ◽

...

Keyword(s):

Systematic Review ◽

Immune Response ◽

Immune Responses ◽

Public Space ◽

Systematic Reviews ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Assessment Tools ◽

Population Type

IntroductionGlobally, some studies show a resurgence of pertussis. The risks and benefits of using whole-cell pertussis (wP) or acellular pertussis (aP) vaccines in the control of the disease have been widely debated. Better control of pertussis will require improved understanding of the immune response to pertussis vaccines. Improved understanding and assessment of the immunity induced by pertussis vaccines is thus imperative. Several studies have documented different immunological outcomes to pertussis vaccination from an array of assays. We propose to conduct a systematic review of the different immunological assays and outcomes used in the assessment of the humoraland cell-mediated immune response following pertussis vaccination.Methods and analysisThe primary outcomes for consideration are quality and quantity of immune responses (humoral and cell-mediated) post-pertussis vaccination. Of interest as secondary outcomes are types of immunoassays used in assessing immune responses post-pertussis vaccination, types of biological samples used in assessing immune responses post-pertussis vaccination, as well as the types of antigens used to stimulate these samples during post-pertussis vaccination immune response assessments. Different electronic databases (including PubMed, Cochrane, EBSCO Host, Scopus and Web of Science) will be accessed for peer-reviewed published and grey literature evaluating immune responses to pertussis vaccines between 1990 and 2019. The quality of included articles will be assessed using standardised risk and quality assessment tools specific to the study design used in each article. Data extraction will be done using a data extraction form. The extracted data will be analysed using STATA V.14.0 and RevMan V.5.3 software. A subgroup analysis will be conducted based on the study population, type of vaccine (wP or aP) and type of immune response (cell-mediated or humoral). Guidelines for reporting systematic reviews in the revised 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement will be used in this study.Ethics and disseminationEthics approval is not required for this study as it is a systematic review. We will only make use of data already available in the public space. Findings will be reported via publication in a peer-reviewed journal and presented at scientific meetings and workshops.Trial registration numberCRD42018102455.

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Clinical, laboratory and imaging predictors for critical illness and mortality in patients with COVID-19: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-039813 ◽

2020 ◽

Vol 10 (12) ◽

pp. e039813

Author(s):

Xinxing Lai ◽

Jian Liu ◽

Tianyi Zhang ◽

Luda Feng ◽

Ping Jiang ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Factors ◽

Critical Illness ◽

Systematic Reviews ◽

Clinical Laboratory ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Early Management ◽

Modifiable Factors

IntroductionWith the threat of a worldwide pandemic of COVID-19, it is important to identify the prognostic factors for critical conditions among patients with non-critical COVID-19. Prognostic factors and models may assist front-line clinicians in rapid identification of high-risk patients, early management of modifiable factors, appropriate triaging and optimising the use of limited healthcare resources. We aim to systematically assess the clinical, laboratory and imaging predictors as well as prediction models for severe or critical illness and mortality in patients with COVID-19.Methods and analysisAll peer-reviewed and preprint primary articles with a longitudinal design that focused on prognostic factors or models for critical illness and mortality related to COVID-19 will be eligible for inclusion. A systematic search of 11 databases including PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, VIP, Wanfang Data, SinoMed, bioRxiv, Arxiv and MedRxiv will be conducted. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction will be performed using the modified version of the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist and quality will be evaluated using the Newcastle-Ottawa Scale and the Quality In Prognosis Studies tool. The association between prognostic factors and outcomes of interest will be synthesised and a meta-analysis will be conducted with three or more studies reporting a particular factor in a consistent manner.Ethics and disseminationEthical approval was not required for this systematic review. We will disseminate our findings through publication in a peer-reviewed journal.PROSPERO registration numberCRD 42020178798.

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