Enhancing the quality and transparency of systematic reviews

Systematic reviews (SR) have been important tools for determining the magnitude of an effect, with appropriate methodology, rigor and scientific quality. This epidemiologic design was developed to conduct an exhaustive, systematic and explicit assessment of the literature, based on a clearly research question, an explicit methodology, a critical appraisal using a variety of tools and a qualitative summary of the evidence. On the other hand, the meta-analysis (MA), is the statistical analysis used in the synthesis of the evidence at the end of a very well performed systematic review. It compares head to head interventions, however nowadays, we have another tool to perform indirect or mixed comparisons (Network meta-analysis). This new statistical tool evaluates the effectiveness when comparing different treatments with similar characteristics, which have not been directly compared in a study. Unlike the traditional meta-analysis, this new tool compares the results of different studies that have a point or a common intervention without a direct comparison.

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What are Systematic Reviews?

WikiJournal of Medicine ◽

10.15347/wjm/2020.005 ◽

2020 ◽

Vol 7 (1) ◽

pp. 5

Author(s):

Jack Nunn ◽

Steven Chang

Keyword(s):

Public Health ◽

Systematic Review ◽

Systematic Reviews ◽

Evidence Synthesis ◽

Meta Analysis ◽

Research Question ◽

Secondary Data ◽

Current Evidence ◽

Economic Evaluations ◽

Environmental Interventions

Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question. While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively. Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine, and a review of existing studies is often quicker and cheaper than embarking on a new study. While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful. Systematic reviews may examine clinical tests, public health interventions, environmental interventions, social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations. An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.

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How to Do a Systematic Review: A Best Practice Guide for Conducting and Reporting Narrative Reviews, Meta-Analyses, and Meta-Syntheses

Annual Review of Psychology ◽

10.1146/annurev-psych-010418-102803 ◽

2019 ◽

Vol 70 (1) ◽

pp. 747-770 ◽

Cited By ~ 122

Author(s):

Andy P. Siddaway ◽

Alex M. Wood ◽

Larry V. Hedges

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Best Practice ◽

Meta Analysis ◽

Research Question ◽

Subject Area ◽

Replication Crisis ◽

Comprehensive Search ◽

High Level ◽

Meta Analyses

Systematic reviews are characterized by a methodical and replicable methodology and presentation. 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. The best reviews synthesize studies to draw broad theoretical conclusions about what a literature means, linking theory to evidence and evidence to theory. This guide describes how to plan, conduct, organize, and present a systematic review of quantitative (meta-analysis) or qualitative (narrative review, meta-synthesis) information. We outline core standards and principles and describe commonly encountered problems. Although this guide targets psychological scientists, its high level of abstraction makes it potentially relevant to any subject area or discipline. We argue that systematic reviews are a key methodology for clarifying whether and how research findings replicate and for explaining possible inconsistencies, and we call for researchers to conduct systematic reviews to help elucidate whether there is a replication crisis.

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Understanding and Appraising Systematic Reviews and Meta-Analysis

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4628-41.5.317 ◽

2017 ◽

Vol 41 (5) ◽

pp. 317-326 ◽

Cited By ~ 1

Author(s):

Neeti Mittal ◽

Manoj Goyal ◽

Parteek K Mittal

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Research Question ◽

Validity And Reliability ◽

Policy Makers ◽

Methodological Rigor ◽

Reproducible Method ◽

Evidence Based Dentistry

Systematic reviews and meta-analysis seek to answer a pre-framed research question to lead to a valid answer through a systematic, explicit and reproducible method of locating; identifying, including and appraising appropriate trials. The results are synthesized considering the methodological rigor of included trials. While the meta-analysis quantitatively pools the results from individual included studies, the systematic review summarizes the findings as qualitative conclusions. These reviews are crux of evidence based dentistry for various stake-holders, i.e., clinicians, researchers and policy-makers. Although the meticulous methodology of systematic review and meta-analysis minimizes the elements of bias, yet the validity and reliability of their findings should be explored prior to translating their conclusions to practice. The goal of this paper is to familiarize readers with rationale, conduct and appraisal of systematic review and meta-analysis. Further, guidance is provided on tracing potential elements of bias in the review to enable readers to judge the quality of evidence generated from the review.

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Association between anxiety, depression and quality of life: study protocol for a systematic review of evidence from longitudinal studies

BMJ Open ◽

10.1136/bmjopen-2018-027218 ◽

2019 ◽

Vol 9 (3) ◽

pp. e027218 ◽

Cited By ~ 4

Author(s):

Johanna Katharina Hohls ◽

Hans-Helmut König ◽

Eleanor Quirke ◽

André Hajek

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Longitudinal Studies ◽

Systematic Reviews ◽

Meta Analysis ◽

Research Question ◽

Primary Data ◽

Current Evidence ◽

Anxiety Depression

IntroductionEvidence from individual longitudinal studies suggests that anxiety and depression may impact quality of life. However, systematic reviews synthesising current evidence have mainly focused on specific samples. Thus, the aim of this study is to synthesise evidence from longitudinal studies on the association between anxiety, depression and quality of life in a systematic review.Methods and analysisA systematic review of evidence from longitudinal studies analysing the association between anxiety, depression and quality of life will be conducted, taking into account the current Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Several electronic databases from relevant fields of research (PubMed, PsycINFO, PSYNDEX, EconLit, NHS EED) will be searched in September 2018 using defined search terms, with an updated search planned. Moreover, reference lists of included studies will be searched manually. Study eligibility will be appraised in a two-step process against pre-defined inclusion/exclusion criteria. Primarily, information on study design and assessment, statistical methods, participant characteristics as well as results regarding our research question will be extracted. The quality of included studies will be assessed using an appropriate tool. Study selection, data extraction and assessment of study quality will be performed by two reviewers. Disagreements will be resolved through discussion or by inclusion of a third party. Results will be synthesised narratively in text and tables. Depending on the number and heterogeneity of the studies included, a meta-analysis will be performed.Ethics and disseminationAs no primary data will be collected, approval from an ethics committee is not required. Results will be disseminated through conference presentations and publication in a peer-reviewed, scientific journal.PROSPERO registration numberCRD42018108008.

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What are Systematic Reviews?

WikiJournal of Medicine ◽

10.15347/wjm/2020.004 ◽

2020 ◽

Vol 7 (1) ◽

pp. 4

Author(s):

Jack Nunn ◽

◽

Steven Chang ◽

Keyword(s):

Public Health ◽

Systematic Review ◽

Systematic Reviews ◽

Evidence Synthesis ◽

Meta Analysis ◽

Research Question ◽

Secondary Data ◽

Current Evidence ◽

Economic Evaluations ◽

Environmental Interventions

Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question.[1] While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively.[2] Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine,[3] and a review of existing studies is often quicker and cheaper than embarking on a new study. While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful.[4] Systematic reviews may examine clinical tests, public health interventions, environmental interventions,[5] social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations.[6][7] An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.

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An Epistemological Criticism of Social Entrepreneurship: Is Social Entrepreneurship a Sound Scientific Field of Research

10.31124/advance.7091927.v1 ◽

2018 ◽

Author(s):

Amir Forouharfar

Keyword(s):

Social Entrepreneurship ◽

Social Constructivism ◽

Social Epistemology ◽

American English ◽

Meta Analysis ◽

Research Question ◽

Knowledge Structure ◽

Scientific Field ◽

The Other ◽

First Time

The paper was shaped around the pivotal question: Is SE a sound and scientific field of research? The question has given a critical tone to the paper and has also helped to bring out some of the controversial debates in the realm of SE. The paper was organized under five main discussions to be able to provide a scientific answer to the research question: (1) is “social entrepreneurship” an oxymoron?, (2) the characteristics of SE knowledge, (3) sources of social entrepreneurship knowledge, (4) SE knowledge: structure and limitations and (5) contributing epistemology-making concepts for SE. Based on the sections, the study relied on the relevant philosophical schools of thought in Epistemology (e.g. Empiricism, Rationalism, Skepticism, Internalism vs. Externalism, Essentialism, Social Constructivism, Social Epistemology, etc.) to discuss these controversies around SE and proposes some solutions by reviewing SE literature. Also, to determine the governing linguistic discourse in the realm of SE, which was necessary for our discussion, Corpus of Contemporary American English (COCA) for the first time in SE studies was used. Further, through the study, SE buzzwords which constitute SE terminology were derived and introduced to help us narrowing down and converging the thoughts in this field and demarking the epistemological boundaries of SE. The originality of the paper on one hand lies in its pioneering discussions on SE epistemology and on the other hand in paving the way for a construction of sound epistemology for SE; therefore in many cases after preparing the philosophical ground for the discussions, it went beyond the prevalent SE literature through meta-analysis to discuss the cases which were raised. The results of the study verified previously claimed embryonic pre-paradigmatic phase in SE which was far from a sound and scientific knowledge, although the scholarly endeavors are the harbingers of such a possibility in the future which calls for further mature academic discussion and development of SE knowledge by the SE academia.

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Optimal Application of Forced Air Warming to Prevent Peri-Operative Hypothermia during Abdominal Surgery: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052517 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2517

Author(s):

Yoonyoung Lee ◽

Kisook Kim

Keyword(s):

Systematic Review ◽

Abdominal Surgery ◽

Critical Appraisal ◽

Meta Analysis ◽

Upper Body ◽

Cochrane Library ◽

Randomized Controlled ◽

Forced Air Warming ◽

Forced Air ◽

Full Body

Patients who undergo abdominal surgery under general anesthesia develop hypothermia in 80–90% of the cases within an hour after induction of anesthesia. Side effects include shivering, bleeding, and infection at the surgical site. However, the surgical team applies forced air warming to prevent peri-operative hypothermia, but these methods are insufficient. This study aimed to confirm the optimal application method of forced air warming (FAW) intervention for the prevention of peri-operative hypothermia during abdominal surgery. A systematic review and meta-analysis were conducted to provide a synthesized and critical appraisal of the studies included. We used PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL to systematically search for randomized controlled trials published through March 2020. Twelve studies were systematically reviewed for FAW intervention. FAW intervention effectively prevented peri-operative hypothermia among patients undergoing both open abdominal and laparoscopic surgery. Statistically significant effect size could not be confirmed in cases of only pre- or peri-operative application. The upper body was the primary application area, rather than the lower or full body. These findings could contribute detailed standards and criteria that can be effectively applied in the clinical field performing abdominal surgery.

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321 Role of Antibiotics in Acute uncomplicated diverticulitis, A Systematic Review and Meta-Analysis

British Journal of Surgery ◽

10.1093/bjs/znab134.404 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A A Tahir ◽

K M Ali ◽

A U Khan ◽

S Kamal ◽

A Hussain ◽

...

Keyword(s):

Systematic Review ◽

Statistical Analysis ◽

Treatment Failure ◽

Hospital Stay ◽

Meta Analysis ◽

Dietary Advice ◽

Duration Of Hospital Stay ◽

Uncomplicated Diverticulitis ◽

Acute Uncomplicated Diverticulitis

Abstract Introduction Diverticular disease is a common health problem with a wide clinical spectrum. About 75% of the patients would have uncomplicated diverticulitis. Cornerstones of treatment are antibiotics, analgesia, and dietary advice. Recent evidence has shown that its treatment is controversial, questioning the use of antibiotics. Aim is to assess the role of antibiotics in the treatment of acute uncomplicated diverticulitis. Method This is a systematic review and Meta-analysis. Literature review of the available studies was conducted using search engines like Pubmed, Medline, Embase, Google Scholar, and Cochrane databases. Statistical analysis was conducted using RevMan5.4. Results Out of 1754 records 1324 were duplicates, 430 studies were screened. 395 were further excluded.35 full text articles were assessed and in the final review 10 studies were included. PRISMA guidelines were used. Pooled OR for recurrence = 0.92 (95% CI = 0.74 to 1.13). Pooled OR for Hospital stay= -0.66 (95% CI= -1.12 to -0.21). Pooled OR for complications = 1.06 (95% CI = 0.69 to 1.64). Pooled OR for treatment failure= 1.24 (95% CI = 0.90-1.69). Conclusions We conclude that from the available evidence antibiotics have no role in reducing recurrence, complications, treatment failure, and duration of hospital stay in acute uncomplicated diverticulitis.

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Study protocol of a systematic review and qualitative evidence synthesis using two different approaches: Healthcare related needs and desires of older people with post-stroke aphasia

BMJ Open ◽

10.1136/bmjopen-2020-039348 ◽

2021 ◽

Vol 11 (4) ◽

pp. e039348

Author(s):

Nadine Janis Pohontsch ◽

Thorsten Meyer ◽

Yvonne Eisenmann ◽

Maria-Inti Metzendorf ◽

Verena Leve ◽

...

Keyword(s):

Systematic Review ◽

Older People ◽

Evidence Synthesis ◽

Meta Analysis ◽

Research Question ◽

Treatment Success ◽

Qualitative Studies ◽

Qualitative Evidence Synthesis ◽

Healthcare Needs ◽

Qualitative Evidence

IntroductionStroke is a frequent disease in the older population of Western Europe with aphasia as a common consequence. Aphasia is known to impede targeting treatment to individual patients’ needs and therefore may reduce treatment success. In Germany, the postacute care of patients who had stroke is provided by different healthcare institutions of different sectors (rehabilitation, nursing and primary care) with substantial difficulties to coordinate services. We will conduct two qualitative evidence syntheses (QESs) aiming at exploring distinct healthcare needs and desires of older people living with poststroke aphasia. We thereby hope to support the development of integrated care models based on needs of patients who are very restricted to communicate them. Since various methods of QESs exist, the aim of the study embedding the two QESs was to determine if findings differ according to the approach used.Methods and analysisWe will conduct two QESs by using metaethnography (ME) and thematic synthesis (ThS) independently to synthesise the findings of primary qualitative studies. The main differences between these two methods are the underlying epistemologies (idealism (ME) vs realism (ThS)) and the type of research question (emerging (ME) vs fixed (ThS)).We will search seven bibliographical databases. Inclusion criteria comprise: patients with poststroke aphasia, aged 65 years and older, studies in German/English, all types of qualitative studies concerning needs and desires related to healthcare or the healthcare system. The protocol was registered in the International Prospective Register of Systematic Reviews, follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and includes three items from the Enhancing Transparency in Reporting the synthesis of Qualitative Research checklist.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented on national conferences.

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Systematic review protocol to assess artificial intelligence diagnostic accuracy performance in detecting acute ischaemic stroke and large-vessel occlusions on CT and MR medical imaging

BMJ Open ◽

10.1136/bmjopen-2020-043665 ◽

2021 ◽

Vol 11 (3) ◽

pp. e043665

Author(s):

Srinivasa Rao Kundeti ◽

Manikanda Krishnan Vaidyanathan ◽

Bharath Shivashankar ◽

Sankar Prasad Gorthi

Keyword(s):

Artificial Intelligence ◽

Systematic Review ◽

Diagnostic Accuracy ◽

Ischaemic Stroke ◽

Study Protocol ◽

Systematic Reviews ◽

Acute Ischaemic Stroke ◽

Meta Analysis ◽

Large Vessel ◽

Sufficient Data

IntroductionThe use of artificial intelligence (AI) to support the diagnosis of acute ischaemic stroke (AIS) could improve patient outcomes and facilitate accurate tissue and vessel assessment. However, the evidence in published AI studies is inadequate and difficult to interpret which reduces the accountability of the diagnostic results in clinical settings. This study protocol describes a rigorous systematic review of the accuracy of AI in the diagnosis of AIS and detection of large-vessel occlusions (LVOs).Methods and analysisWe will perform a systematic review and meta-analysis of the performance of AI models for diagnosing AIS and detecting LVOs. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. Literature searches will be conducted in eight databases. For data screening and extraction, two reviewers will use a modified Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist. We will assess the included studies using the Quality Assessment of Diagnostic Accuracy Studies guidelines. We will conduct a meta-analysis if sufficient data are available. We will use hierarchical summary receiver operating characteristic curves to estimate the summary operating points, including the pooled sensitivity and specificity, with 95% CIs, if pooling is appropriate. Furthermore, if sufficient data are available, we will use Grading of Recommendations, Assessment, Development and Evaluations profiler software to summarise the main findings of the systematic review, as a summary of results.Ethics and disseminationThere are no ethical considerations associated with this study protocol, as the systematic review focuses on the examination of secondary data. The systematic review results will be used to report on the accuracy, completeness and standard procedures of the included studies. We will disseminate our findings by publishing our analysis in a peer-reviewed journal and, if required, we will communicate with the stakeholders of the studies and bibliographic databases.PROSPERO registration numberCRD42020179652.

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