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The Final Step of Systematic Review Is Quizlet

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Comprehensive review of research literature using systematic methods

Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a blazon of prove synthesis which codify research questions that are wide or narrow in scope, and place and synthesize data that directly relate to the systematic review question.[i] While some people might associate 'systematic review' with 'meta-analysis', at that place are multiple kinds of review which can be defined as 'systematic' which do non involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively.[2] Systematic reviews are oftentimes designed to provide an exhaustive summary of electric 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 written report.

While systematic reviews are often applied in the biomedical or healthcare context, they can exist used in other areas where an assessment of a precisely divers bailiwick would be helpful.[iv] Systematic reviews may examine clinical tests, public health interventions, ecology interventions,[5] social interventions, adverse furnishings, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations.[vi] [7]

An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health intendance, public health and public policy.

Characteristics [edit]

Systematic reviews can be used to inform conclusion making in many different disciplines, such as evidence-based healthcare and testify-based policy and practice.[8]

A systematic review tin can exist designed to provide an exhaustive summary of current literature relevant to a research question.

A systematic review uses a rigorous and transparent arroyo for enquiry synthesis, with the aim of assessing and, where possible, minimizing bias in the findings. While many systematic reviews are based on an explicit quantitative meta-analysis of available information, in that location are also qualitative reviews and other types of mixed-methods reviews which adhere to standards for gathering, analyzing and reporting evidence.[9]

Systematic reviews of quantitative data or mixed-method reviews sometimes use statistical techniques (meta-analysis) to combine results of eligible studies. Scoring levels are sometimes used to charge per unit the quality of the evidence depending on the methodology used, although this is discouraged by the Cochrane Library.[10] As testify rating tin can be subjective, multiple people may be consulted to resolve whatsoever scoring differences betwixt how evidence is rated.[11] [12] [13]

The EPPI-Centre, Cochrane and the Joanna Briggs Institute accept all been influential in developing methods for combining both qualitative and quantitative inquiry in systematic reviews.[xiv] [15] [xvi] Several reporting guidelines be to standardise reporting about how systematic reviews are conducted. Such reporting guidelines are not quality assessment or appraisal tools. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement[17] suggests a standardized way to ensure a transparent and complete reporting of systematic reviews, and is now required for this kind of enquiry past more than than 170 medical journals worldwide.[8] Several specialized PRISMA guideline extensions accept been developed to support item types of studies or aspects of the review process, including PRISMA-P for review protocols and PRISMA-ScR for scoping reviews.[8] A listing of PRISMA guideline extensions is hosted past the EQUATOR (Enhancing the QUAlity and Transparency Of health Inquiry) Network.[18]

For qualitative reviews, reporting guidelines include ENTREQ (Enhancing transparency in reporting the synthesis of qualitative research) for qualitative bear witness syntheses; RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) for meta-narrative and realist reviews;[19] [twenty] and emerge (Improving reporting of Meta-Ethnography) for meta-ethnograph.[14]

Developments in systematic reviews during the 21st century included realist reviews and the meta-narrative approach, both of which addressed problems of variation in methods and heterogeneity existing on some subjects.[21] [22]

Types [edit]

At that place are over 30 types of systematic review and the Tabular array ane below summarises some of these, but information technology is not exhaustive.[eight] [17] Information technology is important to annotation that there is non always consensus on the boundaries and distinctions between the approaches described below.

Tabular array i: A summary of some of the types of systematic review.
Review type Summary
Mapping review/systematic map A mapping review maps existing literature and categorizes data. The method characterizes quantity and quality of literature, including by study blueprint and other features. Mapping reviews can exist used to identify the need for primary or secondary inquiry.[8]
Meta-assay A meta-assay is a statistical analysis that combines the results of multiple quantitative studies. Using statistical methods, results are combined to provide testify from multiple studies. The two types of data generally used for meta-assay in wellness research are individual participant information and amass data (such as odds ratios or relative risks).
Mixed studies review/mixed methods review Refers to any combination of methods where one pregnant stage is a literature review (ofttimes systematic). It can too refer to a combination of review approaches such as combining quantitative with qualitative inquiry.[8]
Qualitative systematic review/qualitative show synthesis This method for integrates or compares findings from qualitative studies. The method tin include 'coding' the information and looking for 'themes' or 'constructs' across studies. Multiple authors may improve the 'validity' of the data by potentially reducing individual bias.[8]
Rapid review An cess of what is already known about a policy or practice result, which uses systematic review methods to search for and critically appraise existing research. Rapid reviews are still a systematic review, notwithstanding parts of the procedure may be simplified or omitted in order to increment rapidity.[23] Rapid reviews were used during the COVID-xix pandemic.[24]
Systematic review A systematic search for information, using a repeatable method. Information technology includes appraising the data (for case the quality of the data) and a synthesis of enquiry data.
Systematic search and review Combines methods from a 'disquisitional review' with a comprehensive search process. This review type is usually used to accost broad questions to produce the nigh advisable bear witness synthesis. This method may or may not include quality cess of data sources.[eight]
Systematized review Include elements of systematic review procedure, but searching is often not as comprehensive equally a systematic review and may non include quality assessments of information sources.

Scoping reviews [edit]

Scoping reviews are distinct from systematic reviews in several of import ways. A scoping review is an attempt to search for concepts by mapping the linguistic communication and information which surrounds those concepts and adjusting the search method iteratively to synthesize evidence and assess the scope of an surface area of inquiry.[21] [22] This tin mean that the concept search and method (including information extraction, organisation and analysis) are refined throughout the procedure, sometimes requiring deviations from any protocol or original inquiry programme.[25] [26] A scoping review may oft be a preliminary stage before a systematic review, which 'scopes' out an area of inquiry and maps the language and key concepts to determine if a systematic review is possible or advisable, or to lay the groundwork for a total systematic review. The goal can be to assess how much data or evidence is bachelor regarding a certain area of interest.[25] [27] This process is further complicated if it is mapping concepts across multiple languages or cultures.

As a scoping review should exist systematically conducted and reported (with a transparent and repeatable method), some academic publishers categorize them as a kind of 'systematic review', which may cause confusion. Scoping reviews are helpful when it is non possible to deport out a systematic synthesis of research findings, for example, when there are no published clinical trials in the expanse of inquiry. Scoping reviews are helpful when determining if it is possible or appropriate to carry out a systematic review, and are a useful method when an area of inquiry is very wide,[28] for example, exploring how the public are involved in all stages systematic reviews.[29]

In that location is still a lack of clarity when defining the exact method of a scoping review every bit it is both an iterative process and is still relatively new.[30] There accept been several attempts to ameliorate the standardisation of the method,[31] [32] [27] [33] for instance via a PRISMA guideline extension for scoping reviews (PRISMA-ScR).[34] PROSPERO (the International Prospective Annals of Systematic Reviews) does not allow the submission of protocols of scoping reviews,[35] although some journals will publish protocols for scoping reviews.[29]

Stages [edit]

While at that place are multiple kinds of systematic review methods, the master stages of a review tin be summarised into five stages:

Defining the inquiry question [edit]

Defining an answerable question and agreeing an objective method is required to pattern a useful systematic review.[36] Best practice recommends publishing the protocol of the review earlier initiating it to reduce the risk of unplanned research duplication and to enable consistency between methodology and protocol.[37] Clinical reviews of quantitative data are often structured using the acronym PICO, which stands for 'Population or Problem', 'Intervention or Exposure', 'Comparing' and 'Event', with other variations existing for other kinds of research. For qualitative reviews PICo is 'Population or Problem', 'Involvement' and 'Context'.

Searching for relevant data sources [edit]

Planning how the review volition search for relevant information from research that matches certain criteria is a decisive stage in developing a rigorous systematic review. Relevant criteria can include only selecting inquiry that is good quality and answers the divers question.[36] The search strategy should exist designed to retrieve literature that matches the protocol'southward specified inclusion and exclusion criteria.

The methodology section of a systematic review should listing all of the databases and citation indices that were searched. The titles and abstracts of identified articles can be checked confronting pre-determined criteria for eligibility and relevance. Each included study may be assigned an objective assessment of methodological quality, preferably by using methods conforming to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement,[eighteen] or the loftier-quality standards of Cochrane.[38]

Common information sources used in searches include scholarly databases of peer-reviewed articles such as MEDLINE, Web of Science, Embase, and PubMed as well as sources of unpublished literature such as clinical trial registries and grey literature collections. Fundamental references tin can also be yielded through additional methods such as citation searching, reference list checking (related to a search method called 'pearl growing'), manually searching information sources not indexed in the major electronic databases (sometimes called 'manus-searching'),[39] and directly contacting experts in the field.[forty]

To be systematic, searchers must use a combination of search skills and tools such as database subject headings, keyword searching, Boolean operators, proximity searching, while attempting to rest the sensitivity (systematicity) and precision (accuracy). Inviting and involving an experienced information professional or librarian tin notably improve the quality of systematic review search strategies and reporting.[41] [42] [43] [44] [45]

[edit]

A visualisation of information beingness 'extracted' and 'combined' in a Cochrane intervention effect review where a meta-analysis is possible[46]

Relevant data are 'extracted' from the data sources according to the review method. It is important to note that the information extraction method is specific to the kind of data, and information extracted on 'outcomes' is only relevant to certain types of reviews. For example, a systematic review of clinical trials might excerpt data about how the enquiry was done (often called the method or 'intervention'), who participated in the research (including how many people), how it was paid for (for example funding sources) and what happened (the outcomes).[36] Effectively, relevant data beingness extracted and 'combined' in a Cochrane intervention effect review, where a meta-analysis is possible.[46]

Appraise the eligibility of the data [edit]

This phase involves assessing the eligibility of data for inclusion in the review, past judging it confronting criteria identified at the commencement stage.[36] This can include assessing if a data source meets the eligibility criteria, and recording why decisions nearly inclusion or exclusion in the review were made. Software can be used to support the selection process including text mining tools and motorcar learning, which can automate aspects of the process.[47] The 'Systematic Review Toolbox' is a community driven, web-based catalogue of tools, to help reviewers chose appropriate tools for reviews.[48]

Analyse and combine the data [edit]

Analysing and combining information tin provide an overall event from all the data. Considering this combined result uses qualitative or quantitative data from all eligible sources of data, it is considered more than reliable equally information technology provides better evidence, as the more than data included in reviews, the more confident we can be of conclusions. When advisable, some systematic reviews include a meta-assay, which uses statistical methods to combine data from multiple sources. A review might use quantitative data, or might use a qualitative meta-synthesis, which synthesises information from qualitative studies. The combination of data from a meta-assay tin sometimes be visualised. One method uses a forest plot (likewise called a blobbogram).[36] In an intervention effect review, the diamond in the 'forest plot' represents the combined results of all the data included.[36]

An example of a 'forest plot' is the Cochrane Collaboration logo.[36] The logo is a woods plot of ane of the commencement reviews which showed that corticosteroids given to women who are about to requite birth prematurely can save the life of the newborn kid.[49]

Recent visualisation innovations include the boundness plot, which plots p-values against sample sizes, with approximate effect-size contours superimposed to facilitate assay.[50] The contours can be used to infer consequence sizes from studies that have been analysed and reported in various ways. Such visualisations may have advantages over other types when reviewing complex interventions.

Assessing the quality (or certainty) of evidence is an important part of some reviews. GRADE (Grading of Recommendations, Assessment, Development and Evaluations) is a transparent framework for developing and presenting summaries of evidence and is used to form the quality of testify.[51] The GRADE-CERQual (Confidence in the Show from Reviews of Qualitative enquiry) is used to provide a transparent method for assessing the confidence of show from reviews or qualitative research.[52] Once these stages are complete, the review may be published, disseminated and translated into practice subsequently being adopted as evidence.

Automation of systematic reviews [edit]

Living systematic reviews are a relatively new kind of loftier quality, semi-automated, up-to-engagement online summaries of research which are updated as new research becomes bachelor.[53] The essential departure betwixt a living systematic review and a conventional systematic review is the publication format. Living systematic reviews are 'dynamic, persistent, online-only evidence summaries, which are updated rapidly and oftentimes'.[54]

While living systematic reviews seek to maintain current evidence, the automation or semi-automation of the systematic process itself is increasingly beingness explored. While piddling evidence exists to demonstrate it is as accurate or involves less manual try, efforts that promote preparation and using artificial intelligence for the process are increasing.[55] [56]

Research fields [edit]

Medicine and human being wellness [edit]

History of systematic reviews in medicine [edit]

A 1904 British Medical Journal newspaper past Karl Pearson collated data from several studies in the Britain, India and S Africa of typhoid inoculation. He used a meta-analytic approach to aggregate the outcomes of multiple clinical studies.[57] In 1972 Archie Cochrane wrote: 'It is surely a great criticism of our profession that we have not organised a disquisitional summary, past specialty or subspecialty, adjusted periodically, of all relevant randomised controlled trials'.[58] Critical appraisal and synthesis of inquiry findings in a systematic style emerged in 1975 nether the term 'meta analysis'.[59] [60] Early syntheses were conducted in broad areas of public policy and social interventions, with systematic inquiry synthesis applied to medicine and wellness.[61] Inspired past his own personal experiences every bit a senior medical officer in pw camps, Archie Cochrane worked to improve how the scientific method was used in medical evidence, writing in 1971: 'the general scientific problem with which we are primarily concerned is that of testing a hypothesis that a certain treatment alters the natural history of a disease for the better'.[62] His call for the increased employ of randomised controlled trials and systematic reviews led to the creation of The Cochrane Collaboration,[63] which was founded in 1993 and named after him, building on the work by Iain Chalmers and colleagues in the area of pregnancy and childbirth.[64] [58]

Current use of systematic reviews in medicine [edit]

Many organisations around the world apply systematic reviews, with the methodology depending on the guidelines being followed. Organisations which use systematic reviews in medicine and human health include the National Constitute for Health and Intendance Excellence (NICE, UK), the Agency for Healthcare Research and Quality (AHRQ, The states) and the World Wellness Organization. Nigh notable amidst international organisations is Cochrane, a group of over 37,000 specialists in healthcare who systematically review randomised trials of the effects of prevention, treatments and rehabilitation as well every bit health systems interventions. When appropriate, they also include the results of other types of enquiry. Cochrane Reviews are published in The Cochrane Database of Systematic Reviews section of the Cochrane Library. The 2015 affect factor for The Cochrane Database of Systematic Reviews was half-dozen.103, and it was ranked 12th in the Medicine, General & Internal category.[65]

In that location are several types of Cochrane Review, including:[66] [67] [68] [69]

  1. Intervention reviews assess the benefits and harms of interventions used in healthcare and wellness policy.
  2. Diagnostic test accuracy reviews assess how well a diagnostic test performs in diagnosing and detecting a detail illness. For conducting diagnostic examination accurateness reviews, free software such as MetaDTA and Cast-HSROC in the graphical user interface is available.[seventy] [71]
  3. Methodology reviews address issues relevant to how systematic reviews and clinical trials are conducted and reported.
  4. Qualitative reviews synthesize qualitative evidence to address questions on aspects other than effectiveness.
  5. Prognosis reviews accost the probable course or future issue(due south) of people with a health problem.
  6. Overviews of Systematic Reviews (OoRs) are a new type of written report to compile multiple show from systematic reviews into a unmarried document that is accessible and useful to serve as a friendly forepart end for the Cochrane Collaboration with regard to healthcare decision-making. These are sometimes referred to equally 'umbrella reviews'.
  7. Living Systematic reviews are continually updated, incorporating relevant new show as information technology becomes available.[72] They are a relatively new kind of review, with methods withal being developed and evaluated. They can exist high quality, semi-automated, upwards-to-date online summaries of research which are updated as new research becomes bachelor.[73] The essential difference between a 'living systematic review' and a conventional systematic review is the publication format. Living systematic reviews are 'dynamic, persistent, online-but evidence summaries, which are updated chop-chop and oft'.[74]
  8. Rapid reviews are a class of knowledge synthesis that 'accelerates the procedure of conducting a traditional systematic review through streamlining or omitting specific methods to produce prove for stakeholders in a resource-efficient fashion'.[75]
  9. Reviews of circuitous health interventions in circuitous systems review interventions and interventions delivered in circuitous systems to ameliorate evidence synthesis and guideline evolution at a global, national or wellness systems level.[76]

The Cochrane Collaboration provides a handbook for systematic reviewers of interventions which 'provides guidance to authors for the training of Cochrane Intervention reviews.'[38] The Cochrane Handbook likewise outlines the key steps for preparing a systematic review[38] and forms the basis of two sets of standards for the conduct and reporting of Cochrane Intervention Reviews (MECIR - Methodological Expectations of Cochrane Intervention Reviews).[77] It also contains guidance on how to undertake qualitative prove synthesis, economical reviews and integrating patient-reported outcomes into reviews.

The Cochrane Library is a collection of databases that contains unlike types of independent show to inform healthcare decision-making. It contains a database of systematic review and meta-analyses which summarize and translate the results of multi-disciplinary research. The library contains the Cochrane Database of Systematic Reviews (CDSR), which is a journal and database for systematic reviews in health care. The Cochrane Library also contains the Cochrane Central Register of Controlled Trials (CENTRAL) which is a database of reports of randomized and quasi-randomized controlled trials.[78] The Cochrane Library is also available in Spanish.[79]

The Cochrane Library is endemic by Cochrane. Information technology was originally published by Update Software and at present published by the share-holder owned publisher John Wiley & Sons, Ltd. as role of Wiley Online Library. Royalties from sales of the Cochrane Library are the major source of funds for Cochrane (over £half-dozen one thousand thousand in 2017). There are 3.66 billion people around the world who accept access to the Library through national licences (national licences cost £ane.5 billion[80]) or free provision for populations in low- and middle-income countries eligible under the WHO's HINARI initiative.[eighty] Authors must pay an additional fee for their review to exist truly open access.[81] Cochrane has an annual income of $10m USD.[82]

Public involvement and citizen scientific discipline in systematic reviews [edit]

Cochrane has several tasks that the public or other 'stakeholders' tin be involved in doing, associated with producing systematic reviews and other outputs. Tasks tin can exist organised as 'entry level' or higher. Tasks include:

  • Joining a collaborative volunteer effort to help categorise and summarise healthcare bear witness[83]
  • Data extraction and risk of bias assessment
  • Translation of reviews into other languages

A recent systematic review of how people were involved in systematic reviews aimed to document the evidence-base relating to stakeholder involvement in systematic reviews and to apply this evidence to describe how stakeholders have been involved in systematic reviews.[84] Thirty percent involved patients and/or carers. The ACTIVE framework provides a way to consistently describe how people are involved in systematic review, and may be used every bit a way to support the decision-making of systematic review authors in planning how to involve people in future reviews.[85] Standardised Data on Initiatives (STARDIT) is another proposed manner of reporting who has been involved in which tasks during research, including systematic reviews.[86]

While at that place has been some criticism of how Cochrane prioritises systematic reviews,[87] a contempo project involved people in helping identify research priorities to inform future Cochrane Reviews.[88] [89] In 2014, the Cochrane-Wikipedia partnership was formalised. This supports the inclusion of relevant evidence within all Wikipedia medical articles, as well as other processes to help ensure that medical information included in Wikipedia is of the highest quality and accurateness.[xc]

Learning resources [edit]

Cochrane has produced many learning resources to assistance people sympathise what systematic reviews are, and how to practice them. Most of the learning resources can be plant at the 'Cochrane Grooming' webpage,[91] which also includes a link to the book Testing Treatments, which has been translated into many languages.[92] In improver, Cochrane has created a short video What are Systematic Reviews which explains in evidently English language how they work and what they are used for.[93] The video has been translated into multiple languages,[94] and viewed over 192,282 times (as of August 2020). In add-on, an animated storyboard version was produced and all the video resources were released in multiple versions under Creative Commons for others to employ and arrange.[95] [96] [97] [98] The Disquisitional Appraisement Skills Program (CASP) provides free learning resources to support people to appraise research critically, including a checklist which contains 10 questions to 'help yous make sense of a systematic review'.[99] [100]

Social, behavioural and educational [edit]

In 1959, social scientist and social work educator Barbara Wootton published one of the first contemporary systematic reviews of literature on anti-social beliefs as part of her work, Social Science and Social Pathology.[101] [102]

Several organisations employ systematic reviews in social, behavioural, and educational areas of show-based policy, including the National Institute for Wellness and Intendance Excellence (NICE, Great britain), Social Care Institute for Excellence (SCIE, U.k.), the Agency for Healthcare Research and Quality (AHRQ, The states), the Globe Wellness System, the International Initiative for Touch on Evaluation (3ie), the Joanna Briggs Establish and the Campbell Collaboration. The quasi-standard for systematic review in the social sciences is based on the procedures proposed by the Campbell Collaboration, which is 1 of several groups promoting evidence-based policy in the social sciences. The Campbell Collaboration: 'helps people make well-informed decisions past preparing, maintaining and disseminating systematic reviews in teaching, crime and justice, social welfare and international development.'[103] The Campbell Collaboration is a sibling initiative of Cochrane, and was created in 2000 at the inaugural meeting in Philadelphia, USA, attracting 85 participants from 13 countries.[104]

Concern and economic science [edit]

Due to the dissimilar nature of research fields outside of the natural sciences, the aforementioned methodological steps cannot easily be practical in all areas of business concern research. Some attempts to transfer the procedures from medicine to business research take been made,[105] including a step-by-step approach,[106] and developing a standard procedure for conducting systematic literature reviews in business and economics. The Campbell & Cochrane Economics Methods Group (C-CEMG) works to ameliorate the inclusion of economic evidence into Cochrane and Campbell systematic reviews of interventions, to enhance the usefulness of review findings as a component for decision-making.[107] Such economic evidence is crucial for health technology cess processes.

International development research [edit]

Systematic reviews are increasingly prevalent in other fields, such as international development research.[108] Subsequently, several donors (including the UK Section for International Development (DFID) and AusAid) are focusing more attention and resource on testing the appropriateness of systematic reviews in assessing the impacts of development and humanitarian interventions.[108]

Surround [edit]

The Collaboration for Environmental Show (CEE) works to achieve a sustainable global environment and the conservation of biodiversity. The CEE has a periodical titled Environmental Bear witness which publishes systematic reviews, review protocols and systematic maps on impacts of man activity and the effectiveness of management interventions.[109]

Environmental health and toxicology [edit]

Systematic reviews are a relatively recent innovation in the field of environmental wellness and toxicology. Although mooted in the mid-2000s, the commencement full frameworks for deport of systematic reviews of environmental health evidence were only published in 2014 by the US National Toxicology Program'due south Function of Wellness Cess and Translation[110] and the Navigation Guide at the University of California San Francisco'southward Program on Reproductive Health and the Environment.[111] Uptake has since been rapid, with the estimated number of systematic reviews in the field doubling since 2016 and the kickoff consensus recommendations on all-time practice, as a precursor to a more general standard, being published in 2020.[112]

Review tools [edit]

A 2019 publication identified xv systematic review tools and ranked them co-ordinate to the number of 'disquisitional features' as required to perform a systematic review, including:[113]

  • DistillerSR: a proprietary, paid web awarding
  • Swift Agile Screener: a proprietary, paid spider web application
  • Covidence: a proprietary, paid web application and Cochrane technology platform.
  • Rayyan: a proprietary, gratis of accuse web application
  • Sysrev: a proprietary, freemium web application

Limitations [edit]

While systematic reviews involve a highly rigorous arroyo to synthesizing the evidence, they withal have several limitations.

Out-dated or risk of bias [edit]

While systematic reviews are regarded every bit the strongest form of evidence, a 2003 review of 300 studies found that non all systematic reviews were equally reliable, and that their reporting tin can be improved past a universally agreed upon ready of standards and guidelines.[114] A further study by the same group found that of 100 systematic reviews monitored, vii% needed updating at the time of publication, another 4% within a year, and another eleven% inside 2 years; this figure was higher in rapidly irresolute fields of medicine, particularly cardiovascular medicine.[115] A 2003 report suggested that extending searches beyond major databases, maybe into grey literature, would increment the effectiveness of reviews.[116]

Some authors have highlighted issues with systematic reviews, particularly those conducted by Cochrane, noting that published reviews are ofttimes biased, out of date and excessively long.[117] Cochrane reviews have been criticized as not being sufficiently disquisitional in the pick of trials and including as well many of low quality. They proposed several solutions, including limiting studies in meta-analyses and reviews to registered clinical trials, requiring that original data be made bachelor for statistical checking, paying greater attention to sample size estimates, and eliminating dependence on only published data.

Some of these difficulties were noted every bit early equally 1994:

much poor inquiry arises considering researchers feel compelled for career reasons to conduct out research that they are ill equipped to perform, and nobody stops them.

DG Altman, 1994 [118]

Methodological limitations of meta-assay accept also been noted.[119] Another concern is that the methods used to conduct a systematic review are sometimes changed once researchers see the available trials they are going to include.[120] Some website have described retractions of systematic reviews and published reports of studies included in published systematic reviews.[121] [122] [123] Eligibility criteria must be justifiable and not arbitrary (for example, the date range searched) every bit this may touch on the perceived quality of the review.[124] [125]

Limited reporting of clinical trials and data from human studies [edit]

The 'AllTrials' campaign highlights that around half of clinical trials have never reported results and works to meliorate reporting.[126] This lack of reporting has extremely serious implications for research, including systematic reviews, every bit it is only possible to synthesize data of published studies. In add-on, 'positive' trials were twice as likely to exist published every bit those with 'negative' results.[127] At present, it is legal for for-profit companies to conduct clinical trials and not publish the results.[128] For example, in the past x years 8.7 1000000 patients take taken part in trials that have not published results.[128] These factors mean that it is likely in that location is a significant publication bias, with only 'positive' or perceived favourable results existence published. A recent systematic review of industry sponsorship and enquiry outcomes concluded that 'sponsorship of drug and device studies by the manufacturing company leads to more favorable efficacy results and conclusions than sponsorship by other sources' and that the beingness of an manufacture bias that cannot be explained past standard 'Risk of bias' assessments.[129] Systematic reviews of such a bias may amplify the event, although it is important to notation that the flaw is in the reporting of research generally, not in the systematic review method.

Poor compliance with review reporting guidelines [edit]

The rapid growth of systematic reviews in contempo years has been accompanied past the attendant effect of poor compliance with guidelines, especially in areas such every bit annunciation of registered study protocols, funding source declaration, risk of bias data, issues resulting from data abstraction, and clarification of clear written report objectives.[130] [131] [132] [133] [134] A host of studies accept identified weaknesses in the rigour and reproducibility of search strategies in systematic reviews.[135] [136] [137] [138] [139] [140] To remedy this event, a new PRISMA guideline extension chosen PRISMA-Due south is being developed to better the quality, reporting, and reproducibility of systematic review search strategies.[141] [142] Furthermore, tools and checklists for peer-reviewing search strategies accept been created, such as the Peer Review of Electronic Search Strategies (Press) guidelines.[143]

A key challenge for using systematic reviews in clinical exercise and healthcare policy is assessing the quality of a given review. Consequently, a range of appraisal tools to evaluate systematic reviews have been designed. The two well-nigh popular measurement instruments and scoring tools for systematic review quality assessment are AMSTAR ii (a measurement tool to assess the methodological quality of systematic reviews)[144] [145] [146] [147] and ROBIS (Gamble Of Bias In Systematic reviews); however, these are non advisable for all systematic review types.[148]

Virtually this article [edit]

This commodity is adjusted from a peer-reviewed version of this article from the WikiJournal of Medicine.

Standardised Data on Initiatives (STARDIT) report [edit]

A STARDIT report about this article tin be found here:

  • Reviewed STARDIT report version at fourth dimension of publishing: STARDIT Study: What are systematic reviews? (Q101116128)
  • 'Living' version: STARDIT Written report: What are systematic reviews? (Q101116128)

See also [edit]

  • Critical appraisal
  • Further research is needed
  • Horizon scanning
  • Literature review
  • Living review
  • Metascience
  • Peer review
  • Review journal
  • Generalized model assemblage (GMA)
  • Umbrella review

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  • This article was submitted to WikiJournal of Medicine for external academic peer review in 2019 (reviewer reports). The updated content was reintegrated into the Wikipedia page under a CC-Past-SA-3.0 license (2020). The version of record equally reviewed is:

Jack Nunn; et al. (9 November 2020). "What are Systematic Reviews?" (PDF). WikiJournal of Medicine. vii (1): v. doi:10.15347/WJM/2020.005. ISSN 2002-4436. Wikidata Q99440266.

External links [edit]

  • Systematic Review Tools — Search and listing of systematic review software tools
  • Cochrane Collaboration
  • MeSH: Review Literature—articles most the review process
  • MeSH: Review [Publication Type] - limit search results to reviews
  • Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, "an prove-based minimum set up of items for reporting in systematic reviews and meta-analyses"
  • PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation
  • Blithe Storyboard: What Are Systematic Reviews? - Cochrane Consumers and Communication Grouping
  • Sysrev - a costless platform with open access systematic reviews.

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Source: https://en.wikipedia.org/wiki/Systematic_review

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