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Systematic Reviews

A guide for researchers undertaking a systematic review

Formulate your question

Systematic reviews aim to answer a single research question.

A good review question:

  • Allows you to find relevant and valid information quickly
  • Provides a checklist for the main concepts to be included in your search strategy

There are  many mnemonics like PICO available to assist you with formulating a search strategy based on the type of review you are undertaking and the kind of question you are asking.

 

Question Frameworks

The PICO framework is commonly used to develop focused clinical questions for quantitative systematic reviews.

Population

Participants, patient or population.

What are the characteristics of the patient or problem?

What is the condition or disease you are interested in?
Intervention

Treatment, diagnosis, observation, therapy etc.

What do you want to do with this patient (i.e. treat, diagnose, observe)?
Comparison

Other intervention or treatment option.

What is the alternative to the intervention (e.g. placebo, different drug, surgery)?
Outcome

What are the relevant outcomes (e.g. morbidity, death, complications)?

 

As an example research topic..
 

In middle aged women suffering from migraines, is Botulinium toxin type A compared to placebo effective at decreasing migraine frequency?
 

P = Middle aged women suffering from migraines

I = Botulinium toxin type A

C = Placebo

O = Decreased migraine frequency

The PICo framework is commonly used to develop focused clinical questions for qualitative questions.

Population

Population of problem, condition or disease of interest
Phenomena of Interest

A defined event, activity, experience or process
Context Setting or distinct characteristics.

SPICE can be used to evaluate outcomes of a specific intervention.

Setting Where?
Perspective For whom?
Intervention What?
Comparison In comparison to what?
Evaluation With what result?

SPIDER can be used for both qualitative and mixed methods research.

Sample Who is the sample of interest?
Phenomenon of Interest A defined event, activity, experience or process.
Design What types of study methods are you interested in?
Evaluation What are the evaluation outcomes?
Research type What type of research are you interested in?
Qualitative or mixed method?
Mnenomic Explanation Used for...
PEO Population - Exposure - Outcome Aetiology and Risk
CoCoPop Condition - Context - Population Prevalence and Incidence
PIRD Population - Index test - Reference test - Diagnosis of interest Diagnostic test accuracy
PCC Population - Concept - Context Scoping reviews
PICOC Population - Intervention - Comparator(s) - Outcome - Context Costs / Economic evaluation
CPIMP Construct of interest - Population - Type of measurement instrument - Measurement properties Psychometric
PFO Population - Prognostic Factors - Outcome Prognostic
ECLIPSE Expectation (improvement or information or innovation) - Client group (at whom the service is aimed?) - Location (where is the service located?) - Impact (outcomes) - Professionals (who is involved in providing/improving service?) - Service (for which service are you looking for information?) Health policy/ Management information

Search protocols and reviews

Have you checked to see if there is an existing systematic review answering your research question?

Checking existing reviews and protocols will help avoid duplication and ensure that no reviews on the topic are already in progress.

This may also help you in choosing or refining a review topic.

You can try a search in OneSearch or other databases for publications on your topic that include the term "systematic review" in the title or abstract.

Look at these sources listed in the following tabs to see if a recent review has already been performed on your topic of interest.

A review in progress (or prospective systematic review) is referred to as a protocol.
A protocol clearly documents what the reviewer intends to do in their systematic review.

Current protocols:

Many clinical trial registers include information about trials that are in progress as well as those that have been completed.

Clinical trial registers:

Some databases focus specifically on indexing evidence-based medicine, systematic reviews, etc. such as Cochrane databases.

You can search larger subject databases and limit the search to 'systematic review.'

It's also useful to search the large multidisciplinary citation databases Web of Science and Scopus, particularly if your research is cross-disciplinary.

Databases with systematic reviews:

  • MEDLINE - International database of biomedical literature produced by the U.S. National Library of Medicine.
  • Cochrane Library - All areas of medicine and health.
  • Campbell Systematic Reviews - Education, crime, justice, social welfare and international development.
  • EPPI Centre - Systematic reviews across health, education, welfare, and other public policy sectors.
  • Epistemonikos - Evidence-based health care and information technologies
  • BMJ Best Practice - Point of care reference database. Clinical decision support tool covering disease and evidence-based methodology.
  • Campbell Collaboration - reviews on economics and social policy.

The protocol

Your protocol will describe the rationale, hypothesis, and planned methods of your systematic review.
It should be prepared before you start and used as a guide throughout the review.

 

The protocol should include:

  • The review question and objective
  • Inclusion and exclusion criteria
  • Draft search strategy
  • Information sources (e.g. databases, trial registers, and grey literature etc.)
  • Methodology for selection, management and data extraction of studies
  • Declaration of interests
  • Explanation of how data will be synthesised and reported

 

For more information, visit the PRISMA website. PRISMA is an evidence-based minimum set of items for reporting in systematic reviews and meta-analysis. Here you can access information such as:

  • A checklist to facilitate the development and reporting of systematic review protocols
  • Reporting guidelines designed to help report why systematic reviews were performed, what methods were used, and what was found.
  • Checklist for preparing and writing a systematic review.
  • Flow diagrams showing the flow of information through phases of a systematic review.

It is highly recommended that you register or publish your systematic review protocol prior to undertaking your review because it can:

  • Limit duplication of reviews by identifying topics already under review
  • Allows peer-review of protocol by increasing visibility of research to researchers and editors globally
  • Provides a base of evidence to critically analyse the review versus protocol once complete

 

Depending on your type of review, and the content focus, the following review registers are recommended:

PROSPERO

Systematic reviews, umbrella reviews, and rapid reviews related to health sciences

Note: Does not accept scoping reviews nor resources to register reviews done as part of training courses.
Cochrane Library Systematic reviews of health evidence.
OSF Open Science Framework, a free, open platform to support research and collaboration.
Research Registry Registry of systematic reviews and meta-analyses
Collaboration for Environmental Evidence Environmental and Agricultural Sciences
Research Square Multidisciplinary preprint server that posts research in all scientific areas including physical, biomedical, and social science.
Figshare Provider of open research repository infrastructure covering all subject areas.
INPLASY International platform of registered systematic review and meta-analysis protocols
Protocols.io Platform for collaboration, developing and organising protocols.
Journals

Journals that provide scope to publish systematic and scoping reviews, such as:

JBI Evidence Synthesis (Journal)

Systematic Reviews (Springer Nature)

Environmental Science (Springer Nature)

For more information on where to prospectively register a systematic review:

Pieper, D., & Rombey, T. (2022). Where to prospectively register a systematic review. Systematic reviews, 11(8). https://dx.doi.org/10.1186/s13643-021-01877-1

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