Collaborating to synthesise evidence: perspectives on the role of the

Information Professional

Maura Flynn, UCC

• What is a Systematic Review (SR)?• Involvement of Information Professionals

in Systematic Reviews • Types of SRs • Involvement in SRs in UCC • Role, responsibilities and time

commitments• Training and resources • Authorship • Lessons learned

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Collaborating to synthesise evidence: perspectives on the role of the Information Professional

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“A systematic review is a high-level overview of primary research on a particular research question that tries to identify, select, synthesize and appraise all high quality research evidence relevant to that question in order to answer it.” (Cochrane)

http://community.cochrane.org/about-us/evidence-based-health-care

What is a Systematic Review?

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“The core of evidence synthesis is the systematic review of literature of a particular intervention, condition or issue.

The systematic review is essentially an analysis of the available literature (that is, evidence) and a judgement of the effectiveness or otherwise of a practice, involving a series of complex steps.” (The Joanna Briggs Institute)

http://joannabriggs.org/jbi-approach.html#tabbed-nav=Systematic-Review-Methods

What is a Systematic Review?

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Involvement of Information Professionals in Systematic Reviews

Useful to consider what our role currently is And more… importantly what could/should our role be?

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• Bath, P.A., Beverley, C.A. & Booth, A. (2003) The role of the information specialist in the systematic review process: a health information case study. Health Information and Libraries Journal, 20(2), 65-74.

• Harris, M.R. (2005) The librarian's roles in the systematic review process: a case study. Journal of the Medical Library Association (JMLA), 93(1), 81-87.

• Swinkels, A., Briddont, J. & Hall, J. (2006) Two physiotherapists, one librarian and a systematic literature review: collaboration in action. Health Information and Libraries Journal, 23(4), 248-256.

A sample of papers on this topic

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Types of reviews

• Critical review • Literature review • Mapping review/systematic review • Meta-analysis • Mixed studies review/mixed methods

review• Overview • Qualitative systematic review/qualitative

evidence synthesis • Rapid review• Scoping review• State-of-the-art review • Systematic review • Systematic search and review • Systematised review • Umbrella review Grant, M.J. & Booth, A. (2009) A Typology of Reviews: An Analysis of 14 Review

Types and Associated Methodologies. Health Information and Libraries Journal, 26(2), 91-108.

My own experience

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• Lots of instances of providing guidance (e.g. one training session) in UCC and elsewhere to staff and students who are “conducting a systematic review”

• In my opinion the definition of a “systematic review” seems to be changing in recent years, with reviews being published as “systematic reviews” which I wouldn’t deem to be a systematic review

• Perhaps the reviews that may be called “systematic reviews” might be more appropriately called something else, as per the listing of review types

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• 2014 - provided sustained support for a Cochrane Review, which happened very gradually and organically

• 2014 & 2015 - invited to be part of a multidisciplinary team member on a number of tenders and subsequent review projects

My own experience

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Cochrane Review - 2014

Support to Reviewer grew from initially being envisioned as one or two training sessions to becoming regular support over a number of months

Types of support included: •Running scoping searches •Tailoring search strategies (identifying appropriate synonyms, investigating proximity indicators, modifying syntax depending on databases etc.) •Running test searches•Providing Endnote guidance and support•Liaising with the Trials Search Coordinator•Some full text retrieval

11http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011396/pdf

Cochrane Review

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• Overall project has a 2 year timeframe and developing the search strategy took a considerable length of time

• Very positive experience • Time consuming but enjoyable• Cochrane provided a huge

amount of support through the Trials Search Coordinator

• I’ve learned the complexity of the process and the fact that it will need to be updated every 2 years, so there is an on-going responsibility therein

Experience

Lessons Learned

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I never raised the issue of authorship, the Reviewer kindly suggested that I be listed as a co-author, in light of my contribution

In hindsight I feel that I should have raised this issue myself

This experience definitely raised my profile within the School of Nursing and Midwifery and led to other people inviting me to collaborate on other projects

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My attitude now, while still very positive about being involved in similar projects, is more pragmatic. I ask clear questions about:•the exact timeframes •the time commitments involved (e.g. will there be regular team meetings in addition to work specific to me?) •who the other members of the team are •the nature of my role (advisory or entirely responsible for development of search strategy etc.) •authorship •further collaborative opportunities from this work (e.g. further publications deriving from a body of work etc.)

Lessons Learned

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• I was invited to be part of multidisciplinary teams who competed to be awarded contracts to conduct systematic and desk-based reviews for organisations such as HSE and Irish Hospice Foundation

• I contributed a bio and my input as regards the proposed search strategy for the tender

• For projects awarded to our teams I will be listed as co-author on the report

My own experience – other projects

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Projects relate to:• Clinical Practice Guidance• Dementia and Palliative Care • Delayed Discharges • Chronic Disease Management

Some projects can have other strands, e.g. economic evaluations also included

Variable timeframes: Less than 3 months – 1 year

Given the short timeframes of some of the projects it could be argued that they could represent Rapid Reviews

My own experience

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• For shorter projects weekly team wide meetings organised a month in advance via a Doodle poll are really effective

• I ensure that I attend as many of these as possible, particularly at the start of the project

• My initial involvement in the project can be quite time consuming

• I usually liaise directly with the Principle Investigator (PI) or Work Package Leader, depending on the structuring of the project, at the outset of the project

• We collaborate to generate a draft search and share it with the broader team in initial weekly team meetings, until search approach/protocol is agreed and run

My own experience

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Sample weeks involvement at outset of a project (22nd – 29th April)

• Wednesday – 1 hour team meeting and 30 minutes review of material prior to meeting

• Friday – 1 hour review of search strategy and reply to PI

• Monday – 2 ¼ hour meeting with PI and Research Assistant

• Tuesday – 30 minutes to review updated approach from PI following meeting on Monday and reply with comments

• Tuesday – 1 hour meeting with other Research Assistant (for the economic impact strand of the project)

• Wednesday – 1 ½ hour team meetingTotal: over 7 hours

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• My role hugely depends on the team as a whole. For example, I have worked primarily in large teams, where other colleagues (i.e. dedicated Research Assistant and/or Post Doctoral Researcher) are employed specifically for the lifecycle of the review and they are responsible for: o running the search which the PI and I

draft in consultation with the broader team

o managing the articles and sharing articles with the individual review teams

o full-text retrieval etc.

My own experience

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My own experience

• So while I support the team broadly in all of these tasks and provide assistance as required, the overall responsibility for many of these tasks, which are identified in the literature as possible Librarian roles (Harris, 2005), have not been my direct responsibility for many of the projects

• But I do undertake other tasks, such as contributing to the inclusion and exclusion criteria, proofreading of final reports and reviews, attending meetings with the funding bodies as required etc.

Lessons learned

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Including a Librarian or Information Professional on an application is desirable from the perspective of many academics. Many have suggested to me that it enhances a funding application

Try to block book time in your diary at the outset of the SR process

Lessons learned

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We provide unique skills to the team and can advise on important issues, such as:

o database subject coverage o translating strategies

across different interfaces o proximity indicators,

truncation, phrase searching etc.

o knowledge regarding full text retrieval

o existing search filters (e.g. SIGN)

o grey literature sources

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Each project is different and has different challenges associated with it, but it does become easier if you work with some of the same team members repeatedly, as you develop an effective way of working. For example, I have worked closely Professor Eileen Savage on a number of projects. Professor Savage is the Head of the School of Nursing and Midwifery, and PI on many of the projects. We work very well together

Lessons learned

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Lessons learned

Abstracts can be screened quickly:

“At a conservatively-estimated reading rate of two abstracts per minute, the results of a database search can be ‘scan-read’ at the rate of 120 per hour (or approximately 1000 over an 8-hour period), so the high yield and low precision associated with systematic review searching is not as daunting as it might at first appear in comparison with the total time to be invested in the review.” (Cochrane Handbook, 2011)

(It may be useful to remind the team of this if the search result numbers are large!)

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Lessons learned

The usual challenge of balance between sensitivity (or comprehensiveness) and precision (proportion of relevant papers) is amplified by the short-time frame of some of our projects

Having regular team meetings and scope for discussions around the search approach is helpful in this regard

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Lessons learned

Clearly defined inclusion and exclusion criteria are vital for successful screening by a large team particularly

A group face-to-face mock review of a subset of papers can be helpful to ensure that all screeners are adopting the same approach

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• I attended a one day training course in The University of Exeter, entitled: Searching and Beyond: the Librarian’s role in systematic reviews in January 2015

• Very useful day and I would highly recommend any further training that they may make available

• The organisers have put a request to

jiscmail for a new discussion group called LIS-SRS (Systematic Review Searching), so keep an eye out for that

• Follow @EvidSynthTeam on Twitter for updates from that team

Training

Training and Resources

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• The Centre for Reviews and Dissemination (University of York) frequently run training sessions - http://www.york.ac.uk/crd/training-services/

• The ANLTC also ran a course in February of this year (Identifying the Evidence for Systematic Reviews), which I heard excellent feedback from but did not attend myself

• Dedicated SR journal: http://www.systematicreviewsjournal.com/

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• Health Information and Libraries Journal – useful journal for SR info

• Useful LibGuide from Susan Fowler: http://beckerguides.wustl.edu/content.php?pid=382127&sid=3131645

Training and Resources

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• Question• Scoping search• Protocol• Full search • Reference management • Title and abstract screening• Full text retrieval • Full text screening • Additional searching • Included references agreed• Data extraction • Synthesis • Update search write up (adapted from training materials from the University of

Exeter, entitled: Searching and Beyond: the Librarian’s role in systematic reviews)

Breadth of roles of Information Professionals in SRs

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• Susan Fowler provides an excellent overview as to how the requirements of the International Committee of Medical Journal Editors for authorship can apply to Librarian input into SRs: http://beckerguides.wustl.edu/content.php?pid=382127&sid=4098115

• In my own view it’s important also to raise this issue if you feel that involvement in a project will take up a considerable amount of your time, as your intellectual input is very valuable to the overall process – don’t forget that!!

Authorship

Experience

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• Searching grey literature continues to be challenging, particularly if your timeframe is short!

• Interesting article on Rapid Reviews: Featherstone, R.M., Dryden, D.M., Foisy, M., Guise J., Mitchell, M.D., Paynter, R.A., Robinson, K.A., Umscheid, C.A. & Hartling, L. (2015) "Advancing knowledge of rapid reviews: an analysis of results, conclusions and recommendations from published review articles examining rapid reviews." Systematic Reviews 4(1): 50. Available at: http://www.systematicreviewsjournal.com/content/4/1/50

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Beverley et al. (2003) identify 11 possible roles for Information Professionals in the S.R. process: •project leader•project manager•literature searcher•reference manager•document supplier•critical appraiser•data extractor•data synthesiser•report writer•disseminator•primary researcher

Future directions

Conclusions

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• Information Professionals can play an important role as partners in the research process

• Remember that your skills and inclusion on a SR team may be desirable in the case of tenders

• Cochrane provide significant support for teams undertaking Cochrane SRs

• There are a variety of roles that we can undertake depending on the project, timeframe and team

• It is useful to clearly define your role at the outset of SR projects

• Our skills are greatly appreciated and acknowledged!

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References

• Bath, P.A., Beverley, C.A. & Booth, A. (2003) The role of the information specialist in the systematic review process: a health information case study. Health Information and Libraries Journal, 20(2), 65-74.

• Cochrane Community (2014) About Us. Available at: http://community.cochrane.org/about-us/evidence-based-health-care

• Cochrane Handbook (2011) Available at: http://handbook.cochrane.org/

• Featherstone, R.M., Dryden, D.M., Foisy, M., Guise J., Mitchell, M.D., Paynter, R.A., Robinson, K.A., Umscheid, C.A. & Hartling, L. (2015) "Advancing knowledge of rapid reviews: an analysis of results, conclusions and recommendations from published review articles examining rapid reviews." Systematic Reviews 4(1): 50. Available at: http://www.systematicreviewsjournal.com/content/4/1/50

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• Fowler, S. (2011) Systematic Reviews LibGuide. Available at: http://beckerguides.wustl.edu/content.php?pid=382127&sid=3131645

• Grant, M.J. & Booth, A. (2009) A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies. Health Information and Libraries Journal, 26(2), 91-108.

• Harris, M.R. (2005) The librarian's roles in the systematic review process: a case study. Journal of the Medical Library Association ( JMLA ), 93(1), 81-87.

• The Joanna Briggs Institute (2014) Systematic Review Methods. Available at: http://joannabriggs.org/jbi-approach.html#tabbed-nav=Systematic-Review-Methods

• Swinkels, A., Briddont, J. & Hall, J. (2006) Two physiotherapists, one librarian and a systematic literature review: collaboration in action. Health Information and Libraries Journal, 23(4), 248-256.

• The University of Exeter (2015). Training course entitled: Searching and Beyond: the Librarian’s role in systematic reviews.

References