Systematic review how to- easter 2014

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARY

Systematic Literature Reviews:A 'How To' Guide

Isla Kuhn

Reader Services Librarian

Medical Library


QuestionScoping search

Full search

Title and abstract

screening

Full text screening

Additional searching

Included references

agreed

Data extraction

Synthesis

Writing up

Reference management

Protocol

Update search

Full text retrieval


• how to clarify the question (or perhaps questions) on which you need to find literature

• selecting the databases and other resources you will need to search

• devising the most comprehensive literature search strategy so you know you’ve not missed any relevant studies

• keeping up to date with new information appearing between the initial search and write-up

• issues around management of process and results

• management of references (using software such as EndNote), and getting hold of the full text article


• What are the key elements in the systematic review process?

What do you understand by ‘systematic review’?


“A systematic review attempts to identify, appraise and synthesise all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. Researchers conducting systematic reviews use explicit methods aimed at minimising bias, in order to produce more reliable findings that can be used to inform decision making” (Cochrane)

“Systematic reviews aim to find as much as possible of the research relevant to the particular research questions, and use explicit methods to identify what can reliably be said on the basis of these studies. Methods should not only be explicit but systematic with the aim of producing varied and reliable results”. (EPPI)

“A systematic review uses transparent procedures to find, evaluate and synthesize the results of relevant research. Procedures are explicitly defined in advance, in order to ensure that the exercise is transparent and can be replicated. This practice is also designed to minimise bias” (Campbell)

What is a “systematic review”?

Does not mean quick!


• Critical review

• Literature review

• Mapping review/systematic map

• Meta-analysis

• Mixed studies/mixed methods review

• Overview

• Qualitative systematic review/qualitative evidence synthesis

• Rapid review

• Scoping review

Grant, MJ & Boothe, A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information and Library Journal 26(2), 91-108. 2009

Types of review

• State-of-the-art review

• Systematic review

• Systematic search and review

• Systematized review

• Umbrella review

• Umbrella review


Systematic review Literature review

Question Focused on a single question. Not necessarily focused on a singlequestion, but may describe an overview.

Protocol A peer review protocol or plan is included. No protocol is included.

Background Both provide summaries of rationale to the review.

Objectives Clear objectives are identified Objectives may or may not be identified

Study inclusion and exclusion criteria

Criteria stated before the review is conducted Criteria often not specified.

Search strategy Comprehensive search conducted in a systematic way.

Strategy not explicitly stated.

Process of selecting articles

Usually clear and explicit and involve double screening

Not described in a literature review.

Process of evaluating articles

Comprehensive evaluation of study quality. Evaluation of study qualitymay or may not be included.

Results and data synthesis

Clear summaries of studies taking into account quality of evidence.

Summary based on studies where the quality of articles may not be specified. May also be influenced by the reviewer’s theories, needs and beliefs.

Bias & replicability Minimises publication and selection bias and review can easily be reproduced

Open to bias and difficult to repeat the review

Adapted from : Bettany-Saltikov J (2010) Learning how to undertake a systematic review: part 1. Nursing Standard. 24, 50, 47-55. Date of acceptance: October 26 2009

Systematic vs Literature Review


http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004333.pub3/abstract




#1 Accidents/ #2 exp Accidents, Traffic/ #3 exp Accident Prevention/ #4 exp Motorcycles/ #5 motor-cycl* or motorcycl* or motor-bik* or motorbik* or scooter* or moped* or moto

or motocycl* or motocicl* #6 trauma* or injur* or fatal* or accident* or crash* or prevent* or collide* or collision* #7 #1 or #2 or #3 or #4 or #5 or #6 #8 head near protect* #9 head near shield* #10 helmet* #11 exp Head Protective Devices/ #12 #8 or #9 or #10 or #11 #13 #7 and #12


1 clinical trial.pt.2 randomized.ab,ti.3 placebo.ab,ti.4 dt.fs.5 randomly.ab,ti.6 trial.ab,ti.7 groups.ab,ti.8 or/1-79 Animals/10 Humans/11 9 not (9 and 10)12 8 not 1113 dorsalgia.ab,ti.14 exp Back Pain/15 exp Low Back Pain/16 backache.ab,ti.17 (lumbar adj pain).ab,ti.18 coccyx.ab,ti.19 coccydynia.ab,ti.20 exp Sciatica/21 sciatica.ab,ti.22 spondylosis.ab,ti.23 lumbago.ab,ti.

24 or/13-2325 exp Spine/26 discitis.ab,ti.27 exp Spinal Diseases/28 (disc adj degeneration).ab,ti.29 (disc adj prolapse).ab,ti.30 (disc adj herniation).ab,ti.31 spinal fusion.sh.32 spinal neoplasms.sh.33 (facet adj joints).ab,ti.34 intervertebral disk.sh.35 postlaminectomy.ab,ti.36 arachnoiditis.ab,ti.37 (failed adj back).ab,ti.38 or/25-3739 exp activities of daily living/40 activities of daily living.tw.41 day to day activ$.ti,ab.42 daily activit$.ti,ab.43 ordinary activit$.ti,ab.44 normal activit$.ti,ab.45 stay$ active.ti,ab.

46 exp Bed Rest/47 bed rest.mp.48 or/39-4749 24 or 3850 12 and 4951 48 and 50

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYFrom topic to search

introducing the research topic

• clarifying the question

• setting parameters (inclusion/exclusion criteria not built into search?)

lose marks through sloppy references

QuestionKeywordsSynonyms MeSH / Subject Headings / sub headingsBoolean LogicTruncation / wildcardsLimits


• Topic -> question -> keywords/synonyms

Diabetes, especially the impact of patient education …..

”Is patient education effective in improving blood sugar control in teenage diabetics?”

…………………keywords???.... synonyms???........................

Themes?


”Is patient education effecting in improving blood sugar control in teenage diabetics?”

1 – teenagers

2 – patient education

3 – blood sugar

From topic to search

Synonyms?

PICO ?

Patient/Problem/PopulationInterventionComparisonOutcome

(time?)



1 – teenagers teens adolescents

2– patient education patient information

3 – blood sugar blood glucose hypoglycaemia hyperglycaemia


CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYBoolean Logic

AND – to narrow the search by combining different topics

eg

“teenage” and “patient education”

Both terms must be present in the results.

teenagepatient

education


OR – to broaden your search, by combining similar terms

eg

“teenage” or “adolescent”

Either term can be present in the resulting set of articles.

teenage adolescent


NOT – to restrict your search so that it does not contain a particular term

eg

Hypoglycaemia NOT hyperglycaemia

The first, but not the second, term must be present.

hypoglycaemia hyperglycaemia



teenagers OR teens OR adolescents

AND

patient education OR patient information

AND

blood sugar OR blood glucose OR hypoglycaemia OR hyperglycaemia


CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYQuestion:

1st theme OR OR OR

AND

2nd theme OR OR OR

AND

3rd theme OR OR OR

AND

4th theme? OR OR OR

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYMind map your question?

Research question

1st theme

4th theme

3rd theme

2nd

theme

synonym

synonym

synonym

synonym

synonym

synonym

synonym

synonym

synonym

synonym synonym

synonym

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYTruncation

treat

treats

treating

treated

treater

treatment

treatments

• Treat*

• Treat?

• Treat$

Treatment


Truncation / wildcards?

1 – teenagers OR teens OR adolescents

AND

2 – patient education OR patient information

AND

3 – blood sugar OR blood glucose OR hypoglycaemia OR hyperglycaemia


CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYTask

• Go to http://tinyurl.com/embase

• Click through to open EMBASE

• Using advance search, type a key word (untick “map to subject heading”)

• How many hits?

• Type the keyword with some truncation (use *)

• How many hits?

http://tinyurl.com/embase


• Where in the article record do you want the terms/keywords to appear?

• Title?

• Abstract?

• All/any field?

• Impact on sensitivity/specificity?

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYTask

• In EMBASE

• Type a key word, and search by “keyword”

• How many hits?

• Type a keyword and search by “title”

• How many hits?


http://www.ncbi.nlm.nih.gov/pubmed/20144404



CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYTask - EMBASE

• Type in a keyword, tick “map to subject heading”

Relevant match? Select & explode

How many hits?

• Type in same keyword, tick “map to subject heading”

Relevant match? Select & explode

How many hits?

• Type in same keyword, tick “map to subject heading”

Relevant match? Select & focus

How many hits?


MeSH

1 – teen* OR adolesce* OR exp"Adolescent“/

AND

2 – patient education OR patient information OR exp”Patient Education as Topic“/

AND

3 – blood sugar OR blood glucose OR hypoglycae* OR hyperglyca* OR exp”Blood Glucose“/ OR exp"Hypoglycemia“/



Inclusion / exclusion criterion?

teen* OR adolesce* OR exp"Adolescent“/

AND

patient education OR patient information OR exp”Patient Education as Topic“/

AND

blood sugar OR blood glucose OR hypoglycae* OR hyperglyca* OR exp”Blood Glucose“/ OR exp"Hypoglycemia“/


Year of publication? Humans vs Animals? Type of publication? Language of publication?


1 teen*

2 adolesce*

3 exp"Adolescent“/

4 1 or 2 or 3

5 patient education

6 patient information

7 exp”Patient Education as Topic“/

8 5 or 6 or 7

9 blood sugar

10 blood glucose

11 hypoglycae*

12 hyperglyca*

13 exp”Blood Glucose“/

14 exp"Hypoglycemia“/

15 9 or 10 or 11 or 12 or 13 or 14

16 4 and 8 and 15


1 clinical trial.pt.2 randomized.ab,ti.3 placebo.ab,ti.4 dt.fs.5 randomly.ab,ti.6 trial.ab,ti.7 groups.ab,ti.8 or/1-79 Animals/10 Humans/11 9 not (9 and 10)12 8 not 1113 dorsalgia.ab,ti.14 exp Back Pain/15 exp Low Back Pain/16 backache.ab,ti.17 (lumbar adj pain).ab,ti.18 coccyx.ab,ti.19 coccydynia.ab,ti.20 exp Sciatica/21 sciatica.ab,ti.22 spondylosis.ab,ti.23 lumbago.ab,ti.

24 or/13-2325 exp Spine/26 discitis.ab,ti.27 exp Spinal Diseases/28 (disc adj degeneration).ab,ti.29 (disc adj prolapse).ab,ti.30 (disc adj herniation).ab,ti.31 spinal fusion.sh.32 spinal neoplasms.sh.33 (facet adj joints).ab,ti.34 intervertebral disk.sh.35 postlaminectomy.ab,ti.36 arachnoiditis.ab,ti.37 (failed adj back).ab,ti.38 or/25-3739 exp activities of daily living/40 activities of daily living.tw.41 day to day activ$.ti,ab.42 daily activit$.ti,ab.43 ordinary activit$.ti,ab.44 normal activit$.ti,ab.45 stay$ active.ti,ab.

46 exp Bed Rest/47 bed rest.mp.48 or/39-4749 24 or 3850 12 and 4951 48 and 50


Advice to rest in bed versus advice to stay active for acutelow-back pain and sciatica

The objective of this review is to determine the effects of advice to rest in bed or stay active for patients with acute low-back pain or sciatica.

The following comparisons will be made:

• Bed rest versus staying active

• Bed rest versus other treatments (besides staying active)

• Shorter periods of bed rest versus longer periods of bed rest

• Staying active versus other treatments (besides bed rest)

• Comparison between different forms of advice to stay active (e.g. avoiding bedrest, staying active)

http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD007612/pdf_fs.html

http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD007612/pdf_fs.html


From topic to search: same strategy, different words

Moving from one database to another…..



• http://www.sign.ac.uk/methodology/filters.html Observational Study Filters

Medline (via OVID)1 Epidemiologic studies/ 2 Exp case control studies/ 3 Exp cohort studies/ 4 Case control.tw. 5 (cohort adj (study or studies)).tw. 6 Cohort analy$.tw. 7 (Follow up adj (study or studies)).tw. 8 (observational adj (study or studies)).tw. 9 Longitudinal.tw. 10 Retrospective.tw. 11 Cross sectional.tw. 12 Cross-sectional studies/ 13 Or/1-12

Embase (via OVID)1 Clinical study/ 2 Case control study 3 Family study/ 4 Longitudinal study/ 5 Retrospective study/ 6 Prospective study/ 7 Randomized controlled trials/ 8 6 not 7 9 Cohort analysis/ 10 (Cohort adj (study or studies)).mp. 11 (Case control adj (study or studies)).tw. 12 (follow up adj (study or studies)).tw. 13 (observational adj (study or studies)).tw. 14 (epidemiologic$ adj (study or studies)).tw. 15 (cross sectional adj (study or studies)).tw. 16 Or/1-5,8-15

http://www.sign.ac.uk/methodology/filters.html



• http://www.sign.ac.uk/methodology/filters.html Observational Study Filters

Medline (via OVID)1 Epidemiologic studies/ 2 Exp case control studies/ 3 Exp cohort studies/ 4 Case control.tw. 5 (cohort adj (study or studies)).tw. 6 Cohort analy$.tw. 7 (Follow up adj (study or studies)).tw. 8 (observational adj (study or studies)).tw. 9 Longitudinal.tw. 10 Retrospective.tw. 11 Cross sectional.tw. 12 Cross-sectional studies/ 13 Or/1-12

Medline (via Pubmed)#1 “Epidemiologic studies”[Mesh]#2 “case control studies”[Mesh]#3 “cohort studies”[Mesh]#4 Case control[Text Word] #5 (cohort stud*))[Text Word] #6 Cohort analy*[Text Word]#7 (Follow up AND (study or studies))[Text Word] #8 (observational AND (study or studies))[Text Word]#9 Longitudinal[Text Word]#10 Retrospective[Text Word]#11 Cross sectional[Text Word]#12 “Cross-sectional studies”[Mesh]#13 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12

http://www.sign.ac.uk/methodology/filters.html

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYKeywords


reviewing relevant literature

• identifying keywords and synonyms and MeSH

• structuring your search strategy with boolean logic

References

• DON’T plagiarise!

• Don’t lose marks through sloppy references

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYSensitivity vs Specificity




Identify relevant sources (and then search them!)

databases?

websites?

hand searching?

snowballing?

books?

grey literature?

ongoing trials?

• http://www.lib.cam.ac.uk/electronicresources/

• Google? Search by Organisation

• Which journals are key to your work?

• WoK or Scopus

• LibrarySearch or COPAC or GoogleBooks

• Google: blog search; SIGLE; conference proceedings

• Trials registers

http://www.lib.cam.ac.uk/electronicresources/

http://wok.mimas.ac.uk/

http://www.scopus.com/

http://search.lib.cam.ac.uk/

http://copac.ac.uk/

http://books.google.com/

http://www.google.com/blogsearch

http://www.opengrey.eu/

http://wok.mimas.ac.uk/

https://delicious.com/#ilk21/york_session





References & PDFs

• Critically appraising

• managing

• storing

• using them (cite while you write)

• Data extraction

CASP http://www.casp-uk.net

“How to read a paper” Trish Greenhalgh WB 18.343 – in the Medical Library or http://tinyurl.com/bmj-trish

ZoteroMendeleyEndnoteWebEndnoteReference ManagerRefWorksPapers

Pdf xchange

http://www.casp-uk.net/

http://tinyurl.com/bmj-trish

http://www.zotero.org/

http://www.mendeley.com/

http://www.myendnoteweb.com/

http://www.endnote.com/

http://www.refman.com/

http://www.refworks.com/

http://www.mekentosj.com/papers/

http://pdf-xchange-viewer.en.softonic.com/


QuestionScoping search

Full search

Title and abstract

screening

Full text screening

Additional searching

Included references

agreed

Data extraction

Synthesis

Writing up

Reference management

Protocol

Update search

Full text retrieval





References

Keeping up to Date

• alerts

• journal TOCs

• citation tracking

Email alertsRSS fees





References

Keeping up to Date

Management of process and results – more info on data management

• What is the data you need to record?• Where will you record it? Where will you store it?• How will you record it?• How will you share it?

When should all this start?

PRISMA

http://www.lib.cam.ac.uk/dataman/training.html

http://www.prisma-statement.org/





References

Keeping up to Date

Management of process and results

Writing Up

• what did you actually do?

• and where did you do it? (750 words?)

• Search log/diary• Results matrix• Tidying up your strategy• What did you find, where? • Explicit criterion = reproducable methodology

PRISMA

http://750words.com/



http://jech.bmj.com/content/61/12/1069.full.pdf

http://www.bmj.com/content/328/7446/991.full.pdf

PRISMA


CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYBooks that might help

• http://search.lib.cam.ac.uk/?itemid=|cambrdgedb|1258728

http://search.lib.cam.ac.uk/?itemid=|cambrdgedb|317470



http://search.lib.cam.ac.uk/?itemid=%7Ccambrdgedb%7C1258728




CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYStopping

• Repetition

• Change in ratio of “good” : ”bad” articles retrieved

• Boundaries/Parameters?

• Databases are not infinite:

• if your strategy is good enough, and your current awareness strategy is in place, trust it, and stop.


http://tinyurl.com/2013-sysrev

http://tinyurl.com/2013-sysrev

CAMBRIDGE UNIVERSITY LIBRARYMEDICAL LIBRARYHelp!

Isla Kuhn

Reader Services Librarian

Medical Library

Box 111

Addenbrooke’s Hospital

Thank you.

email: [email protected]

twitter: @ilk21

phone: (01223) (3)36750

web: http://library.medschl.cam.ac.uk

mailto:[email protected]

https://twitter.com/ilk21

http://library.medschl.cam.ac.uk/

Systematic review how to- easter 2014

Education

Transcript of Systematic review how to- easter 2014