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Systematic Reviews in Social Work

Systematic Reviews in Social Work



A workshop presented at WLU Faculty of Social Work by Carol Stephenson and Lorie Kloda, May 2010

A workshop presented at WLU Faculty of Social Work by Carol Stephenson and Lorie Kloda, May 2010



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  • From Cochrane presentation by PaulGlasziou:Knowledge syntheses use rigorous scientific methods to identify, assess and synthesize the worldwide available evidence.Broad range of methodological approaches: (list all)Methods to conduct syntheses of qualitative studies have been developed and are being refined. These tend to be interpretive and go by many names:Narrative summary, thematic analysis, grounded theory, meta-ethnography, meta-study, realist synthesis, etc.
  • Key features:Explicit and transparent methodsa standard set of stages Accountable, replicable and updateable
  • DISCUSSION:Interaction from the group – fill in the blanks From Cochrane talk by Paul Glasziou: forms the building blocks for knowledge translation activities highlights problems with methods and reporting of current studies helps in prioritizing future research outlines what is currently known on a topic (to form foundation for further research) build capacity through teaching critical appraisal skills
  • Cochrane Library includesCDSR a repository of systematic reviews (with the full-text of these) produced by the Cochrane Collaboration. Originally the Library was updated 4x a year, but now it is updated monthly. This means that new SRs are added, and existing ones updated. Sometimes SRs are retracted. Also included in the Library are the protocols.To date:4000 reviews2000 protocolsQuality: (from Cochrane talk by Paul Glasziou 2010):Study by Moher et al (PLoS Medicine 2007) suggests that Cochrane reviews account for 20% of SRs published annually82% of non-Cochrane reviews are published in specialty journals (Moher et al 2007)Compared to non-Cochrane reviews, Cochrane reviews more likely to:- use protocol- report being an update of previous reviewNo language restriction assess quality, assess publication bias- report funding sources
  • General question (prevention)
  • Start with a specific, focused question that is answerable.COPES questions come from daily practice, posed by practitioners, that matter to clientsAlso have practical significance (for problems that arise frequently)And guide searching
  • This is just one possible question from the more general question before.
  • pp. 71-73 of Gibbs
  • Form groups of 4-5 peopleIn groups, choose a topic, and write a question. Try to create a focused question (using COPES if that helps) and classify what type of question it is.You can also specify other details about the question, as if you are planning a SR.
  • [Explanation of how Cochrane creates and maintains their database. Initially only reviews of interventions, but now added in methodology and diagnostic accuracy]WLU now has a subscription to Cochrane Library, and the website allows anyone to search and read the structured abstracts, as well as the plain language summaries.DARE includes abstracts from Cochrane (confusingly) but also indexes other health care SRs from all over. Added value of critical appraisal of non-Cochrane reviews. DARE is also searchable from the NHS CRD’s website for free. Excellent one-stop-shop for finding SRs.In education, there is also the Campbell Collaboration, which is building a library of SRs similar to Cochrane. At this point, it’s much smaller, but includes protocols as well.
  • Librarians typically involved in Step 2 (and often the entire process, but especially step 1 and 3). Refer to McGowan articleMost importantly, the PROTOCOL must outline all of these in detail and guide the research.The protocol decision points are available in the SCIE document on p.5 (Figure 2) in detail. See sample document (Braganza).
  • DAY 2
  • Initial search based on subject terms, and sourcesSupplemental search based on known items/researchersFor the initial searches, the sources (and strategy) are described in the protocol:Select databases, websites, conferences, journals, published bibliographies And determine the strategy to be used in the databases (terms, limits)For the supplemental searches, these are conducted after the initial searches are done, based on what is found. E.g., top authors/papers can be used for citation searches All included studies (and review papers) can be snowball searched top researchers can be contacted
  • Refer to handout: discuss social work databases and citation databasesDemo: Citation search in Web of Science
  • In same groups, referring to your question:Select potentially relevant databases (based on your knowledge, experience, and referring to the list in the workbook). Can also ask librarians. List all databases to search, as well as grey lit sources (1 conference name, 1 association/website)For hand search: name 1 top journal, 1 expert to contact (“key researcher”)Use the worksheet to keep track of these. This is the kind of content that would go in a protocol, and the worksheet also serves a template for documenting the search.
  • p. 122 (quote)
  • Consider searching the literature to find strategies used by others in their SRs and narrative reviews. Adapt these (and remember to cite them).
  • In same groups, referring to your question:Identify the main concepts for searching (using your question). Ask for librarians’ input.Generate terms for each concept to increase retrievalSuggest “limits” that could be applied to the search based on your question.
  • This does not mimic PRESS exactly. Instead, we will evaluate each others’ search protocol: from question, to sources, to termsProvide constructive criticism to other teams Either as a group, going over everyone’s protocols, or groups will exchange. (Depends on time)
  • In addition to inclusion/exclusion criteria, and sources, keep track of all strategies – very specific information is required for PRISMA.There are articles that outline what to include for grey lit, theses, clinical trial registry searches too.This will all be useful when writing up the methods section.Keep the PRISMA flow diagram in mind as well – all these numbers need to be recorded along the way.
  • Should be used from the very start.Filters or instructions available for many online databases, including Google Scholar (for citation searching), DARE.
  • Validated tools for assessing quality of studies

Systematic Reviews in Social Work Systematic Reviews in Social Work Presentation Transcript

  • Systematic Reviews
    Lorie Kloda
    McGill University Library
    Carol Stephenson
    WLU Library
    May 18-19, 2010
  • Knowledge Syntheses
    Systematic review
    Meta analysis
    Scoping review
    Evidence mapping
    Mixed methods synthesis
    Mata-synthesis approaches
    Realist synthesis approaches
  • Systematic Reviews
    “…reviews of a clearly formulated question that use explicit methods to identify, select, and critically appraise relevant research and to collect and analyse data from the studies that are included in the review.”
    Cochrane Collaboration
  • From: Wong R. (2003). Systematic reviews and the Cochrane Collaboration. Oncology Rounds, 5(10). [Available from www.oncologyrounds.ca].
  • Types of Review Articles
    Individual patient
    data (IPD) meta-analyses
    All reviews
    (also called overviews)
    Reviews that are not systematic (traditional, narrative reviews)
    Systematic reviews
    Pai M., et al. (2004). Systematic reviews and meta-analyses: An illustrated, step-by-step guide. National Medical Journal of India, 17(2), 86-95.
  • In practice, not all meta-analyses are conducted as part of SRs
    Individual patient
    data (IPD) meta-analyses
    All reviews
    (also called overviews)
    Reviews that are not systematic (traditional, narrative reviews)
    Systematic reviews
  • Benefits of Knowledge Syntheses
  • Cochrane Reviews
    Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment
    (co-registered with Campbell Collaboration)
    Motivational interviewing for smoking cessation
  • Asking Questions
    What is the most effective way to educate youth about HIV/AIDS?
  • Generating a Research Question
    COPES (Client-oriented, practical, evidence search) Question:
    Client type and problem
    What you might do
    Alternate course of action
    What you want to accomplish
    Question Types:
    Effectiveness question
    Prevention question
    Assessment question
    Description question
    Risk question
  • COPES Question
    Among teenage school children, which HIV/AIDS prevention program will result in the highest percentage of condom use during sexual encounters?
  • 12
    Which is the most effective way to prevent Hmong youth from joining gangs?
    Among Hmong and Asians less than 16 years old, which gang prevention program will most effectively prevent them from joining a gang?
  • Sample Effectiveness Questions
    If children of mothers in a shelter home for abused women receive play therapy or nothing, then will the former have higher self-esteem?
    If aged persons without dementia just being admitted to a nursing home participate in a new admissions support group, then will they experience lower depression than those who do not?
    If high school students who have been identified as alcohol problem drinkers are matched with a peer mentor or not so matched, then will the matched group have higher academic performance?
    Gibbs, L. E. (2003). Evidence-Based Practice for the Helping Professions. Toronto: Thomson.
  • Activity 1: Posing a Specific Question
  • Sources for Finding Systematic Reviews
    Cochrane Library
    • Cochrane Database of Systematic Reviews (includes Methodology Reviews)
    • Database of Abstracts of Reviews of Effects (DARE)
    • Health Technology Assessments
    • Other databases of original studies (clinical trials, methods, economic evaluations)
    Campbell Library (Database of Systematic Reviews)
    Database for Promoting Health Effectiveness (DoPHER)
    Social work and health databases
    • CINAHL
    • PsycINFO
    • ….
  • Steps in a Systematic Review
    Define the clinical question
    Identify all relevant research (published and unpublished)
    Select studies for inclusion
    Assess the quality of each study
    Synthesize the findings (meta-analysis or meta-synthesis, if possible)
    Interpret the findings and present an unbiased summary
    McGowan, J. & Sampson, M. (2005). Systematic reviews need systematic searchers. Journal of the Medical Library Association, 93(1), 74-80.
  • Systematic Reviews
    Lorie Kloda
    McGill University Library
    Carol Stephenson
    WLU Library
    May 18-19, 2010
  • 18
    “Conducting a comprehensive, objective and reproducible search for studies can be the most time consuming and challenging task in preparing a systematic review.”
    Higgins, J.P.T.& Green, S. (eds.) (2009). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2. The Cochrane Collaboration. Available from www.cochrane-handbook.org.
  • Steps in a Comprehensive Literature Search
    Database /trial registry searches
    Grey literature search
    Hand searches
    Conference proceedings
    Major journals
    Citation searches
    Snowball searches
    Review papers
    All included studies
    Contact researchers
    Initial searches
    Supplemental searches
  • Selection of Sources
    Several required (+ clinicial trial registries)
    Unpublished trials contribute ~20% of the weight in meta-analysis
    Fries JF, Krishnan E. (2004). Equipoise, design bias, and randomized controlled trials: The elusive ethics of drug development. Arthritis Res Ther, 6, R250-R255.
    Grey literature
    “unpublished,” fugitive,” “in-house,” “non-commercial”
    Definition/distinction not important; as long as it’s relevant, it should be included
    Reduces publication bias
    Hopewell S, McDonald S, Clarke MJ, Egger M. Grey literature in meta-analyses of randomized trials of health care interventions. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: MR000010. DOI:10.1002/14651858.MR000010.pub3.
  • Citation Searching
    Supplements subject search
    Across disciplines
    Can be used for books or book chapters
    “Safety net” – can confirm a comprehensive strategy
    3 citation databases offer overlapping content:
    Web of Science (“Science Citation Index”) – most multisciplinary
    Google Scholar – can lead to grey lit
    Search all 3 if possible, using a few key references
    Kloda, L.A. (2007). Evidence Summary: Use Google Scholar, Scopus and Web of Science for comprehensive citation tracking. Evidence Based Library and Information Practice 2 (3),87-90.
  • Activity 2: Selecting Sources
  • 23
    “Terms within social sciences are often ambiguous, poorly defined and constantly changing. Unfortunately, the use of controlled vocabularies and indexing is not applied across the social sciences databases with the same rigour as in medical databases.”
    Papaioannou, D., Sutton, A., Carroll, C., Booth, A. & Wong, R. (2010). Literature searching for social science systematic reviews: Consideration of a range of search techniques. Health Information and Libraries Journal, 27(2),114-122.
  • Search Strategy Development
    Keywords (natural language)
    Truncation, synonyms, alternative spelling
    Subject Headings
    Languages, date, publication type
    Boolean (logical operators),
    Field searching
    Title, abstract
    Hedges (optimal search strategies; filters)
  • Activity 3: Search Strategy
  • Peer Review
    Entire protocol can be peer reviewed, including the search
    Checklist developed (PRESS) for assessing quality of search
    McGowan, J., Sampson, M. & Lefebvre, C. (2010). An evidence based checklist for the peer review of electronic search strategies (PRESS EBC). Evidence Based Library and Information Practice 5 (1),149-154.
  • Activity 4: Peer Review
  • Record Keeping
    PRISMA Statement for Reporting SRs:
    • Databases with dates of coverage, date last searched, platform/provider
    • Who developed and conducted the search
    • Supplementary methods: hand searches, citation searches, snowball searches, contacting known researchers
    • Full electronic search strategy for at least one database, such that it can be repeated
    • Use of hedges or any peer reviewed search strategies
    • Additional limitations
  • Managing References
    Citation Software (RefWorks, Reference Manager or EndNote)
    • Exporting from databases (filters)
    • Removes duplicates
    • Search for full-text articles online
    • Groups (folders)
    • Annotations
    • Citation in manuscript
    Systematic Review Software
    e.g., EPPI-Reviewer
  • 30
  • 31
  • 32
  • Critical Appraisal
    Primary studies:
    EQUATOR network
    Systematic Reviews: