Systematic Reviews in Social Work

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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

    1. 1. Systematic Reviews <br />Lorie Kloda <br />McGill University Library<br />Carol Stephenson<br />WLU Library<br />May 18-19, 2010<br />
    2. 2. Knowledge Syntheses<br />2<br />Systematic review<br />Meta analysis<br />Scoping review<br />Evidence mapping<br />Mixed methods synthesis<br />Mata-synthesis approaches<br />Realist synthesis approaches<br />
    3. 3. Systematic Reviews<br />3<br /> “…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.”<br />Cochrane Collaboration<br />
    4. 4. From: Wong R. (2003). Systematic reviews and the Cochrane Collaboration. Oncology Rounds, 5(10). [Available from www.oncologyrounds.ca].<br />
    5. 5. Types of Review Articles<br />Individual patient<br />data (IPD) meta-analyses<br />All reviews<br />(also called overviews)<br />Meta-analyses<br />Reviews that are not systematic (traditional, narrative reviews)<br />Systematic reviews<br />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.<br />
    6. 6. In practice, not all meta-analyses are conducted as part of SRs<br />Individual patient<br />data (IPD) meta-analyses<br />All reviews<br />(also called overviews)<br />Meta-analyses<br />Reviews that are not systematic (traditional, narrative reviews)<br />Systematic reviews<br />
    7. 7. Benefits of Knowledge Syntheses<br />7<br />___________<br />___________<br />___________<br />___________<br />___________<br />
    8. 8. Cochrane Reviews<br />8<br />Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment<br />(co-registered with Campbell Collaboration)<br />Motivational interviewing for smoking cessation<br />
    9. 9. Asking Questions<br />9<br /> What is the most effective way to educate youth about HIV/AIDS?<br />
    10. 10. Generating a Research Question<br />10<br /> COPES (Client-oriented, practical, evidence search) Question:<br />Client type and problem<br />What you might do<br />Alternate course of action<br />What you want to accomplish<br /> Question Types:<br />Effectiveness question<br />Prevention question<br />Assessment question<br />Description question<br />Risk question<br />
    11. 11. COPES Question<br />11<br /> Among teenage school children, which HIV/AIDS prevention program will result in the highest percentage of condom use during sexual encounters?<br />
    12. 12. 12<br /> Which is the most effective way to prevent Hmong youth from joining gangs?<br /> Among Hmong and Asians less than 16 years old, which gang prevention program will most effectively prevent them from joining a gang?<br />
    13. 13. Sample Effectiveness Questions<br />13<br />If children of mothers in a shelter home for abused women receive play therapy or nothing, then will the former have higher self-esteem?<br />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?<br />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?<br />Gibbs, L. E. (2003). Evidence-Based Practice for the Helping Professions. Toronto: Thomson. <br />
    14. 14. Activity 1: Posing a Specific Question<br />14<br />
    15. 15. Sources for Finding Systematic Reviews<br />Cochrane Library<br /><ul><li>Cochrane Database of Systematic Reviews (includes Methodology Reviews)
    16. 16. Database of Abstracts of Reviews of Effects (DARE)
    17. 17. Health Technology Assessments
    18. 18. Other databases of original studies (clinical trials, methods, economic evaluations)</li></ul>Campbell Library (Database of Systematic Reviews)<br />Database for Promoting Health Effectiveness (DoPHER)<br />Social work and health databases<br /><ul><li>CINAHL
    19. 19. MEDLINE
    20. 20. PsycINFO
    21. 21. ….</li></ul>15<br />
    22. 22. Steps in a Systematic Review<br />Define the clinical question<br />Identify all relevant research (published and unpublished)<br />Select studies for inclusion<br />Assess the quality of each study<br />Synthesize the findings (meta-analysis or meta-synthesis, if possible)<br />Interpret the findings and present an unbiased summary<br />16<br />McGowan, J. & Sampson, M. (2005). Systematic reviews need systematic searchers. Journal of the Medical Library Association, 93(1), 74-80.<br />
    23. 23. Systematic Reviews <br />Lorie Kloda <br />McGill University Library<br />Carol Stephenson<br />WLU Library<br />May 18-19, 2010<br />
    24. 24. 18<br /> “Conducting a comprehensive, objective and reproducible search for studies can be the most time consuming and challenging task in preparing a systematic review.”<br />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. <br />
    25. 25. Steps in a Comprehensive Literature Search<br />19<br />Database /trial registry searches <br />Grey literature search<br />Hand searches<br />Conference proceedings<br />Major journals<br />Bibliographies<br />Citation searches<br />Snowball searches<br />Review papers<br />All included studies<br />Contact researchers<br />Initial searches<br />Supplemental searches<br />
    26. 26. Selection of Sources<br />20<br />Databases<br />Several required (+ clinicial trial registries)<br />Unpublished trials contribute ~20% of the weight in meta-analysis<br />Fries JF, Krishnan E. (2004). Equipoise, design bias, and randomized controlled trials: The elusive ethics of drug development. Arthritis Res Ther, 6, R250-R255.<br />Grey literature<br />“unpublished,” fugitive,” “in-house,” “non-commercial”<br />Definition/distinction not important; as long as it’s relevant, it should be included<br />Reduces publication bias<br />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.<br />
    27. 27. Citation Searching<br />21<br />Supplements subject search<br />Across disciplines<br />Can be used for books or book chapters<br />“Safety net” – can confirm a comprehensive strategy<br />3 citation databases offer overlapping content:<br />Web of Science (“Science Citation Index”) – most multisciplinary<br />Scopus<br />Google Scholar – can lead to grey lit<br />Search all 3 if possible, using a few key references<br />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.<br />
    28. 28. Activity 2: Selecting Sources<br />22<br />
    29. 29. 23<br /> “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.”<br />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.<br />
    30. 30. Search Strategy Development<br />24<br />Keywords (natural language)<br />Truncation, synonyms, alternative spelling<br />Subject Headings<br />Explode<br />Limitations<br />Languages, date, publication type<br />Boolean (logical operators),<br />Field searching<br />Title, abstract<br />Hedges (optimal search strategies; filters)<br />
    31. 31. Activity 3: Search Strategy<br />25<br />
    32. 32. Peer Review<br />26<br />Entire protocol can be peer reviewed, including the search<br />Checklist developed (PRESS) for assessing quality of search<br />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.<br />
    33. 33. Activity 4: Peer Review<br />27<br />
    34. 34. Record Keeping<br />28<br />PRISMA Statement for Reporting SRs: <br /><ul><li>Databases with dates of coverage, date last searched, platform/provider
    35. 35. Who developed and conducted the search
    36. 36. Supplementary methods: hand searches, citation searches, snowball searches, contacting known researchers
    37. 37. Full electronic search strategy for at least one database, such that it can be repeated
    38. 38. Use of hedges or any peer reviewed search strategies
    39. 39. Additional limitations</li></li></ul><li>Managing References<br />29<br />Citation Software (RefWorks, Reference Manager or EndNote)<br /><ul><li>Exporting from databases (filters)
    40. 40. Removes duplicates
    41. 41. Search for full-text articles online
    42. 42. Groups (folders)
    43. 43. Annotations
    44. 44. Citation in manuscript</li></ul>Systematic Review Software<br />e.g., EPPI-Reviewer<br />
    45. 45. 30<br />
    46. 46. 31<br />
    47. 47. 32<br />
    48. 48. Critical Appraisal<br />33<br />Primary studies:<br />EQUATOR network<br />Systematic Reviews:<br />AMSTAR <br />

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