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Introduction to scoping reviews

A short introduction to the methods and principles of conducting a scoping review in health sciences.

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Introduction to scoping reviews

  1. 1. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Scoping reviews: An introduction Dr. S. A. Rizwan, M.D., 7.11.2020
  2. 2. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Ground rules • Mute your mic • Keep pen and paper to write • Unmute and answer when called • Questions are in Red • Type questions in the chat box • Queries answered at the end
  3. 3. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Acknowledgements • Joanna Briggs Institute • Cochrane Collaboration
  4. 4. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Things that you’ll learn in this lecture • What is scoping review? • How is it different from systematic review? • When is it carried out? – Scope of a Scoping review • What are the steps? • What are the tools/formats available? • What resources are available to learn more?
  5. 5. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Learning objectives • At the end of this lecture you should • Define scoping review and describe its role in knowledge synthesis • Describe the key concepts and the steps in carrying out a scoping review • Read and appraise a scoping review paper • Take home basic tools for starting off • Identify resources for further learning
  6. 6. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Definition of scoping review • Exploratory projects that systematically map the literature available on a topic, identifying key concepts, theories, sources of evidence and gaps in the research - Colquhoun (2014) What do you understand by the word ‘systematically’?
  7. 7. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Birth of scoping reviews – 1/2 • Since early 2000s • 25 different types of knowledge synthesis • Most common member - systematic review • Terminology • Mapping studies, systematic scoping studies, scoping studies • Don’t confuse with evidence mapping or evidence gap maps J. Hosp. Med. 2019 July;14(7):416-418.
  8. 8. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Birth of scoping reviews – 2/2
  9. 9. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Scope of a scoping review • Precursor to systematic review • Identify types of evidence available in a field • Analyze knowledge gaps • Clarify key concepts/definitions • Examine how is research conducted on a certain topic • Nature and diversity of knowledge in the field • ‘MAP’ of available evidence • Esp. when field is complex, heterogenous ‘ab tak iss field mein kya kya kaam hua hai, kaise kaise kaam hua hai aur kitna kaam hua hai’ Correia et al. BMC Public Health (2019) 19:1542
  10. 10. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction ScR is different from SR – 1/2 • Broad objective • PCC instead of PICO(ST) • Less restrictive inclusion criteria, not restricted to one type of study design • No synthesis of results (meta-analysis) • No risk of bias assessment • Limited in informing clinical practice or policy making What is the PICO(ST) format?
  11. 11. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction ScR is different from SR – 2/2
  12. 12. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction PICO(ST) PCC Definition Example Population Important characteristics of participants (age, criteria or other) – May not be applicable in some situations Adults with no apparent disease condition Intervention Main treatment we are interested in Herbal mouthrinse Comparator Control group with another intervention or placebo or standard care Regular toothpaste with/without placebo Outcomes Main effect of the treatment expected, how it will be measured, single or multiple, can also specify the time to effect Gingival inflammation by Loe’s Gingival index at 6 weeks of use Study designs Types that will be included Randomized controlled trials (RCTs) Timeframe Year of publication or time of outcome 2005-2015
  13. 13. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction PCC (population, concept, context) PCC Definition Example Population Important characteristics of participants (age, criteria or other) – May not be applicable in some situations Adults, Children with caries, Patients with facial injury, Women with diabetes, Obese patients Concept Core idea of the review, interventions, phenomenon of interest, outcomes Caries interventions, types of bleaching agents, dental problems in autistic children, surgeries for facial reconstruction, root canal irrigants, mouthwashes, use of stem cells Context Cultural factors, geographic location, race or gender based, health-care setting Emergency dental care, primary care setting, advanced dental care centre, South-Asia, minorities and economically backward sections
  14. 14. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Precise Vs. Broad review question • What is the effectiveness of using 5% Potassium Nitrate as a desensitizer (compared to placebo) before in-office bleaching with 35% hydrogen peroxide (over 3 sittings) for reducing post-operative sensitivity as measured by VAS score after 48 hours in adult patients indicated for tooth bleaching? • What are the different types of desensitizing procedures used before tooth bleaching (with any agent) in general dental practice in adult patients for any indication? ü Which of the above is a systematic review question and which is the scoping review question? ü Identify the PCC and PICO(ST) items for the above.
  15. 15. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Framework and steps of ScR 1. Protocol development & registration a) Title, Abstract, Introduction b) Objectives c) Methods: eligibility criteria, approach to literature search, selection, data extraction, presentation of evidence 2. Searching the literature 3. Selecting studies/documents 4. Data extraction – ‘charting’ the evidence 5. Analysis of the evidence 6. Presentation of the evidence 7. Summary, conclusions and implications
  16. 16. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Framework and steps of ScR Arksey and O’Malley (2005)
  17. 17. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Protocol & registration • Write the protocol as per guidelines (JBI format) • Register in Open Science Framework (PROSPERO in future) • Enables transparency • May publish protocols in journals
  18. 18. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Title and review question • Title should include ‘scoping review’ • Review question should follow PCC • May have sub-questions to focus on one or two aspects of the topic What are the different types of desensitizing procedures used before tooth bleaching (with any agent) in general dental practice in adult patients for any indication? Can you think of a title, identify PCC and some sub-questions for the above?
  19. 19. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Introduction and objective • Introduction should clearly articulate the rationale for the review and provide clear explanations for PCC • The last line should mention the objective This scoping review was conducted to map key concepts of dental management approaches for children with dentinogenesis imperfecta type II and identify, summarize and describe strategies aimed to improve the oral health of this population.
  20. 20. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Inclusion criteria • Inclusion criteria for the studies to be selected • Should be based on the PCC and the types of literature that will be included • May or may not restrict types of studies Studies in dentistry that considered the effect of irrigant solutions on the mechanical properties of endodontically treated teeth. This included studies that evaluated the study design and the effect of at least one irrigant solution on dentin, regardless of origin (human or animal), but only studies written in English were included. Criteria Example Population Human or animal origin tooth Concept Effect of irrigant solutions on the mechanical properties of endodontically treated teeth Context Dentistry (general dental practice) Type of evidence Study design and time duration not restricted but only English
  21. 21. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Search strategy • Search strategy - comprehensive, grey literature included, primary and reviews • Language and time frame • Atleast 2 online databases • Iterative process as new terms become evident PUBMED "Tooth, Nonvital"[Mesh] OR "Tooth, Nonvital" OR “Nonvital Tooth” OR “Tooth, Devitalized” OR “Devitalized Tooth” OR “Tooth, Pulpless” OR “Pulpless Tooth” OR “Teeth, Pulpless” OR “Pulpless Teeth” OR “Teeth, Devitalized” OR “Devitalized Teeth” OR “Teeth, Nonvital” OR “Nonvital Teeth” OR “Teeth, Endodontically- Treated” OR “Endodontically-Treated Teeth” OR “Teeth, Endodontically Treated” OR “Tooth, Endodontically-Treated” OR “Endodontically-Treated Tooth” OR “Tooth, Endodontically Treated” OR “dentin*” AND "Root Canal Irrigants"[Mesh] OR “Root Canal Irrigants" OR “Canal Irrigants, Root” OR “Irrigants, Root Canal” OR “Root Canal Medicaments” OR “Canal Medicaments, Root” OR “Medicaments, Root Canal” OR “Chlorhexidine” OR “EDTA” OR “Sodium hypochlorite” OR “chemical irrigant” OR “NaOCl” OR “CHX” OR “ethylenediamine tetraacetic acid” AND “fracture” OR “strength” OR “resistance” OR “fatigue” OR “mechanical properties” OR “flexural strength” OR “microhardness” OR “modulus of elasticity” NOT “bond” SCOPUS "Tooth, Nonvital" OR "Nonvital Tooth" OR "Tooth, Devitalized" OR "Devitalized Tooth" OR "Tooth, Pulpless" OR "Pulpless Tooth" OR "Teeth, Pulpless" OR "Pulpless Teeth" OR "Teeth, Devitalized" OR "Devitalized Teeth" OR "Teeth, Nonvital" OR "Nonvital Teeth" OR "Teeth, Endodontically-Treated" OR "Endodontically-Treated Teeth" OR "Teeth, Endodontically Treated" OR "Tooth, Endodontically-Treated" OR "Endodontically-Treated Tooth" OR "Tooth, Endodontically Treated" AND "Root Canal Irrigants" OR "Canal Irrigants, Root" OR "Irrigants, Root Canal" OR "Root Canal Medicaments" OR "Canal Medicaments, Root" OR "Medicaments, Root Canal" OR "Chlorhexidine" OR "EDTA" OR "Sodium hypochlorite" AND "fracture" OR "strength" OR "resistance" OR "fatigue" OR "mechanical properties" OR "flexural strength" OR "microhardness" OR "modulus of elasticity" AND NOT bond AND ( LIMIT- TO ( DOCTYPE , "ar" ) ) AND ( LIMIT-TO ( SUBJAREA , "DENT" )
  22. 22. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Selection of studies • Selection of studies - based on inclusion criteria • Atleast two reviewers with a third one for disagreement situations • Flowchart as per PRISMA-ScR
  23. 23. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Data extraction – ‘charting’ • Data extraction – a standardized form • Iterative process – pilot tested Items to extract Citation (author, year) Country Aims Population and sample size Methods Intervention type, comparison group, duration of intervention Outcomes and details Key findings that relate to the objectives of the review
  24. 24. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Analysis of the evidence • Multiple ways • Simple counts of concepts, populations, characteristics • Sometimes, qualitative content analysis • Sometimes, advanced analysis may be required • Usually, meta-analysis is NOT done
  25. 25. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Presentation of the evidence • Purpose is to identify, characterize and summarise the available evidence on a topic • Several forms of presentation can be used
  26. 26. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Presentation of the evidence • Qualitative form • Major themes
  27. 27. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Presentation of the evidence • Tabular form • Simple counts according to subgroups are given
  28. 28. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Presentation of the evidence • Graphical form
  29. 29. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Presentation of the evidence • Graphical form
  30. 30. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Discussion • Results should be discussed in the context of current literature, practice and policy • Scoping reviews are subject to the limitations • As no rating of the quality of evidence is provided, implications for practice or policy cannot be graded
  31. 31. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Conclusions and recommendations • Overall conclusion based on the results • Clear, specific implications for future research • Future conduct of systematic reviews • May not be possible to develop implications for practice/policy Regardless of the considered irrigation solution, most existing cases corroborate the occurrence of some damage to the mechanical properties of endodontically treated teeth. The findings from this scoping review show that aesthetic perception is not directly related to acceptability and satisfaction of patients and parents but related to a lower professional's acceptance. Therefore, it is recommended that professionals should be encouraged to offer this treatment to patients and their parents, better advising them about the facilities and effectiveness of the Silver Diamine Fluoride technique.
  32. 32. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Appendices • A detailed search strategy for all sources searched • Sources excluded following full- text review • Data extraction form • Table of study characteristics • PRISMA-ScR filled • Protocol
  33. 33. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Resources • JBI Manual https://wiki.jbi.global/display/MANUAL/Chapter+11%3A+Scoping+reviews • Cochrane website https://training.cochrane.org/resource/scoping-reviews-what-they-are-and-how-you-can-do-them • Papers Arksey, H & O’Malley, L 2005, ‘Scoping studies: towards a methodological framework’, Int J Soc Res Methodol, vol. 8, no. 1, pp.19-32. Levac, D, Colquhoun, H & O’Brien, KK 2010, ‘Scoping studies: advancing the methodology’, Implement Sci, vol. 5, no. 69, pp. 1-9. • PRISMA-ScR https://knowledgetranslation.net/portfolios/the-prisma-scr-prisma-extension-for-scoping- reviews/
  34. 34. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Tools shared with you • JBI format for protocol • Example protocol • Example studies • Gail Davidson Workbook for practice • PRISMA-ScR checklist for reporting a scoping review
  35. 35. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Time for questions
  36. 36. Dr. D. Y. Patil Dental College and Hospital, Pune Department of Public Health Dentistry Dr. S. A. Rizwan, M.D.,Scoping reviews: An introduction Thank you

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