Systematic review how to- easter 2014

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Systematic review how to- easter 2014

  1. 1. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY Systematic Literature Reviews: A 'How To' Guide Isla Kuhn Reader Services Librarian Medical Library
  2. 2. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY Question Scoping 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
  3. 3. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY Question Scoping 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
  4. 4. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY • 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
  5. 5. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY • What are the key elements in the systematic review process? What do you understand by „systematic review‟?
  6. 6. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY “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!
  7. 7. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY • 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
  8. 8. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY Systematic review Literature review Question Focused on a single question. Not necessarily focused on a single question, 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 quality may 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
  9. 9. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY http://onlinelibrary.wiley.com/doi/10.1002/146518 58.CD004333.pub3/abstract
  10. 10. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY #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
  11. 11. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY 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/1-7 9 Animals/ 10 Humans/ 11 9 not (9 and 10) 12 8 not 11 13 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/13-23 25 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/25-37 39 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/39-47 49 24 or 38 50 12 and 49 51 48 and 50
  12. 12. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL 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 Question Keywords Synonyms MeSH / Subject Headings / sub headings Boolean Logic Truncation / wildcards Limits
  13. 13. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYFrom topic to search • 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?
  14. 14. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY ”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/Population Intervention Comparison Outcome (time?)
  15. 15. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY ”Is patient education effecting in improving blood sugar control in teenage diabetics?” 1 – teenagers teens adolescents 2– patient education patient information 3 – blood sugar blood glucose hypoglycaemia hyperglycaemia From topic to search
  16. 16. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYBoolean Logic AND – to narrow the search by combining different topics eg “teenage” and “patient education” Both terms must be present in the results. teenage patient education
  17. 17. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYBoolean Logic 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
  18. 18. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYBoolean Logic 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
  19. 19. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY ”Is patient education effecting in improving blood sugar control in teenage diabetics?” teenagers OR teens OR adolescents AND patient education OR patient information AND blood sugar OR blood glucose OR hypoglycaemia OR hyperglycaemia From topic to search
  20. 20. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYQuestion: 1st theme OR OR OR AND 2nd theme OR OR OR AND 3rd theme OR OR OR AND 4th theme? OR OR OR
  21. 21. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL 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
  22. 22. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYTruncation treat treats treating treated treater treatment treatments • Treat* • Treat? • Treat$ Treatment
  23. 23. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY 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 From topic to search
  24. 24. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL 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?
  25. 25. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYFrom topic to search • Where in the article record do you want the terms/keywords to appear? • Title? • Abstract? • All/any field? • Impact on sensitivity/specificity?
  26. 26. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYTask • In EMBASE • Type a key word, and search by “keyword” • How many hits? • Type a keyword and search by “title” • How many hits?
  27. 27. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY
  28. 28. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY http://www.ncbi.nlm.nih.gov/p ubmed/20144404
  29. 29. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL 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?
  30. 30. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY 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“/ From topic to search
  31. 31. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY 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“/ From topic to search Year of publication? Humans vs Animals? Type of publication? Language of publication?
  32. 32. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY 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
  33. 33. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY 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/1-7 9 Animals/ 10 Humans/ 11 9 not (9 and 10) 12 8 not 11 13 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/13-23 25 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/25-37 39 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/39-47 49 24 or 38 50 12 and 49 51 48 and 50
  34. 34. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY 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/1-7 9 Animals/ 10 Humans/ 11 9 not (9 and 10) 12 8 not 11 13 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/13-23 25 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/25-37 39 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/39-47 49 24 or 38 50 12 and 49 51 48 and 50
  35. 35. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY Advice to rest in bed versus advice to stay active for acute low-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
  36. 36. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY From topic to search: same strategy, different words Moving from one database to another…..
  37. 37. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY From topic to search: same strategy, different words • 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
  38. 38. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY From topic to search: same strategy, different words • 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
  39. 39. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYKeywords introducing the research topic 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
  40. 40. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYSensitivity vs Specificity
  41. 41. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYSensitivity vs Specificity
  42. 42. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYSensitivity vs Specificity
  43. 43. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY introducing the research topic reviewing relevant literature 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
  44. 44. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY introducing the research topic reviewing relevant literature Identify relevant sources (and then search them!) 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 Zotero Mendeley EndnoteWeb Endnote Reference Manager RefWorks Papers Pdf xchange
  45. 45. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY Question Scoping 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
  46. 46. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY introducing the research topic reviewing relevant literature Identify relevant sources (and then search them!) References Keeping up to Date • alerts • journal TOCs • citation tracking Email alerts RSS fees
  47. 47. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY introducing the research topic reviewing relevant literature Identify relevant sources (and then search them!) 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
  48. 48. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY introducing the research topic reviewing relevant literature Identify relevant sources (and then search them!) 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
  49. 49. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY http://jech.bmj.com/content/61/12/1069.full.pdf http://www.bmj.com/content/328/7446/991.full.pdf PRISMA
  50. 50. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL 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=|cambrdgedb|4750307 http://search.lib.cam.ac.uk/?itemid=|cambrdgedb|5651706
  51. 51. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL 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.
  52. 52. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY
  53. 53. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARY http://tinyurl.com/2013-sysrev
  54. 54. CAMBRIDGE UNIVERSITY LIBRARY MEDICAL LIBRARYHelp! Isla Kuhn Reader Services Librarian Medical Library Box 111 Addenbrooke’s Hospital Thank you. email: ilk21@cam.ac.uk twitter: @ilk21 phone: (01223) (3)36750 web: http://library.medschl.cam.ac.uk

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