This document outlines the structure and key elements that should be included in a systematic review report. It recommends including an abstract, introduction, methods, results, discussion and conclusion sections. The methods section should describe the literature search strategy, eligibility criteria, data extraction and quality assessment processes. Results should be presented according to the review questions. The discussion should synthesize the findings, discuss limitations and draw conclusions. Guidelines like PRISMA can help improve reporting quality.
How to conduct abstract screening for systematic review – PubricaPubrica
Abstract screening is a necessary step in conducting a thorough and efficient systematic assessment.
• Before screening begins
• During abstract screening
• After screening ends
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How to conduct abstract screening for systematic review – PubricaPubrica
Abstract screening is a necessary step in conducting a thorough and efficient systematic assessment.
• Before screening begins
• During abstract screening
• After screening ends
Continue Reading: https://bit.ly/2UmT1HQ
For our services: https://pubrica.com/services/research-services/systematic-review/
Why Pubrica:
When you order our services, We promise you the following – Plagiarism free | always on Time | 24*7 customer support | Written to international Standard | Unlimited Revisions support | Medical writing Expert | Publication Support | Biostatistical experts | High-quality Subject Matter Experts.
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A well recognised form of research is called systematic reviews on specific point. Why do we need them and How they can be done?? this talk is trying to answer these questions in a simple way
For a School of Information class on medical librarianship, this presentation was created to provide a very basic introduction and overview of the concepts, expectations, and experience of the librarian portion of working in a systematic review team.
A systematic review uses systematic and explicit methods to identify, select, critically appraise, and extract and analyze data from relevant research [Higgins & Green 2011].
This workshop is meant to be an introduction to the systematic review process. Further information about systematic reviews was available through a research guide. http://libguides.ucalgary.ca/content.php?pid=593664
Quality assessment in systematic literature reviewJingjing Lin
This tutorial is to introduce the definition, process, and tools of quality assessment in the systematic literature review.
If you are new to my channel, you can check out the previous events together with this one to get started with the systematic literature review as a research approach.
EP11 Systematic Literature Review Planning: workflow, literature scoping, and review protocol (https://youtu.be/qukb-VytjxQ)
EP12 Develop search strategy: fishing relevant literature for your research (https://youtu.be/9cH5I03jbg0)
EP13 Literature screening: inclusion and exclusion
(https://youtu.be/BCdveqka-E4)
You can browse other previous research sharing in this YouTube list of mine (https://www.youtube.com/playlist?list...)
Please kindly subscribe if you want to be reminded when I have new videos published on YouTube.
A well recognised form of research is called systematic reviews on specific point. Why do we need them and How they can be done?? this talk is trying to answer these questions in a simple way
For a School of Information class on medical librarianship, this presentation was created to provide a very basic introduction and overview of the concepts, expectations, and experience of the librarian portion of working in a systematic review team.
A systematic review uses systematic and explicit methods to identify, select, critically appraise, and extract and analyze data from relevant research [Higgins & Green 2011].
This workshop is meant to be an introduction to the systematic review process. Further information about systematic reviews was available through a research guide. http://libguides.ucalgary.ca/content.php?pid=593664
Quality assessment in systematic literature reviewJingjing Lin
This tutorial is to introduce the definition, process, and tools of quality assessment in the systematic literature review.
If you are new to my channel, you can check out the previous events together with this one to get started with the systematic literature review as a research approach.
EP11 Systematic Literature Review Planning: workflow, literature scoping, and review protocol (https://youtu.be/qukb-VytjxQ)
EP12 Develop search strategy: fishing relevant literature for your research (https://youtu.be/9cH5I03jbg0)
EP13 Literature screening: inclusion and exclusion
(https://youtu.be/BCdveqka-E4)
You can browse other previous research sharing in this YouTube list of mine (https://www.youtube.com/playlist?list...)
Please kindly subscribe if you want to be reminded when I have new videos published on YouTube.
A systematic review (SR) is a rigorous and organized method to synthesize
the evidence from multiple studies on a particular research question or topic.
The purpose of a systematic review is to identify, appraise, and summarize all
available evidence relevant to a specific research question in a transparent
and replicable manner.
It aims to provide a comprehensive overview of academic literature
concerning a particular research question of topic.
This presentation explores the steps nee
How to structure your table for systematic review and meta analysis – PubricaPubrica
According to the, a systematic review is "a scholarly method in which all empirical evidence that meets pre-specified eligibility requirements is gathered to address a particular research question."
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An introduction to conducting a systematic literature review for social scien...rosie.dunne
An introduction to conducting a systematic literature review for social scientists and health researchers presented by Luke van Rhoon Health Behaviour Change Research Group, School of Psychology, NUI Galway November 2020
• A systematic review is a secondary research as it requires a careful analysis of the quality, quantity, and consistency of research findings.
• Systematic reviews formulate research questions that are specifically targeted and designed to provide a complete summary of the issue based on evidence.
• The methodology used in systematic reviews is specific and precise, which intends to minimize bias by increasing the reliability of the drawn conclusion.
Full information: https://bit.ly/2ZNTlPU
Reference: https://pubrica.com/services/research-services/systematic-review/
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When you order our services, we promise you the following – Plagiarism free, always on Time, outstanding customer support, written to Standard, Unlimited Revisions support and High-quality Subject Matter Experts.
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Systematic review article and Meta-analysis: Main steps for Successful writin...Pubrica
A review article is a piece of writing that gives a complete and systematic summary of results available in a certain field while also allowing the reader to perceive the subject from a different viewpoint.
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When you order our services, We promise you the following – Plagiarism free | always on Time | 24*7 customer support | Written to international Standard | Unlimited Revisions support | Medical writing Expert | Publication Support | Biostatistical experts | High-quality Subject Matter Experts.
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DMID Interventional Protocol TemplateVersion 2.028 April 2005DustiBuckner14
DMID Interventional Protocol Template Version 2.0
28 April 2005
Protocol Title Version number and date
GENERAL INSTRUCTIONS – delete this box from the submitted Protocol
This template is for students in the Virginia University of Lynchburg Doctor of Healthcare Administration Research Practicum course who are preparing a detailed protocol for a study involving human subjects. Depending on the nature of what you are doing, some sections may not be applicable to your research. If a section is not applicable, delete. You may delete subsections that are not applicable. The full research protocol must be uploaded to Moodle to be considered complete. This includes the IRB Application with research protocol, Informed Consent Document (s), Recruitment Collateral, and any other supporting documentation. Applications with ANY missing elements will be considered incomplete and will be graded accordingly.
Use this template to create a study protocol as follows:
· Red text represents instructions to you – to be deleted from the final version
· Blue text represents guidance on suggested content – to be edited and changed to black or replaced with black in the final version.
· Black text represents text that should ordinarily be incorporated as-is, if applicable
Note that the table of contents is automatically included, so do not change the content or formatting of the headings. Be sure to right click on the table of contents and select “Update field” before saving the protocol and uploading it to Moodle. As always, make sure to proofread the document before submission.
Please make sure to complete the header on this page with the protocol title and version number and date.
The submitted protocol should have no red or blue text (including the header and instruction boxes like this one). The submitted protocol should have no spelling or grammar errors. All references MUST be in APA 7 format. PROTOCOL TITLEProtocol Version Number: CompleteProtocol Version Date: day, month, year [Include if there is an external funder; otherwise, delete heading] Funding Mechanism: organization and grant or contract #[Include if there is industry support; otherwise, delete heading] Industry Support provided by: name of industryPrincipal Investigator: name Phone: Complete E-mail: Complete[Include if the study has a medical monitor; otherwise, delete heading] Medical Monitor: name
Table of Contents
1List of Abbreviations4
2Protocol Summary4
3Background/Rationale & Purpose5
3.1Background Information5
3.2Rationale and Purpose5
4Objectives5
4.1Study Objectives5
4.2Study Outcome Measures6
4.2.1Primary Outcome Measures6
4.2.2Secondary Outcome Measures6
5Study Design6
6Potential Risks and Benefits7
6.1Risks7
6.2Potential Benefits8
6.3Analysis of Risks in Relation to Benefits8
7Study Subject Selection8
7.1Subject Inclusion Criteria8
7.2Subject Exclusion Criteria8
7.3Recruitment Methods9
7.4Compensation for Participation in Research Activities9
7.5Withdrawal of Pa ...
A research study Writing a Systematic Review in Clinical Research – PubricaPubrica
A systematic review summarises the findings of precisely organized healthcare research (controlled trials) and gives a high degree of evidence on the efficacy of healthcare interventions. The evidence may be used to make decisions and guide healthcare recommendations.
Reference: https://bit.ly/3morikF
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When you order our services, We promise you the following – Plagiarism free | always on Time | 24*7 customer support | Written to international Standard | Unlimited Revisions support | Medical writing Expert | Publication Support | Biostatistical experts | High-quality Subject Matter Experts.
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A research study writing a systematic review in clinical research – pubricaPubrica
A systematic review summarises the findings of precisely organized healthcare research (controlled trials) and gives a high degree of evidence on the efficacy of healthcare interventions. The evidence may be used to make decisions and guide healthcare recommendations.
Reference: https://bit.ly/3morikF
For our services: https://pubrica.com/services/research-services/systematic-review/
Why Pubrica:
When you order our services, We promise you the following – Plagiarism free | always on Time | 24*7 customer support | Written to international Standard | Unlimited Revisions support | Medical writing Expert | Publication Support | Biostatistical experts | High-quality Subject Matter Experts.
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Retrospective versus | Meta analysis | Systematic literature reviewPubrica
Systematic review for prospective studies is a meticulous and essential process ensuring research findings’ reliability and validity. The key to success lies in adhering to a well-structured methodology that includes defining the research question, developing a comprehensive search strategy, screening studies based on pre-defined criteria, and critically appraising the selected articles.
https://pubrica.com/academy/manuscript-editing/conduct-a-systematic-review-for-prospective-studies/
· Reflect on the four peer-reviewed articles you critically apprai.docxVannaJoy20
· Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
· Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
· Consider the best method of disseminating the results of your presentation to an audience.
The Assignment: (Evidence-Based Project)
Part 4: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide
narrated PowerPoint presentation in which you do the following:
· Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
· Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
· Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
· Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
· Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
· Add a lessons learned section that includes the following:
· A summary of the critical appraisal of the peer-reviewed articles you previously submitted
· An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)
Zeinab Hazime
Nurs 6052
10/16/2022
Evaluation Table
Use this document to complete the
evaluation table requirement of the Module 4 Assessment,
Evidence-Based Project, Part 3A: Critical Appraisal of Research
Full
APA formatted citation of selected article.
Article #1
Article #2
Article #3
Article #4
Abraham, J., Kitsiou, S., Meng, A., Burton, S., Vatani, H., & Kannampallil, T.
(2020). Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews.
BMJ Quality & Safety, 29(10), 1-2.
Alanazi, A. (2020). The effect of computerized physician order entry on mortality rates in pediatric and neonatal care setting: Meta-analysis.
Informatics in Medicine
Unlocked, 19, 100308. https.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Reporting the Review
1. Reporting the Review Prepared for: The Agency for Healthcare Research and Quality (AHRQ) Training Modules for Systematic Reviews Methods Guide www.ahrq.gov
26. Examples of Flow Diagrams Fuccio L, et al. Ann Intern Med 2007;147:53-62. Reprinted with permission from the American College of Physicians. Sharma M, et al. Ann Intern Med 2009:151:622-30. Reprinted with permission from the American College of Physicians.
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Editor's Notes
Reporting the Review
Learning Objectives This module has been prepared to help authors of comparative effectiveness reviews ensure that their reports are of the highest possible quality. When authors do not provide sufficient details concerning the conduct of their study, readers are left with an incomplete picture of what was done. As such, they are not able to judge the reliability of the results or interpret them. There are two learning objectives for this module. The first one is to describe the various elements that need to be reported upon completion of the review. The second one is to distinguish examples of reporting that are adequate from those that are inadequate. The examples in the subsequent slides are of adequate reporting.
Systematic Review Process Overview This slide illustrates the steps in the systematic review process. This module focuses on reporting the review, which is more than simply presenting the findings. Reporting the results of a systematic review includes, for example, information on the number of databases searched, the number of records screened, and the complete methods and results.
Writing the Report Authors should use a standard template (guidance) for the overall report. The purpose of using a standard template is to make reading and understanding of the report easier for readers. The subsections in the report may vary. Using the PICOTS framework (population, intervention, comparator, outcome, timing, and study design or setting) can help guide the construction. Subsequent slides will provide more details about the framework’s use. Note: In this module, “PICOTS” is used for the purposes of consistency. The basic framework, PICO is used in all five steps of conducting a systematic review: preparing the topic, searching for and selecting studies, abstracting data, presenting findings, and reporting the review. In order to understand the review topic or question, the Evidence-based Practice Center investigators must identify the relevant Population, the Intervention, the Comparison, and the Outcome of interest. PICOTS, or PICO(TS), includes two other elements — timing and setting — that are sometimes included as part of the other study criteria or are called out specifically to bring attention to these items. For example, the timing of the outcome assessment may be included with the outcome (PICOT); but if timing is not specified clearly, investigators may forget to define it. The “S” in PICOS or PICOTS usually represents setting but occasionally (as in the modules on quantitative synthesis and the reporting of the review) it is used to refer to the study design. The setting encompasses issues of both population (hospital populations have different characteristics than those in outpatient clinics) and the intervention (particularly for behavioral or surgical interventions in which service delivery may vary greatly in different settings). In preparing their report, authors should use the framework they employed during the first four steps of their systematic review process.
Systematic Review Report Structure (I) This slide shows the first three of the five major sections of the standard template used in a systematic review report. The structure of the review report, particularly for comparative effectiveness reviews, will include an abstract and an executive summary. Some readers will read only the abstract and executive summary, so particular focus and attention should be given to this section.
Systematic Review Report Structure (II) This slide shows the last two of the five major sections of the standard template used in a systematic review report.
Using Formal Guidelines To Improve the Reporting of Systematic Reviews International guidelines have been developed to help improve the quality of research reporting. The PRISMA Statement is an example of reporting guidelines especially developed to help authors report systematic reviews. These guidelines consist of a checklist and a flow diagram that can be downloaded from the PRISMA Web site. References: PRISMA Statement Web site. Home page. Available at: http://www.prisma-statement.org/index.htm . Liberati A, Altman DF, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 2009;151:W65-94. http://www.ncbi.nlm.nih.gov/pubmed/19622512 David Moher, Alessandro Liberati, Jennifer Tetzlaff, Douglas G Altman for the PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535 http://www.ncbi.nlm.nih.gov/pubmed/ 19622552
Title of the Review Report In the title of the report, it is important to identify the type of review — a systematic review, a meta-analysis, or a comparative effectiveness review — that was conducted. It is also important to remember that the title needs to be understandable to readers of the report. Consider these examples. The first example, “Comparative Effectiveness of Lipid-Modifying Agents,” does not provide much detail. It is simple and gives a higher level overview of what the review is about. Very often, this type of title is sufficient for the audience. The second example, ”Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis,” is more detailed and provides a more information for readers. Both examples are reasonable. When developing the title, as in many other aspects of the report, the PICOTS framework can be used as a guide.
Executive Summary (I) Although the review team may work hard to develop a 100-page report, not everyone will have the time to read it. Because the executive summary may be used for decisionmaking by individuals who do not have time to read the full report, it is important that it be well-organized, as illustrated on this slide. It should include the background to the review, the review objectives, the key research questions, and the methods, which also might include the data sources, the eligibility criteria, the study appraisal, and the synthesis methods. The results, limitations, and conclusions, including the implications of key findings, should also be included.
Executive Summary (II) The executive summary is meant to be a distillation of the entire review report and should not include study-by-study results. It should provide an overall summary of the review and describe the evidence that supports the summary statements. It is important to describe the strength of the evidence, as was categorized in the evidence review.
Introduction: Purpose and Scope In the introductory section of the document, it is important to share with the reader the purpose and scope of the review, including the clinical decisional dilemma, the current literature, and the current state of practice. Providing this information gives the reader context, which is extremely important. The next step is to provide information about the objectives and the key questions that the evidence review will address. It might be helpful at this point to use the PICOTS framework to describe the objectives and state the key research questions.
Methods Overview Ideally, research methods are detailed in a preexisting protocol (and any subsequent amendments), which is typically prepared by Evidence-based Practice Center investigators in advance of a systematic review. In this report, the Methods overview should provide information on literature search strategy and data sources, eligibility criteria, and data collection processes and data items. The Methods overview should also provide information on quality assessment and synthesis of results, grading of evidence and additional analysis methods. The information should be provided in as clear and transparent a manner as possible. Using the PICOTS framework might be helpful in considering what to include. A point to be noted on writing style: this section of the review should be written in the past tense.
Methods: Literature Search All systematic reviews conducted by Evidenced-based Practice Centers must present the complete electronic search strategy in the Appendix. The purpose of including the entire search strategy is to ensure transparency and to permit replication of the review. Reference : Alejandria MM, Lansang MA, Dans LF, et al. Intravenous immunoglobulin for treating sepsis and septic shock. Cochrane Database Syst Rev 2002;(1):CD001090. http://www.ncbi.nlm.nih.gov/pubmed/11869591
Methods: Information Sources All information sources used in the literature search — including the databases used, dates covered in each database, and any contacts with authors — should be reported. This slide shows an example of how this information is reported. Reference : Bolen S, Wilson L, Vassy J, et al. Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes . Comparative Effectiveness Review No. 8 (Prepared by The Johns Hopkins University Evidence-based Practice Center under Contract No. 290-02-0018). Rockville, MD: Agency for Health Care Research and Quality, July 2007. AHRQ Publication No. 07-EHC010-EF. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/6/39/OralFullReport.pdf.
Methods: Eligibility Criteria (I) Authors of systematic reviews should report the processes by which they selected studies for analysis. Specifically, they should explain how the studies were screened for inclusion or exclusion and which eligibility criteria were applied. The brief example on this slide shows the level of detail that authors should provide in a report. This level of detail is needed ensure transparency and to permit replication of the review. Reference : Shah MR, Hasselvlad V, Stevenson LW, et al. Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomzied clinical trials. JAMA 2005;294:1664-70. http://www.ncbi.nlm.nih.gov/pubmed/16204666
Methods: Eligibility Criteria (II) This slide offers examples of how studies and participants were described in the methods section of a published report. The PICOTS (population, intervention, comparator, outcome, timing, and study design or setting) framework can serve as a guide for reporting the eligibility criteria of the review. Specifically, the type of study, the types of participants, the type of intervention, and the type of outcome should be reported. This ensures that readers, such as clinicians, can determine if the review results can be generalized to their patient population. It is also important to provide this information clearly so that anyone who would like to replicate the review are able to do so. Reference: Schroth RJ, Hitchon CA, Uhanova J, et al. Hepatitis B vaccination for patients with chromic renal failure. Cochrane Database Syst Rev 2004;(3):CD003775. http://www.ncbi.nlm.nih.gov/pubmed/15266500
Methods: Eligibility Criteria (III) This slide offers examples of how interventions and outcomes were described in the methods section of a published report. The PICOTS (population, intervention, comparator, outcome, timing, and study design or setting) framework can serve as a guide for reporting the eligibility criteria of the review. This ensures that readers, such as clinicians, can determine if the review results can be generalized to their patient population. It is also important to provide this information clearly so that anyone who would like to replicate the review are able to do so. Reference : Schroth RJ, Hitchon CA, Uhanova J, et al. Hepatitis B vaccination for patients with chromic renal failure. Cochrane Database Syst Rev 2004;(3):CD003775. http://www.ncbi.nlm.nih.gov/pubmed/15266500
Methods: Data Extraction Authors should describe the method used for extracting data from the studies selected for the review. The level of detail that should be included in the description of the data collection process is illustrated in the example on this slide. Authors should also describe any processes they followed to obtain and confirm any information they received from the authors of the primary studies. Once again, the goal is to ensure transparency and to permit replication of the review. Reference Mistiaen P, Poot E. Telephone follow-up, initiated by a hospital-based health professional, for postdischarge problems in patients discharged from hospital to home. Cochrane Database Syst Rev 2006;(4):CD004510. http://www.ncbi.nlm.nih.gov/pubmed/17054207
Methods: Data Items Authors should list and define all the variables for which data were sought. The PICOTS (population, intervention, comparator, outcome, timing, and study design or setting) framework can be used as a guide. In addition, authors should describe any assumptions and simplifications that were made in defining the variables. Following this approach will make the report clear and ensure transparency. Reference : Allen C, et al. Non-steroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database Syst Rev 2005;(4):CD004753. http://www.ncbi.nlm.nih.gov/pubmed/16235379
Methods: Quality Assessment Authors should describe the methods and criteria they used to assess the quality (risk of bias) of the studies selected for the review. As noted in the previous slides on methods, authors should provide a certain level of detail about the approaches they used for quality assessment. This information helps to ensure transparency and to permit replication of the review. References: Tracz MJ, Sideras K, Boloña ER, et al. Testosterone use in men and its effects on bone health. A systematic review and meta-analysis of randomized placebo-controlled trials. J Clin Endocrinol Metab 2006;91:2011-6. http://www.ncbi.nlm.nih.gov/pubmed/16720668 Bucher HC, Hengstler P, Schindler C, et al. Percutaneous transluminal coronary angioplasty versus medical treatment for non-acute coronary heart disease: meta-analysis of randomised controlled trials. BMJ 2000;321:73-7. http://www.ncbi.nlm.nih.gov/pubmed/10884254
Methods: Synthesis of Results Authors should describe the methods they used to handle the data and to combine the results of studies. If measures of consistency, such as an I-squared test, were used, the results should be reported for each meta-analysis. This level of detail will also be helpful to ensure transparency and to permit replication of the review. This slide shows two examples of descriptions of methods used for synthesizing data. References: Jones M, Schenkel B, Just J, et al. Epoetin alfa improves quality of life in patients with cancer: results of metaanalysis. Cancer 2004;101:1720-32. http://www.ncbi.nlm.nih.gov/pubmed/15386341 Briel M, Studer M, Glass T, et al. Effects of statins on stroke prevention in patients with and without coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med 2004;117:596-606. http://www.ncbi.nlm.nih.gov/pubmed/15465509
Methods: Grading Strength of Evidence Authors should report any assessments they made of risk of bias that may effect the cumulative evidence. One example of such bias is study level publication bias. The example in the slide gives the level of detail that authors should report. Reference: Hróbjartsson A, Gøtzsche PC. Placebo interventions for all clinical conditions. Cochrane Database Syst Rev 2004;(1):CD003974. http://www.ncbi.nlm.nih.gov/pubmed/20091554
Methods: Additional Analyses Additional analysis, such as a subgroup analysis or a meta-regression, should be reported in the same detail as the other methods used in the review. this slide shows an example of additional analyses conducted as part of a review. Reference: Briel M, Schwartz GG, Thompson PL, et al. Effects of early treatment with statins on short-term clinical outcomes in acute coronary syndromes: a meta-analysis of randomized controlled trials. JAMA 2006;295:2046-56. http://www.ncbi.nlm.nih.gov/pubmed/16670413
Results Overview The next several slides describe how results should be reported, including information on the study selection, the study characteristics, and quality assessment.
Results: Study Selection In reporting the study selection, authors should provide information on the numbers of studies screened, assessed for eligibility, and actually included in the review. Authors should also provide the rationale for the exclusion of studies at each of these stages. This can be done in two ways. In the example in this slide, authors provide the rationale in a narrative format. The authors report the starting total of 548 records (usually titles and/or abstracts) initially identified in searches of electronic databases and then describe how studies were excluded until only 5 studies remained that met the inclusion criteria for the systematic review. The other way to provide this information is to use a flow diagram, an example of which is presented on the next slide. One common mistake in reporting study selection is to put the information in the Methods section, for example, under eligibility criteria. Study selection should be the first part of the Results section. Reference: Uitterhoeve RJ, Vernooy M, Litjens M, et al. Psychosocial interventions for patients with advanced cancer — a systematic review of the literature. Br J Cancer 2004;91:1050-62. http://www.ncbi.nlm.nih.gov/pubmed/15316564
Examples of Flow Diagrams The flow diagram is a good option to consider when reporting the steps used to select studies for the systematic review. Such diagrams can be included within the report or in the appendix. There are many different ways to design flow diagrams. This slide shows two examples. In the example labeled Figure 2, the authors have laid out the flow diagram in an easy-to-comprehend manner. Notice too that the bottom three boxes contain numerical data, a level of detail that is important to give when using flow diagrams. Reference: Sharma M, Ansari MT, Abou-Setta AM, et al. Systematic review: comparative effectiveness and harms of combination therapy and monotherapy for dyslipidemia. Ann Intern Med 2009;151:622-30. http://www.ncbi.nlm.nih.gov/pubmed/19884623 Fuccio L, Minardi ME, Zagari RM, et al. Meta-analysis: duration of first-line proton-pump inhibitor based triple therapy for Helicobacter pylori eradication. Ann Intern Med 2007;147:553-62. http://www.ncbi.nlm.nih.gov/pubmed/17938394
Results: Study Characteristics Authors should report the characteristics of the studies that were included in the review. This can be adequately achieved within the text or by using tables and figures. The example shows how to report study characteristics in text and the level of detail required. The Presentation of Findings module offers additional guidance on how to present study characteristics. Reference: Curioni C, André C. Rimonabant for overweight or obesity. Cochrane Database Syst Rev 2006;(4):CD006162. http://www.ncbi.nlm.nih.gov/pubmed/17054276
Results: Quality Assessment Authors should provide quality assessment information on each of the studies included in the review. In this example, the columns represent the quality criteria used, and the rows represent the individual studies included in the review. The table is populated with the quality assessment results. Refer to the Assessing the Quality of Individual Studies module for additional guidance. References: Devereaux PJ, Beattie WS, Choi PT, et al. How strong is the evidence for the use of perioperative beta blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials. BMJ 2005;331:313-21. http://www.ncbi.nlm.nih.gov/pubmed/15996966 Liberati A, Altman DF, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 2009;151:W65-94. http://www.ncbi.nlm.nih.gov/pubmed/19622512
Results: Individual Studies When reporting the results of individual studies included in a review, authors should report all outcomes, including benefits and harms, that were assessed. For each study, authors should present simple summary data for each intervention group and some effect estimates and confidence intervals with a forest plot, assuming that a meta-analysis has been done. Ideally, authors should also report the results of individual studies in evidence tables.
Results: Synthesis of Results There are at least three ways to present syntheses of results. It can be textual, as in the detailed example in this slide. Summary tables and evidence maps are also useful. More detailed information on the use of tables can be found in the Presentation of Findings module. Reference: Duffett M, Choong K, Ng V, Randolph A, et al. Surfactant therapy for acute respiratory failure in children: a systematic review and meta-analysis. Crit Care 2007;11:R66. http://www.ncbi.nlm.nih.gov/pubmed/17573963
Results: Risk of Bias Across Studies There should be synergy between what authors report about their methods and what they report about their results. For example, in reporting methods, authors should also report on the risk of bias across studies (see the slide “Methods: Risk of Bias Across Studies” in this talk for additional information). The results of such as assessment need to be included in the results section as well. For example, in providing information about how the strength of a body of evidence was graded, authors should discuss risk of bias, directness, consistency, and precision. Review the Grading the Strength of Evidence module for additional guidance. Reference: Ip S, Terasawa T, Balk EM, et al. Comparative Effectiveness of Radiofrequency Catheter Ablation for Atrial Fibrillation . Comparative Effectiveness Review No. 15 (Prepared by Tufts–Mew England Medical Center Evidence-based Practice Center under Contract No. 290-02-0022). Rockville, MD: Agency for Healthcare Research and Quality, July 2009. AHRQ Publication No. 09-EHC015-EF. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/51/114/2009_0623RadiofrequencyFinal.pdf.
Results: Additional Sensitivity Analyses Authors should report sensitivity analyses, which is usually methodological (e.g., high quality vs. low quality; low risk of bias vs. high risk of bias), separate from subgroup analyses in the report. The example in this slide provides the type of information authors should include in reporting any additional sensitivity analyses. Reference: Reichenbach S, Sterchi R, Scherer M, et al. Meta-analysis: chondroitin for osteoarthritis of the knee or hip. Ann Intern Med 2007;146:580-90. http://www.ncbi.nlm.nih.gov/pubmed/17438317
Results: Additional Subgroup Analyses It is important to separate subgroup analyses, which is usually clinical (e.g., men vs. women; young vs. old), from sensitivity analyses when reporting results. The example in this slide provides the type of information authors should include in reporting any additional subgroup analyses. Reference: Hodson EM, Craig JC, Strippoli GF, et al. Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients. Cochrane Database Syst Rev 2008;(2):CD003774. http://www.ncbi.nlm.nih.gov/pubmed/18425894
Discussion: Summary of Evidence Authors should summarize the main findings, including the strength of evidence for each of the main outcomes. Review the Assessing Applicability and Grading of Strength of Evidence modules for helpful information.
Discussion: Summary of Evidence This slide illustrates a well-written example of a summary of evidence. Reference: Wilt TJ, Shamliyan T, Taylor B, et al. Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer . Comparative Effectiveness Review No. 13 (Prepared by Minnesota Evidence-based Practice Center under Contract No. 290-02-0009). Rockville, MD: Agency for Healthcare Research and Quality, February 2008. AHRQ Publication No. 08-EHC010-EF. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/9/80/2008_0204ProstateCancerFinal.pdf.
Discussion: Limitations Authors should feel comfortable reporting on the limitations of the review, because all reviews have limitations. Some of the limitations will be at the study level and some will be at the outcome level. The example illustrates the sort of information that should be included in the discussion section of the document. Reference: Liberati A, D'Amico R, Pifferi, et al. Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev 2004;(1):CD000022. http://www.ncbi.nlm.nih.gov/pubmed/14973945
Discussion: Conclusions Authors should provide a general interpretation of the results in the context of other evidence and the implications for future research. Reference: Sharma M, Ansari MT, Soares-Weiser K, et al. Comparative Effectiveness of Lipid-Modifying Agents . Comparative Effectiveness Review No. 16 (Prepared by the University of Ottawa Evidence-based Practice Center under contract No. 290-02-0021). Rockville, MD: Agency for Healthcare Research and Quality, September 2009. AHRQ Publication No. 09-EHC024-EF. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/11/171/reptbodyfin-typofixed4-12-2010.pdf.
Key Messages Reporting the findings of a systematic review is the final step in the continuum of the review process. The report should convey in a transparent manner what was done and what was found. It is especially important to be transparent in reporting the methods and the results. Doing so helps all readers—including consumers, clinicians, and policymakers—better understand the review process. Inadequate reporting makes it more difficult to judge the validity of the methods and the results, thereby making the review less useful as tool for effective health care.