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Systematic Review Guide

The Systematic Review Process

Systematic reviews are considered the highest levels of evidence, but only if they are done rigorously. The Institute of Medicine (IOM) in the United States has 21 standards for developing high-quality systematic reviews: Finding What Works in Health Care: Standards for Systematic Reviews.                                                         

You can use the AMSTAR (A MeaSurement Tool to Assess Systematic Reviews) checklist to assess the quality of a systematic review.

Steps Involved in a Systematic Review

The interactive Systematic Review Process Diagram tool, developed by the St. Michael’s hospital Knowledge Translation Program, takes you through the steps on how to conduct a rigorous a systematic review.

Here are the steps in brief:

1.  Determine your reason for doing a systematic review and why it is needed.
2.  Check to see whether there are recent systematic reviews on this topic already.
3.  Form your systematic review team. Include a librarian experienced in systematic reviews.
4.  Write an answerable research question.
5.  Agree on specific inclusion and exclusion criteria
6.  Complete a systematic review protocol.
7.  Register your protocol. Consider publishing it.
8.  Choose citation management software.
9.  Create your Medline search strategy using a combination of medical subject headings and keywords. Have the search strategy peer reviewed by another experienced librarian.
10. Complete an exhaustive search for studies, including at least 3 databases and grey literature.
11. Perform data extraction.
12. Assess the quality of the results.
13. Synthesize the results. Perform meta-analysis if applicable.                                                  
14. Interpret the findings.
15. Write your paper.     

How Long Does it Take?

Systematic reviews are done with a team of reviewers and they take a while to complete - at least 9 to 12 months depending on the topic. If you don’t have the time for such a large undertaking, consider carrying out a literature review or rapid review. LINK to Types of Reviews.

You may also consider using PredicTER which is a software tool to help researchers and practitioners estimate the length of time necessary to complete a systematic review (SR) or systematic map (SM). 

The Systematic Review Team

A systematic review cannot be conducted by one person. You need a team that includes:

  • Subject experts with clinical and methodological expertise
  • Two people to review the results independently 
  • A tie breaker to make decisions if there is disagreement about whether a study meets the inclusion criteria
  • An information specialist/medical librarian trained in systematic review searching
  • A statistician if doing a meta-analysis

The Information Specialist's Role

 An information specialist trained in systematic review searches plays a crucial role in carrying out a comprehensive and unbiased search for the evidence.

Leading organizations such as the Cochrane Collaboration, Institute of Medicine (IOM), Centre for Reviews and Dissemination (CRD), and the Agency for Healthcare Research and Quality (AHRQ) all recommend including an information specialist as a member of the review team.

"…it is recommended that review authors seek guidance from a healthcare librarian or information specialist, where possible with experience of supporting systematic reviews" (Cochrane Handbook of Systematic Reviews, 6.3.1)


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