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Learn about Systematic Reviews, their importance, structure, and how to conduct critical appraisal. Explore databases and search methods for comprehensive literature review. Improve research skills with practical tools for evidence-based practice.
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Secondary Data Analysis: Systematic Reviews & Associated Databases Prof. Eileen Savage OMCYA Keeping Children Safe Summer School, 12th – 16th September 2011, UCC.
What is a Systematic Review? • a concise scientific investigation, with pre-planned methods that summarise, appraise, synthesise and communicate the results of multiple primary studies (Cooke et al, 1997; Centre for Reviews and Dissemination, 2008). ie Research on Research with findings of existing data becoming raw data Differs from a narrative review/ traditional literature review
Traditional Review vs. Systematic Review (Nasseri-Moghaddeam & Malekzadeh 2006)
Expanding volume of published & unpublished literature Conflicting findings across studies leading to ‘uncertainty’ Contributes to Evidence Based Movement Systematic Reviews – Origins of Growth
When to Do a Systematic Review • When there is ‘uncertainty’ about the effectiveness of interventions in practice • When key questions remain unanswered e.g. about treatments, interventions, practices, experiences etc… • To inform practice/policy with best available research evidence • To identify what is known/not known in an area to guide future research (includes research methods) (Petticrew & Roberts 2007)
Where to find a Systematic Review • Peer Reviewed Journals (search bibliography databases) • Cochrane Database of Systematic Reviews (Cochrane Library; several Groups) • Database of Abstracts of Reviews of Effects (DARE) • Health Technology Assessment Database • NHS Economic Evaluation Database • The Campbell Collaboration Library (Groups e.g. Crime & Justice; Education; Social Welfare; Methods; Communication & internationalization; Users Groups. • The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), University of London. (Education; Health Promotion; Employment; Social care; Crime and Justice) • Others
Structure of Systematic Review e.g. • Introduction/Background • Questions/Aim & Objectives • Criteria for considering studies • Search Methods • Methods of the Review (e.g screening reading papers; quality assessment; data extraction) • Results • Discussion • Conclusions
Criteria for Including/Excluding Studies • Types of Studies (see hierarchy of evidence) • Types of Participants • Types of Outcomes Link to Questions being asked
Hierarchy of Evidence Meta-synthesis Qualitative studies
Search Method • Search Terms • Databases • +/- Hand searching • +/- Reference lists • +/-Grey Literature • +/- Contacting authors (Refer to Booth et al on standards for Reporting Search Methods)
Search Strategy: Embase (Elsevier) Search Strategy: CINAHL with Full Text (EBSCO)
Methods – Screening for Inclusion/ Exclusion • Titles & Abstracts – In/Unsure/Out • Read in full –> in/unsure /out
Quality Assessment of Individual Studies • Quality threshold for inclusion ie exclude poor quality studies • Assessment of Quality may be part of SR • How - No –’gold standard’ exists - Checklists available e.g. CASP - Quality Scales/Criteria
Data Extraction • Use a data extraction form (s) • 2 or more reviewers / cross-check • Extract details relevant to Questions/ Objectives • Present raw data in report – table format
Data Analysis & Synthesis • Collation & summary of results • Present in tabular form/forest plots/other + descriptive narrative account • +/- Meta-analysis, if appropriate (not possible with heterogeneity ie cannot pool apples with oranges for the purpose of statistical analysis as one data set)
Critical Appraisal of Systematic Reviews • The PRISMA Statement: standards for reporting SRs & Meta-analyses • Critical Appraisal Tool Kit for SRs (CASP)
Website on Critical Appraisal Tools (covers a range of methods) • At: Division of Health SciencesInternational Centre for Allied Health Evidence http://www.unisa.edu.au/cahe/Resources/CAT/default.asp
References • To follow