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Systematic Reviews & Knowledge Syntheses:
What a Librarian Needs to Know
Lorie Kloda, MLIS, AHIP, PhD
Assessment Librarian
GLIS-671
February 11, 2015
Systematic Reviews
2
“…reviews of a clearly formulated question that use explicit methods to identify, select, and critically appraise relevant research and to collect and analyse data from the studies that are included in the review.”
Cochrane Collaboration
Knowledge Synthesis
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“the contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic. A synthesis must be reproducible and transparent in its methods...”
Canadian Institutes of Health Research http://www.cihr-irsc.gc.ca/e/41382.html
Systematic Review Nonsystematic Review
Question • Usually narrow question • Usually broad question
Search Strategy • Explicitly stated
• May be performed in duplicate
• Not stated
Study
Identification
• Criteria explicitly stated
• May be performed in duplicate
• Not stated
Methods • Methods & outcomes of interest
explicitly stated
• May include study quality
assessment, sensitivity analyses
• Not stated
Presentation of
Results
• Typically by study characteristics
so that equivalent components are
compared
• Typically by study
Conclusions • Typically confined to what the data
could infer
• May include personal approaches,
opinions not supported by data
From: Wong R. (2003). Systematic reviews and the Cochrane Collaboration. Oncology
Rounds, 5(10). Retrieved from www.oncologyrounds.ca
Knowledge Syntheses
5
Systematic review
Meta analysis
Scoping review
Evidence mapping
Mixed methods synthesis
Meta-synthesis approaches
Realist synthesis approaches
Rapid evidence assessment
Why Conduct a Knowledge Synthesis?
6
Growth of Systematic Review Publications
7 Bastian, H., Glasziou, P., & Chalmers, I. (2010). Seventy-five trials and eleven systematic reviews a day: How will we ever keep up? PLOS Medicine, 7(9), e1000326. DOI: 10.1371/journal.pmed.1000326
Growth of Syntheses in Graduate Theses
a
Cobus-Kuo, L., Gore, G., & Kloda, L. A. (2014). Research syntheses in graduate research: A scoping review. Canadian Health Libraries Association Annual Conference, June 16-20, 2014, Montreal, QC.
Growth of Syntheses in Theses per 1000
Syntheses in Graduate Theses by Discipline
Cochrane Reviews
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Midwife-led continuity models versus other
models of care for childbearing women
Oral immunotherapy for milk allergy
Standards
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For conducting systematic reviews (or research syntheses):
Cochrane Handbook
Institute of Medicine – Standards for Systematic Reviews
Agency for Health Quality Research – Methods Guide for Effectiveness and Comparative Effectiveness Reviews
For reporting systematic reviews & protocols
PRISMA Statement – Preferred Reporting Items for Systematic Reviews and Meta-Analyses (& PRISMA-P, PRISMA-C)
Sources for Finding Systematic Reviews
• Cochrane Library– Cochrane Database of Systematic Reviews (includes Methodology
Reviews)– Database of Abstracts of Reviews of Effects (DARE)– Health Technology Assessments– Other databases of original studies (clinical trials, methods,
economic evaluations)
• Database for Promoting Health Effectiveness (DoPHER)• Health databases
– AMED– CINAHL– EMBASE– MEDLINE– PsycINFO
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Steps in a Systematic Review
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1. Define the (clinical) question
2. Identify all relevant research (published and unpublished)
3. Select studies for inclusion
4. Assess the quality of each study
5. Synthesize the findings (meta-analysis or meta-synthesis, if possible)
6. Interpret the findings and present an unbiased summary
McGowan, J., & Sampson, M. (2005). Systematic reviews need systematic searchers. Journal of the Medical Library Association, 93(1), 74-80.
Lorie Kloda, McGill University
Mary Ellen Macdonald, McGill University
Rosa Caporicci, McGill University
Susan Cadell, Wilfrid Laurier University
Stephen Liben, Montreal Children’s Hospital
Canadian Health Libraries Association Annual Conference, May 29, 2011, Calgary, Alberta
Experiences of Family
Members after a Child Dies:Scoping the Literature in
Interdisciplinary Research
16
Steps in a Comprehensive Literature Search
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Database /trial registry searches
Grey literature search
Hand searches
Conference proceedings
Major journals
Bibliographies
Citation searches
“Related citations”
Snowball searches (Reference harvesting)
Review papers
All included studies
Contact researchers
Initial
searches
Supplemental
searches
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“Conducting a comprehensive,
objective and reproducible search
for studies can be the most time
consuming and challenging task in
preparing a systematic review.”
Higgins, J. P. T., & Green, S. (eds.) (2009). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2. The Cochrane Collaboration. Available from www.cochrane-handbook.org.
Selection of Sources
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Databases Several required (+ clinical trial registries) Unpublished trials contribute ~20% of the weight in
meta-analysisFries, J. F., & Krishnan, E. (2004). Equipoise, design bias, and randomized controlled trials: The
elusive ethics of drug development. Arthritis Research Therapy, 6, R250-R255.
Grey literature “unpublished,” fugitive,” “in-house,” “non-commercial” Definition/distinction not important; as long as it’s
relevant, it should be included Reduces publication bias
Hopewell, S., McDonald, S., Clarke, M. J., & Egger, M. Grey literature in meta-analyses of randomized trials of health care interventions. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: MR000010. doi: 10.1002/14651858.MR000010.pub3
20
Search Strategy Development
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Keywords (natural language) Truncation, synonyms, alternative spelling
Subject Headings Explode
Limitations Languages, date, publication type
Boolean (logical operators),
Field searching Title, abstract
Hedges (optimal search strategies; filters)
Peer reviewMcGowan, J., Sampson, M. & Lefebvre, C. (2010). An evidence based checklist for the peer review of
electronic search strategies (PRESS EBC). Evidence Based Library and Information Practice 5 (1),149-154.
22
23
“Terms within social sciences are often
ambiguous, poorly defined and constantly
changing. Unfortunately, the use of
controlled vocabularies and indexing is not
applied across the social sciences
databases with the same rigour as in
medical databases.”
Papaioannou, D., Sutton, A., Carroll, C., Booth, A., & Wong, R. (2010). Literature
searching for social science systematic reviews: Consideration of a range
of search techniques. Health Information and Libraries Journal, 27(2),114-
122.
Record Keeping
24
PRISMA Statement checklist includes:• Databases with dates of coverage, date last searched,
platform/provider
• Who developed and conducted the search
• Supplementary methods: hand searches, citation searches, snowball searches, contacting known researchers
• Full electronic search strategy for at least one database, such that it can be repeated
• Use of hedges or any peer reviewed search strategies
• Additional limitationsMoher. D., Liberati, A., Tetzlaff, J., Altman, D.G., & The PRISMA Group. (2009). Preferred Reporting Items for
Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Medicine 6(6), e1000097. doi:10.1371/journal.pmed1000097
25
26
27
Citation Searching
28
Supplements subject search
Across disciplines
Can be used for books or book chapters
“Safety net” – can confirm a comprehensive strategy
3 citation databases offer overlapping content: Web of Science (“Science Citation Index”) – most multisciplinary
Scopus
Google Scholar – can lead to grey lit
Search all 3 if possible, using a few key referencesKloda, L.A. (2007). Evidence Summary: Use Google Scholar, Scopus and Web of Science for comprehensive citation tracking. Evidence Based Library and Information Practice 2 (3),87-90.
Managing References
29
Citation Software (e.g., EndNote, RefWorks)
• Exporting from databases (filters)
• Removes duplicates
• Search for full-text articles online
• Groups (folders)
• Annotations
• Citations / references in manuscript
Systematic Review Software(e.g., SRdistiller, EPPI-Reviewer)
Librarians and Syntheses
30
What roles can librarians play in supporting systematic reviews?
To fulfill these roles, what skills and knowledge do librarians need?
How would you go about acquiring these skills?
Systematic Reviews: Library Guide
31
http://wikisites.mcgill.ca/systematicreview
Health Librarians’ Competencies
32
Systematic Reviews with Librarian (Co-)Authors
33
Agencies Requiring or Recommending a Librarian
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Canadian Institutes of Health Research (CIHR) Knowledge Synthesis Grant
Agency for Healthcare Research and Quality (AHRQ)
Cochrane Collaboration Programme Grant
Role of Librarians & Syntheses in the Literature
35
PubMed from 1995 to 2015…