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Systematic Reviews

Pre-Review Tasks

Step 1: Completing the pre-review tasks below will help you prepare for conducting a systematic review. During this step you will:

  • Familiarize yourself with the systematic review process and purpose
  • Develop and refine your research question
  • Build your team
  • Decide if a systematic review is needed on your topic/question

Refer to the rest of this page to see what you should know about PRISMA for this step, different question frameworks, who to have on your systematic review team, and how a librarian can help you complete pre-review tasks.

Purpose and Process of a Systematic Review

Purpose:

By using a systematic approach to assessing primary research, systematic reviews aim to provide an up-to-date summary of the state of research knowledge on an intervention, diagnostic test, prognostic factor or other health or healthcare topic. These reviews aim to minimize bias using pre-specified research questions and methods that are documented in protocols, and by basing their findings on reliable research. Systematic reviews were developed out of a need to ensure that decisions affecting people's lives can be informed by an up-to-date and complete understanding of the relevant research process (Lasserson et al., 2023).

Process:

The seven steps in this guide will outline the process of a systematic review. For more information to gain understanding on the process or purpose of these types of reviews, please see the two resources below:

How a Librarian Can Help with Pre-Review Tasks

In this stage, the librarian on your team can help you:

  • Determine if there is already a systematic review on the same or a similar topic
  • Develop and refine your research question framework
  • Refer you to relevant systematic review reporting standards
  • Review the systematic review process and steps with the team

PRISMA

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) are reporting guidelines. PRISMA details what should be reported about your systematic review. Below are helpful documents for the pre-review stage, you can familiarize yourself with the PRISMA checklist and flow diagram. For more information on PRISMA, you can refer to the PRISMA website (linked below). 

Build your Systematic Review Team

When building your systematic review team, consider these points:

  • Minimum of 3 Reviewers: Essential for robust review.Review team members can include a principal investigator, 3 reviewers, a librarian, a statistician, and others.
  • More Reviewers: Accelerates the screening process.
  • Odd Number of Reviewers: Eases tie-breaking.
  • Field Experts: Essential for focused review and defining eligibility criteria.
  • Librarian Collaboration: Enhances the search strategy.
  • Statistician: Important if conducting a meta-analysis.
  • Define Roles Early: Clarify communication, timelines, and project management.

Develop and Refine Your Research Question

  • A well-developed and answerable question is the foundation for any systematic review. 
  • Systematic review protocols (discussed more in Step 2) include a list of studies that will be included in the review. These studies, known as exemplars, guide the search development but also serve as proof of concept that your question is answerable. If you are unable to find studies to include, you may need to reconsider your question
  • Systematic reviews aim to answer a specific research question. There are many frameworks that will help you make your research question specific.
  • Use the tabs in this box to find learn more about some widely used question frameworks and the purpose of each.
  • Still unsure? There are 25 other question frameworks that can help you create a focused research question. See the PDF below for more information.

For quantitative research topics (therapy, diagnosis, prognosis, etiology/harm, and prevention) the PICO question framework is useful. The PICO framework helps refine your research question using four concepts: population, intervention, comparison, and outcome.

PICO Definition Example
Patient/Population/Problem Who is my question focused on? Infants diagnosed with necrotizing enterocolitis (NEC)
Intervention What is the proposed new intervention? Early enteral refeeding
Comparison (optional) What is the current or alternative state? Late enteral re-feeding
Outcome What is the measurable outcome being impacted? NEC recurrence 

Research question based on PICO framework: In infants diagnosed with necrotizing enterocolitis (NEC), what is the effect of early enteral refeeding on NEC recurrence compared with late enteral refeeding?

The PEO format is useful for qualitative research topics. It uses three concepts: population, exposure, and outcome.

PEO Definition Example
Population Who is my question focused on?

mothers

Exposure What is the issue I'm interested in? postnatal depression
Outcome What, in relation to the issue, do I want to examine? daily living experiences

Research question based on PEO framework: What are the daily living experiences of mothers with postnatal depression?

The SPIDER question format can be used for qualitative or mixed methods research topics focusing on "samples" rather than populations. SPIDER questions use five concepts: sample, phenomenon of interest, design, evaluation, and research type.

SPIDER Definition Example
Sample Who is the group of people being studied? young parents
Phenomenon of Interest What are the reasons for behavior and decisions? attendance at antenatal education classes
Design How has the research been collected (e.g. interview, survey)? interviews
Evaluation What is the outcome being impacted? experiences
Research Type What type of research (qualitative or mixed methods)? qualitative studies

Research question based on SPIDER framework: What are the experiences of young parents in attendance at antenatal education classes?

For qualitative research topics in which the goal is to evaluate the outcomes of a service, project, or intervention the SPICE question format can be used. The SPICE format uses five concepts: setting perspective, intervention/exposure/interest, comparison, and evaluation.

Element Definition Example
Setting the context for the question (where) South Carolina
Perspective The users, potential users, or stakeholders of the service (for whom) teenagers
Intervention/Interest/Exposure the action taken for the users, potential users, or stakeholders (what) provision of Quit Kits to support smoking cessation
Comparison the alternative actions or outcomes (compared to what) no support or "cold turkey"
Evaluation the results or measurement that will determine the success of the intervention (what is the results, how well) number of successful attempts to give up smoking with Quit Kits compared to number of successful attempts with no support

Research question based on SPICE framework: For teenagers in South Carolina, what is the effect of provision of Quit Kits to support smoking cessation on number of successful attempts to give up smoking compared to no support ("cold turkey")?

References

Lasserson TJ, Thomas J, Higgins JPT. Chapter 1: Starting a review. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.

Image used on this page was found on the UNC Systematic Review LibGuide