Systematic Reviews: Overview

"A properly conducted systematic review faithfully summarizes the evidence from all relevant studies on the topic of interest, and it does so concisely and transparently." (Cook, 1997)

• Systematic Review
• Meta-Analyses
• Integrative Review
• Rapid Review
• Individual Patient-Level Meta-Analyses

Search "systematic review" in Sage Research Methods database

EPID 582: Systematic Reviews and Meta-Analysis

Please check with Department as this course is not offered every year
1 course unit
Prerequisite: EPID 510 or equivalent & EPID 526 or equivalent (may be taken concurrently) and permission of instructor
Instructor: Craig Umscheid MD, MSCE 
This course will provide an introduction to the fundamentals of systematic reviews and meta-analysis.  It will cover introductory principles; protocol development; search strategies; data abstraction methods; quality assessment; meta-analytic methods; and applications of meta-analysis.  The course is composed of a series of weekly small group lectures and exercises, including protocol presentations.

1. Develop a Research Topic

• The PICO (Population, Intervention, Comparator/Comparison, Outcomes) help to clarify the critical elements of a key question
• A research question might be refined after performing a preliminary literature search
  
  

2. Define Inclusion and Exclusion Criteria

• Define which subjects or studies will be included into the review
• Determined by the research  question
• Need to be defined before the search is conducted
  
  

3. Search the Literature

      More details are provided in Literature Search

4. Select Studies

• Usually conducted in two passes
      i. Review title and abstract
      ii. Review full text
• At least two independent reviewers with a third person availabe for conflicts
• Keep a log of excluded studies with reasons for exclusion
  
  

5. Assess study quality

• Each study meeting the inclusion criteria is accessed for quality
• More studies may be excluded after this step
• Must be documented
  
  

6. Extract Data

• Reviewers will extract data from the included documents to be analyzed either qualitatively or quantitatively
• Reviewers may develop standardized forms
  
  

7. Analyze and Present Results

• Either qualitative or quantitative (Meta - Analysis)
• May have to perform sensitivity analyses and examine funnel and forest plots
  
  

8. Interpret Results

Reviewers should comment on:

• Strength of the evidence
• Applicability of the results
• Benefits/costs/tradeoffs
• Limitations
• Implication for future research
  
  

9. Update the Review as Needed

New research findings can quickly make Systematic Reviews out of date. 

Standards for Systematic Reviews – from Institute of Medicine (IOM)

Establish a team with appropriate expertise and experience to conduct the systematic review

• 2.1.1 Include expertise in the pertinent clinical content areas
• 2.1.2 Include expertise in systematic review methods
• 2.1.3 Include expertise in searching for relevant evidence
• 2.1.4 Include expertise in quantitative methods
• 2.1.5 Include other expertise as appropriate