Duvendack et al. A thorough search strategy should involve multiple databases, registries, sources of grey literature (https://onlinelibrary.london.ac.uk/resources/databases/opengrey)13, conference proceedings and abstracts. First‐line therapy for adults with advanced renal cell carcinoma: a systematic review and network meta‐analysis Marius Goldkuhle, Angela Aldin, Tina Jakob, Anne Adams, Ina Monsef, Axel Heidenreich, Philipp Dahm, Nicole Skoetz When systematic review principles are applied sensitively, systematic reviews have a clear advantage over traditional literature reviews. 37, No. Systematic reviews search, appraise and collate all relevant empirical evidence in order to provide a complete interpretation of research results. Sign in to view your account details and order history, A brief history, overview and practical guide for authors. An infusion of systematic review methods would strengthen narrative reviews and in turn systematic reviews could benefit from the presentation strengths of narrative reviews. Likewise, traditional literature reviews in international development research often focus exclusively on results of other studies, without considering study design, data and analytical methods used. Following the predefined eligibility criteria, you then need to analyze the screened search results to extract data from those publications that meet the inclusion criteria. The aim of this updated systematic review is to assess the effects, both in terms of benefits and harms of statins, for the primary prevention of CVD. You can also include a meta-analysis if applicable. Furthermore, they are often registered with systematic review research networks, for instance, the Cochrane Collaboration in the medicine field or the Campbell Collaboration for reviews in education, crime and justice and social welfare. “Systematic reviews are literature reviews that summarize evidence by identifying, selecting, assessing, and synthesizing the findings of similar but separate studies. One is how to comprehensively record and assess the state of knowledge on a particular topic. 2002). Ultimately, systematic reviews should be seen as a means to an end – helping to get a robust and sensible answer to a focused research question – and not an end in themselves (Lichtenstein et al. Concrete examples will be provided from the systematic review on cash transfers and employment creation (Hagen-Zanker et al. Carrying out a rigorous review is far from easy and, like any piece of research, a systematic review can be done badly. This led to a greater international emphasis on the need to improve research synthesis by policy makers, academics, and clinicians3. This is problematic from a practical perspective: unclear titles and vague, unstructured abstracts make it more difficult to accurately assess the relevance of a study on the basis of a title or abstract alone. Cochrane drew attention to the vital importance of randomized control trials in determining the effectiveness of health treatments. However, while piloting enables researchers to screen more consistently, there will always be some degree of subjectivity. Systematic reviews offer a number of benefits. The objective of registering reviews is to minimise bias of the review, to reduce duplication of effort between groups, to keep systematic reviews updated (PLoS Medicine Editors 2011) and to provide a library with all systematic reviews in the field. For example, in the systematic review on cash transfers and employment guarantee schemes (Hagen-Zanker et al. Moreover, SRs also help identify research gaps in our current understanding of a field. Systematic reviews were pioneered in the natural sciences where the predominant methodologies are quantitative. While the findings are valid across a broader development context, six of the reviews focus specifically on fragile and conflict-affected situations. These will now be discussed in turn. For example, in Hagen-Zanker et al. A number of systematic reviews may eventually be published as ‘systematic maps’ due to the low number of relevant studies included in the final analysis. Originally used in the medical sciences in the 1970s to examine the effectiveness of health-care interventions and, more broadly, to support the practice of evidence-based medicine, systematic reviews have since permeated into a wide range of disciplinary fields, from ‘astronomy to zoology’ (Petticrew 2001). International development is arguably the latest field to have been introduced to systematic reviews. However, to date, there has been only limited critical reflection on their application within this field. In order to achieve objectivity, inclusion and exclusion criteria are used to screen potentially relevant studies. You must adopt a comprehensive, objective and reproducible search strategy to capture all relevant sources of evidence. Systematic reviews are usually peer-reviewed at different stages in the process. If appropriate, the results of the identified studies may be combined in a meta-analysis. Patient satisfaction is a key indicator of how well the telemedicine modality met patient expectations. Meta-analysis is rarely possible in the international development field because of the non-availability of data as well as methodological diversity. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE until 2011. There has been increased interest in the role of cannabis for treating medical conditions. Furthermore, researchers might find that identifying and highlighting a recent high quality systematic review will prove of most benefit to decision makers using their review or reviews. Further, it raises a series of fundamental concerns for those working in international development, as well as the social sciences more broadly. There is a need to adapt the methodology to make systematic reviews work for international development and humanitarian research, and finding ways to achieve this will only happen through experimentation with the process. Method. However, we suspect that many authors would not be enthusiastic about detailed questioning of their work (see Duvendack (2010) and Duvendack and Palmer-Jones (2011) for their replication experience). The widespread consumption of chocolate and the evidence of health benefits from the constituents of chocolate were the basis for this systematic review of studies that evaluated the effects of whole chocolate and its potentially psychoactive components on mood and cognition. The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) has done some work on combining qualitative and quantitative research in systematic reviews (see Thomas et al. Systematic reviews help reduce implicit researcher bias. That said, development researchers should be concerned about the way in which systematic reviews tend to grade evidence. Since doing a systematic review properly implies following the same protocol for each study, each article had to be thoroughly screened and assessed – no short cuts could be taken. Finally, our systematic reviews did not generate the practical policy recommendations anticipated. People who need to know the overall answer to a question from all currently available studies can get a quick answer. Our shared experience of conducting systematic reviews suggests that adhering to core systematic review principles – rigour, transparency and replicability – can improve the quality and strength of traditional literature reviews in a number of ways. Increasingly considered a key tool for evidence-informed policymaking, a number of donors – most notably the UK Department for International Development (DFID) and the Australian Agency for International Development (AusAID) – are focusing attention and resources on testing the appropriateness of systematic reviews in assessing the impacts of development and humanitarian interventions. Beyond these general reflections, we offer five specific conclusions: first, applying systematic review principles to a literature review is highly valuable as it increases breadth, improves transparency and emphasises the importance of empirical evidence over preconceived knowledge. Similarly, Duvendack et al. This reflects the fact that systematic reviews do in fact not constitute a homogeneous approach: there are different ‘levels’ of systematic review (see, for example, the work by the Matrix Knowledge Group 2 ). A detailed search strategy and comprehensive criteria for in- and exclusion of studies are essential to avoid introducing bias and spurious results. Donors are under increasing pressure to adopt spending practices that not only generate positive development and humanitarian outcomes, but also represent value for money. In healthcare, for example, the first step would be to define an explicit research question by using the PICOTS (Population, Intervention, Comparator, Outcome, Timing, Setting) framework11, and also register the protocol for the review on PROSPERO (https://www.crd.york.ac.uk/prospero/), the international database of prospectively registered systematic reviews. In secondary prevention, the small benefits of bisphosphonates likely outweigh the harms during the first 3 years of … Methodology reviews address issues relevant to how systematic reviews and clinical trials are conducted and reported. These will be discussed next. The choice of indicator clearly affected the impacts identified and comparisons across studies using different indicators were not meaningful. Systematic reviews have been considered as the pillar on which evidence-based healthcare rests. 6, 8 – 15 Systematic reviewers and program/policy officials in particular suggested that engaging stakeholders from the beginning increases the likelihood that they truly understand the process and feel that their insights are incorporated into the design and conduct of the review. To ensure consistent screening, the screening process is sometimes piloted with all researchers screening the same studies and then comparing the results. In international development research, however, much of the research is and should be multi-disciplinary, hence also including qualitative methodologies. Empirical impact studies in development studies are not written in a uniform fashion, unlike in the natural and medical sciences or even compared to economics. In order to assess the methodological quality of systematic reviews in biomedical sciences, checklists like the AMSTAR – “A MeaSurement Tool to Assess systematic Reviews”14 (https://amstar.ca) can be utilized. Quantitative methodologies adopted in the natural sciences aim to measure impact and causality by controlling for confounding factors. Since 2015 Tina has been the co-director of Cochrane Croatia. These are first increasing breadth, while retaining focus, second, focusing on empirical evidence, not preconceived knowledge and third being transparent and replicable. Second, it may be much harder to assess evidence in development studies, compared to other fields in which systematic reviews were pioneered. If you have any questions or observations, please feel free to comment below. Using a rigid systematic review procedure is an extremely demanding and time-consuming process, in part because of the high number of studies that are often assessed at the first stage of screening. Lastly, they can be used to identify questions for which the available evidence provide clear answers and thus for which further research is not necessary… ed these recommendations to indicate that this volume of activity is the minimum required for health benefits. We hope that you have found this introduction to systematic reviews helpful. To address the uncertainties of the benefits and harms of the HPV vaccines, we conducted a systematic review with meta-analyses of trial data from clinical study reports. Registries can provide researchers, consumers, and practitioners with powerful search engines for finding answers to questions in a format customized to the users' needs. The Benefits of Gardening for Older Adults: A Systematic Review of the Literature. They can help clarify what is known and not known about the potential benefits and harms of drugs, … Her background is in dental medicine, and her research interests include evidence synthesis, methodological research and clinical guidelines. For starters, they deliver a clear and comprehensive overview of available evidence on a given topic. Introduction. Randomised controlled trials (RCTs) are considered by many to be the ‘gold standard’ of development research, but there should be a place for all kinds of research. Sarah is also involved with professional societies such as the Cochrane Collaboration and the American Academy of Neurology. However, data and methodology are, in general, poorly described in the development studies literature. Thus, research questions should not simply be reduced to the ‘pragmatics of technical efficiency and effectiveness’ (Evans and Benefield 2001, p. 539). What are the benefits of systematic reviews? Practical challenges when conducting systematic reviews, https://doi.org/10.1080/19439342.2012.711342, http://www.dfid.gov.uk/r4d/SystematicReviewFeature.asp (http://www.dfid.gov.uk/r4d/SystematicReviewFeature.asp), http://www.bmj.com/content/323/7316/765.short (http://www.bmj.com/content/323/7316/765.short), https://ueaeprints.uea.ac.uk/19437/1/Maren_Duvendack_Smoke_and_Mirrors_PhD_Sept2010.pdf (https://ueaeprints.uea.ac.uk/19437/1/Maren_Duvendack_Smoke_and_Mirrors_PhD_Sept2010.pdf), www.odi.org.uk/slrc (http://www.odi.org.uk/slrc), http://www.3ieimpact.org/ (http://www.3ieimpact.org/), Number of studies screened on title/abstract (after removing duplicates), Number of studies included in the final analysis. A systematic review of the literature examined peer-reviewed research using Embase, PubMed, CINALH Plus, and PsychInfo with the following search terms: cooking, culinary, baking, food preparation, cookery, occupational therapy, mental health, mood, psychosocial, affect, confidence, self-confidence, self-esteem, socialization, and rehabilitation. In other words, the question of why things work is just as policy relevant as whether or not they do in the first place (Gough et al. In principle, systematic reviews should be backed up with correspondence with the authors of the included studies and subsequent replication and/or reproduction of their results, which is often not feasible due to resource constraints. IS: The main benefit is that it can make the screening process much faster, especially on larger projects. Due to the often low number of studies, inconsistency of methodological approaches and lack of meta-analysis, the findings were often too broad, too incomparable and too research-oriented. Fourth, systematic review methodology can be adjusted or developed (see, for example, the work of van der Knaap et al. A systematic literature review of studies examining physical activity, cardiorespiratory, metabolic and psychological outcomes associated with e-cycling. In the next stages, however, all retrieved studies are screened on relevance of title, abstract and full text, by using predefined inclusion and exclusion criteria. (2003), Petticrew and Roberts (2006)), this remains a challenging area that requires greater attention (Dixon-Woods and Fitzpatrick 2001). Systematic literature reviews including meta-analyses are invaluable scientific activities. (cited in van der Knaap et al. They can highlight methodological concerns in research studies that can be used to improve future work in the topic area17. This article is based on a briefing paper published by Hagen-Zanker et al. Next the systematic search is conducted. Therefore, while efforts have been made outside the field of international development to make systematic reviews more inclusive of qualitative evidence (for example, the Cochrane Collaboration's qualitative methods network; see also Spencer et al. They are less costly to carry out than a new set of experiments, and they take less time. This article aims to guide you on the different kinds of systematic review, the standard procedures to be followed, and the best approach to conducting and writing a systematic review. Privacy Policy Described by Petrosino et al. Systematic reviews and meta-analyses of clinical trials have examined the efficacy of Buddhist-based mindfulness meditation (MM). Although conventional SRs are typically used in clinical research and social sciences, they have found application in various other subject areas for example in advertising, education, international development, public policy, ecology, environmental sciences, engineering and basic science research4-7. She will be starting her PhD in Pharmaceutical Health Services Research at University of Maryland, USA in late 2019, So, E(x)POSE! By privileging impact studies that are fixated with achieving internal validity, systematic reviews generate only partial findings and a skewed picture of reality. It draws on the authors' shared experience of conducting eight systematic reviews 1 since 2010 on the respective impacts of, microfinance programmes (Duvendack et al. These are discussed next. Systematic research synthesis to inform policy, practice and democratic debate, Application of systematic review methodology to the field of nutrition, Systematic reviews from astronomy to zoology: myths and misconceptions, SLRC (Secure Livelihoods Research Consortium), Best practice in systematic reviews: the importance of protocols and registration, Integrating qualitative research with trials in systematic reviews. These included the searching, screening and synthesis stages and will now be discussed in turn. Section 4 discusses the specific practical challenges the authors faced before Section 5 raises some more fundamental concerns regarding the use of systematic review in international development. Used widely in medical research and the natural sciences since the 1970s and early 1980s, systematic reviews are considered a ‘rigorous method to map the evidence base in an [as] unbiased way as possible, and to assess the quality of the evidence and synthesize it’ (DFID 2011). SLRs are more reliable and useful than any single study Their conclusions come from a combination of multiple studies that have been assessed for relevance and quality. In other words, systematic reviews encourage researchers to engage with studies more critically and to be consistent in prioritising empirical evidence over preconceived knowledge. Design Systematic overview of reviews. Once screening has been completed, the studies that are included in the final analysis are often characterised by intervention, study quality, outcomes, research design and type of analysis. 3 Promoting systematic reviews as best practice, therefore, sits uneasily alongside donors' interests in developing southern research capacity and in encouraging a more inclusive process of evidence building. It also gives the researcher useful skills, notably the organised identification and retrieval of literature and the ability to critically appraise research and assess its quality. Each Cochrane Review addresses a clearly formulated question; for example: Can antibiotics help in alleviating the symptoms of a sore throat? As of July 2017, about one third of the HPV vaccine studies had not been published and study results were not posted for about half of the completed studies on ClinicalTrials.gov [ 36 ]. The rationale for such reviews is well established. It involves a systematic search for studies and aims for a transparent report of study identification, leaving readers clear about what was done to identify studies, and how the findings of the review are situated in the relevant evidence. However, a meta-analysis is not impossible in the international development field. We found 18 randomised controlled trials with 19 trial arms (56,934 patients) dating from 1994 to 2008. This may lead to a revision of the search strategy. 3099067 Past reviews and (2011) conclude that the majority of the microfinance impact evaluations they examined suffer from weak methodologies and thus recommend better research to get a clearer picture of how and for whom microfinance interventions actually work. In addition to the practical difficulties outlined above, the use of systematic reviews in international development research throws up a series of deeper dilemmas. Systematic reviews are a rigorous and transparent form of literature review. 2011), four different researchers were working on the screening at different stages of the process. 2011), cash transfers and employment guarantee schemes (Hagen-Zanker et al. Systematic review methodology has evolved and been modified over the years to accommodate the range of questions that may arise in the health and medical sciences. We would like to ask you for a moment of your time to fill in a short questionnaire, at the end of your visit. In doing so, you can be confident of having incorporated all the appropriate material for the topic at hand. The availability of different cannabis-based products can make the side effects of exposure unpredictable. Reviews published literature on the social and health benefits of rivers, lakes and coastal waters – referred to collectively as ‘Blue Space’. (2008)) if it helps to get a more useful answer to the research question. The procedure for the systematic approach is methodical, repeatable and can be learned step-by-step. Finally, bear in mind that systematic reviews are not an easy option and require ti… Very new or very specific topics often do not have enough primary research data upon which to base useful conclusions. For most of our systematic reviews, even at the full-text screening stage, hundreds of articles still had to be screened. 2012), ‘Markets for the Poor’ (M4P) programmes (SLRC 2012), seeds-and-tools interventions (SLRC 2012). This article aims to help address this gap by offering critical reflections on the use of systematic reviews within international development research. Systematic reviews of educational research: does the medical model fit? Finally, systematic reviews miss context and process, which are very important in international development research. 2, pp. Objective To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). RESULTS: Women who undergo reduction mammaplasty have a functional … 1. In short, we should be focusing on the utility that can be gained from a systematic review approach rather than its rigid application. 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