Doing a Cochrane Systematic Review:
Experience of one Speech and Language
Zelda Greene MSc,
Senior Speech and Language Therapist,
Transitional Care Unit,
Our Lady’s Children’s Hospital Crumlin
 The HRB Fellowship award
 Training and education supports
 Development of the review protocol
 Systematic literature searching
 Data screening and extraction process
 Challenges!
 Positive contribution that this experience has made to ongoing
developments in the SLT department in OLCHC
 The future.......................
 The Cochrane Collaboration is a not-for-profit and
independent organisation dedicated to making up-to-date,
accurate information about the effects of healthcare
interventions readily available worldwide.
 It produces and disseminates systematic reviews of
healthcare interventions in over fifty topic areas and makes
them available as The Cochrane Library
 In 2002, Ireland became the first country in the world to
provide free national access to the Cochrane Library, an
initiative co-funded by the Health Research Board (HRB)
and the Research and Development Office in Northern
HRB Cochrane
Fellowship Award
 The aim of the Cochrane Fellowships Scheme is to build capacity in
conducting systematic reviews in the health and social care field in
Ireland by freeing up protected time for applicants to conduct a
Cochrane systematic review in any topic of their choice.
• Announced every March - Closing date end of May
 ‘This scheme is open to individuals resident on the island of Ireland
working in the health and social care area as health practitioners,
researchers or policy makers’.
 ‘As intensive and continuous training will be provided as part of the
Fellowship, applications are invited from those with no prior experience
or training in conducting systematic reviews’.
What it involves.......
 The Fellowship provides the Fellow with protected
time of up to two days per week (14 hours) for up to
two years to conduct their review.
 The award covers systematic review training costs,
salary-related costs and research expenses.
 Application process - you must;
Form a local review group with people who have
experience of conducting reviews in the field
Register a title with a Cochrane Review Group before
you can apply for HRB grant (our group was based in
Apply via HRB website why it is important to do the review
why it is important for you to do the review.
Available Training and Support..........
Via HRB: Cochrane Training Courses
 Build awareness and capacity in conducting systematic review in
the island of Ireland.
 The HRB and the HSC Research & Development Division in
Northern Ireland (HSC R&D Division), in association with the
Training Team of the UK Cochrane Centre, offer two short courses
on a number of dates annually.
Online training also via the UK Cochrane Group
Your Cochrane Review group editors
(in our case Neonatal group)
Your co-authors (when you can find them!!!)
The Handbook (don’t read this first......!!!)
Developing the Protocol...........
Provided with software ‘Revman’ - specifically for
writing the protocol and the review
Background info (lit review)
Description of the condition
Description of the intervention
How the intervention might work
Why it is important to do this review
Primary & secondary objectives
Methods - Describe
 types of studies
 types of participants
 types of interventions
 types of outcome measures (primary
and secondary)
 Search methods for identification of
studies (electronic/other; trial search
 Data collection and analysis (how are
you going to select studies for
inclusion/extract data and manage
Searching the databases........
 Screen titles arising from search results in each
(we had 4,491 in total)
 Identify titles where you get the abstracts for
further screening
(we had 81)
 After screening these abstracts, finally identify
eligible RCTs for all authors to extract data from
(we identifed 24 RCTs)
 You need to justify also why you EXCLUDE studies
from your review
Data Extraction….
Data Extraction sheets
Describe in detail for each study;
Comparison groups
Outcome measures used
 Determine Risk of Bias
Random sequence generation
Allocation concealment
Blinding of participants
Blinding of outcome assessors
Incomplete outcome data
Selective reporting
 Rate the quality of the study in
Data analysis......
 Heterogenous studies - Possible to make
 Metanalysis then if possible
 Revman will do the work once you put in the
 Our studies we felt were not comparable and
were of poor overall quality.
The Experience……..
 Very positive
 Nice opportunity to get protected research time
 Massive learning curve
 Good training and support available
 Very structured process
 Software really helps with the flow of the project
 Lovely opportunity to really delve deeply into the
literature in one specific area in great detail
 Approach literature very differently now methodology is key: still don’t really understand
Positives contd............
 Capable of extensive database searching
 Minimum of 2 high impact publications at the
end of the process
 Other publications have arisen also
 Have been asked to peer review 2 other
studies for publication by other journals
 Helps hone skills for designing good quality
studies which is hopefully the next stage from
 Isolation at times
 Periods of great activity followed by no activity
 Getting everyone on same task at same time
 The Editorial teams can vary: initially good
support, latterly less so when editor changed.
Review groups vary.
 Although it was cost neutral to OLCHC & I had a
replacement for 2 years - I still was part of the
department headcount. This affected
recruitment of other staff for maternity cover etc
during the duration of the grant: may affect future
grant applications
 HRB were tricky to deal with at times: paperwork
OLCHC SLT Department benefits:
 Encouragement & support to colleagues
 currently 7 active research projects
 Using research resources available to us
 Definitely present at local and national
 Now aiming for International meetings also 2 presentations at European feeding
conference last year.
 2 Evidence based MDT clinical guidelines