Peggy Cruse and Shandra Protzko
Library & Knowledge Services, National Jewish Health
COLLABORATING TO PRODUCE
SYSTEMATIC REVIEWS
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Agenda
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Background
 SRs in the context of publishing
 SRs and the librarian
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The SR process
 For the investigator
 For the librarian
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Discussion
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Why is everyone talking about SRs?
“attempts to collate empirical evidence that fits pre-specified
eligibility criteria to answer a specific research question.”
(Liberati et al)
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Climate of best practice
 IoM Standards
 Society publishing standards
 PRISMA - Preferred Reporting Items for
Systematic Reviews and Meta-Analysis
 Grade - Grading of Recommendations
Assessment, Development and Evaluation
Resources: GRADE, IoM report, PRISMA, J Amer Dental Assoc
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Why do a systematic review?
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Reduce bias in how conclusions are
reached
Improve the power and precision of results
Too much information - summarize
evidence about the effectiveness of
particular approaches for addressing a
public health problem
Analyze generalizability of findings
Too little information - identify knowledge
gaps and need for additional research
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MOU/Level of service
Getting paid
 Authorship
 Timeline
 Services
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Formulate a searchable question
Peer review search
Citations in reference management software
Screening sheets
Document the results/methodology
Resources: ICJME, AGREE
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Resources: ICJME
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What the investigator is doing
Define the question/
inclusion criteria
Search for studies
Select studies/collect data
Assess risk of bias in studies
Address reporting bias
Present results and
‘summary of findings’ tables
Interpret results/
draw conclusions
Resources: Cochrane handbook
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What you are doing
Define the
question/inclusion
criteria
Define the question
Search for studies
Peer reviewed search
Select
studies/collect data
Export results/screening
sheets/document
Assess risk of bias
in studies
Wait
Address reporting
bias
Wait some more
Present results and
‘summary of
findings’ tables
Document the results and
write the methodology
Interpret
results/draw
conclusions
Wait for publication
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Reference interview: define the question
PICO
In children with influenza-like illness, does
treatment with oseltamivir (compared to
combination therapy or no drug) reduce
mortality and duration of symptoms?
Resources: GRADE, IoM report, Journal of the American Dental Association
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Searching

Scope Search
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Final Search
 MeSH and text words
 Revisions
 Numbers
 Peer review
 Sample results
 Select databases
 Grey lit
○ Pharma, .gov, etc.
○ Publication bias
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Explaining the search
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Tips and Tricks
 [square brackets] to annotate lines
 Excel to group related concepts
 Other visualization tools?
○ Adobe Illustrator
○ eulerAPE
Resources: eulerAPE
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Concepts drawn in Illustrator
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EulerAPE
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Export

Tips and tricks
 De-dup
 Save everything!!
 Name EN files w standard conventions
○ Date_Subject_Screen#.enlx
○ 20140825_IPF_1stScreen.enlx
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Record keeping
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Write the methodology
Resources: PRISMA
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PRISMA 2009 Flow Diagram
Identification PRISMA Flow Diagram
# of records identified through database searching # of additional records identified through other sources Eligibility Screening # of records after duplicates removed # of records screened # of records excluded # of full‐text articles assessed for eligibility # of full‐text articles excluded, with reasons Included # of studies included in qualitative synthesis # of studies included in quantitative synthesis (meta‐analysis) 18
Tools
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RevMan: prepare reviews
http://ims.cochrane.org/revman/download
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GRADEPro: create ‘summary of findings’ (SoF) table
http://www.gradeworkinggroup.org/toolbox/index.htm
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HLWiki International, Software for Systematic Reviewing
http://hlwiki.slais.ubc.ca/index.php/Software_for_systematic_reviewing
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CADTH Peer Review Checklist for Search Strategies
http://www.cadth.ca/en/resources/finding-evidence-is/peer-review-searchstrat
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Resources
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AHRQ Effective Health Care Program Guides
http://www.effectivehealthcare.ahrq.gov/search-for-guides-reviews-andreports/?pageaction=displayproduct&mp=1&productID=318
Appraisal of Guidelines Research and Evaluation (AGREE)
AGREE is an international collaboration of researchers and policy
makers who work together to improve the quality and effectiveness of
clinical practice guidelines by establishing a shared framework for their
development, reporting and assessment.
Centre for Reviews and Dissemination Guide
http://www.york.ac.uk/inst/crd/SysRev/!SSL!/WebHelp/SysRev3.htm
Cochrane Handbook for Systematic reviews of Interventions. Updated
Version 5.1.0http://handbook.cochrane.org/ Updated: March 2011
Cruse PE and Protzko SP (2014). Librarian Contributions to Clinical
Practice Guidelines, Medical Reference Services Quarterly, 33:3, 327334, DOI: 10.1080/02763869.2014.925710
EulerAPE. Area-proportional Venn diagrams.
http://www.eulerdiagrams.org/eulerAPE/
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Resources
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Grading of Recommendations Assessment, Development and Evaluation (GRADE)
A systematic approach to grading the strength of management recommendations
can minimize bias and aid interpretation of expert-created medical guidelines. The
IDSA began to employ the use of the GRADE system in new guidelines and
guideline updates initiated after October 2008.
IoM: Finding What Works in Health Care: Standards for Systematic Reviews
http://iom.edu/Reports/2011/Finding-What-Works-in-Health-Care-Standards-forSystematic-Reviews.aspx Released: March 23, 2011
JADA Submissions and Author guidelines
http://www.ada.org/en/publications/jada/submissions-and-author-guidelines
Liberati A, Altman DG, Tetzlaff J, et al. (2009). The PRISMA statement for reporting
systematic reviews and meta-analyses of studies that evaluate health care
interventions: explanation and elaboration. PLoS Med 6(7): e1000100.
doi:10.1371/journal.pmed1000100
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred
Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA
Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097
PRISMA: http://www.prisma-statement.org/statement.htm
PICO: McMaster Formulating questions and choosing outcomes
http://cebgrade.mcmaster.ca/QuestionsAndOutcomes/index.html
Systematic Reviews and Protocol Registries
http://nihlibrary.campusguides.com/c.php?g=38332&p=244525
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Questions/Comments
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