Systematic Reviews: Training - Health

Scoping searches are fairly brief searches of existing literature designed to help you gain an overview of the range and depth of research that exists for a particular research idea. It can cover published work and discover on-going studies. Research proposals are shaped by the results of a scoping search for your research idea.

In short it should ensure that your research complements and adds to existing research so that your proposal is not rejected for ‘re-inventing the wheel’. https://www.rds-yh.nihr.ac.uk/scoping-searchesfunding-upda

Check to make sure no one else has done a Systematic Review on your topic before. Look at PROSPERO and Cochrane Library.

The following websites will give you a comprehensive overview of health related information  - you can filter your results easily to find the specific resources that you need.

A clearly defined, focused review begins with well framed questions. These questions will guide many aspects of the review process such as eligibility, data collection as well as the basis for the search criteria.

Campbell Collaboration Training videos on Question Formulation  - from 25 mins onwards.

Look at chapter on formulating searchable questions from Searching Skills Toolkit: Finding the evidence 2nd ed. 2014 De Brun

Using PICO to formulate a search strategy - link to useful guide

SPICE (Setting, Perspective, Intervention, Comparison, Evaluation

ECLIPSE (Expectation, Client Gp, Location, Impact, Professionals. SErvice)

COPES (Client Orientated Evidence Search (questions come directly from practice)

SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type)

Boolean operator

OR      combine synonyms together

cat OR mouse will retrieve all records that contain the word cat plus all the records that contain mouse

Using OR gets MORE

AND    combine different concepts together 

cat AND mouse will retrieve all records that contain both the word cat and the word mouse

NOT   eliminate a word from the results   **use carefully!**

cat NOT mouse will retrieve all records that contain cat, but not any records that also contain mouse

We recommend that you start with OR and build up your search for synonyms for each of your core topics - cat OR feline OR felis

Use AND to combine the results of the synonym searches

Please see Video for more information.

The building block of a search strategy are your keywords, these can be "Natural" or "Academic"; a good example of this is Teenager OR adolescent. A good systematic review will have a comprehensive keyword search at its heart where all the appropriate synonyms of a keyword have been used.

Teen OR Teens OR teenager OR teenagers OR Young person OR young adult OR adolescent OR adolescence.

You can then use Syntax (instructions to database) to modify and improve  - example below is using EBSCO platform syntax.

This then becomes Teen* OR (Young N (person* OR people OR adult*)) OR adolescen*

There is a tool to help you with finding synonyms called Search Blocks. You can also use a Thesaurus.

For other database platforms using different syntax, check this guide.

Wildcards and Truncation

These are symbols such as * $ ? that are used to replace a single letter, a missing letter or a series of letters in a word.  When the symbol is placed in the word it is a wildcard and when it is at the end of the word it is a truncation mark. 

Symbols vary according to the database you are using so it is important to check the Help section in each database before you start. Please see this guide to the search operators for different databases (syntax) - truncation, boolean, phrase searching and proximity.

A wildcard is useful to:

• replace a letter that may be different - ​sterili$ation will find sterilisation OR sterilization
• a letter that can be missing - colo?r will find colour OR colour

Using a * will search for the main root of the word and any variable endings…

Assess* will find articles containing assess, assessing, assessed, assessment

Please see the videos on this page to help you understand these concepts.

When you enter two words next to each other in a search, most databases will add a hidden  AND when carrying out a search.  This means that they will look for both words anywhere in the record.

For example hand washing will find articles with Hand in the title and Washing in the abstract as well as as Phrase. 

If you want to only search for the words as a phrase then you need to use the right syntax to tell the database what you want.  Usually this is where you add quotation marks around the words.  For example, "Hand washing" or "critical care"

In Scopus use of double quotation marks are used to search for a loose / approximate phrase. To search for an exact phrase you should enclose the phrase in braces: {oyster toadfish}.

If you are searching for a phrase, check the database Help to confirm what you should use.

"Proximity" or "adjacency" can be a very useful tool. It is a way to search for two or more words that occur within a certain number of words from each other. This can be very helpful when your topic can be described in different ways.  For example, 'climate change' could also appear in a paper as 'change in the climate'.  

For example in the Web of Science Core Collection you use NEAR/x where x is the maximum number of words that separate the terms from each other so to search for 'climate change' or 'change in the climate'.  You would use "climate NEAR/3 change"

Other databases use different terms for this. Check this guide 

EBSCO uses N3 - Neonat* N3 Care will find Neonatal care as well as Care of the Neonate 

EPPI-Centre 

The Evidence for Policy and Practice Information and Co-ordinating Centre is a specialist centre for developing methods for:

• for systematic reviewing and synthesis of research evidence; and
• for the study of the use research. 

Don't get reporting guidelines and critical appraisal tools confused. See recent article from Logullo et all (2020) for clarification.

Enhancing the QUAlity and Transparency Of health Research - Equator Network is an international initiative to improve the reliability and value of published heath research literature by promoting transparent and accurate reporting and wider use of robust reporting guidelines. They have 36 reporting guidelines for Systematic Reviews/Meta Analysis alone! Well worth a look.

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is evidence-based minimum set of items for reporting in systematic reviews and meta-analyses.

A PRISMA Flow Diagram, described in the PRISMA Statement is a graphical representation of the flow of citations reviewed in the course of a Systematic Review.

PRISMA P has been produced to help with Protocols

PRISMA-ScR The checklist contains 20 essential reporting items and 2 optional items to include when completing a scoping review 

RepOrting standards for Systematic Evidence Syntheses in environmental research.

ROSES is a set of detailed state-of-the art forms for ensuring evidence syntheses report their methods to the highest possible standards.

Peer Review of Electronic Search Strategies  - PRESS.  The PRESS guideline provides a set of recommendations concerning the information that should be used by librarians and other information specialists when they are asked to evaluate these electronic search strategies.

The full guideline statement and checklist document may be accessed via the following open access article from the Journal of Clinical Epidemiology: ​McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS Peer Review of Electronic Search Strategies: 2015 guideline statement. J Clin Epidemiol. 2016 Jul;75:40-6. 

A Measurement Tool to Assess systematic Reviews. AMSTAR seeks to create valid, reliable and useful instruments to help users differentiate between systematic reviews, focusing on their methodological quality and expert consensus as well as facilitate the development of high-quality reviews. Please access Checklist here, and publication list here 

ROBIS (Risk of Bias in Systematic Reviews) is a new tool for assessing the risk of bias in systematic reviews (rather than in primary studies). ROBIS has been developed using rigorous methodology and is currently aimed at four broad categories of reviews mainly within healthcare settings: interventions, diagnosis, prognosis and aetiology. There are other tools you can use that might be more appropriate. Please see useful overview here from NHMRC in Australia. 

There is usually some time between conducting your initial searches and then writing up your results. You can create alerts with the help of the databases, publisher platforms as well as specific journals.

If you want to update your searches in the databases that you have used to make sure you have found any new articles since you last ran them, please see this useful guide from the University of Alberta. 

 Very good guide on creating alerts for your topic to help you stay up to date.

To help you balance precision against recall, you can use a search filter/hedge to help you.

Please look at this guide to help you find any appropriate filters for study design, age groups, subjects etc. 

Please see this useful guide on various Screening tools you can use. Rayaan is a free tool and McGill have a comprehensive guide on how to use it. 

There is also a tool called Systematic Review Accelerator which you can use to help you de-duplicate and look at your Word Frequency (to help you construct and refine)

"Critical appraisal is the course of action for watchfully and systematically examining research to assess its reliability, value, and relevance in order to direct professionals in their vital clinical decision making." 

• Critical Appraisal Skills Programme (CASP) Tools and Checklists. A set of eight critical appraisal tools designed to be used when reading research including one for use with Systematic Reviews.
• How to read a paper : the basics of evidence-based medicine and healthcare. 6th edition. 2019. Greenhalgh. Tricia. Ebook.
• Finding and Appraising the Evidence – by Amanda Burls and Anne Brice  - Video modules by Health Knowledge
• Joanna Briggs Critical Appraisal Tools - Available to Download. 
• Testing Treatments. Online resource to promote critical thinking about treatment claims. 
• A Tool for making sense of health studies from "Understanding Health Research" resource
• Useful chapter on Critical Appraisal from from Searching Skills Toolkit: Finding the Evidence 2nd ed. 2014, De Brun
• NICE Manual  - Guidelines on which Appraisal checklists, evidence tables, GRADE and economic profiles to use with links. Very useful. 

Risk of Bias

Understanding how to assess and critically appraise published research to identify potential sources of bias is an essential skill.

ROBIS is a new tool for assessing the risk of bias in systematic reviews. There are other tools that might be more appropriate, please see this useful guide from NHMRC in Australia.