Evidence Based Practice (EBP)

Systematic Reviews and Literature Reviews

Systematic reviews are considered the gold standard of evidence synthesis. A systematic review does not just mean a literature review that has been conducted systematically. A systematic review is a specific type of research methodology that has its own set of standards and methods. Systematic reviews are typically written with a team and include protocols or rules on how they are conducted. UNCG librarians can help you learn more about systematic reviews, so be sure to contact your liaison librarian for assistance

UNCG Libraries Systematic Review Guide

This page was modified from the USC Libraries Choosing Evidence tutorial

Systematic literature reviews are at the top of the levels of evidence pyramid, but other literature reviews are not. Literature reviews, traditional literature reviews, or narrative literature reviews are considered expert or consensus opinion.

  Systematic Review Literature Review
Definition Identifies, selects, appraises, and synthesizes all research evidence related to that question. Qualitatively summarizes evidence on a topic using informal or subjective methods to collect and interpret studies.
Goals

Answer a focused clinical question

Eliminate bias

Provide a secondary analysis of existing research

Provide summary or overview of topic
Question

Clearly defined and answerable clinical question

Recommend using PICO as guide

Can be a general topic or a specific question
Components

Pre-specified eligibility criteria

Systematic search strategy

Assessment of the validity of finding

Interpretation and presentation of results

Reference list

All components are tested, turned into a protocol that is shared and finalized before the full review is carried out

Introduction

Methods 

Discussion 

Conclusion

Reference list

May include systematic review components such as eligibility criteria but it is acceptable to adjust these as needed during any part of the project

Number of Authors

Three or more

One or more

Timeline

Months to years

Average 18 months

 Weeks to months
Requirements

Thorough knowledge of topic

Perform searches of all relevant databases 

Additional searching and browsing to find all published and unpublished research on the question 

Use a checklist or similar tool to standardize the appraisal of research studies

Statistical analysis resources (for meta-analysis)

 

Understanding of topic

Perform searches of one or more databases

Value

Connects practicing clinicians to high quality evidence

Supports evidence-based practice

 Provides summary of literature on a topic

Table modified from USC Libraries Choosing Evidence tutorial

For more information about literature reviews: UNCG Libraries Literature Review Module

When searching for systematic reviews, you can usually spot a systematic review by the title. 

  • The title of a systematic review should include “systematic review,” or “meta-analysis,” or even “systematic review and meta-analysis.”
  • Some health science databases, such as PubMed, have a filter that includes “systematic reviews.”
  • The title of a literature review will include “literature review” or "narrative review," and sometimes just “review.”
  • Keep an eye out for scoping reviews or integrative reviews. These are other literature reviews that find and synthesize evidence, but they are not systematic reviews. 
  • Keep an eye out for systematic review protocols. These are the blueprint/plan for conducting a systematic review but not the completed systematic review. 

If creating a systematic review, keep in mind that systematic reviews are different from literature or narrative reviews. A systematic review addresses a "...clearly formulated question that uses systematic and explicit methods to identify, select and critically appraise relevant research, and to collect and analyze data from the studies that are included in the review." (Cochrane Handbook). Because of this, the time commitment for a systematic review is significant, please plan ahead and be sure to leave enough time to work on your review.

 

                   Month                 Activity

                   1 – 2                     Preparation of protocol.

                   3 – 8                     Searches for published and unpublished studies.

                   2 – 3                     Pilot test of eligibility criteria.

                   3 – 8                     Inclusion assessments.

                   3                          Pilot test of ‘Risk of bias’ assessment.

                   3 – 10                   Validity assessments.

                   3                          Pilot test of data collection.

                   3 – 10                   Data collection.

                   3 – 10                   Data entry.

                   5 – 11                   Follow up of missing information.

                   8 – 10                   Analysis.

                   1 – 11                   Preparation of review report.

                   12 –                      Keeping the review up-to-date.

Source: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.

From East Carolina University’s Systematic Review LibGuide

A meta-analysis is a statistical analysis of quantitative data sometimes included in systematic reviews that combine studies, such as randomized controlled trials (RCTs), with quantitative and comparable data.

Meta-analysis within a systematic review

Image from USC Libraries Choosing Evidence tutorial

More guides on systematic reviews:

NIH Systematic Reviews Guide

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