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What is a Systematic Review

A systematic review is a scholarly synthesis of evidence on a clearly presented topic using critical methods to identify, define, and assess research.

A systematic literature review (SLR) is a rigorous and structured approach to synthesizing scientific evidence on a specific research question. Unlike traditional literature reviews, which often rely on authors’ expertise, SLRs follow a formal process to minimize bias and enhance transparency.

Students write systematic reviews to contribute to evidence-based knowledge, reduce bias, and provide reliable information for decision-making in their respective fields. These reviews play a crucial role in advancing research and informing practice.

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Main reasons why students often need to write systematic reviews:

Research Synthesis: Systematic reviews aim to provide a thorough summary of current literature relevant to a research question. Unlike other types of reviews, systematic reviews adhere to a strict scientific design based on pre-specified and reproducible methods. They use rigorous and transparent approaches to assess and minimize bias in findings.

Evidence-Based Decision-Making: Systematic reviews are considered the most trusted form of evidence. They extract and interpret data from published studies, analyze, describe, critically appraise, and summarize interpretations into refined evidence-based conclusions. Students write systematic reviews to contribute to evidence-based decision-making in various fields.

Reducing Bias: What sets systematic reviews apart is their methodological rigor. The research methods are designed to reduce bias. The approach is formal and systematic, involving several steps:

  • Formulate a Research Question: Clearly define the research question.
  • Develop a Protocol: Create a detailed plan for the review process.
  • Search for Relevant Studies: Systematically search for all relevant studies.
  • Apply Selection Criteria: Select studies based on predefined criteria.
  • Extract Data: Collect data from selected studies.
  • Synthesize Data: Combine information to tell a cohesive story.
  • Write and Publish a Report: Document the process and findings.

Discipline-Specific Use: Systematic reviews are most commonly used in medical and public health research, but they can also be found in other disciplines. Whether evaluating clinical tests, public health interventions, or social interventions, systematic reviews provide reliable estimates about the effects of interventions.

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Systematic Review vs Meta Analysis

The differences between a systematic review and a meta-analysis:

Systematic Review:

Definition: A systematic review aims to identify, appraise, and synthesize all empirical evidence related to a specific research question. It provides a comprehensive summary of relevant, adequate, and current information on a topic.

Process:

  • Research Question: A systematic review starts with a well-defined research question (often in the form of a PICO question).
  • Eligibility Criteria: Researchers pre-specify eligibility criteria to decide which articles will be included or discarded from the review.
  • Minimizing Bias: Systematic reviews follow a transparent, reproducible, and predefined method to minimize bias.
  • Data Synthesis: The review team synthesizes extracted study data, often using meta-analysis if appropriate.

Importance: Systematic reviews are considered the gold standard of scientific evidence because they rigorously assess the available evidence.

Meta-Analysis:

Definition: A meta-analysis is a quantitative, epidemiological study design that systematically assesses the results of previous research. It combines outcomes from multiple studies, usually based on randomized controlled trials (RCTs), to generate an average result.

Implementation Criteria: Meta-analyses are most effective when the studies included in the systematic review are of good quality, have similar designs, and use similar outcome measures.

Benefits:

  • Precision: Meta-analysis provides a more precise estimate of the effect of a treatment by mathematically combining outcomes from multiple studies.
  • Forest Plot: Results are often presented in a forest plot diagram.
  • Publication Bias Detection: Meta-analyses include a funnel plot diagram to visually detect publication bias.

Role: Meta-analyses enhance the reliability of evidence by combining data from various trials.

A systematic review is an article that synthesizes available evidence using a specific research question and predefined criteria, while a meta-analysis mathematically assesses the results of articles included in a systematic review. Both play crucial roles in evidence-based research.

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Common Challenges in Conducting a Systematic Review by Students

Conducting a systematic review (SR) can be both rewarding and challenging, especially for students. Here are some common challenges faced by students during the process of conducting a systematic review:

Navigating the Literature Landscape:

  • Challenge: Students often struggle with understanding the vast literature landscape. Identifying relevant databases, search terms, and appropriate filters can be daunting.
  • Solution: Seek guidance from experienced researchers or librarians. They can help you create effective search strategies and select appropriate databases.

Defining Clear Inclusion and Exclusion Criteria:

  • Challenge: Determining which studies to include or exclude can be tricky. Ambiguities in criteria may lead to biased results.
  • Solution: Clearly define inclusion and exclusion criteria based on your research question. Be transparent about study characteristics.

Quality Assessment and Risk of Bias:

  • Challenge: Assessing study quality and risk of bias requires expertise. Students may struggle with critical appraisal.
  • Solution: Familiarize yourself with quality assessment tools (e.g., Cochrane’s Risk of Bias tool). Collaborate with mentors or peers for feedback.
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Data Extraction and Synthesis:

  • Challenge: Extracting relevant data and synthesizing findings can be time-consuming. Errors in data extraction may affect results.
  • Solution: Develop standardized data extraction forms. Double-check data entries and seek input from colleagues.

Managing Time and Resources:

  • Challenge: SRs demand significant time and effort. Balancing coursework, research, and other commitments can be tough.
  • Solution: Create a realistic timeline. Break tasks into manageable chunks. Prioritize efficiently.

Handling Heterogeneity:

  • Challenge: Studies in SRs often vary in design, populations, and outcomes. Combining heterogeneous data can be challenging.
  • Solution: Use appropriate synthesis methods (e.g., narrative synthesis, meta-analysis) based on study heterogeneity.

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Writing and Reporting:

  • Challenge: Structuring and writing the SR can be overwhelming. Meeting reporting guidelines (e.g., PRISMA) is essential.
  • Solution: Follow established reporting frameworks. Seek feedback on drafts from mentors or peers.

Staying Objective and Transparent:

  • Challenge: Bias can creep into the process. Students may unintentionally favor certain studies.
  • Solution: Maintain transparency. Document decisions, conflicts, and rationale throughout the review.

Conducting a systematic review is a valuable learning experience. Seek support, collaborate, and persevere—you’ll contribute to evidence-based practice and enhance your research skills.

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