Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Putting evidence into practice
Slide content:Steps in Creating a Systematic Review ( Guyatt , Rennie, Meade, & Cook, 2008) Define the questionPopulation, intervention, comparison, outcome(s) Conduct literature searchDefine information sources and searching strategy Apply inclusion and exclusion criteria for articles retrieved, and measure reproducibility Abstract appropriate data Conduct analysisDetermine method of pooling, explore heterogeneity, and assess for publication and other bias 5
Slide notes:5 If were going to create a systematic review, what are the steps? Guyatt [ guy -iht], in a textbook on evidence-based medicine, describes the steps in creating a systematic review. First, we have to define the clinical question as it pertains to the population, intervention, comparison where appropriate, and outcome. We then conduct a literature search. We have to define the information sources were going to use and come up with a search strategy. In a systematic review, a literature search isnt done just by typing a few terms into Medline. We have to conduct a comprehensive search of the literature and cast a broad net to ensure that we retrieve a sufficient number of articles to evaluate. We can then appropriately include what usually turns out to be a relatively small number of articles. Once we have a large number of related articles, we establish inclusion and exclusion criteria for the articles that well ultimately use in our review. Most steps in the process have measures of reproducibility, so typically, the Medline recordswith their titles and abstracts as well as the full-text articles that we choose to analyze furtherare selected in more than one copy to determine whether different individuals evaluating the same article have reached the same judgment. Once we identify the articles that were going to use in the systematic review, we abstract the data from them and then conduct the analysis. For example, if were going to perform a meta-analysis, we determine the method of pooling and explore heterogeneity [het-uh-row- juh - nee - i -tee] of the results, so we explore whether some results point in one direction of a treatment and other results point in a different direction. We also assess for publication and other types of bias.