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Systematic Reviews Workshop #1 �Setting yourself up for success

Instructors: Zahra Premji & Alix Hayden

(UVic) (UofC)

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Territory Acknowledgement

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Calgary

Victoria

We acknowledge and respect the lək̓ʷəŋən peoples on whose traditional territory the university stands and the Songhees, Esquimalt and W̱SÁNEĆ peoples whose historical relationships with the land continue to this day.

I would like to take this opportunity to acknowledge the traditional territories of the people of the Treaty 7 region in Southern Alberta, which includes the Blackfoot Confederacy (comprising the Siksika, Piikani, and Kainai First Nations), as well as the Tsuut’ina First Nation, and the Stoney Nakoda (including the Chiniki, Bearspaw, and Wesley First Nations). The City of Calgary is also home to Métis Nation of Alberta, Region 3. 

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Introductions

Who are we?

  • Zahra (University of Victoria)
  • Alix (University of Calgary)

Who are you?

  • Introduce yourself in the chat box (discipline, university, familiarity with systematic reviews)

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Workshop objectives

By the end of this workshop, attendees will be able to

  • Create a researchable question using a question framework
  • Understand the importance of a protocol for a systematic review
  • Describe the elements of a systematic review protocol
  • Develop inclusion/exclusion criteria
  • Find and analyze seed/known papers for keywords and subject headings
  • Define subject headings and keywords and understand the differences between them

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Workshop 1 summary

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

A. Creating a focused researchable question

B. Pre-scan of the literature

2. Creating your protocol/plan

A. PRISMA –P

B. Choosing the information sources

C. Developing inclusion/exclusion criteria

3. Data collection

A. Pre-scan of the literature and locating seed papers

B. Keywords/textwords and Subject Headings

C. Mining seed papers for keywords and subject headings

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What is knowledge/�evidence synthesis?

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Synthesis is

“the contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic. A synthesis must be reproducible and transparent in its methods, using quantitative and/or qualitative methods.”

(Canadian Institutes of Health Research: http://www.cihr-irsc.gc.ca/e/29418.html#4.1)

A systematic review is

A review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyse data from the studies that are included in the review.”

(Cochrane: https://community.cochrane.org/glossary#letter-S)

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Typical steps of a knowledge synthesis project

to

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1. Determine the review question

2. Create the protocol/plan

3. Data collection

4. Study selection

5. Data extraction

6. Critical appraisal

7. Synthesize (narrative or meta-analysis)

8. Write manuscript (using reporting standards)

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Competencies required

  • Content experts
  • Information expert
  • Statistics expert (for a meta-analysis)

It Takes a Team!

Average # is 5 authors

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Borah, R., Brown, A. W., Capers, P. L., & Kaiser, K. A. (2017). Analysis of the time and workers needed to conduct systematic reviews of medical interventions using data from the PROSPERO registry. BMJ open, 7(2), e012545.

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Time to Complete

  • Estimated time to complete and publish is 67 weeks

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Borah, R., Brown, A. W., Capers, P. L., & Kaiser, K. A. (2017). Analysis of the time and workers needed to conduct systematic reviews of medical interventions using data from the PROSPERO registry. BMJ open, 7(2), e012545.

Start Your Review

Publish Your Review

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Why Does it Take So Long?

  • Detailed work for searching and data extraction
  • Reviewing 1000’s (yes, thousands) of records
  • Tasks completed in duplicate
  • Often done off-the-side of your desk

Each review is different

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Guiding documents

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A review can follow PRISMA and still lack comprehensiveness

Conducting/methodological guides

Reporting standards

Tells you how to conduct your review ☺

Tells you how to write your review ☺

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So why conduct a review?

  • To keep up to date with the latest research
  • To introduce/change a treatment/ intervention / program
  • To avoid duplication of effort and avoid wasting resources on researching topics where the evidence is already clear
  • To inform policy with the best evidence

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Families of Reviews

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Mixed Methods Reviews

Sutton, A., Clowes, M., Preston, L., & Booth, A. (2019). Meeting the review family: exploring review types and associated information retrieval requirements. Health Information & Libraries Journal, 36(3), 202-222.

Purpose Specific Reviews

Qualitative Reviews

Traditional Reviews

Systematic Reviews

Rapid Reviews

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Systematic vs Scoping

Systematic Review

may be undertaken to confirm or refute whether or not current practice is based on relevant evidence, to establish the quality of that evidence, and to address any uncertainty or variation in practice that may be occurring.

Scoping Review

to determine the scope or coverage of a body of literature on a given topic and give clear indication of the volume of literature and studies available as well as an overview (broad or detailed) of its focus.

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Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18(1), 143.

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Traditional vs Systematic vs Scoping

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Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18(1), 143.

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Which One: Systematic Review or Traditional Review?

Systematic Review

  • Systematic reviews address narrowly focused questions

  • Key contribution is summarising data

Traditional (Narrative) Review

  • Narrative reviews provide interpretation and critique�
  • Key contribution is deepening understanding

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Greenhalgh, T., Thorne, S., & Malterud, K. (2018). Time to challenge the spurious hierarchy of systematic over narrative reviews?. 

European journal of clinical investigation48(6).

“The narrative review is not a poor cousin of the systematic review but a different and potentially complementary form of scholarship.”

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

A. Creating a focused researchable question

B. Pre-scan of the literature

2. Creating your protocol/plan

3. Data collection

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Question Frameworks

    • P (population or problem)
    • I (Intervention)
    • C (Comparison)
    • S (Setting)

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  • Frameworks can be used to help guide question formulation
  • Components provide structure to a question
  • Components such as

  • Many frameworks such as PICO, CIMO, PCC, SPICE and more

    • O (Outcome)
    • E (Exposure)
    • E (Evaluation)
    • P (Perspective)

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Question formulation using PICO

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P

Population/Problem

I

Intervention (or exposure or factor)

C

Comparison

O

Outcomes

Patient, population, problem, disease

Intervention, exposure, prognostic factor

Comparison (such as gold standard, alternate intervention, no exposure)

Outcome of interest (such as efficacy, incidence, prevalence, sensitivity, or other measurable outcome)

Original reference for PICO: Richardson, W.S., Wilson, M.C., Nishikawa, J. and Hayward, R.S.A. (1995), “The well‐built clinical question: a key to evidence based decisions”, ACP Journal Club, Vol. 123 No. 3, pp. A12‐A13.

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PICO: Examples

Humor in romantic relationships: A meta‐analysis

The goal of the present investigation is to identify the direction and strength of the association between humor and relationship satisfaction in romantic relationships.

Hall, J. A. (2017). Humor in romantic relationships: A meta‐analysis. Personal Relationships24(2), 306-322.

P – individual in a romantic relationship

I/E – Humor

C – none

O – relationship satisfaction

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PICO: Examples

Paw preferences in cats and dogs: Meta-analysis

…determine the existence and extent of population level paw preferences in domesticated cats and dogs.

Ocklenburg, S., Isparta, S., Peterburs, J., & Papadatou-Pastou, M. (2019). Paw preferences in cats and dogs: Meta-analysis. Laterality: Asymmetries of Body, Brain and Cognition, 1-31.

P – domesticated cats and dogs

I/E – paw preference

C – none

O – existence and extent

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PICO: Examples

Laughter-inducing therapies: Systematic review and meta-analysis

This research aims to broadly describe the field of laughter-inducing therapies, and to estimate their effect on mental and physical health for a broad range of populations and conditions.

van der Wal, C. N., & Kok, R. N. (2019). Laughter-inducing therapies: Systematic review and meta-analysis. Social Science & Medicine.

P – Any individuals

I/E – laughter-inducing therapy

C – other intervention, or no intervention

O- mental and physical health outcomes

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PICO Activity - example

Initial Question: Is pet therapy effective?

Answerable research question: In post-secondary students, is pet therapy an effective intervention for alleviating stress?

P (population) – Post-secondary students

I/E (intervention) – Pet Therapy

C (Comparison) – none

O (Outcome) – Stress reduction

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PICO Activity

Initial Question: Is social media harmful

Answerable research question:

Complete the activity on the Google form, individually.

We will share your PICO or research questions with the class

P (population) –

I/E (intervention) –

C (Comparison) –

O (Outcome) –

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

A. Creating a focused researchable question

B. Pre-scan of the literature

2. Creating your protocol/plan

3. Data collection

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Pre-scan of the literature

  • Quick search of the literature in one or two databases
    • Check if another protocol/review already exists
    • Ensure there is enough literature
    • Identify study designs
    • Identify disciplinary areas
    • Identify terminology/language
    • Locate seed/known articles
    • Determine searchable concepts

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https://graduateresearcherspace.files.wordpress.com/2015/10/litrevgoogle.gif

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Pre-scan of the literature

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Hybholt, L., Buus, N., Erlangsen, A., & Lauge Berring, L. (2018). Older adults bereaved by suicide: a systematic literature search identifying zero studies. Archives of suicide research, 1-6.

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

2. Creating your protocol/plan

A. PRISMA –P

B. Choosing the information sources

C. Developing inclusion/exclusion criteria

3. Data collection

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What is a Protocol?

“In the context of systematic reviews and meta-analyses, a protocol is a document that presents an explicit plan for a systematic review. The protocol details the rationale and a priori methodological and analytical approach of the review.”

(Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi: 10.1186/2046-4053-4-1)

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Protocols

Why: promotes consistent conduct, accountability, research integrity, transparency, aid in decision-making

When: A priori

Where: Should be published (Prospero, some journals, Open science framework, or institutional repository).

Sample 1

Sample 2

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi: 10.1186/2046-4053-4-1

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PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols)

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http://www.prisma-statement.org/documents/PRISMA-P-checklist.doc

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

2. Creating your protocol/plan

A. PRISMA –P

B. Choosing the information sources

C. Developing inclusion/exclusion criteria

3. Data collection

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Choosing the Information Sources

  • What disciplines inform your study?
  • What types of literature inform your study?
    • Peer/non-peer review studies (ie journal literature)
    • Conferences
    • Trade publications
    • Working papers
    • Government reports

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What databases to search

AND

What are some of the limits we might use in database searches

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

2. Creating your protocol/plan

A. PRISMA –P

B. Choosing the information sources

C. Developing inclusion/exclusion criteria

3. Data collection

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Inclusion / Exclusion Criteria

Inclusion Criteria

Exclusion Criteria

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Inclusion / Exclusion Criteria

  • Is this study relevant?
  • How do you determine what will be included, or excluded, in your study?
  • Inclusion / exclusion criteria are your intellectual checklist to determine if a study is relevant

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Common Inclusion / Exclusion Criteria

  • Age
  • Gender
  • Population characteristics
  • Specific interventions
  • Specific outcomes

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  • Study design
  • Geographic location
  • Time restrictions
  • Publication type

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Common Inclusion / Exclusion Criteria

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Ocklenburg, S., Isparta, S., Peterburs, J., & Papadatou-Pastou, M. (2019). Paw preferences in cats and dogs: Meta-analysis. Laterality: Asymmetries of Body, Brain and Cognition, 1-31.

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Time for a break

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

2. Creating your protocol/plan

3. Data collection

A. Pre-scan of the literature and locating seed papers

B. Keywords/textwords and Subject Headings

C. Mining seed papers for keywords and subject headings

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Locating Seed/Known Articles

What: Quick search of P and I/E (in Google Scholar, or multi-disciplinary database)

Goal: Locate 3-5 articles that meet our inclusion criteria.

Aim for a “diverse” set

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Searchable Concepts

Not all concepts are searchable. Not all concepts need to be searched.

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Searchable Concepts

Humor in romantic relationships

P – individual in a romantic relationship

I/E – Humor

C – none

O – relationship satisfaction

Hall, J. A. (2017). Humor in romantic relationships: A meta‐analysis. Personal Relationships24(2), 306-322

Paw preferences in cats and dogs

P – domesticated cats and dogs

I/E – paw preference

C – none

O – existence and prevalence

Ocklenburg, S., Isparta, S., Peterburs, J., & Papadatou-Pastou, M. (2019). Paw preferences in cats and dogs: Meta-analysis. Laterality: Asymmetries of Body, Brain and Cognition, 1-31.

Laughter-inducing therapies:

P – Any individuals

I/E – laughter-inducing therapy

C – other or no intervention

O- mental and physical health outcomes

van der Wal, C. N., & Kok, R. N. (2019). Laughter-inducing therapies: Systematic review and meta-analysis. Social Science & Medicine.

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

2. Creating your protocol/plan

3. Data collection: Planning

A. Pre-scan of the literature and locating seed papers

B. Keywords/textwords and Subject Headings

C. Mining seed papers for keywords and subject headings

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Textwords/Keywords

  • These are all the potential words that authors could use to describe a concept. This may include:
    • Different forms of the same word (singular, plural, verbs, etc.)
    • Synonyms and antonyms
    • Variation in spelling (British vs. American; color vs. colour)
    • Terms used in other regions (soccer versus football)
    • Terms that have changed over time (previously used terms which may have been replaced)

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Subject Headings

  • Subject Headings: Also known as Index term, Subject term, controlled vocabulary, descriptors
  • Used to “tag” records so they can be found easily (in one place)
  • Assigned by a database (which means that each database has its own thesaurus/list)
  • A subject heading search can make up for a missed keyword term (but is not a substitute for a full list of keywords)

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Subject Headings versus textwords/Keywords

Subject Headings

  • Assigned by database (needs to be looked up)
  • One assigned term for that topic
  • Takes time for it to appear (indexing time)
  • Similar to a twitter #hashtag

Textwords/Keywords

  • Chosen by authors and used in the title/abstract/author-supplied keywords
  • Many synonyms/ variations/words/spellings
  • Immediately available from the article record in a database
  • Similar to the words in a tweet

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What is knowledge/evidence synthesis

Systematic versus scoping review

1. Defining your question

2. Creating your protocol/plan

3. Data collection: Planning

A. Pre-scan of the literature and locating seed papers

B. Keywords/textwords and Subject Headings

C. Mining seed papers for keywords and subject headings

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Mining seed papers

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Subject heading for pet therapy concept

Textwords for pet therapy concept

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Mining Seed Papers - Activity

Keywords/textwords, and subject headings can be found by analyzing database records

  1. Looking up a known article and looking at the metadata for subject headings
  2. Reviewing titles/abstracts/author keywords for textwords

Activity

Look up 2 seed papers in each database and analyze the article record.

Add 1) relevant subject headings and 2) textwords to the appropriate columns of the table in the following Googledoc:

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Planning Your Review

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The Government of Alberta is the copyright holder and

the Health Knowledge Network is the creator of this material

Research question

Eligibility criteria

Information sources

Searchable concepts

Protocol completed. Study begins

Textwords and subject headings. i.e. database search strategies

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Summary

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First: We identified a PICO and research question & decided on information sources

Second: We generated keywords and identified searchable concepts

Third: We identified some subject headings in 2 different databases

Workshop #2: We will use the keywords and subject headings to build a comprehensive search strategy

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THANKS!

Any questions?

Zahra Premji

zahrapremji@uvic.ca

University of Victoria

Alix Hayden

ahayden@ucalgary.ca

University of Calgary

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