Systematic Review Mohammed TA Omar PhD PT Rehabilitation Health Science What is a systematic Review A systematic review is defined as a review of the evidence on a clearly formulated question that uses ID: 562657
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Slide1
Developing Research Proposal Systematic Review
Mohammed TA, Omar Ph.D. PT
Rehabilitation Health Science Slide2
What is a systematic Review ?
A systematic review is defined as “a review of the evidence on a
clearly
formulated question that uses
systematic and explicit
methods
to identify, select and critically appraise relevant primary research, and to extract and
synthesis, analyze
data from the studies that are included in the review.”Slide3
Why ? The problems are that …
Too much information, too little time
Many
too poorly done
or
insufficiently relevant to be clinically usefulMany have conflicting resultsOn top of these, high quality information is often not easy to find
3Slide4
Why do systematic reviews?Support Evidence Based Practice
Research
Inform clinical policy
Publication
Personal professional developmentSlide5
Systematic reviews are the same as
narrative reviewsSlide6
Types of Systematic Review Slide7
Stages of S
ystematic Review
Formulate
research /
policy
conclusions
Search bibliographic databases
Identify possible papers from titles/abstracts
Retrieve papers
Extract data
Further selection of primary studies using inclusion criteria
Synthesis
Formulate research question
Design search
strategy/plan
Quality appraisal Slide8
Formulate
Research Question
PICO
What
types of
P
articipants?
What types of
I
nterventions?
What types of
C
omparison?
What types of
O
utcomes?
The first and most important decision in preparing a review is to determine its focus
This is best done by asking clearly framed questions.Slide9
Formulation of
a intervention question
Does low level laser therapy effective in treatment of diabetic foot ulcer?
In p
atients with Chronic Diabetic
F
oot Ulcer (DFU), does low level laser therapy lead to higher rates of healing as compared to standardized wound care?Slide10
Design Research Strategy/Plan
Your development plan should include:
Your clinical question
Criteria for the literature search
Key
words Databases
Dates
to include (how far back do you go?)
Inclusion and exclusion
criteria Types of studies design Types of participants Types of intervention Type of outcome measurements4. A timeline for your projectSlide11
Key Words
Key Text words for the condition, e.g.,
‘Foot
ulcer' , 'diabetic foot ulcer' , 'diabetic wound', 'diabetic complications'
Key Text words for the intervention, e.g., Low level Laser TherapyLow Power Laser
Low Energy Laser
Laser Bio-stimulation
Dates to include (how far back do you go?) Time of the fist review (if possible) No systematic review before ( back for 10 years) Slide12
Data sources for a systematic review
Electronic databases
MEDLINE and EMBASE
Specialized or local databases (CINAHL, CENTRAL, AMED,…)
Hand searching
“Grey literature” ( thesis, Internal reports, pharmaceutical industry files)
Checking reference lists
Unpublished sources
known to experts in the specialty (seek by personal communication)
Raw data from published trials12Slide13
Criteria Slide14
Exercises:
As group carful read the following paper and selected the following
Research questions
Keywords
Date of search
Language of search Types of data baseCriteria of search Slide15
Study Timeline
Project Tasks
Timeline
Project Development Plan
Perform Literature Search
Inclusion/exclusion of Articles
Table of Evidence/Data Extraction
Table of Evidence Review
First Draft of Review
Committee Review
External ReviewSlide16
Synthesis and Critical Appraisal
Data Extraction
(draw diagram )
Create Tables of
Evidence
Methodological Quality Slide17
Data extraction flow chart Slide18
Create Tables of Evidence
Most common approaches to classification and grading of the
evidence
Sackett
's 5 levels of
evidenceOxford Centre for Evidence-Based Medicine levels of evidence Slide19
Methodological Quality: Jadad Scale
JADAD SCAL Criteria
Score
1a. Was the study described as randomized?
+1
1b.
Was the method of randomization described and
appropriate to conceal allocation?
+1
1c.
If described and inappropriate, describe:
-1
2a.
Was the study described as double blinded?
+1
2b.
Was the method of double-blinding described and
appropriate to maintain a double-blinding?
=12c. Was the method of blinding inappropriate? -13. Was there a description of withdrawals and drop outs? +1Total (0-5)5Slide20
Methodological Quality:
PEDroScale
Slide21
Methodological Quality:
Van
Tulder
Slide22
Systematic Review to User Product
Using the synthesis of evidence resulting from you
review
What
would you take as a next step for each of the following audiences
CLINICIANSRESEARCHERSCONSUMERS