Systematic Reviews

Search using PICO: this is a template to formulate a clinical question

• Patient, Population or Problem
  • What are the characteristics of the patient or population?
  • What is the condition or disease you are interested in?
• Intervention or exposure
  • What do you want to do with this patient (e.g. treat, diagnose, observe)?
• Comparison
  • What is the alternative to the intervention (e.g. placebo, different drug, surgery)?
• Outcome
  • What are the relevant outcomes (e.g. morbidity, death, complications)?
• T is sometimes included, but it can mean Time, Type of study, or Type of question

• Asking the Well Built Clinical Question  a classic from ACP Journal Club
• Finding the Evidence 1 – Using PICO to formulate a search question  Centre for Evidence-Based Medicine 
• PICO video https://youtu.be/rXQQsFeRLz0

Determine inclusion/exclusion criteria before searching.  What kind of studies will be included? What kind of studies will be excluded? Some examples are:

• Date of publication (5 years, 10 years, unlimited)
• Language of publication
• Methodology, quantitative or qualitative or mixed method
  • Randomized controlled trials only
  • Other: cohort, case-control
  • Qualitative: Interviews, focus groups, ethnography
• Age of subjects
• Gender
• Ethnicity
• Socioeconomic level

Joanna Briggs Manual for Evidence Synthesis; Chapter 3.2.4 Inclusion Criteria

Cochrane Handbook for Systematic reviews of Interventions; Part 2,  Chapter 3  Defining the criteria for including studies

Protocol tools to help develop the steps:

• PRISMA Checklist
• AMSTAR Checklist

• PRISMA   PRISMA stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. It is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses. Includes a checklist and flow diagram for planning a systematic review
• PRISMA Checklist 27-item checklist addressing the introduction, methods, results and discussion sections of a systematic review report.
• The 2020 PRISMA Flow Diagram