Peggy Cruse and Shandra Protzko Library & Knowledge Services, National Jewish Health COLLABORATING TO PRODUCE SYSTEMATIC REVIEWS 1

Agenda  Background SRs in the context of publishing SRs and the librarian  The SR process For the investigator For the librarian  Discussion 2

Why is everyone talking about SRs? “attempts to collate empirical evidence that fits pre-specified eligibility criteria to answer a specific research question.” (Liberati et al)  Climate of best practice IoM Standards Society publishing standards PRISMA - Preferred Reporting Items for Systematic Reviews and Meta-Analysis Grade - Grading of Recommendations Assessment, Development and Evaluation Resources: GRADE, IoM report, PRISMA, J Amer Dental Assoc 3

Why do a systematic review?  Reduce bias in how conclusions are reached  Improve the power and precision of results  Too much information - summarize evidence about the effectiveness of particular approaches for addressing a public health problem  Analyze generalizability of findings  Too little information - identify knowledge gaps and need for additional research 4

MOU/Level of service  Getting paid  Authorship  Timeline  Services Formulate a searchable question Peer review search Citations in reference management software Screening sheets Document the results/methodology Resources: ICJME, AGREE 5

Resources: ICJME 6

What the investigator is doing Resources: Cochrane handbook 7 Define the question/ inclusion criteria Search for studies Select studies/collect data Assess risk of bias in studies Address reporting bias Present results and ‘summary of findings’ tables Interpret results/ draw conclusions

What you are doing Define the question/inclusion criteria Define the question Search for studies Peer reviewed search Select studies/collect data Export results/screening sheets/document Assess risk of bias in studies Wait Address reporting bias Wait some more Present results and ‘summary of findings’ tables Document the results and write the methodology Interpret results/draw conclusions Wait for publication 8

Reference interview: define the question PICO Resources: GRADE, IoM report, Journal of the American Dental Association 9 In children with influenza-like illness, does treatment with oseltamivir (compared to combination therapy or no drug) reduce mortality and duration of symptoms?

Searching  Scope Search MeSH and text words Numbers Sample results  Final Search Revisions Peer review Select databases Grey lit ○ Pharma,.gov, etc. ○ Publication bias 10

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Explaining the search  Tips and Tricks [square brackets] to annotate lines Excel to group related concepts Other visualization tools? ○ Adobe Illustrator ○ eulerAPE 12 Resources: eulerAPE

Concepts drawn in Illustrator 13

EulerAPE 14

Export  Tips and tricks De-dup Save everything!! Name EN files w standard conventions ○ Date_Subject_Screen#.enlx ○ _IPF_1stScreen.enlx 15

Record keeping 16

Resources: PRISMA Write the methodology 17

PRISMA Flow Diagram 18

Tools  RevMan: prepare reviews  GRADEPro: create ‘summary of findings’ (SoF) table  HLWiki International, Software for Systematic Reviewing  CADTH Peer Review Checklist for Search Strategies strat strat 19

Resources  AHRQ Effective Health Care Program Guides reports/?pageaction=displayproduct&mp=1&productID=318 reports/?pageaction=displayproduct&mp=1&productID=318  Appraisal of Guidelines Research and Evaluation (AGREE) AGREE is an international collaboration of researchers and policy makers who work together to improve the quality and effectiveness of clinical practice guidelines by establishing a shared framework for their development, reporting and assessment. Appraisal of Guidelines Research and Evaluation (AGREE)  Centre for Reviews and Dissemination Guide  Cochrane Handbook for Systematic reviews of Interventions. Updated Version 5.1.0http://handbook.cochrane.org/ Updated: March 2011http://handbook.cochrane.org/  Cruse PE and Protzko SP (2014). Librarian Contributions to Clinical Practice Guidelines, Medical Reference Services Quarterly, 33:3, , DOI: /  EulerAPE. Area-proportional Venn diagrams

Resources  Grading of Recommendations Assessment, Development and Evaluation (GRADE) A systematic approach to grading the strength of management recommendations can minimize bias and aid interpretation of expert-created medical guidelines. The IDSA began to employ the use of the GRADE system in new guidelines and guideline updates initiated after October Grading of Recommendations Assessment, Development and Evaluation (GRADE)  IoM: Finding What Works in Health Care: Standards for Systematic Reviews Systematic-Reviews.aspx Released: March 23, Systematic-Reviews.aspx  JADA Submissions and Author guidelines  Liberati A, Altman DG, Tetzlaff J, et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7): e doi: /journal.pmed  Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e doi: /journal.pmed PLoS Med 6(6): e doi: /journal.pmed  PRISMA:  PICO: McMaster Formulating questions and choosing outcomes  Systematic Reviews and Protocol Registries

Questions/Comments 22