Identifying the evidence Laura Macdonald Health Protection Scotland

Where do I start?

Ask the right questions Determine the scope of the guidance Get input from guideline development team and key stakeholders Prioritise! Formulate key questions –P opulation –I ntervention –C omparison (control) –O utcome

Write a protocol Why? –Background and context What? –Aims and objectives –Key questions –Outputs How? –Search strategy –Inclusion/exclusion criteria –Screening –Critical appraisal –Recording and organisation

Searching for literature Select resources based on topic Resources –Knowledge Network MEDLINE Embase CINAHL –Cochrane Library –Grey literature databases –Guideline databases...etc

Searching for literature Search terms: –Different terminology –Controlled vocabulary (e.g. MeSH) –Free text terms Advanced searching –Combine search terms using Boolean operators –Apply limits Adapt your searches for each resource Save your searches

Inclusion/exclusion criteria Exclusion versus inclusion criteria Types of study PICO framework –Population –Intervention –Comparison (control) –Outcome Date Language

Screening Screen search results against inclusion/exclusion criteria Time consuming and tedious! First screen –Title and abstract Second screen –Full text Remaining items – in the review

Recording and organisation Transparent process Keep a record of what you do –Changes to protocol –Search terms –Search dates –Excluded items –Reasons for excluding items Systematic review management software (e.g. EPPI- Reviewer; RevMan)

Critical Appraisal Structured process to systematically assess evidence: –Quality –Validity –Generalizability –Applicability –Conclusions etc Range of critical appraisal tools available (e.g. SIGN)

Thank you