1. Secondary Data Analysis: Systematic Reviews & Associated Databases
Prof. Eileen Savage
OMCYA Keeping Children Safe Summer School,
12th – 16th September 2011,
UCC.

2. What is a Systematic Review?
a concise scientific investigation, with pre-planned methods that summarise, appraise, synthesise and communicate the results of multiple primary studies (Cooke et al, 1997; Centre for Reviews and Dissemination, 2008).
ie Research on Research with findings of existing data becoming raw data
Differs from a narrative review/
traditional literature review

3. Traditional Review vs. Systematic Review
(Nasseri-Moghaddeam & Malekzadeh 2006)

5. Growth of Systematic Reviews

6. Systematic Reviews – Origins of Growth
Expanding volume of published & unpublished literature
Conflicting findings across studies leading to ‘uncertainty’
Contributes to Evidence Based Movement

7. When to Do a Systematic Review
When there is ‘uncertainty’ about the effectiveness of interventions in practice
When key questions remain unanswered e.g. about treatments, interventions, practices, experiences etc…
To inform practice/policy with best available research evidence
To identify what is known/not known in an area to guide future research (includes research methods)
(Petticrew & Roberts 2007)

8. Where to find a Systematic Review
Peer Reviewed Journals (search bibliography databases)
Cochrane Database of Systematic Reviews (Cochrane Library; several Groups)
Database of Abstracts of Reviews of Effects (DARE)
Health Technology Assessment Database
NHS Economic Evaluation Database
The Campbell Collaboration Library (Groups e.g. Crime & Justice; Education; Social Welfare; Methods; Communication & internationalization; Users Groups.
The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), University of London. (Education; Health Promotion; Employment; Social care; Crime and Justice)
Others

9. Structure of Systematic Review e.g.
Introduction/Background
Questions/Aim & Objectives
Criteria for considering studies
Search Methods
Methods of the Review (e.g screening reading papers; quality assessment; data extraction)
Results
Discussion
Conclusions

10. Criteria for Including/Excluding Studies
Types of Studies (see hierarchy of evidence)
Types of Participants
Types of Outcomes
Link to Questions being asked

11. Hierarchy of Evidence
Meta-synthesis
Qualitative studies

12. Search Method
Search Terms
Databases
+/- Hand searching
+/- Reference lists
+/-Grey Literature
+/- Contacting authors
(Refer to Booth et al on standards for Reporting Search Methods)

13. Search Strategy: CINAHL with Full Text (EBSCO)
Search Strategy: Embase (Elsevier)
Date of Search
30th March 2011
Years Covered
January 1990 to March 2011
Complete Strategy
cystic fibrosis. ti,ab,de.
mucoviscidosis. ti,ab,de.
1 or 2
'clinical trial'. ti,ab,de.
'trial'. ti,ab,de.
random*'. ti,ab,de.
4 or 5 or 6
educat*. ti, ab, de.
program*. ti,ab,de.
8 or 9
self care ti, ab, de.
selfcare. ti,ab,de.
self management. ti, ab,de
manag*. ti, ab,de.
11 or 12 or 13 or 14
10 or 15
3 and 7 and 16
Date of Search
30th March 2011
Years Covered
January 1990 to March 2011
Complete Strategy
cystic fibrosis.TX.
mucoviscidosis.TX.
1 or 2
clinical trial.PT.
trial.TX.
random*TX.
4 or 5 or 6
educat*.TX.
program*TX.
8 or 9
self care.TX.
self-care.TX.
selfcare. TX.
self management. TX.
self-management.TX.
manag*.TX.
11 or 12 or 13 or 14 or 15 or 16
10 or 17
3 and 7 and  
Language Restrictions
None

15. Methods – Screening for Inclusion/ Exclusion
Titles & Abstracts – In/Unsure/Out
Read in full –> in/unsure /out

16. Quality Assessment of Individual Studies
Quality threshold for inclusion ie exclude poor quality studies
Assessment of Quality may be part of SR
How
- No –’gold standard’ exists
- Checklists available e.g. CASP
- Quality Scales/Criteria

17. Data Extraction Use a data extraction form (s)
2 or more reviewers / cross-check
Extract details relevant to Questions/ Objectives
Present raw data in report – table format

18. Data Analysis & Synthesis
Collation & summary of results
Present in tabular form/forest plots/other + descriptive narrative account
+/- Meta-analysis, if appropriate (not possible with heterogeneity ie cannot pool apples with oranges for the purpose of statistical analysis as one data set)

19. Results, Discussion, Implications

20. Critical Appraisal of Systematic Reviews
The PRISMA Statement: standards for reporting SRs & Meta-analyses
Critical Appraisal Tool Kit for SRs (CASP)

21. Website on Critical Appraisal Tools (covers a range of methods)
At:
Division of Health Sciences International Centre for Allied Health Evidence

22. References
To follow