Summary
Samenvatting CRD's guidance for undertaking reviews in health care
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This summary summarizes the appendix CRD's guidance for undertaking reviews in healthcare for the nursing literature review course.
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1 Getting started1.1 Is a review required
Before starting a systematic review, it is essential to check if existing or ongoing reviews
address the topic in question. This involves:
1. Searching Existing Databases:
o Database of Abstracts of Reviews of Effects (DARE)
o Cochrane Database of Systematic Reviews (CDSR)
o Other relevant sources like NICE, NIHR HTA programme, Campbell
Collaboration, and EPPI Centre databases.
2. Assessing Existing Reviews:
o Determine if they are of sufficient quality.
o Ensure they focus on well-defined questions using appropriate methods.
o Check if they include comprehensive searches, clear selection criteria,
unbiased and transparent processes for data extraction and synthesis.
3. Quality Appraisal:
o Use checklists to identify flaws that might bias results.
o DARE provides examples of structured abstracts and quality assessments.
4. Relevance and Updates:
o If a high-quality review exists but is outdated, consider updating it.
o Assess the current relevance, especially in rapidly evolving fields.
o Collaboration with the original research team might be beneficial for updates.
5. Decision to Conduct a New Review:
o If an existing review is of adequate quality and still relevant, a new review may
not be necessary .
1.2 The review team
The review team is crucial for managing and conducting a systematic review, and should have
a diverse range of skills:
1. Expertise Required:
o Systematic review methods.
o Information retrieval.
o Relevant clinical or topic area.
o Statistics.
o Health economics and/or qualitative research methods, as appropriate.
2. Team Composition:
o Ideally, a minimum of two researchers should be involved to minimize bias
and errors throughout the review process.
o Any conflicts of interest should be identified early and managed to prevent
them from impacting the review.
3. Role of Team Members:
o Collaborate to ensure rigorous preparation and conduct of the review.
, o Use their combined expertise to manage all aspects of the systematic review
process effectively.
1.3 The advisory group
The advisory group provides valuable input and guidance at various stages of the systematic
review:
1. Composition:
o May include healthcare professionals, patient representatives,
service users, and experts in research methods.
o Some funding bodies may require the establishment of an advisory
group.
2. Functions and Benefits:
o Comment on the review protocol and final report.
o Ensure the review has practical relevance to its likely end users.
o Provide insights into outcomes and aspects of quality of life
important to stakeholders.
3. Consultation:
o Helps ensure the review is relevant and applicable to stakeholders'
needs.
o Time-consuming and should be factored into the project timeline.
4. Engagement:
o Early discussions about relevant audiences can help in planning
dissemination strategies from the beginning.
o Informal advice can also be sought from clinical or methodological
experts even if no formal advisory group is established.
Key Points:
Preparation and Conduct:
o Rigorous preparation and conduct of the review.
o Search existing resources to ensure new reviews are justified.
Review Team:
o Establish a team with a range of necessary skills.
o Handle conflicts of interest and aim to minimize bias and errors.
Advisory Group:
o Include a diverse range of stakeholders.
o Ensure the review is relevant and applicable to end users.
o Plan for stakeholder engagement and consultation within the project
timeline.
, 2 The review protocol
2.1 Introduction
The review protocol is a critical document that outlines the methods to be used in a systematic
review. Key points include:
1. Purpose of the Protocol:
o Sets out methods for the review, covering the review question, inclusion
criteria, search strategy, study selection, data extraction, quality assessment,
data synthesis, and dissemination plans.
o Aims to reduce bias by specifying methods in advance, such as clear inclusion
criteria to prevent selective inclusion of studies based on desired outcomes.
2. Modifications:
o Any necessary modifications to the protocol should be documented and
justified.
o Changes should arise from a better understanding of the review question, not
from an awareness of individual study results.
3. Development Process:
o Often iterative, requiring communication within the review team and advisory
group, and sometimes with the funder.
In summary, the review protocol serves as a comprehensive plan ensuring the systematic
review is conducted with rigor and transparency, minimizing bias and providing a clear path
for the review process
2.2 Key areas to cover in a review protocol
1. Background:
o Communicate key contextual factors and conceptual issues relevant to the
review question.
o Explain why the review is required and justify the inclusion criteria and focus
of the review question.
2. Review Question and Inclusion Criteria:
o Clearly and precisely state the review questions.
o Questions may be broad or specific; if broad, they might need to be broken
down into more specific questions.
3. Defining Inclusion Criteria:
o Use the PICOS (Population, Intervention, Comparison, Outcome, Study
design) framework to define criteria.
o Ensure criteria are appropriate for addressing the review question and justify
each element.
4. Identifying Research Evidence:
o Describe the search strategy to identify relevant studies.
o Outline sources to be searched, search terms, and any limitations.
5. Study Selection:
o Detail the process for selecting studies for inclusion.
o Describe the screening process and how decisions will be made.
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