SYSTEMATIC REVIEW SYSTEMATIC REVIEW

Community Research Program Medical Faculty of North Sumatra

Systematic Review (SR)

Paper that summarizes other papers Known as:
Review article Systematic review Meta analysis

Definition
An overview of primary studies that used explicit (objectives, material, and methods) and reproducible methods

Systematic review
Systematic in :
Gathering relevant articles Appraising the articles

The difference between SR and Meta analysis is: In SR, there is no formal statistical analysis In Meta analysis, there is

Review article

Systematic review Meta analysis

Integrative literature

Integrative literature
Review article Systematic review

Meta analysis

Methodology for systematic review of RCT

 When systematic review is undertaken, not only must the search for relevant articles be thorough and objectives but the criteria used to reject articles as flawed must be explicit and independent of the results of those trials

 The most enduring and useful systematic review, notably those undertaken by the Cochrane Collaboration are regularly updated to incorporate new evidence

Advantages
Explicit methods limit bias in identifying and rejecting studies Conclusions are more reliable and accurate because of methods used Large amounts of information can be assimilated quickly by healthcare providers, researches, and policymakers Delay between research discoveries and implementation of effective diagnostic and therapeutics strategies may be reduced

Advantages
Results of different studies can be formally compared to establish generalisability of finding and consistency (lack of heterogeneity) of results Reasons for heterogeneity (inconsistency in results across studies) can be identified and new hupotheses generated about particular subgroups Quantitative systematic reviews (metaanalysis) increases the precision of the overall result

Evaluating Systematic Review

Validity Important Applicability

Validity (Methods)
Questions: Is it a systematic review of randomized trials of the treatment youre interested in? Does it include a methods section that describes: Were the results consisten from study to study?
Finding and including all the relevant trials? Assesing their individual validity?

Important (Results)
Odds ratio to NNTs OR RRR CER PEER NNTs

Applicability (Discussions)
YES to all Do they really make biologic and clinical sense? Is the qualitative difference both clinically (beneficial for some useless or harmful for others) and statistically significant? Was this difference hypothesised before the study began (rather than the product of dredging the data), and has it been confirmed in other, independent studies? Was this one of just a few subgroup analuses carried out in this study?

Thank you