A well defined research question should address a gap in the current literature and is the essential starting point of your synthesis.
You can use the following frameworks to help construct your research question.
PICO for Quantitative Studies
Example: Is gabapentin (intervention), compared to placebo (comparison), effective in decreasing pain symptoms (outcome) in middle aged male amputees suffering phantom limb pain (population)?
PICo for Qualitative Studies
I Phenomenon of Interest
Example: What are the experiences (phenomenon of interest) of caregivers providing home based care to patients with Alzheimer's disease (population) in Australia (context)?
P Perspective (for whom)
Example: What are the benefits (evaluation) of a doula (intervention) for low income mothers (perspective) in the developed world (setting) compared to no support (comparison)?
PI Phenomenon of Interest
R Study Type
Example: What are the experiences (evaluation) of women (sample) undergoing IVF treatment (phenomenon of interest) as assessed?
Design: questionnaire or survey or interview
Study Type: qualitative or mixed method
The above was adapted from Cornell University A Guide to Evidence Synthesis: 1. Develop a Research Question https://guides.library.cornell.edu/evidence-synthesis/research-question
After finalizing your research question but before you start your search, you need to define your inclusion and exclusion criteria. You must decide what contents an article MUST have before being included in the review. You also must determine which attributes would exclude an article from the review.
Image from the University of Melbourne Libguide Systematic Reviews https://unimelb.libguides.com/c.php?g=492361&p=3368110
Your search strategy must be exhaustive, encompasses multiple databases, include grey literature and be reproducible. PRISMA guidelines state that the full search strategy for at least one major database should be reported in an appendix and published along with the review ( http://www.prisma-statement.org/).
The University Library System provides access to a wide range of databases which can be accessed by subject on the A-Z database list. Most databases have controlled vocabulary (a certain way words and phrases are indexed) which is unique to the database. This may require using different terms for different databases."Given the complexity of the many indexing languages and rules governing the various databases, we recommend that early in the process you make use of an experienced research librarian who can examine your search strategy and help you choose citation databases relevant to your review question." (Aromataris, Edoardo PhD; Riitano, Dagmara BHSC, BA Systematic Reviews: Constructing a Search Strategy and Searching for Evidence, AJN, American Journal of Nursing: May 2014 - Volume 114 - Issue 5 - p 49-56 doi: 10.1097/01.NAJ.0000446779.99522.f6)
Grey literature is produced outside of traditional publishing and distribution norms. This can included, among other things, white papers, government publications, working papers, preprints, unpublished trial data, and conference proceedings and abstracts. Grey literature can be found in some citation databases, as well as databases dedicated to grey literature.
Some databases dedicated to grey literature include:
Some sources for preprints include:
An example of a complete and reproducible search strategy can be found in Appendix 1 of Petriwskyj, P. (2013). Family involvement in decision making for people with dementia in residential aged care: a systematic review of quantitative and qualitative evidence. JBI Database of Systematic Reviews and Implementation Reports, 11(7), 131–282. https://doi.org/10.11124/jbisrir-2013-977
A protocol lists the objectives, methods, and outcomes of primary interest of the systematic review. Protocols promote transparency of methods and allows your peers to review how you will extract information to summarize the data. Registration of your protocol establishes your intent to conduct this review which may reduce the risk of others conducting similar reviews.
Here is an example of a published protocol
Mengesha, M.M., Ajema, D., Teshome, A. et al. The association between diagnosis disclosure and adherence to antiretroviral therapy among adolescents living with HIV in sub-Saharan Africa: a protocol for systematic review and meta-analysis. Syst Rev 9, 160 (2020). https://doi.org/10.1186/s13643-020-01420-8
Protocol Reporting Guidelines and Checklists
It is important to keep track of all search results from each database. The use of a template is recommended to capture the following information:
After running the search through a database, export the results to a citation manager. The method of export will depend on the database and the citation management tool used. Once all results from all sources are uploaded into a citation manager, you will need to de-duplicate the result list.
Visit our Library Guide, "Introduction to Citation Management" for an introduction to citation management tools and links to upcoming citation management workshops workshops.
Start with the screening of title and abstract to determine if a reference is relevant to your review. Obtain the full text of a reference if further screening is necessary. At least two reviewers will be needed to make a final determination on inclusion.
There are systematic review tools available to help with the screening process:
Tools which have a subscription cost
More tools for conducting systematic reviews can be found at the SR Toolbox
The reviewers must read the full text of the articles which were selected for inclusion in the review. The pertinent data must be extracted from each article. A standardized data extraction form should be used. An example of a data extraction form can be found below.
If your review will contain a meta-analysis you may want to code the data in order to automate the statistical analysis process. Some systematic review software packages listed in step 6. can help you create coded data instruction forms. Instructions on designing a coded data extraction form can be found in the following article:
It is necessary to evaluate each study included in your review for bias. Cochran defines bias as "a systematic error, or deviation from the truth, in results or inferences. Biases can operate in either direction: different biases can lead to underestimation or overestimation of the true intervention effect". (Cochran Handbook 8.2.1)
Bias is evaluated on a level of risk. The risk of bias (RoB) can be demonstrated using a variety of tools:
More information and an analysis of RoB tools can be found in the article:
Ma, L. L., Wang, Y. Y., Yang, Z. H., Huang, D., Weng, H., & Zeng, X. T. (2020). Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better?. Military Medical Research, 7(1), 7. https://doi.org/10.1186/s40779-020-00238-8
Some study quality assessment tools include
PRISMA provides a list of items to consider when reporting results.
PRISMA Diagram Generators
Other Reporting Templates