SYSTEMATIC REVIEWS OF EXPERT OPINION & POLICY DOCUMENTS 8 TH February 2019
SYSTEMATIC REVIEWS OF EXPERT OPINION & POLICY DOCUMENTS WELCOME, OVERVIEW, AND PARTICIPANTS’ INTRODUCTION Dr Catalin Tufanaru Research Fellow NHMRC Centre of Research Excellence in Digital Health Dr Yvonne Zurynski Associate Professor of Health System Sustainability Honorary A/Prof, Sydney Medical School, The University of Sydney Adjunct A/Prof, Menzies Institute for Medical Research, University of Tasmania Dr K-lynn Smith Research Officer NHMRC Partnership Centre in Health System Sustainability Australian Institute of Health Innovation 2
SYSTEMATIC REVIEWS OF EXPERT OPINION & POLICY DOCUMENTS DAY PROGRAM • 9.00 am : Welcome, Overview, and Participants’ Introduction • 9.20 am : Session 1: Brief Introduction to systematic reviews (review protocol writing; searching; study selection; data extraction; critical appraisal; data synthesis; report writing) • 9.55 am : Session 2: The importance of expert opinion and policy documents in healthcare policy and practice (Session presented by Associate Professor Yvonne Zurynski) • 10.15 am : Morning break • 10.35 am : Session 3: Writing a review protocol for a systematic review of expert opinion and policy documents • 10.55 am : Session 4: Developing a search strategy and searching for a systematic review of expert opinion and policy documents [ The literature searching process ] • 11.15 am : Session 5: Texts/Documents selection for a systematic review of expert opinion and policy documents (including hands-on practical exercise) • 12.00 pm : Lunch break Australian Institute of Health Innovation 3
SYSTEMATIC REVIEWS OF EXPERT OPINION & POLICY DOCUMENTS DAY PROGRAM • 12.30 pm : Session 6: Data extraction for a systematic review of expert opinion and policy documents (including hands-on practical exercise) • 1.30 pm : Session 7: Critical appraisal for a systematic review of expert opinion and policy documents (including hands-on practical exercise) • 2.50 pm : Afternoon break • 3.10 pm : Session 8: Data synthesis for a systematic review of expert opinion and policy documents (including hands-on practical exercise) • 4.10 pm : Session 9: Report writing for a systematic review of expert opinion and policy documents • 4.25 pm : Summative Discussion Session • 5.00 pm : Program Close Australian Institute of Health Innovation 4
SYSTEMATIC REVIEWS OF EXPERT OPINION & POLICY DOCUMENTS SESSION 1: BRIEF INTRODUCTION TO SYSTEMATIC REVIEWS Australian Institute of Health Innovation 5
Systematic Reviews SYSTEMATIC REVIEWS – DEFINED • “A systematic review is a research article that identifies relevant studies, appraises their quality and summarizes their results using a scientific methodology .” [Ref: Khalid Khan, Regina Kunz, Jos Kleijnen and Gerd Antes. Systematic reviews to support evidence based medicine. How to review and apply findings of healthcare research. Second edition. Hodder Arnold, 2011. Page 1] • “ Research Synthesis : A review of a clearly formulated question that uses systematic and explicit methods to identify, select and critically appraise relevant research, and to collect and analyze data from the studies that are included in the synthesis. Statistical methods (meta-analysis) may or may not be used to analyze and summarize the results of the included studies. Systematic review is a synonym of research synthesis .” [Ref: Harris Cooper, Larry V. Hedges, Jeffrey C. Valentine (Editors) The handbook of research synthesis and meta-analysis. Second edition. Russell Sage Foundation, 2009. Page 581] Australian Institute of Health Innovation 6
Systematic Reviews SYSTEMATIC REVIEWS – DEFINED • “ Research syntheses focus on empirical research findings and have the goal of integrating past research by drawing overall conclusions (generalizations) from many separate investigations that address identical or related hypotheses. The research synthesist’s goal is to present the state of knowledge concerning the relation(s) of interest and to highlight important issues that research has left unresolved.” [Ref: Harris Cooper. Research Synthesis and Meta-Analysis. A Step-by-Step Approach. Fifth Edition. SAGE, 2017. Page 23] • “A systematic review attempts to collate all empirical evidence that fits pre-specified eligibility criteria in order to answer a specific research question. It uses explicit, systematic methods that are selected with a view to minimizing bias , thus providing more reliable findings from which conclusions can be drawn and decisions made (Antman 1992, Oxman 1993).” [Ref: Green S, Higgins JPT, Alderson P, Clarke M, Mulrow CD, Oxman AD. Chapter 1: Introduction. In: Higgins JPT, Green S (editors), Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): John Wiley & Sons, 2008. Page 6] Australian Institute of Health Innovation 7
Systematic Reviews THE ESSENTIAL CHARACTERISTICS OF REAL SYSTEMATIC REVIEWS • “The key characteristics of a systematic review are: a clearly stated set of objectives with pre-defined eligibility criteria for studies ; an explicit, reproducible methodology ; a systematic search that attempts to identify all studies that would meet the eligibility criteria ; an assessment of the validity of the findings of the included studies, for example through the assessment of risk of bias ; and a systematic presentation, and synthesis, of the characteristics and findings of the included studies .” [Ref: Green S, Higgins JPT, Alderson P, Clarke M, Mulrow CD, Oxman AD. Chapter 1: Introduction. In: Higgins JPT, Green S (editors), Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): John Wiley & Sons, 2008. Page 6] Australian Institute of Health Innovation 8
Systematic Reviews SYSTEMATIC REVIEWS VERSUS (TRADITIONAL) LITERATURE REVIEWS Systematic Reviews (Traditional) Literature Reviews • Informed by an a priori protocol • “imprecise in both process and outcome” • Clearly articulated objectives and questions • “rarely involve systematic procedures to ensure that all • Inclusion and exclusion criteria, stipulated a priori (in the the relevant research was located and included in the protocol) synthesis” • Systematic, exhaustive, comprehensive searching to • “prone to use post hoc criteria to decide whether identify all relevant studies (published and unpublished) individual studies met an acceptable threshold for • Critical appraisal of the included studies methodological quality” • Steps taken to reduce bias • Unreproducible and not transparent • Transparent and reproducible methods (Ref: Aromataris E & Pearson A. The Systematic Review: An Overview. AJN The American (Ref: Harris Cooper. Research Synthesis and Meta-Analysis. A Step-by-Step Approach. Fifth Journal of Nursing, 2014;114(3): 47-55.) Edition. SAGE, 2017. Page 24) Australian Institute of Health Innovation 9
Systematic Reviews STAGES/STEPS IN THE SYSTEMATIC REVIEW PROCESS • Review Protocol Development • Review Protocol Registration • Searching [The literature searching process with eight key stages] • Selection or Screening of studies (publications) • Data Extraction • Critical Appraisal (Risk of Bias Assessment) • Data Synthesis • Writing the Systematic Review Report • Publish the report • Disseminate the report Australian Institute of Health Innovation 10
SYSTEMATIC REVIEWS OF EXPERT OPINION & POLICY DOCUMENTS REPORT WRITING: PRISMA FLOW DIAGRAM Australian Institute of Health Innovation 11
Systematic Reviews DIFFERENT TYPES OF SYSTEMATIC REVIEWS • Systematic Reviews (SRs) of primary research studies • SRs of systematic reviews ( Umbrella Reviews ; Overview of Reviews ) • SRs of non-research publications (expert opinion; policy documents; position statements etc.) • Scoping Reviews • ‘Comprehensive’ SRs • Mixed-methods SRs • ‘Living’ SRs • Rapid Reviews Australian Institute of Health Innovation 12
Systematic Reviews DIFFERENT TYPES OF SYSTEMATIC REVIEWS Australian Institute of Health Innovation 13
Systematic Reviews DIFFERENT TYPES OF SYSTEMATIC REVIEWS Australian Institute of Health Innovation 14
SYSTEMATIC REVIEWS OF EXPERT OPINION & POLICY DOCUMENTS DIFFERENT TYPES OF SYSTEMATIC REVIEWS 15 Australian Institute of Health Innovation
Systematic Reviews DIFFERENT TYPES OF SYSTEMATIC REVIEWS Australian Institute of Health Innovation 16
Systematic Reviews REVIEW APPROACHES: UMBRELLA REVIEWS Australian Institute of Health Innovation 17
Systematic Reviews REVIEW APPROACHES: SCOPING REVIEWS • Scoping Reviews Australian Institute of Health Innovation 18
Systematic Reviews REVIEW APPROACHES: RAPID REVIEWS Australian Institute of Health Innovation 19
Systematic Reviews GUIDANCE AND STANDARDS FOR SYSTEMATIC REVIEW PROCESS Review Stage: Review Protocol Development PRISMA-P : PRISMA for systematic review protocols http://www.prisma-statement.org/Extensions/Protocols.aspx “PRISMA-P was published in 2015 aiming to facilitate the development and reporting of systematic review protocols.” (Source: PRISMA-P Official Website) Australian Institute of Health Innovation 20
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