Systematic Review

What is a systematic review?

• A systematic review provides a fully-informed and unbiased answer to a focused research question. It can be written on any academic topic. Most systematic reviews address healthcare and medicine, but increasingly, psychology and social policy are covered. It may include recommendations for professional practice or further research.
• It searches for, summarises, analyses and synthesises a full range of evidence (published and unpublished).
• It accounts for differences in research methods and sample sizes and may give more weight to certain types of study when assessing quality.
• Normally, it documents the search process so that other researchers can reproduce the same sets of results.

Steps for the process:

1. Formulate a research question which should be focused and well-defined.
2. Write a protocol for your literature searching, screening criteria, data extraction and analysis, synthesis of results and dissemination.
3. Search the literature (published and unpublished) on your topic, using the Library's databases. You need to build an effective strategy for searching each database.
4. Manage references. You will collect a large number of literature references and need a system for storing and managing these.
5. Select studies from the literature you found which are suitable for inclusion in your review. Check for quality and risk of bias in each study.
6. Assess the evidence. Extract and analyse the data, interpret and synthesise findings, draw conclusions and make recommendations.
7. Write your review. Include a detailed report of databases used and your search strategy for each of them.

Formulating a question

Defining the research question and developing a protocol are the essential first steps in your systematic review. The success of your systematic review depends on a clear and focused question, so take the time to get it right.

• A framework may help you to identify the key concepts in your research question and to organise your search terms in one of the Library's databases.
• Several frameworks or models exist to help researchers structure a research question and three of these are outlined on this page: PICO, SPICE and SPIDER.
• It is advisable to conduct some scoping searches in a database to look for any reviews on your research topic and establish whether your topic is an original one.
• You will need to identify the relevant database(s) to search and your choice will depend on your topic and the research question you need to answer.
• By scanning the titles, abstracts and references retrieved in a scoping search, you will reveal the terms used by authors to describe the concepts in your research question, including the synonyms or abbreviations that you - may wish to add to a database search.
• The Library can help you to search for existing reviews: make an appointment with your Subject Librarian to learn more.

Question formulation frameworks

There are 3 frameworks to formulate a question :

1. PICO
2. SPIDER
3. SPICE

PICO framework

PICO stands for :

1. Population : defines the group you are studying
2. Intervention : treatment you aim to study
3. Comparator : is another type of treatment you aim to compare the first treatment with, or perhaps a placebo.
4. Outcome : is the result you intend to measure, for example (increased or decreased) life expectancy, or (cessation of) pain.

SPIDER framework

SPIDER stands for :

1. Sample: qualitative research may have fewer participants than quantitative research and findings may not be generalised to the entire population.
2. ​Phenonemon of Interest: experiences, behaviours or decisions may be of more interest to the qualitative researcher, rather than an intervention.
3. Design: the research method may be an interview or a survey.
4. Evaluation: outcomes may include more subjective ones, e.g. attitudes.
5. Research type: the search can encompass qualitative and mixed-methods research, as well as quantitative research.

SPICE framework

SPICE stands for :

1. Setting: the location or environment relevant to your research (e.g. accident and emergency unit)
2. ​Population (or perspective): the type of group that you are studying (e.g. older people)
3. Intervention: the intervention/practice/treatment that you are evaluating (e.g. initial examination of patients by allied health staff)
4. Comparator: an intervention with which you compare the above comparator (e.g. initial examination by medical staff)
5. Evaluation: the hypothetical result you intend to evaluate (e.g. lower mortality rates)

Remember that these are spoken of in terms of healthcare, but is equally applicable to any system.