What technique is used to combine the statistics from studies included in a systematic review?

What technique is used to combine the statistics from studies included in a systematic review?

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What technique is used to combine the statistics from studies included in a systematic review?

CLINICAL TRIALS AND OBSERVATIONSSystematic review and meta-analysis methodology

Abstract

Systematic reviews and meta-analyses are being increasingly used to summarize medical literature and identify areas in which research is needed. Systematic reviews limit bias with the use of a reproducible scientific process to search the literature and evaluate the quality of the individual studies. If possible the results are statistically combined into a meta-analysis in which the data are weighted and pooled to produce an estimate of effect. This article aims to provide the reader with a practical overview of systematic review and meta-analysis methodology, with a focus on the process of performing a review and the related issues at each step.

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Copyright © 2010 American Society of Hematology

Evidence Pyramid

Systematic reviews and meta-analyses are situated at the top of what is known as the “Evidence Pyramid” (see figure below). As you move up the pyramid the amount of available literature on a given topic decreases, but the relevancy and quality of that literature increases. Systematic reviews and meta-analyses are considered to be the highest quality evidence on a research topic because their study design reduces bias and produces more reliable findings. However, you may not always be able to find (or need to find) the highest level of evidence to answer your research question. In the absence of the best evidence, you then need to consider moving down the pyramid.

What technique is used to combine the statistics from studies included in a systematic review?

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A systematic review is a high-level overview of primary research on a particular research question that systematically identifies, selects, evaluates, and synthesizes all high quality research evidence relevant to that question in order to answer it. In other words, it provides an exhaustive summary of scholarly literature related to a particular research topic or question. A systematic review is often written by a panel of experts after reviewing all the information from both published and unpublished studies. The comprehensive nature of a systematic review distinguishes it from traditional literature reviews which typically examine a much smaller set of research evidence and present it from a single author’s perspective. Systematic reviews originated in the biomedical field and currently form the basis of decision-making in Evidence-Based Treatment (EBT) and evidence-based behavioral practice (EBBP).  

For additional information, read this entry in the e-reference book The A-Z of Social Research:

Meta-Analyses

Systematic reviews often use statistical techniques to combine data from the examined individual research studies, and use the pooled data to come to new statistical conclusions. This is called meta-analysis, and it represents a specialized subset of systematic reviews. Not all systematic reviews include meta-analysis, but all meta-analyses are found in systematic reviews. Simply put, a systematic review refers to the entire process of selecting, evaluating, and synthesizing all available evidence, while the term meta-analysis refers to the statistical approach to combining the data derived from a systematic-review. Conclusions produced by meta-analysis are statistically stronger than the analysis of any single study, due to increased numbers of subjects, greater diversity among subjects, or accumulated effects and results. Meta-analyses have become common in the social and biomedical sciences. However, some challenge the validity of meta-analysis, arguing that combining data from disparate studies produces misleading or unreliable results.

For additional information, read this entry in e-reference book The Concise Corsini Encyclopedia of Psychology and Behavioral Science:

Finding Systematic Reviews & Meta-Analyses

Since there are far fewer systematic reviews and meta-analyses than most other types of research, you will often need to broaden your search terms when searching in the Library’s Databases or the Internet. Also, keep in mind that the term "systematic review" originated in the medical field, so you can expect to see the majority of articles related to medical areas and conditions.

Locating systematic reviews and meta-analyses is extremely beneficial not only because they provide high-quality evidence, but also because they will include extensive references to primary studies relevant to your research topic.

See the Resources box below for instructions on locating systematic reviews and meta-analyses in the Library databases.

Systematic Reviews & Meta-Analyses Workshop

This workshop provides an introduction to library resources which can be used to locate systematic reviews and meta-analysis studies.

Databases

  • APA PsycInfo
  • CINAHL Complete
  • Cochrane Library
  • MEDLINE Complete
  • OVID Nursing Full Text
  • PubMed
  • Roadrunner Search
  • Web of Knowledge

  • APA PsycInfo This link opens in a new window

    • What technique is used to combine the statistics from studies included in a systematic review?

    EBSCO’s platform of APA compiled resources covering all aspects of psychology, plus the behavioral aspect of education, medicine, sociology, law, management and other fields. Filter results by methodology and test instrument used. Includes a tool for discovering citing articles, and thesaurus to assist you in the discovery process. Note: This database provides more citations than full-text articles.

Compiled by the American Psychological Association (APA), APA PsycInfo covers all aspects of psychology, plus the behavioral aspect of education, medicine, sociology, law, management, and other fields.

To limit your APA PsycInfo search results to systematic reviews, select Systematic Review within the Methodology box (as shown below) and then type your search terms into the search box.

What technique is used to combine the statistics from studies included in a systematic review?

  • CINAHL Complete This link opens in a new window

    • What technique is used to combine the statistics from studies included in a systematic review?

    EBSCO’s nursing database covering biomedicine, alternative/complementary medicine, consumer health and allied health disciplines. Strong in qualitative studies. Filter studies by nurse as author, evidence-based practice, and type of study. Includes MESH indexing, PICO search functionality, and a tool for discovering citing articles.

CINAHL allows you to limit your publication type not only systematic reviews or meta analyses, but also to a "meta synthesis." This publication type value is applied to articles that indicate the presence of a qualitative methodology that integrates results from a number of different, but inter-related studies.

To limit your results, select Systematic Reviews (or Meta Analysis or Meta Synthesis) within the Publication Type box (as shown below) and then type your search terms into the search box.
 

What technique is used to combine the statistics from studies included in a systematic review?

 

Alternatively, you may wish to limit your CINAHL search results to Evidence-Based Practice, as shown below. Applying this limiter allows you to limit results to: articles from evidence-based practice journals; articles about evidence-based practice; research articles (including systematic reviews, clinical trials, meta analyses, etc.) and commentaries on research studies (applying practice to research). Selecting Evidence-Based Practice will produce a broader set of results than applying a single publication type limiter.
 

What technique is used to combine the statistics from studies included in a systematic review?

  • Cochrane Library This link opens in a new window

    • What technique is used to combine the statistics from studies included in a systematic review?

    Database of intervention focused systematic reviews. Learn the effectiveness of interventions proven through evidence-based research. Includes MESH and PICO search functionality.

Cochrane Library is a collection of six databases that contain different types of high-quality, independent evidence to inform healthcare decision-making, and a seventh database that provides information about Cochrane groups.

Select Advanced Search and then click on Search limits to choose your Cochrane Reviews as shown below.
 

What technique is used to combine the statistics from studies included in a systematic review?

  • MEDLINE Complete This link opens in a new window

    • What technique is used to combine the statistics from studies included in a systematic review?

    Government database provided through EBSCO platform. Biomedical and health journals. Provides MESH subject headings and offers the full text of many popular MEDLINE-indexed journals that are not available in other databases.

MEDLINE provides authoritative medical information on medicine, nursing, dentistry, veterinary medicine, the health care system, pre-clinical sciences, and much more.

To limit your results to systematic reviews, select Systematic Reviews within the Subject Subset box (as shown below) and then type your search terms into the search box.

What technique is used to combine the statistics from studies included in a systematic review?

  • Ovid Nursing Full Text This link opens in a new window

    • What technique is used to combine the statistics from studies included in a systematic review?

    Medical database covering nursing, allied health, education and training, development and management, midwifery, health and healthcare economics, clinical medical and healthcare social work, psychiatry and mental health, and traumatology, emergency and critical-care medicine. Advanced search functions including MESH capability.

Ovid Nursing Full Text is a collection of unique scholarly nursing journals. with subjects ranging from alternative medicine to perinatal nursing.

On the OVID Basic Search screen, select from among the options under the field EBM-Evidence Based Medicine, as shown below. To select both Meta Analysis and Systematic Review, hold down the Control button on your keyboard.
 

What technique is used to combine the statistics from studies included in a systematic review?

  • PubMed Central This link opens in a new window

    • What technique is used to combine the statistics from studies included in a systematic review?

    Governmental biomedical database with literature pulled from the National Library of Medicine’s Medline. Does not include books or other formats. Includes MESH search functionality.

PubMed systematic reviews cover a broad set of articles that build consensus on biomedical topics and medical genetics. PubMed also includes meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, and guidelines.

After doing your search, go to the Article Type limit within the left-hand column and select  Meta-Analysis or Systematic Review.

What technique is used to combine the statistics from studies included in a systematic review?

Note that the Systematic Reviews filter in PubMed will include meta-analyses results. If however, you want to search for only for meta-analyses, select the Meta-Analysis filter under Article Type. You will need to deselect everything in this filter except Meta-Analysis.

Alternatively, you can also search for systematic reviews in PubMed by using the Clinical Queries search page. Results of searches on this page are limited to specific clinical research areas.

What technique is used to combine the statistics from studies included in a systematic review?

  • Roadrunner Search This link opens in a new window

    The library’s main search engine that searches across databases for a comprehensive search that will yield the most results in the form of scholarly journals, e-books, videos and more. However, certain databases and publisher content are not searchable in Roadrunner, and individual databases may need to be searched to retrieve information due to unique content.

Roadrunner Search is a great starting point for your research as it searches approximately 95% of the library’s database content, including articles, e-books and videos.

To include systematic reviews in your Roadrunner search results, include the phrase “systematic review” in one of the search boxes and change the drop-down menu to TI Title (as shown below).
 

What technique is used to combine the statistics from studies included in a systematic review?

  • Web of Knowledge This link opens in a new window

    • What technique is used to combine the statistics from studies included in a systematic review?

    Citations and articles in multi-disciplines not found through a Roadrunner search. Used to conduct topic searches as well as find additional resources that have cited a specific resource (citation network).

Web of Knowledge provides access to current and retrospective bibliographic information, author abstracts, and cited references in social science journals that cover more than 50 disciplines. Note there is no full-text within this database.

To include systematic reviews in your Web of Knowledge search results, enter your topic keyword on the top line for Topic. On the second line, type “systematic review” and change the drop-down box to Title (as shown below).
 

What technique is used to combine the statistics from studies included in a systematic review?

Additional Resources

  • Journals
  • Websites
  • Articles & Books
  • Tutorials & Guides

  • Campbell Systematic Reviews

    Bimonthly peer-reviewed publication with follows structured guidelines and standards for summarizing the international research evidence on the effects of interventions in crime and justice, education, international development, and social welfare.

  • Systematic Reviews

    Browse articles covering systematic review products, review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modeling. (2012-present)

  • Systematic Reviews in Pharmacy

    Journal provides full length reviews related to different subjects in pharmacy and that are of broad readership interest to users in industry, academia, and government. (2010-present)

  • Center for Evidence-Based Crime Policy

    Provides systematic reviews on policing, specifically designed and formatted to appeal to law enforcement practitioners and stakeholders.

  • Center for Evidence-Based Dentistry

    The American Dental Association’s collection includes over 2,000 systematic reviews relevant to healthcare in dental settings.

  • DARE (Database of Abstracts of Reviews of Effects)

    Contains details of systematic reviews that evaluate the effects of healthcare interventions and the delivery and organization of health services. DARE also contains reviews of the wider determinants of health such as housing, transport, and social care where these impact directly on health, or have the potential to impact on health.

  • Database of Promoting Health Effectiveness Reviews

    Focused coverage of systematic and non-systematic reviews of effectiveness in health promotion and public health worldwide. This register currently contains details of over 2,500 reviews of health promotion and public health effectiveness.

  • Evidence for Policy and Practice Information and Co-ordinating Centre

    Provides a large number of systematic reviews in the fields of Education, including Initial Teacher Education (ITE), Health Promotion and Public Health, as well as social welfare and international development.

  • Health Evidence

    Provides access to over 3,000 quality-rated systematic reviews evaluating the effectiveness of public health interventions.

  • NREPP Systematic Review Library

    The National Registry of Evidence-based Programs and Practices site provides systematic reviews on topics related to (1) mental health treatment and promotion, and (2) substance abuse treatment and prevention.

  • Nutrition Evidence Library

    The U.S. Department of Agriculture site specializes in conducting systematic reviews to inform Federal nutrition policy and programs.

  • OTseeker

    Contains abstracts of systematic reviews, randomized controlled trials and other resources relevant to occupational therapy interventions.

  • PEDro

    Free database of over 26,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy.

  • Physiotherapy Evidence Database

    Free database of over 25,000 randomized trials, systematic reviews and clinical practice guidelines in physiotherapy.

  • PROSPERO

    International database of over 2,000 prospectively registered systematic reviews in health and social care.

  • PubMed Health

    PubMed Health specializes in systematic reviews of clinical effectiveness research.

  • Trip Database

    Clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

  • Neely, J., Magit, A. E., Rich, J. T., Voelker, C. J., Wang, E. W., Paniello, R. C., & ... Bradley, J. P. (2010). A practical guide to understanding systematic reviews and meta-analyses. Otolaryngology-Head & Neck Surgery, 142(1), 6. doi:10.1016/j.o

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What statistical analysis is used for systematic review?

During the systematic review process, the quality of studies is evaluated, and a statistical meta-analysis of the study results is conducted on the basis of their quality. A meta-analysis is a valid, objective, and scientific method of analyzing and combining different results.

What methods are used in a systematic review?

The steps for implementing a systematic review include (i) correctly formulating the clinical question to answer (PICO), (ii) developing a protocol (inclusion and exclusion criteria), (iii) performing a detailed and broad literature search and (iv) screening the abstracts of the studies identified in the search and ...

Which statistical technique is used for combining the results of many studies on the same subject?

A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting measurements that are expected to have some degree of error.

What is the type of study that uses a statistical technique to combine the results of several to many smaller studies?

Meta-analysis is a statistical method to combine results of different studies, especially those with small sample size or with conflicting results. Meta-analysis is often an important component of systematic reviews.