by Erinn Aspinall
Systematic reviews – literature reviews that synthesize the best research on a specific question – are the foundation of evidence-based practice.
Finding the best research to support a systematic review, however, is not as simple as you might think. For this reason, the Bio-Medical Library has launched its new Systematic Review Service, with the goal of helping researchers conduct comprehensive literature searches so they can complete and publish a quality review related to their research interests.
A growing need
There is growing need for systematic review support within the University of Minnesota Academic Health Center. Librarian Judy Stanke first completed literature searches in support of systematic reviews in 2009. Since that time, the Bio-Medical Library staff has seen an increased interest in systematic reviews within the Academic Health Center, conducting over 35 literature searches for systematic reviews in 2013.
It starts with a question
Systematic reviews are based upon a specific research interest, such as Crohn’s disease (an inflammatory bowel disease).
Translating this topic into a focused and searchable question takes careful consideration, effort, and time. Researchers are encouraged to consider framing the question in the PICO format (patients/problem, interventions, comparisons, outcome). Doing so identifies who or what is being studied, what interventions are being compared, and what outcome(s) are used to assess the impact of these interventions.
For a research interest related to Crohn’s disease, an example PICO question that would support a systematic review would be whether corticosteroids are superior to 5-ASA drugs for inducing the remission of Crohn’s disease in the elderly.
Finding articles: a multi-step process
To conduct a systematic review, you would first determine if similar reviews have been conducted. If a current and comprehensive review did not exist, you would have to develop a search strategy to identify relevant articles.
The importance of developing a quality search strategy was made evident to Dr. Stephanie Misono as she worked with librarian Jonathan Koffel on a recently-published systematic review comparing carbon dioxide laser and stapler-assisted endoscopic Zenker’s diverticulotomy (to treat a condition that impacts a person’s ability to swallow).
“The quality of a systematic review is dependent on the quality of the included studies, which in turn highly depends upon the quality of the search strategy,” Misono notes. “I found it extremely helpful to work with a knowledgeable librarian. Doing so allowed us to be confident that our literature review had truly been comprehensive and systematic” she added. “Jonathan helped us develop a formal search strategy that identified more studies than a simple keyword search would have pulled up, thus allowing us to have more data to examine in the review.”
More publishable results in less time
The Bio-Medical librarians are expert searchers of the literature and have the required knowledge to do an inclusive search of multiple databases. They can meet with researchers to discuss their project, recommend databases to search, and develop a search strategy. They can be consulted about reference management and can write the search methodology section of the review.
Perhaps more importantly, Stanke has found that, “Meeting with a librarian in the early phases of a systematic review project will save time and help avoid common errors.” Koffel agrees, adding that following best practices leads to, “better, more publishable systematic reviews with less wasted time and backtracking.”
Dr. Tina Slusher recently worked with Koffel and Stanke to complete a systematic review on severe neonatal jaundice. Through their collaboration, Slusher found that, “Librarians are an essential part of doing a systematic review and should be a part of the team from the first day such a review is planned.” “They are critical to a well done, clinically applicable and timely review,” she said. “They add a valuable piece to the review both during the search process and during the write up.”
The Systematic Review Service has made a positive impact on researchers at the Academic Health Center. Several systematic reviews have been completed with the assistance of Bio-Medical librarians. A wide range of topics is represented by their work. This includes the management of chronic hepatitis B, lactose intolerance, endodontic pain, migraines, and osteoarthritis knee pain. The results of librarian-supported systematic reviews have been published in Annals of Internal Medicine, Lancet, Journal of Clinical Epidemiology, and Journal of General Internal Medicine, among others.
Recommendations for librarian involvement
Both the Institute of Medicine and the Campbell Collaboration (producer of the Cochrane Reviews) recommend the involvement of librarians in the development of a systematic review.
However, the best recommendation for librarian involvement comes from Slusher, who adds, “I only wish I had known just how important a librarian is – and that we had known about you all and what you could offer from the get go.”
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