Dr Jeremy Segrott - public health research ... ymchwil iechyd cyhoeddus
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What systematic reviews have taught me

14/3/2013

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With several colleagues I am working on updating a systematic review of tools and interventions in primary care to reduce vascular risk factors.  It's an interesting study, and it's taught me a lot about the process of actually doing a systematic review.  
We've just reached the end of screening paper titles and abstracts to determine which papers should be included (and the full text reviewed), and which should be excluded, based on our inclusion criteria.

Systematic reviews are, well, systematic.  That makes them hard work.  They need to be well designed with clear research questions, appropriate inclusion/exclusion criteria, and a clear search strategy.  Having support and input from information specialists at SURE has helped us a great deal at various points in the study, and I am lucky to be working with colleagues who know how to design an Access database and other systems we needed.

So much of the work seems to involve screening titles and abstracts, with many papers being excluded for every one paper that is included.  Screening is hard work, with the need to work quickly, accurately and repetitively through hundreds - often thousands of papers.

I've only done a small portion of the screening of the papers.  It was a good experience because when the medical student who has done most of the screening talks about what she's been doing, I think I now have a greater appreciation of just how much she's done, and how hard the process can be sometimes.  It's difficult to achieve sometimes in busy schedules, but maybe it's good for all of us to make sure we get first hand experience of the tasks which we ask students or staff that work with us to do.  

The other thing the process has really brought home to me is that there is a good way and bad way to write a paper abstract.  Some that I read managed to explain complex concepts or procedures in clear and relatively accessible language.  There were others where I had to do some serious detective work to understand what the study was about (though I confess this may be partly my lack of knowledge of medical terminology).  There were many paper abstracts which didn't state clearly where they were conducted (we only include UK-based studies), or the study setting (we are only including studies based in primary care).which made it much harder to decide whether or not to include a paper

So next time I read a systematic review which mentions, almost in passing, how many papers were excluded from the total screened, I think I'll have a far better appreciation of just how much work lies behind .    
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    Jeremy Segrott

    Research Fellow in Public Health

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