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Systematic Review

Systematic Reviews are an increasingly important publication type for making informed health policy and patient care decisions. They are labor intensive, but synthesize and summarize existing information.

Why would we try to talk you out of doing a systematic review?

Once again, we are not...despite appearances.

We are starting this service to help the UCSF community by clarifying the systematic review process.

Many potential systematic review authors approach us. Within minutes of discussion we realize these authors do not understand what a systematic review is or how much work it takes to produce one. A common scenario we see: Research supervisors or mentors send potential authors (usually students, residents or fellows) to the library with the instruction to get help writing a systematic review. The mentor does not realize they have asked the impossible of their mentee!

Systematic reviews require time. 12-24 months is usual from conception to submission.

Systematic reviews require a team. 4 or more team members are recommended. A principal investigator, a second investigator, a librarian, and someone well-versed in statistics forms the basic team. Ideally the team might have another investigator and someone to coordinate all the moving pieces. Smaller teams are possible, three is the realistic minimum. Two investigators each wearing more than one hat and one librarian. Sometimes an investigator has the time and energy to coordinate. Occasionally one of the investigators is also a statistical guru.

Systematic reviews require enough data to make conclusions. Very new or very specific topics often do not have enough primary research data upon which to base useful conclusions. For those of you who have read Cochrane Reviews you will recognize the all too common bottom line of not enough quality data to make a conclusion and more research is needed. Given the time and effort needed to create a systematic review, questions with the potential to have significant impact on health care quality or cost are preferred.

Still interested?

If so, how do you start with the library? You will need to meet with us for a consultation. That initial consultation will take 60-90 minutes. We would like you to have done some preparation before the meeting. Please complete the form (page 5), we will use that during the consultation. Your answers will help identify weak spots in your plan.

Most Systematic Review authorities recommend formally involving a librarian in the process from the outset. Why? Information literacy research repeatedly shows that information seekers almost universally over-estimate their ability to find the information they need. Health care professionals and researchers are no different. It makes sense. As an example, doctors know medicine and particularly their special areas of interest. They do not have the time and have not had the training to become expert searchers and statisticians. That is not to say it can’t happen but it is not common.

There is increasing belief that librarians should either be paid for their service or be listed as an author on the review.

But that is outrageous! It is just a few database searches, what is the big deal?

There are two main reasons for this idea.

SR experts estimate a librarian will spend 60-100 hours developing a search strategy for a systematic review. Each element of the search is tested extensively in an enormously repetitive process of trial and error. Additional time is spent identifying the best sources in which to search. Finding useful material not included in traditional article databases (grey literature) is also very time consuming. We may also provide input on question formulation, PICO, search term identification, methods section write-up. Some librarians are involved in initial screening of articles as well. Typically, librarians help with getting search results into reference managers and may help with identification and troubleshooting systematic review software as well.

Why do a systematic review? A well done systematic review is a major contribution to the literature.

Why not? The requirements in time and effort are massive. Cochrane estimates one year from conception to completion. This does not including time for review, revision and publication. The time from start to end is likely 18-24 months! You need to assemble a team and they need to commit for the duration. The team ideally is 4 or more and includes, a lead author, at least two reviewers (one of whom can be the lead author), a librarian, and someone expert with statistics (this can be a second role for any qualified member of the team). A smaller team is problematic. The time commitment for a librarian to create the final form of the searches in a systematic review is 60-100 hours. We ask these questions of you because of the time commitment. We have three librarians who can assist with SRs; we do not have the work force to devote 60-100 hours to projects likely to fail.

With that introduction, we would like to have you work through the following questions before the first meeting with one of us.

Qualtrics survey