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Health (Nursing, Medicine, Allied Health): Literature Reviews

Guide to locating health evidence.

Resources for finding and conducting systematic reviews

"A systematic review is a literature review focused on a research question that tries to identify, appraise, select, and synthesize all high-quality research evidence relevant to that question.

An understanding of systematic reviews and how to implement them in practice is becoming mandatory for all professionals involved in the delivery of health care. However, systematic reviews are not limited to medicine and health fields and are quite common in other sciences where data are collected, published in the literature, and an assessment of methodological quality for a precisely defined subject would be helpful. Other fields where systematic reviews are used include psychology, nursing, public health, occupational therapy, speech therapy, physical therapy, educational research, sociology, and business and management.

In a literature review, we assess the relevance of the published research to the research question. A systematic review takes that a stage further. It employs defined criteria to assess the actual quality of the research itself. The review then goes on to synthesize the findings of the research in order to generate an account of the present state of knowledge about the question. That account is based on the knowledge gained from the research which is considered to be of adequate quality. A systematic review aims to provide an exhaustive summary of current literature relevant to a research question....

Systematic reviews often, but not always, use statistical techniques called meta-analysis to combine results of the eligible studies, or at least use scoring of the levels of evidence depending on the methodology used. A systematic review uses an objective and transparent approach for research synthesis, with the aim of minimizing bias. While many systematic reviews are based on an explicit quantitative meta-analysis of available data, there are also qualitative reviews which adhere to the standards for gathering, analyzing and reporting evidence." 

Byrne, D. (2016). What is a systematic review? Project Planner. 10.4135/9781526408563. Retrieved from Sage Research Methods Online.

 

Additionally, it is possible to limit a set of results to just systematic reviews and/or meta-analyses in the subject-specific bibliographic databases listed below. Often this limit is found as an option in the facet for "methodology" or "article/publication type."

HEALTH SCIENCES

SOCIAL SCIENCES

DIFFERENT TYPES OF REVIEWS

INTEGRATIVE REVIEWS

SCOPING REVIEWS

RAPID REVIEWS

ONLINE TUTORIALS ON HOW TO USE COVIDENCE FROM COCHRANE TRAINING

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Steps, Literature Reviews, Systematic Reviews

Steps*

Tools

Notes and Links

Example

1. Define a Focused Question (consider Population, Intervention, Comparison, Outcome)

PICO Question Help

Define Problem/Patient or Population 
AND 
Intervention  
(do not limit to comparison and outcome, not yet!)

Evaluate review type appropriate for question

What are the effects of the Pilates method for patients with low back pain?

2. Scope the literature for eligible studies. A "scoping search" investigates the breadth and/or depth of the initial question or may identify a gap in the literature.

Eligible studies may come from:

  • Background sources (books, POC tools)
  • Article Databases
  • Trial Registries
  • Grey Lit
  • Cited reference searching
  • Reference Lists

Translate terms to controlled vocabulary of the database, when possible; use keyword searching when necessary.

Combine with AND
Expand synonyms with OR

Download a Boolean worksheet

3. Refine Searchexpand  strategy with synonyms harvested from

  • database thesauri
  • reference lists
  • relevant studies

As you develop a final, reproducible strategy for each database, save strategies in a:

  • shared Google sheet
  • PubMed “My NCBI” 
  • Article database may allow saving a strategy in a personal account

http://guides.nyu.edu/saving 

This is the place where you keep track of a reproducible strategy, the basis for a solid review.

 

Click image to view the beginning of a reproducible search strategy.

Open* and Make a Copy: Literature Search Template 

4. Limit search results, based on defined inclusion/exclusion criteria

 Filtering Help 

database categorical limits, as well as manual filtering of results is often needed

Limit to Article type, e.g.,:  "randomized controlled trial" OR multicenter study
Limit by publication years, age groups, language, etc.

5. Download citations into citation management tool

Citation Managers:

  • Create group for each database total (needed for flow chart)
  • Create combined  set for total
  • De-dupe 
    "combined" set

Example of Zotero collections.

 

6. Abstract, Analyze, Synthesize

  • Migrate citations to data collection/extraction tool
  • Screen Title/Abstracts for inclusion/exclusion
  • Screen and appraise full text for relevance, methods, 
  • Resolve disagreements by consensus

Add team members to Covidence


​Manage settings and rules for screening and extraction

 

 

(screenshot of Covidence)

7. Create flow diagram 

Transfer total numbers of citations from each stage of the review into the flow diagram.


(Navarra et al., 2017)

Click image to view sample flow sheet

8. Report Results

Reporting Guidelines

Organize findings in a review matrix, aka "TOE" (table of evidence)

Sample health sciences review matrix
Click image to view TOE. 
Download template as an excel file.
 

 

 

*Modified from: Cook, D. A., & West, C. P. (2012). Conducting systematic reviews in medical education: a stepwise approach.  Medical Education, 46(10), 943–952.

**Navarra, A.-M. D., Gwadz, M. V., Whittemore, R., Bakken, S. R., Cleland, C. M., Burleson, W., … Melkus, G. D. (2017). Health Technology-Enabled Interventions for Adherence Support and Retention in Care Among US HIV-Infected Adolescents and Young Adults: An Integrative Review. AIDS and Behaviorhttps://doi.org/10.1007/s10461-017-1867-6

Example, Systematic Review:
 
Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RW, Cabral CM, … Costa LO. (2015). Pilates for low back pain. Cochrane Database of Systematic Reviews, (7), N.PAG-N.PAG. Available at: getit.library.nyu.edu/go/9444737?umlaut.institution=NYU

Covidence

Covidence is a web based tool that improves healthcare evidence synthesis by improving the efficiency and experience of creating and maintaining Systematic Reviews.

What are Systematic Reviews?

Access the Cochrane Library via NYU at:

https://arch.library.nyu.edu/databases/proxy/NYU03092

PRISMA Statement Website

PRISMA stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. It is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses.