Five tips for successful systematic reviews

I recently had the pleasure of working alongside a group of Australian Oncologists to prepare a systematic review and a discussion of potential future treatments for hormone receptor positive metastatic breast cancer.

In a rapidly developing area of research such as breast cancer, accuracy and speed of publication are essential to ensure the systematic review is current and relevant to clinical practice at the time of publication. I thought I might share with you how we have been able to achieve this.

Fundamentally, authors with current clinical research and everyday experience with patients provide the foundation for a relevant review. Busy clinicians focussed on furthering patient care may have limited time available for managing the process of developing a systematic review. In our example, I facilitated the process by projecting and communicating project deadlines, working closely with all the authors to share the effort needed to complete each step of the review process around their individual availability and acting as liaison with the lead author for key decision-making.

Along with our statistician, we started to collaborate with the authors when designing the protocol and preparing an outline of the manuscript. Clearly defined eligibility criteria improve the accuracy of search results, however searches can still yield large volumes of studies all of which need to be assessed. At this stage, I first reviewed search results based on the agreed eligibility criteria, expediting the review by the authors. Data extraction from selected studies, can be particularly time-consuming. Again, following the author-defined data needs in the protocol, I conducted initial data extraction, thereby allowing the authors more time to focus on intellectual review of each study when they verified the accuracy of the data I had extracted. Our statistician also came back into the process to help the authors decide how best to present data in the publication.

I now had a clear understanding of the aims of the systematic review, had developed close working relationships with all the authors, and had become familiar with the data and clinical feedback from the authors. The next step, to combine the authors’ collective intellectual contribution and data into a first draft was simplified by having already captured many of their thoughts and ideas. During the drafting process, feedback and further knowledge of changes in the research environment since the start of the project enabled us to enhance the commentary in the review. We were able to rapidly finalise, and the authors approved the manuscript ready for our publication date.

I’d very much like to thank the authors for their ongoing engagement, proactivity and responsiveness throughout the project.

5 tips for successful systematic reviews

1. Be organised. Use Covidence.org or EndNote to organise the results of your literature review.
2. Clearly communicate the project aims. Clear communication helps teams understand what their role is in the project, and when their input is required.
3. Register the project. Before you start, check the PROSPERO Register to make sure your project is not the same as an ongoing project.  If not, register your protocol on PROSPERO.
4. Involve a statistician. A statistician can help decide whether your systematic review is appropriate for meta-analysis, or whether a descriptive review is more appropriate.
5. Be realistic about how long a systematic review takes. Systematic reviews take time – there is a lot of effort put into retrieving and reviewing individual papers.  Allow adequate review time for each step, and clearly communicate with the project team how long each step is expected to take.