One key component of evidence-based medicine is a systematic review (SR). A SR is defined as a summary of research evidence in which bias has been reduced by the systematic identification, appraisal and synthesis of all relevant studies on a specific question according to a predetermined and explicit method. Systematic reviews lead to identification of areas where evidence is lacking, thereby assisting researchers and research funders to chart methodical paths for future primary research. In addition, SRs have an inherent ability to minimise bias in the assessment of existing research and provide a means for policy makers and programme managers to access all available evidence on key questions in a judicious manner. Above all, systematic reviews require fewer resources than most primary research studies. The widespread and ever-increasing application of systematic review methods for the synthesis of data from important or urgent research and clinical questions emphasizes the need for health-care professionals to understand this research design.
Critical Appraisal Tools for Systematic Reviews
Critical appraisal refers to the systematic evaluation of journal articles to assess internal and external validity of published research. Critical appraisal needs to be appropriate for the type of study being systematically evaluated. There are several available tools for conducting critical appraisal. Examples of Critical Appraisal Worksheets can be found on the CEBM website. Even systematic review studies have tools for critical appraisal. Published systematic review does not imply the study and the process was rigorous, reproducible or exhaustive. One of the common tools used for appraising systematic reviews is Assessing the Methodological Quality of Systematic Reviews (AMSTAR).
Registration of a systematic review protocol is a critical step of conducting a SR. Most journals will refuse to publish a non-registered protocol. One popular platform to register a systematic review protocol is PROSPERO. Below are links to 5 PROSPERO registered systematic review protocols affiliated to UCT researchers.
There are benefits to publishing a systematic review protocol. First, peer review process can provide valuable inputs that could enhance the quality of the study. Second, the publication counts as a scientific output that is usually indexed in major databases. Finally, and together with registration, it minimizes the risk of duplication of systematic reviews. Below are links to a selected 5 protocol publications that are affiliated to UCT researchers.
Publication of completed systematic reviews is crucial for the evidence generated to be widely accessible. Ultimately, evidence generated from high quality systematic reviews can be translated to practice. Below are links to a selected 5 systematic review publications that are affiliated to UCT researchers.