systematic literature review synonym

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An overview of methodological approaches in systematic reviews

Prabhakar veginadu.

1 Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo Victoria, Australia

Hanny Calache

2 Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln UK

Akshaya Pandian

3 Department of Orthodontics, Saveetha Dental College, Chennai Tamil Nadu, India

Mohd Masood

Associated data.

APPENDIX B: List of excluded studies with detailed reasons for exclusion

APPENDIX C: Quality assessment of included reviews using AMSTAR 2

The aim of this overview is to identify and collate evidence from existing published systematic review (SR) articles evaluating various methodological approaches used at each stage of an SR.

The search was conducted in five electronic databases from inception to November 2020 and updated in February 2022: MEDLINE, Embase, Web of Science Core Collection, Cochrane Database of Systematic Reviews, and APA PsycINFO. Title and abstract screening were performed in two stages by one reviewer, supported by a second reviewer. Full‐text screening, data extraction, and quality appraisal were performed by two reviewers independently. The quality of the included SRs was assessed using the AMSTAR 2 checklist.

The search retrieved 41,556 unique citations, of which 9 SRs were deemed eligible for inclusion in final synthesis. Included SRs evaluated 24 unique methodological approaches used for defining the review scope and eligibility, literature search, screening, data extraction, and quality appraisal in the SR process. Limited evidence supports the following (a) searching multiple resources (electronic databases, handsearching, and reference lists) to identify relevant literature; (b) excluding non‐English, gray, and unpublished literature, and (c) use of text‐mining approaches during title and abstract screening.

The overview identified limited SR‐level evidence on various methodological approaches currently employed during five of the seven fundamental steps in the SR process, as well as some methodological modifications currently used in expedited SRs. Overall, findings of this overview highlight the dearth of published SRs focused on SR methodologies and this warrants future work in this area.

1. INTRODUCTION

Evidence synthesis is a prerequisite for knowledge translation. 1 A well conducted systematic review (SR), often in conjunction with meta‐analyses (MA) when appropriate, is considered the “gold standard” of methods for synthesizing evidence related to a topic of interest. 2 The central strength of an SR is the transparency of the methods used to systematically search, appraise, and synthesize the available evidence. 3 Several guidelines, developed by various organizations, are available for the conduct of an SR; 4 , 5 , 6 , 7 among these, Cochrane is considered a pioneer in developing rigorous and highly structured methodology for the conduct of SRs. 8 The guidelines developed by these organizations outline seven fundamental steps required in SR process: defining the scope of the review and eligibility criteria, literature searching and retrieval, selecting eligible studies, extracting relevant data, assessing risk of bias (RoB) in included studies, synthesizing results, and assessing certainty of evidence (CoE) and presenting findings. 4 , 5 , 6 , 7

The methodological rigor involved in an SR can require a significant amount of time and resource, which may not always be available. 9 As a result, there has been a proliferation of modifications made to the traditional SR process, such as refining, shortening, bypassing, or omitting one or more steps, 10 , 11 for example, limits on the number and type of databases searched, limits on publication date, language, and types of studies included, and limiting to one reviewer for screening and selection of studies, as opposed to two or more reviewers. 10 , 11 These methodological modifications are made to accommodate the needs of and resource constraints of the reviewers and stakeholders (e.g., organizations, policymakers, health care professionals, and other knowledge users). While such modifications are considered time and resource efficient, they may introduce bias in the review process reducing their usefulness. 5

Substantial research has been conducted examining various approaches used in the standardized SR methodology and their impact on the validity of SR results. There are a number of published reviews examining the approaches or modifications corresponding to single 12 , 13 or multiple steps 14 involved in an SR. However, there is yet to be a comprehensive summary of the SR‐level evidence for all the seven fundamental steps in an SR. Such a holistic evidence synthesis will provide an empirical basis to confirm the validity of current accepted practices in the conduct of SRs. Furthermore, sometimes there is a balance that needs to be achieved between the resource availability and the need to synthesize the evidence in the best way possible, given the constraints. This evidence base will also inform the choice of modifications to be made to the SR methods, as well as the potential impact of these modifications on the SR results. An overview is considered the choice of approach for summarizing existing evidence on a broad topic, directing the reader to evidence, or highlighting the gaps in evidence, where the evidence is derived exclusively from SRs. 15 Therefore, for this review, an overview approach was used to (a) identify and collate evidence from existing published SR articles evaluating various methodological approaches employed in each of the seven fundamental steps of an SR and (b) highlight both the gaps in the current research and the potential areas for future research on the methods employed in SRs.

An a priori protocol was developed for this overview but was not registered with the International Prospective Register of Systematic Reviews (PROSPERO), as the review was primarily methodological in nature and did not meet PROSPERO eligibility criteria for registration. The protocol is available from the corresponding author upon reasonable request. This overview was conducted based on the guidelines for the conduct of overviews as outlined in The Cochrane Handbook. 15 Reporting followed the Preferred Reporting Items for Systematic reviews and Meta‐analyses (PRISMA) statement. 3

2.1. Eligibility criteria

Only published SRs, with or without associated MA, were included in this overview. We adopted the defining characteristics of SRs from The Cochrane Handbook. 5 According to The Cochrane Handbook, a review was considered systematic if it satisfied the following criteria: (a) clearly states the objectives and eligibility criteria for study inclusion; (b) provides reproducible methodology; (c) includes a systematic search to identify all eligible studies; (d) reports assessment of validity of findings of included studies (e.g., RoB assessment of the included studies); (e) systematically presents all the characteristics or findings of the included studies. 5 Reviews that did not meet all of the above criteria were not considered a SR for this study and were excluded. MA‐only articles were included if it was mentioned that the MA was based on an SR.

SRs and/or MA of primary studies evaluating methodological approaches used in defining review scope and study eligibility, literature search, study selection, data extraction, RoB assessment, data synthesis, and CoE assessment and reporting were included. The methodological approaches examined in these SRs and/or MA can also be related to the substeps or elements of these steps; for example, applying limits on date or type of publication are the elements of literature search. Included SRs examined or compared various aspects of a method or methods, and the associated factors, including but not limited to: precision or effectiveness; accuracy or reliability; impact on the SR and/or MA results; reproducibility of an SR steps or bias occurred; time and/or resource efficiency. SRs assessing the methodological quality of SRs (e.g., adherence to reporting guidelines), evaluating techniques for building search strategies or the use of specific database filters (e.g., use of Boolean operators or search filters for randomized controlled trials), examining various tools used for RoB or CoE assessment (e.g., ROBINS vs. Cochrane RoB tool), or evaluating statistical techniques used in meta‐analyses were excluded. 14

2.2. Search

The search for published SRs was performed on the following scientific databases initially from inception to third week of November 2020 and updated in the last week of February 2022: MEDLINE (via Ovid), Embase (via Ovid), Web of Science Core Collection, Cochrane Database of Systematic Reviews, and American Psychological Association (APA) PsycINFO. Search was restricted to English language publications. Following the objectives of this study, study design filters within databases were used to restrict the search to SRs and MA, where available. The reference lists of included SRs were also searched for potentially relevant publications.

The search terms included keywords, truncations, and subject headings for the key concepts in the review question: SRs and/or MA, methods, and evaluation. Some of the terms were adopted from the search strategy used in a previous review by Robson et al., which reviewed primary studies on methodological approaches used in study selection, data extraction, and quality appraisal steps of SR process. 14 Individual search strategies were developed for respective databases by combining the search terms using appropriate proximity and Boolean operators, along with the related subject headings in order to identify SRs and/or MA. 16 , 17 A senior librarian was consulted in the design of the search terms and strategy. Appendix A presents the detailed search strategies for all five databases.

2.3. Study selection and data extraction

Title and abstract screening of references were performed in three steps. First, one reviewer (PV) screened all the titles and excluded obviously irrelevant citations, for example, articles on topics not related to SRs, non‐SR publications (such as randomized controlled trials, observational studies, scoping reviews, etc.). Next, from the remaining citations, a random sample of 200 titles and abstracts were screened against the predefined eligibility criteria by two reviewers (PV and MM), independently, in duplicate. Discrepancies were discussed and resolved by consensus. This step ensured that the responses of the two reviewers were calibrated for consistency in the application of the eligibility criteria in the screening process. Finally, all the remaining titles and abstracts were reviewed by a single “calibrated” reviewer (PV) to identify potential full‐text records. Full‐text screening was performed by at least two authors independently (PV screened all the records, and duplicate assessment was conducted by MM, HC, or MG), with discrepancies resolved via discussions or by consulting a third reviewer.

Data related to review characteristics, results, key findings, and conclusions were extracted by at least two reviewers independently (PV performed data extraction for all the reviews and duplicate extraction was performed by AP, HC, or MG).

2.4. Quality assessment of included reviews

The quality assessment of the included SRs was performed using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews). The tool consists of a 16‐item checklist addressing critical and noncritical domains. 18 For the purpose of this study, the domain related to MA was reclassified from critical to noncritical, as SRs with and without MA were included. The other six critical domains were used according to the tool guidelines. 18 Two reviewers (PV and AP) independently responded to each of the 16 items in the checklist with either “yes,” “partial yes,” or “no.” Based on the interpretations of the critical and noncritical domains, the overall quality of the review was rated as high, moderate, low, or critically low. 18 Disagreements were resolved through discussion or by consulting a third reviewer.

2.5. Data synthesis

To provide an understandable summary of existing evidence syntheses, characteristics of the methods evaluated in the included SRs were examined and key findings were categorized and presented based on the corresponding step in the SR process. The categories of key elements within each step were discussed and agreed by the authors. Results of the included reviews were tabulated and summarized descriptively, along with a discussion on any overlap in the primary studies. 15 No quantitative analyses of the data were performed.

From 41,556 unique citations identified through literature search, 50 full‐text records were reviewed, and nine systematic reviews 14 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 were deemed eligible for inclusion. The flow of studies through the screening process is presented in Figure  1 . A list of excluded studies with reasons can be found in Appendix B .

Study selection flowchart

3.1. Characteristics of included reviews

Table  1 summarizes the characteristics of included SRs. The majority of the included reviews (six of nine) were published after 2010. 14 , 22 , 23 , 24 , 25 , 26 Four of the nine included SRs were Cochrane reviews. 20 , 21 , 22 , 23 The number of databases searched in the reviews ranged from 2 to 14, 2 reviews searched gray literature sources, 24 , 25 and 7 reviews included a supplementary search strategy to identify relevant literature. 14 , 19 , 20 , 21 , 22 , 23 , 26 Three of the included SRs (all Cochrane reviews) included an integrated MA. 20 , 21 , 23

Characteristics of included studies

SR = systematic review; MA = meta‐analysis; RCT = randomized controlled trial; CCT = controlled clinical trial; N/R = not reported.

The included SRs evaluated 24 unique methodological approaches (26 in total) used across five steps in the SR process; 8 SRs evaluated 6 approaches, 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 while 1 review evaluated 18 approaches. 14 Exclusion of gray or unpublished literature 21 , 26 and blinding of reviewers for RoB assessment 14 , 23 were evaluated in two reviews each. Included SRs evaluated methods used in five different steps in the SR process, including methods used in defining the scope of review ( n  = 3), literature search ( n  = 3), study selection ( n  = 2), data extraction ( n  = 1), and RoB assessment ( n  = 2) (Table  2 ).

Summary of findings from review evaluating systematic review methods

There was some overlap in the primary studies evaluated in the included SRs on the same topics: Schmucker et al. 26 and Hopewell et al. 21 ( n  = 4), Hopewell et al. 20 and Crumley et al. 19 ( n  = 30), and Robson et al. 14 and Morissette et al. 23 ( n  = 4). There were no conflicting results between any of the identified SRs on the same topic.

3.2. Methodological quality of included reviews

Overall, the quality of the included reviews was assessed as moderate at best (Table  2 ). The most common critical weakness in the reviews was failure to provide justification for excluding individual studies (four reviews). Detailed quality assessment is provided in Appendix C .

3.3. Evidence on systematic review methods

3.3.1. methods for defining review scope and eligibility.

Two SRs investigated the effect of excluding data obtained from gray or unpublished sources on the pooled effect estimates of MA. 21 , 26 Hopewell et al. 21 reviewed five studies that compared the impact of gray literature on the results of a cohort of MA of RCTs in health care interventions. Gray literature was defined as information published in “print or electronic sources not controlled by commercial or academic publishers.” Findings showed an overall greater treatment effect for published trials than trials reported in gray literature. In a more recent review, Schmucker et al. 26 addressed similar objectives, by investigating gray and unpublished data in medicine. In addition to gray literature, defined similar to the previous review by Hopewell et al., the authors also evaluated unpublished data—defined as “supplemental unpublished data related to published trials, data obtained from the Food and Drug Administration  or other regulatory websites or postmarketing analyses hidden from the public.” The review found that in majority of the MA, excluding gray literature had little or no effect on the pooled effect estimates. The evidence was limited to conclude if the data from gray and unpublished literature had an impact on the conclusions of MA. 26

Morrison et al. 24 examined five studies measuring the effect of excluding non‐English language RCTs on the summary treatment effects of SR‐based MA in various fields of conventional medicine. Although none of the included studies reported major difference in the treatment effect estimates between English only and non‐English inclusive MA, the review found inconsistent evidence regarding the methodological and reporting quality of English and non‐English trials. 24 As such, there might be a risk of introducing “language bias” when excluding non‐English language RCTs. The authors also noted that the numbers of non‐English trials vary across medical specialties, as does the impact of these trials on MA results. Based on these findings, Morrison et al. 24 conclude that literature searches must include non‐English studies when resources and time are available to minimize the risk of introducing “language bias.”

3.3.2. Methods for searching studies

Crumley et al. 19 analyzed recall (also referred to as “sensitivity” by some researchers; defined as “percentage of relevant studies identified by the search”) and precision (defined as “percentage of studies identified by the search that were relevant”) when searching a single resource to identify randomized controlled trials and controlled clinical trials, as opposed to searching multiple resources. The studies included in their review frequently compared a MEDLINE only search with the search involving a combination of other resources. The review found low median recall estimates (median values between 24% and 92%) and very low median precisions (median values between 0% and 49%) for most of the electronic databases when searched singularly. 19 A between‐database comparison, based on the type of search strategy used, showed better recall and precision for complex and Cochrane Highly Sensitive search strategies (CHSSS). In conclusion, the authors emphasize that literature searches for trials in SRs must include multiple sources. 19

In an SR comparing handsearching and electronic database searching, Hopewell et al. 20 found that handsearching retrieved more relevant RCTs (retrieval rate of 92%−100%) than searching in a single electronic database (retrieval rates of 67% for PsycINFO/PsycLIT, 55% for MEDLINE, and 49% for Embase). The retrieval rates varied depending on the quality of handsearching, type of electronic search strategy used (e.g., simple, complex or CHSSS), and type of trial reports searched (e.g., full reports, conference abstracts, etc.). The authors concluded that handsearching was particularly important in identifying full trials published in nonindexed journals and in languages other than English, as well as those published as abstracts and letters. 20

The effectiveness of checking reference lists to retrieve additional relevant studies for an SR was investigated by Horsley et al. 22 The review reported that checking reference lists yielded 2.5%–40% more studies depending on the quality and comprehensiveness of the electronic search used. The authors conclude that there is some evidence, although from poor quality studies, to support use of checking reference lists to supplement database searching. 22

3.3.3. Methods for selecting studies

Three approaches relevant to reviewer characteristics, including number, experience, and blinding of reviewers involved in the screening process were highlighted in an SR by Robson et al. 14 Based on the retrieved evidence, the authors recommended that two independent, experienced, and unblinded reviewers be involved in study selection. 14 A modified approach has also been suggested by the review authors, where one reviewer screens and the other reviewer verifies the list of excluded studies, when the resources are limited. It should be noted however this suggestion is likely based on the authors’ opinion, as there was no evidence related to this from the studies included in the review.

Robson et al. 14 also reported two methods describing the use of technology for screening studies: use of Google Translate for translating languages (for example, German language articles to English) to facilitate screening was considered a viable method, while using two computer monitors for screening did not increase the screening efficiency in SR. Title‐first screening was found to be more efficient than simultaneous screening of titles and abstracts, although the gain in time with the former method was lesser than the latter. Therefore, considering that the search results are routinely exported as titles and abstracts, Robson et al. 14 recommend screening titles and abstracts simultaneously. However, the authors note that these conclusions were based on very limited number (in most instances one study per method) of low‐quality studies. 14

3.3.4. Methods for data extraction

Robson et al. 14 examined three approaches for data extraction relevant to reviewer characteristics, including number, experience, and blinding of reviewers (similar to the study selection step). Although based on limited evidence from a small number of studies, the authors recommended use of two experienced and unblinded reviewers for data extraction. The experience of the reviewers was suggested to be especially important when extracting continuous outcomes (or quantitative) data. However, when the resources are limited, data extraction by one reviewer and a verification of the outcomes data by a second reviewer was recommended.

As for the methods involving use of technology, Robson et al. 14 identified limited evidence on the use of two monitors to improve the data extraction efficiency and computer‐assisted programs for graphical data extraction. However, use of Google Translate for data extraction in non‐English articles was not considered to be viable. 14 In the same review, Robson et al. 14 identified evidence supporting contacting authors for obtaining additional relevant data.

3.3.5. Methods for RoB assessment

Two SRs examined the impact of blinding of reviewers for RoB assessments. 14 , 23 Morissette et al. 23 investigated the mean differences between the blinded and unblinded RoB assessment scores and found inconsistent differences among the included studies providing no definitive conclusions. Similar conclusions were drawn in a more recent review by Robson et al., 14 which included four studies on reviewer blinding for RoB assessment that completely overlapped with Morissette et al. 23

Use of experienced reviewers and provision of additional guidance for RoB assessment were examined by Robson et al. 14 The review concluded that providing intensive training and guidance on assessing studies reporting insufficient data to the reviewers improves RoB assessments. 14 Obtaining additional data related to quality assessment by contacting study authors was also found to help the RoB assessments, although based on limited evidence. When assessing the qualitative or mixed method reviews, Robson et al. 14 recommends the use of a structured RoB tool as opposed to an unstructured tool. No SRs were identified on data synthesis and CoE assessment and reporting steps.

4. DISCUSSION

4.1. summary of findings.

Nine SRs examining 24 unique methods used across five steps in the SR process were identified in this overview. The collective evidence supports some current traditional and modified SR practices, while challenging other approaches. However, the quality of the included reviews was assessed to be moderate at best and in the majority of the included SRs, evidence related to the evaluated methods was obtained from very limited numbers of primary studies. As such, the interpretations from these SRs should be made cautiously.

The evidence gathered from the included SRs corroborate a few current SR approaches. 5 For example, it is important to search multiple resources for identifying relevant trials (RCTs and/or CCTs). The resources must include a combination of electronic database searching, handsearching, and reference lists of retrieved articles. 5 However, no SRs have been identified that evaluated the impact of the number of electronic databases searched. A recent study by Halladay et al. 27 found that articles on therapeutic intervention, retrieved by searching databases other than PubMed (including Embase), contributed only a small amount of information to the MA and also had a minimal impact on the MA results. The authors concluded that when the resources are limited and when large number of studies are expected to be retrieved for the SR or MA, PubMed‐only search can yield reliable results. 27

Findings from the included SRs also reiterate some methodological modifications currently employed to “expedite” the SR process. 10 , 11 For example, excluding non‐English language trials and gray/unpublished trials from MA have been shown to have minimal or no impact on the results of MA. 24 , 26 However, the efficiency of these SR methods, in terms of time and the resources used, have not been evaluated in the included SRs. 24 , 26 Of the SRs included, only two have focused on the aspect of efficiency 14 , 25 ; O'Mara‐Eves et al. 25 report some evidence to support the use of text‐mining approaches for title and abstract screening in order to increase the rate of screening. Moreover, only one included SR 14 considered primary studies that evaluated reliability (inter‐ or intra‐reviewer consistency) and accuracy (validity when compared against a “gold standard” method) of the SR methods. This can be attributed to the limited number of primary studies that evaluated these outcomes when evaluating the SR methods. 14 Lack of outcome measures related to reliability, accuracy, and efficiency precludes making definitive recommendations on the use of these methods/modifications. Future research studies must focus on these outcomes.

Some evaluated methods may be relevant to multiple steps; for example, exclusions based on publication status (gray/unpublished literature) and language of publication (non‐English language studies) can be outlined in the a priori eligibility criteria or can be incorporated as search limits in the search strategy. SRs included in this overview focused on the effect of study exclusions on pooled treatment effect estimates or MA conclusions. Excluding studies from the search results, after conducting a comprehensive search, based on different eligibility criteria may yield different results when compared to the results obtained when limiting the search itself. 28 Further studies are required to examine this aspect.

Although we acknowledge the lack of standardized quality assessment tools for methodological study designs, we adhered to the Cochrane criteria for identifying SRs in this overview. This was done to ensure consistency in the quality of the included evidence. As a result, we excluded three reviews that did not provide any form of discussion on the quality of the included studies. The methods investigated in these reviews concern supplementary search, 29 data extraction, 12 and screening. 13 However, methods reported in two of these three reviews, by Mathes et al. 12 and Waffenschmidt et al., 13 have also been examined in the SR by Robson et al., 14 which was included in this overview; in most instances (with the exception of one study included in Mathes et al. 12 and Waffenschmidt et al. 13 each), the studies examined in these excluded reviews overlapped with those in the SR by Robson et al. 14

One of the key gaps in the knowledge observed in this overview was the dearth of SRs on the methods used in the data synthesis component of SR. Narrative and quantitative syntheses are the two most commonly used approaches for synthesizing data in evidence synthesis. 5 There are some published studies on the proposed indications and implications of these two approaches. 30 , 31 These studies found that both data synthesis methods produced comparable results and have their own advantages, suggesting that the choice of the method must be based on the purpose of the review. 31 With increasing number of “expedited” SR approaches (so called “rapid reviews”) avoiding MA, 10 , 11 further research studies are warranted in this area to determine the impact of the type of data synthesis on the results of the SR.

4.2. Implications for future research

The findings of this overview highlight several areas of paucity in primary research and evidence synthesis on SR methods. First, no SRs were identified on methods used in two important components of the SR process, including data synthesis and CoE and reporting. As for the included SRs, a limited number of evaluation studies have been identified for several methods. This indicates that further research is required to corroborate many of the methods recommended in current SR guidelines. 4 , 5 , 6 , 7 Second, some SRs evaluated the impact of methods on the results of quantitative synthesis and MA conclusions. Future research studies must also focus on the interpretations of SR results. 28 , 32 Finally, most of the included SRs were conducted on specific topics related to the field of health care, limiting the generalizability of the findings to other areas. It is important that future research studies evaluating evidence syntheses broaden the objectives and include studies on different topics within the field of health care.

4.3. Strengths and limitations

To our knowledge, this is the first overview summarizing current evidence from SRs and MA on different methodological approaches used in several fundamental steps in SR conduct. The overview methodology followed well established guidelines and strict criteria defined for the inclusion of SRs.

There are several limitations related to the nature of the included reviews. Evidence for most of the methods investigated in the included reviews was derived from a limited number of primary studies. Also, the majority of the included SRs may be considered outdated as they were published (or last updated) more than 5 years ago 33 ; only three of the nine SRs have been published in the last 5 years. 14 , 25 , 26 Therefore, important and recent evidence related to these topics may not have been included. Substantial numbers of included SRs were conducted in the field of health, which may limit the generalizability of the findings. Some method evaluations in the included SRs focused on quantitative analyses components and MA conclusions only. As such, the applicability of these findings to SR more broadly is still unclear. 28 Considering the methodological nature of our overview, limiting the inclusion of SRs according to the Cochrane criteria might have resulted in missing some relevant evidence from those reviews without a quality assessment component. 12 , 13 , 29 Although the included SRs performed some form of quality appraisal of the included studies, most of them did not use a standardized RoB tool, which may impact the confidence in their conclusions. Due to the type of outcome measures used for the method evaluations in the primary studies and the included SRs, some of the identified methods have not been validated against a reference standard.

Some limitations in the overview process must be noted. While our literature search was exhaustive covering five bibliographic databases and supplementary search of reference lists, no gray sources or other evidence resources were searched. Also, the search was primarily conducted in health databases, which might have resulted in missing SRs published in other fields. Moreover, only English language SRs were included for feasibility. As the literature search retrieved large number of citations (i.e., 41,556), the title and abstract screening was performed by a single reviewer, calibrated for consistency in the screening process by another reviewer, owing to time and resource limitations. These might have potentially resulted in some errors when retrieving and selecting relevant SRs. The SR methods were grouped based on key elements of each recommended SR step, as agreed by the authors. This categorization pertains to the identified set of methods and should be considered subjective.

5. CONCLUSIONS

This overview identified limited SR‐level evidence on various methodological approaches currently employed during five of the seven fundamental steps in the SR process. Limited evidence was also identified on some methodological modifications currently used to expedite the SR process. Overall, findings highlight the dearth of SRs on SR methodologies, warranting further work to confirm several current recommendations on conventional and expedited SR processes.

CONFLICT OF INTEREST

The authors declare no conflicts of interest.

Supporting information

APPENDIX A: Detailed search strategies

ACKNOWLEDGMENTS

The first author is supported by a La Trobe University Full Fee Research Scholarship and a Graduate Research Scholarship.

Open Access Funding provided by La Trobe University.

Veginadu P, Calache H, Gussy M, Pandian A, Masood M. An overview of methodological approaches in systematic reviews . J Evid Based Med . 2022; 15 :39–54. 10.1111/jebm.12468 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

📋 SLR Template

A Systematic Literature Review (SLR) template is a structured framework used for conducting and documenting a systematic review of existing research studies on a specific topic or research question. Systematic literature reviews are commonly used in academic and research settings to provide a comprehensive and unbiased summary of the available literature on a particular subject. Here's a template for conducting a systematic literature review:

Systematic Literature Review (SLR) Template

Provide a clear and descriptive title for your systematic literature review.

2. Objective:

State the main research question or objectives of the systematic literature review.

3. Inclusion and Exclusion Criteria:

Define the criteria for selecting and excluding studies. This may include criteria related to publication date, study design, geographic location, and relevance to the research question.

4. Search Strategy:

Describe the search strategy used to identify relevant studies, including databases searched, search terms, and any filters or limits applied.

5. Study Selection Process:

Outline the process for screening and selecting studies, including how duplicates were handled and the number of reviewers involved.

6. Data Extraction:

Specify the data extraction process, including the data items collected from each selected study (e.g., author, publication year, study design, key findings).

7. Quality Assessment:

Explain how the quality or risk of bias of the included studies was assessed (e.g., using quality assessment tools or scales).

8. Data Synthesis:

Describe how the data from the selected studies were synthesized and analyzed. This may include narrative synthesis, meta-analysis, or thematic analysis.

9. Results:

Present the main findings of the systematic literature review, including key themes, trends, and conclusions drawn from the included studies.

10. Discussion: - Interpret the results in the context of the research question and objectives. Discuss the implications of the findings and any limitations of the review.

11. Conclusion: - Summarize the main contributions of the systematic literature review and provide recommendations for future research or practice.

12. References: - List all the studies included in the systematic literature review following a consistent citation style (e.g., APA, MLA).

13. Appendices: - Include any supplementary materials, such as flowcharts of the study selection process or data extraction forms.

14. Acknowledgments: - If applicable, acknowledge individuals or organizations that provided support or assistance during the review process.

This template can serve as a guide for conducting and documenting a systematic literature review in a structured and transparent manner. Adapt it to your specific research topic and requirements, and ensure that your systematic literature review adheres to established guidelines and best practices in the field.

Last updated 1 year ago

Systematic Reviews and Other Evidence Synthesis Types Guide

• Systematic Review and Other Evidence Synthesis Types
• Types of Evidence Synthesis
• Evidence Synthesis Comparison
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• UT Southwestern Evidence Synthesis Services
• Task 1 - Find Articles
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• Evidence Synthesis - Search (Task 5)
• Screen and Appraise (Tasks 6 – 11)
• Synthesize (Tasks 12 – 15)
• Write Up Review (Task 16)

Systematic Review or Meta-Analysis

• Integrative Review
• Narrative/Literature Review
• Rapid Review
• Scoping Review
• Umbrella Review

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• Use the Training Request Form .

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• Contact LibAsk Schedule an appointment with UT Southwestern librarians.

• Public Health Systematic Review Guidelines
• Electronic Books

Systematic Review – seeks to systematically search for, appraise and synthesize research evidence on a specific question, often adhering to guidelines on the conduct of a review.

Meta-analysis – a technique that statistically combines the results of quantitative studies to provide a more precise effect of the results. A good systematic review is essential to a meta-analysis of the literature.

Standards (see the Books tab) and guidelines have been developed on how to conduct and report systematic reviews and meta analyses.

Guidelines and Best Practices

• Cochrane Handbook for Systematic Reviews of Interventions, Current Version While this Handbook focuses on systematic reviews of interventions, Cochrane publishes five main types of systematic reviews , and has developed a rigorous approach to the preparation of each of the following: ❖ Effects of interventions ❖ Diagnostic test accuracy ❖ Prognosis ❖ Reviews of reviews (umbrella reviews) ❖ Reviews of methodology Part 3 provides considerations for tackling systematic reviews from different perspectives, such as when thinking about specific populations, or complex interventions, or particular types of outcomes. It comprises the following chapters: 16. Equity 17. Intervention complexity 18. Patient-reported outcomes 19. Adverse effects 20. Economic evidence 21. Qualitative evidence
• MECIR Manual The MECIR Standards present a guide to the conduct of new Cochrane Intervention Reviews, and the planning and conduct of updates. This online version will be kept up to date;a PDF of each section can be generated. All substantive changes will be noted here .
• Campbell Collaboration An international social science research network that produces high quality, open and policy-relevant evidence syntheses, plain language summaries and policy briefs.

Reporting Guidelines

• PRISMA 2020 Statement An evidence-based minimum set of items for reporting in systematic reviews and meta-analyses, PRISMA primarily focuses on the reporting of reviews evaluating the effects of interventions, but can also be used as a basis for reporting systematic reviews with objectives other than evaluating interventions (e.g. evaluating etiology, prevalence, diagnosis or prognosis). The PRISMA 2020 Statement is accompanied by the PRISMA 2020 Explanation and Elaboration paper.
• PRISMA 2020 Checklist The 27 checklist items pertain to the content of a systematic review and meta-analysis, which include the title, abstract, methods, results, discussion and funding. Note: As a member of the ES/SR Team, the UT Southwestern Librarian completes Item 7 (Search Strategy) in the checklist.
• PRISMA Flow Diagram The flow diagram depicts the flow of information through the different phases of a systematic review. It maps out the number of records identified, included and excluded, and the reasons for exclusions. Different templates are available depending on the type of review (new or updated) and sources used to identify studies.
• PRISMA for Searching Published in 2021, the checklist includes 16 reporting items, each of which is detailed with exemplar reporting and rationale. The intent of PRISMA-S is to complement the PRISMA Statement and its extensions by providing a checklist that could be used by interdisciplinary authors, editors, and peer reviewers to verify that each component of a search is completely reported and therefore reproducible. For additional information, refer to the PRISMA for searching statement/exploratory paper .

Protocol Guidelines

• PRISMA for Systematic Review Protocols (PRISMA-P) PRISMA-P, published in 2015, includes a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. The developers note that there are many review types outside of this scope. They recommend that due to the general lack of protocol guidance for other types of reviews, reviewers preparing any type of review protocol make use of PRISMA-P as applicable.

Protocol Registration

• PROSPERO An international prospective register of systematic reviews. Key details from new Cochrane protocols are automatically uploaded into PROSPERO. It is produced by the Centre of Reviews and Dissemination, University of York, United Kingdom.

The Cochrane Library includes:

• Cochrane Database of Systematic Reviews – peer-reviewed systematic reviews and protocols)
• Cochrane Central Register of Controlled Trials (CENTRAL) – reports of randomized and quasi-randomized controlled trials
• Cochrane Clinical Answers (CCAs) – developed to inform point-of-care decision-making each CCA contains a clinical question, a short answer, and relevant outcomes data for the clinician
• JBI Systematic Review Register Members of the JBI Collaboration can register their review titles with JBI via completion of the online Systematic Review Title Registration Form. Once titles become registered with JBI, they are listed on the website. Titles are subsequently removed when the full protocol is publicly available, either published or posted to an accessible website.
• Cumpston, M. S., McKenzie, J. E., Welch, V. A., & Brennan, S. E. (2022). Strengthening systematic reviews in public health: guidance in the Cochrane Handbook for Systematic Reviews of Interventions, 2nd edition. J Public Health (Oxf), 44(4), e588-e592. https://doi.org/10.1093/pubmed/fdac036
• Jackson, N., & Waters, E. (2005). Criteria for the systematic review of health promotion and public health interventions. Health Promotion International, 20(4), 367-374. https://doi.org/10.1093/heapro/dai022
• Thomas, B. H., Ciliska, D., Dobbins, M., & Micucci, S. (2004). A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing, 1(3), 176-184. https://doi.org/10.1111/j.1524-475X.2004.04006.x

3 Should I undertake a scoping review or a systematic review? (Ask JBI) on YouTube (12:43).

Agency for Healthcare Research and Quality

• Training Modules for the Systematic Reviews Methods Guide (Agency for Healthcare Research and Quality)

Campbell Collaboration and the Open Learning Initiative

• Systematic Reviews and Meta-Analysis Open & Free (Carnegie Mellon University) Provides an overview of the steps involved in conducting a systematic (scientific) review of results of multiple quantitative studies.
• Cochrane Collaboration Online Training Includes links to learning resources relevant to systematic reviews and evidence-based medicine
• Cochrane Methodology Learning resources on key areas of Cochrane review methodology.

Joanna Briggs Institute

• JBI SUMARI Knowledge Base

Johns Hopkins University/Coursera

• Introduction to Systematic Review and Meta-Analysis (Johns Hopkins University)

University of North Carolina Health Sciences Library

• Introduction to Conducting a Systematic Review Workshop (University of North Carolina Health Sciences Library) Used with permission from the Systematic Reviews LibGuide developed by the University of North Carolina Health Sciences Library.
• Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., … PRISMA-P Group (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews, 4(1), 1. https://doi.org/10.1186/2046-4053-4-1
• Page, M. J., Moher, D., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., Stewart, L. A., Thomas, J., Tricco, A. C., Welch, V. A., Whiting, P., & McKenzie, J. E. (2021). PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 372, n160. https://doi.org/10.1136/bmj.n160
• Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J., Koffel, J. B., & PRISMA-S Group (2021). PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Systematic reviews, 10(1), 39. https://doi.org/10.1186/s13643-020-01542-z
• Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, the PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2015;349:g7647. https://doi.org/10.1136/bmj.g7647
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Synonyms for Systematic review

384 other terms for systematic review - words and phrases with similar meaning.

• University of Michigan Library
• Research Guides

Evidence Syntheses (Scoping, systematic, & other types of reviews)

• Search Strategy
• Types of Reviews
• Should You Do a Systematic Review?
• Work with a Search Expert
• Evidence in an Evidence Synthesis
• Information Sources

Developing an Answerable Question

Preliminary searching, creating a search strategy, identifying synonyms & related terms, keywords vs. index terms, combining search terms using boolean operators, a sr search strategy, search limits.

• Covidence Review Software
• Selection Process
• Data Collection Process
• Study Risk of Bias Assessment
• Reporting Results
• For Search Professionals

Validated Search Filters

Depending on your topic, you may be able to save time in constructing your search by using specific search filters (also called "hedges") developed & validated by researchers. Validated filters include:

• PubMed’s Clinical Queries &  Health Services Research Queries pages
• Ovid Medline’s Clinical Queries  filters (also documented by McMaster Health Information Research Unit)
• EBSCOhost’s main search page for CINAHL (Clinical Queries category)
• American U of Beirut, esp. for " humans" filters .
• Countway Library of Medicine methodology filters
• InterTASC Information Specialists' Sub-Group (ISSG) Search Filter Resource
• SIGN (Scottish Intercollegiate Guidelines Network) filters page

Why Create a Sensitive Search?

In many literature reviews, you try to balance the sensitivity of the search (how many potentially relevant articles you find) and specificit y (how many definitely relevant articles  you find ), realizing that you will miss some.  In an evidence synthesis, you want a very sensitive search:  you are trying to find all potentially relevant articles.  An evidence synthesis search will:

• contain many synonyms & variants of search terms
• use care in adding search filters
• search multiple resources, databases & grey literature, such as reports & clinical trials.

PICO is a good framework to help clarify your systematic review question.

P -   Patient, Population or Problem: What are the important characteristics of the patients &/or problem?

I -  Intervention:  What you plan to do for the patient or problem?

C -  Comparison: What, if anything, is the alternative to the intervention?

O -  Outcome:  What is the outcome that you would like to measure?

Beyond PICO: the SPIDER tool for qualitative evidence synthesis.

5-SPICE: the application of an original framework for community health worker program design, quality improvement and research agenda setting.

Conducting preliminary, exploratory searching is an important part of any literature review.  While there is often a desire to quickly begin crafting a final search for a review question, spending time on preliminary searches is crucial for your search.

• Determines what others have written on your topic . Has a review already been conducted? If so, how will yours differ?
• Assists in determining search strategies : Reviewing other strategies can help you harvest relevant terminology to create your own structured and sensitive searches.
• Identifies "sample set" of articles: This "sample set" of articles are articles that should appear in the final search. They are also used to validate the final search strategy. 
• Conduct basic searches and examine relevant articles: Looking at terminology in titles and abstracts to identify synonyms, as well as MeSH terms.
• Related Citations : Open relevant records in PubMed and examine related citations
• Citation Tracking:   Take relevant articles and use Scopus or other citation tracking tool to see where it has been recently cited.

Sentinel articles

• Create a subset of articles that should show up in the search, to validate the final search strategy
• https://rmit.libguides.com/c.php?g=724535&p=5191553#s-lg-box-17010012

A well constructed search strategy is the core of your evidence synthesis and will be reported on in the methods section of your paper. The search strategy retrieves the majority of the studies you will assess for eligibility & inclusion. The quality of the search strategy also affects what items may have been missed.  Informationists can be partners in this process.

For an evidence synthesis, it is important to broaden your search to maximize the retrieval of relevant results.

Use keywords:  How other people might describe a topic?

Identify the appropriate index terms (subject headings) for your topic.

• Index terms differ by database (MeSH, or  Medical Subject Headings ,  Emtree terms, Subject headings) are assigned by experts based on the article's content.
• Check the indexing of sentinel articles (3-6 articles that are fundamental to your topic).  Sentinel articles can also be used to  test your search results.

Include spelling variations (e.g., behavior , behaviour).  

Both types of search terms are useful & both should be used in your search.

Keywords help to broaden your results. They will be searched for at least in journal titles, author names, article titles, & article abstracts. They can also be tagged to search all text.

Index/subject terms  help to focus your search appropriately, looking for items that have had a specific term applied by an indexer.

Boolean operators let you combine search terms in specific ways to broaden or narrow your results.

An example of a search string for one concept in a systematic review.

In this example from a PubMed search, [mh] = MeSH &  [tiab] = Title/Abstract, a more focused version of a keyword search.

A typical database search limit allows you to narrow results so that you retrieve articles that are most relevant to your research question. Limit types vary by database & include:

• Article/publication type
• Publication dates

In an evidence synthesis search, you should use care when applying limits, as you may lose articles inadvertently.  For more information, see, Chapter 4: Searching for and selecting studies of the Cochrane Handbook particularly regarding language & format limits in Section 4.4.5 .

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Green product development (GPD): a systematic literature review and future research directions

• Published: 21 September 2024

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• Hafiz Muhammad Usman Khizar 3 ,
• Kinaan Khalid 1 ,
• Safeer Haider 1 &
• Jingbo Yuan 2  

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Over the years, the concept of green product development (GPD) has received immense interest from scholars and practitioners around the globe. This study presents a state-of-the-art research profile and an in-depth review of the literature on GPD. Additionally, this review also critically evaluates existing literature to highlight the gaps and proposes an agenda for future development in the body of knowledge. We utilized the systematic literature review (SLR) technique to identify, select, and review existing research on GPD. In doing so, we employed a hybrid analysis technique: (i) quantitative bibliometric analyses, and (ii) qualitative literature synthesis. Our findings are presented in three main sections, research profiling, literature synthesis, and future research agenda. The research profile of existing literature on GPD is presented in terms of annual scientific production, most relevant journals, affiliations, countries, word-cloud analysis, and thematic mapping. Afterward, we discussed various drivers and barriers of GPD as well as also presented the findings of prior studies regarding the outcomes of GPD at the micro and macro levels. A key contribution of this review is the development of a new framework, Circular Product Development (CPD), for moving forward the academic debate from GPD towards CPD.

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Acknowledgements

This paper was supported by the National Natural Science Foundation of China (Grant Number: 72172094): Humanities and Social Sciences Foundation of the Ministry of Education in China (Grant Number: 21YJC630160); National Social Sciences Foundation Project – Late Funding (Grant Number: 21FGLB050).

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Kinaan Khalid & Safeer Haider

Department of Marketing, School of Management, Shenzhen University, Shenzhen, China

Jingbo Yuan

Human Capital Research Center, United Arab Emirates University, AlAin, UAE

Hafiz Muhammad Usman Khizar

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Khizar, H.M.U., Khalid, K., Haider, S. et al. Green product development (GPD): a systematic literature review and future research directions. Environ Dev Sustain (2024). https://doi.org/10.1007/s10668-024-05404-9

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Received : 20 July 2023

Accepted : 04 September 2024

Published : 21 September 2024

DOI : https://doi.org/10.1007/s10668-024-05404-9

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