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Systematic Reviews: Define question
Overview of systematic review methodology and key strategies for searching and reporting to the Cochrane Collaboration's Gold Standard
The first step of the systematic review process is to develop a clear, well-formed, and focused question. This will make it easier to apply the key concepts in your question to your search and will ultimately make searching for evidence more straightforward.
Watch the video below to learn more about developing a research question.
Does your question have any political implications that may potentially broaden the health inequality? For example, have you explicitly described the effect of the intervention not only on the greater population, but also on disadvantaged groups or/and health inequality within the community?
A GP with a special interest in smoking cessation wants to encourage his practice to engage with teenagers to stop them smoking. In order to persuade his colleagues, he wants to see what evidence is available, particularly on the effectiveness of brief intervention techniques.
PICO is a way of formulating your question and identifying potential search terms to retrieve the best set of results possible.
P stands for patient, population, or problem.
I stands for intervention.
C stands for comparison or control.
O stands for outcome.
Authors use different phrases to describe the same concepts, so it is necessary to think of alternative words to include in your search in order to capture all of the relevant literature.
In the example above, the P element is teenagers. They may also be described as adolescents or young people.
The I element is 'brief intervention'. This can also be called brief advice, brief counseling, or minimal advice.
The O element is smoking cessation, but authors may also refer to patients who stop smoking or quit smoking.
It's not always necessary to use all four arms of the PICO framework. This example does not use a control or comparator.
Bringing all the elements together, we get the following focused question:
Can brief intervention be used as an effective smoking cessation technique with teenagers?
It is important to keep this question in mind at every stage of the search process. It is the key to retrieving a focused set of results for your search.
conduct some scoping searches to help define your concepts and identify additional terminology
check to see if a systematic review has been done before / recently
confirm that there is enough evidence (studies) to answer your question
You need to start with some preliminary (scope-out) searches. This will help you define your concepts, develop, focus and refine your question, and identify additional terminology used in the literature. The locations linked below are a good place to start:
Supports clinical decision-making with evidence-based recommendations. Authored, edited and reviewed by medical practitioners, UpToDate covers thousands of clinical topics grouped into specialties with links to articles, drugs and drug interaction databases, medical calculators and guidelines. Example specialties: allergy and immunology, geriatrics, oncology, pulmonary and critical care medicine.
You can search for existing systematic reviews in the locations linked below:
The Cochrane Library is a collection of six databases that contain different types of high-quality, independent evidence to inform healthcare decision-making, and a seventh database that provides information about groups in The Cochrane Collaboration.
The Joanna Briggs Institute (JBI) is the international not-for-profit, research and development Centre within the Faculty of Health and Medical Sciences at the University of Adelaide, South Australia. It brings together a range of practice-oriented research activities to improve the effectiveness of nursing practice and health care outcomes.
The Campbell Collaboration is an international research network producing systematic reviews of the effects of social interventions in Crime & Justice, Education, International Development, and Social Welfare.
Watch the video below to learn more about preliminary searching and finalising your question:
This chapter provides recommendations for authors on how to determine the scope of the review and the question it will address. It also includes the relevant Methodological Expectations of Cochrane Intervention Reviews (MECIR).