Undertaking a systematic review: the road to successful completion

Abstract

The systematic review is an important research method that allows for the critical analysis of the results from a range of existing studies to answer research questions. The findings can be used to inform clinical decisions, as well as the development of protocols and guidelines. The aim of this paper is to explore the steps involved in undertaking a Cochrane systematic review and to encourage more nurses to participate in this world wide collaboration to answer questions that are relevant to nursing practice. The first stage of a review involves initiating a focussed clinical question in which the patient group or problem is identified as are the intervention, comparison and outcome, which will become the focus of study. Each review is guided by a protocol that is subject to peer review and followed by a structured search of the worldwide literature on the subject. Quality assessment and data extraction are done systematically and subject to cross-checking. The results are analysed using statistical methods, including meta-analysis. Publication is electronic in the Cochrane Library and many will also be published in other journals. As with all research, findings should be presented in a way that enables the reader to assess whether the review can be applied to their patient.

Keywords

systematic review,Cochrane reviews,randomised controlled trial,quantitative data,statistical methods,meta-analysis

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References

Armstrong EC (1999) The well-built clinical question: the key to finding the best evidence efficiently . Wis Med J 98: 25 – 28 .

Berragan L (1998) Nursing practice draws upon several different ways of knowing . J Clin Nurs 7: 209 – 217 .

Colland VT (1993) Learning to cope with asthma: a behavioural self-management program for children . Patient Educ Couns 22: 141 – 152 .

Crichton N (2001) Principles of statistical analysis in nursing and healthcare research . The Intern J of Res Method in Nurs and Health Care 9: 4 – 16 .

Dawes M (2005) Formulating a question. In: M Dawes P Davies A Gray J Mant K Seers R Snowball (eds), Evidence-based Practice: A Primer for Health Care Professionals. London : Elsevier Churchill Livingstone .

Dawes M Davies P Gray A Mant J Seers K Snowball R (2005) Evidence-based Practice: A primer for Health Care Professionals. London : Elsevier Churchill Livingstone .

Deter HC Allert G (1983) Group therapy for asthma patients: a concept for the psychosomatic treatment of patients in a medical clinic–a controlled study . Psychother Psychosom 40: 95 – 105 .

Easterbrook PJ Berlin JA Gopalan R Matthews DR (1991) Publication bias in clinical research . Lancet 337: 867 – 872 .

Epstein GN Halper JP Barrett EA Birdsall C McGee M Baron KP (2004) A pilot study of mind-body changes in adults with asthma who practice mental imagery . Altern Ther Health Med 10: 66 – 71 .

10.

Ewer TC Stewart DE (1986) Improvement in bronchial hyper-responsiveness in patients with moderate asthma after treatment with a hypnotic technique: a randomised controlled trial . Br Med J 293: 1129 – 1132 .

11.

Flemming K (2007) The knowledge base for evidence-based nursing. A role for mixed methods ? ANS Adv Nurs Sci 30: 41 – 51 .

12.

Henry M de Rivera JL Gonzalez-Martin IJ Abreu J (1993) Improvement of respiratory function in chronic asthmatic patients with autogenic therapy . J Psychosom Res 37: 265 – 270 .

13.

Hockemeyer J Smyth J (2002) Evaluating the feasibility and efficacy of a self-administered manual-based stress management intervention for individuals with asthma: results from a controlled study . Behav Med 27: 161 – 172 .

14.

Jadad AR Moore RA Carroll D Jenkinson C Reynolds DJ Gavaghan DJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary ? Control Clin Trials 17: 1 – 12 .

15.

Jolliffe JA Rees K Taylor RS Thompson D Oldridge N Ebrahim S (2001) Exercise-based rehabilitation for coronary heart disease . Cochrane Database Syst Rev 1: CD001800 .

16.

Juniper EF Guyatt GH Epstein RS Ferrie PJ Jaeschke R Hiller TK (1992) Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials . Thorax 47: 76 – 83 .

17.

Khan AU Staerk M Bonk C (1973) Role of counter-conditioning in the treatment of asthma . J Asthma Res 11: 57 – 62 .

18.

Khan AU (1977) Effectiveness of biofeedback and counter-conditioning in the treatment of bronchial asthma . J Asthma Res 21: 97 – 104 .

19.

Lehrer PM Hochron SM Mayne T Isenberg S Carlson V Lasoski AM (1994) Relaxation and music therapies for asthma among patients prestabilized on asthma medication . J Behav Med 17: 1 – 24 .

20.

Lehrer P Carr RE Smetankine A Vaschillo E Peper E Porges S (1997) Respiratory sinus arrhythmia versus neck/trapezius EMG and incentive inspirometry biofeedback for asthma: a pilot study . Appl Psychophysiol Biofeedback 22: 95 – 109 .

21.

Lehrer PM Vaschillo E Vaschillo B Lu SE Scardella A Siddique M (2004) Biofeedback treatment for asthma . Chest 126: 352 – 361 .

22.

Payette BA (1977) The effect of EMG biofeedback training on selected physiological and personality variables in the adult asthma patient . Disser Abst Intern 38: 2419 .

23.

Put C van den, BO, Lemaigre, V, Demedts, M, Verleden, G (2003) Evaluation of an individualised asthma programme directed at behavioural change . Eur J Respir Dis 21: 109 – 115 .

24.

http://www.cc-ims.net/RevMan (accessed 1/8/07)

25.

Ross CJ Davis TM MacDonald GF (2005) Cognitive-behavioral treatment combined with asthma education for adults with asthma and coexisting panic disorder . Clin Nurs Res 14: 131 – 157 .

26.

Seers K (2005) Systematic review. In: M Dawes P Davies A Gray J Mant R Snowball (eds), Evidence-based Practice: A Primer for Health Care Professionals. London : Elsevier Churchill Livingston .

27.

Sterne JA Egger M Smith GD (2001) Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis . Br Med J 323: 101 – 105 .

28.

www.cochrane.org/resourses/handbook/glossary.doc (accessed 1/3/06)

29.

www.cochrane.org/reviews/clibintro.htm (accessed 1/3/06)

30.

http://www.cochrane.org/resources/handbook/hbook.htm (accessed 1/3/06)

31.

http://www.cochrane-net.org/openlearning (accessed 1/3/06)

32.

Thompson SG (1994) Why sources of heterogeneity in meta-analysis should be investigated . Br Med J 309: 1351 – 1355 .

33.

Timmins F McCabe C (2005) How to conduct an effective literature search . Nurs Stand 20: 41 – 47 .

34.

Wagaman MJ; (2000) Physiological and psychological effects of various hypnotic suggestions with asthma patients. Disser Abst Intern. 61: 1-B, 185.

35.

Yorke J Fleming S Shuldham C (2005) Psychological interventions for children with asthma . Cochrane Database Syst Rev 4: CD003272 .

36.

Yorke J Shuldham C (2005) Family therapy for chronic asthma in children . Cochrane Database Syst Rev 2: CD000089 .

37.

Yorke J Fleming SL Shuldham CM (2006) Psychological interventions for adults with asthma . Cochrane Database Syst Rev 1: CD002982 .

38.

Yorke J Fleming SL Shuldham C (2007a) Psychological interventions for adults with asthma: A systematic review . Respir Med 101: 1 – 14 .

39.

Yorke J Fleming SL Shuldham C (2007b) A systematic review of psychological interventions for children with asthma . Pediatr Pulmonol 42: 114 – 124 .

40.

ZuWallack RL Haggerty MC Jones P (2004) Clinically meaningful outcomes in patients with chronic obstructive pulmonary disease . Am J Med 117 (Suppl. 12A): 49S – 59S .