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Public Health Nursing: Evidence Based Practice

A guide for the public health nursing classes

What is a Systematic Review

A sytematic review (SR) is a well structured review of literature that focuses on a specific topic while adhering to strict standards.  A well constructed SR identifies, selects, assesses and synthesis  relevant bodies of research in a tightly structured manner.  The goal of the SR is to answer a predertermined specific clinical question (PICO) based on all available information and data and present this answer in a balance and unbiased conclsion.  It is essential the SR be transparent, non-biased, duplicatable and clear in the final report.  SRs must also be "objective, scientifically valid, and consistent."

PICO

P

I

C

O

Patient, Population, or Problem

Intervention

Comparison

Outcome

What are the characteristics of the patient or population

What do you want to do with this patient (e.g. treat, diagnose, observe)?

What is the alternative to the intervention (e.g. placebo, different drug, surgery)?

What are the relevant outcomes (e.g. morbidity, death, complications)?

Data Management

RefWorks is a citation management software that is free to TCU students, faculty and staff. With RefWorks, you can: import references directly from multiple databases; organize and manage references; and format bibliographies and manuscripts.

Data Extraction Tools

AHRQ's Systematic Review Data Repository  The Systematic Review Data Repository (SRDR) is a powerful and easy-to-use tool for the extraction and management of data for systematic review or meta-analysis. It is also an open and searchable archive of systematic reviews and their data.

DistilerSR  DistillerSR is an online application designed specifically for the screening and data extraction phases of a systematic review. Subscription Fee. Additional technical information at: http://www.tectutorials.com/TERDistillerSR.htm

Fundamentals of Systematic Reviews

Step 1:  Initiate the process (develop PICO), organize your team, develop a search strategy that minimizes bias and conflict of interests

Step 2:  Develop the process for literature review:  procedures, keywords

Step 3:  Locate and screen studies for review as per agreed upon procedure

Step 4:  Appraise any bias or conflict of interest in the studies and extract the data for analysis

Step 5:  Summarize findings and asses body of evidence

Step 6:  Prepare final report and proceed with peer review.

Reference:  Eden, J.; Levit, L.; Berg, A.; & Morton, S. (Eds.) (2015).  Finding what worked in health care:  Standards for systematic reviews.  Washington D.C.:  The National Academies Press.  Retrieved from http://www.nap.edu/openbook.php?record_id=13059&page=R1 

Systematic Review Databases