1. An Introduction to Systematic Reviews Shakila Thangaratinam Professor of Maternal and Perinatal Health Women’s Health Research Unit R & D Director of Women’s Health Barts Health NHS Trust

2. Systematic review What is it?

3. Traditional reviews Search and acquisition of evidence not clear Personal interests of the authors Reliability issues

4. What is a systematic review? Systematic undertaking of a review with a focused research question that tries to identify, appraise, select and synthesise all high quality research evidence relevant to that question.

5. Systematic reviews What is it? Why do we need it?

6. Why do we need Systematic reviews New evidence changes patient management Delay in implementation can harm patient. It is difficult to get evidence when it is needed Knowledge and clinical performance deteriorates with time without an attempt to keep up-to-date Traditional continuing education programs do not improve clinical performance EBM keeps its practitioners up-to date

7. Why do systematic reviews? Support Evidence Based Practice Research Inform clinical policy Publication Personal professional development

8. Systematic reviews Yes Good quality reviews Poor quality reviews No Primary studies Yes Poor quality study Good quality study No Review of reviews Conduct Systematic reviews Design and conduct primary study Survey of practice EBM

9. Systematic reviews What is it? Why do we need it? How to do them?

10. How to do systematic reviews?  Formulate clear clinical questions from our knowledge needs · Search the literature to identify relevant articles ¸ Critically appraise the evidence for its validity and usefulness ¸ Synthesise evidence

11. Workshop Objectives Aim: Familiarisation with Systematic reviews Objectives: – Literature Retrieval – Critical Appraisal of: Therapy and Diagnosis Primary studies and Systematic Reviews – Use of clinically meaningful statistics

12. The systematic review process Formulate research / policy conclusions Search bibliographic databases Identify possible papers from titles/abstracts Retrieve papers Extract data Further selection of primary studies using inclusion criteria Synthesis Formulate research question Design search strategy Quality appraisal