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Understanding Systematic Reviews

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36 views4 pages

Understanding Systematic Reviews

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KKG
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© All Rights Reserved
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Available Formats
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A brief on Systematic Reviews

( Adapted from Briner and Rousseau,2011)


Systematic reviews are fundamental to
evidence-based practice. As such, much is
written about them in other fields (Gough
et al., 2003; Soukup, 2000; Tranfield,
Denyer, & Smart, 2003). Experience indicates
that it is impossible to fully engage
in evidence-based practice without them:
Such reviews provide one of the four
sources of information required when making
evidence-based decisions. A systematic
review’s purpose would be to search for,
collect, critically appraise, and pull together
research evidence relevant to the causes
and possible solutions to the research problem.

Systematic reviews are literature reviews


that adhere closely to a set of scientific
methods that explicitly aim to limit systematic
error (bias), mainly by attempting
to identify, appraise and synthesize all
relevant studies (of whatever design) in
order to answer a particular question (or
set of questions). In carrying out this task
they set out their methods in advance,
and in detail, as one would for any piece
of social research.
Systematic reviews are, essentially, a
way of analyzing existing research using
explicit and replicable methods, allowing
conclusions to be drawn about what is
known and what is not known in relation
to the review question (and within the
limitations of the method). Similar, but not
identical to the traditional meta-analysis,
systematic reviews are studies of studies.
Meta-analyses are a type of systematic
review but one that uses only quantitative
data and statistical synthesis and focuses
on a question repeatedly addressed in the
same way by researchers rather than a
practice question or problem. As with meta analyses,
systematic reviews are conducted
out of recognition that single empirical
studies, although useful and sometimes
informative, should not be emphasized
because their biases and limitations cannot
be fully accounted for. Looking at all
relevant studies, systematically gathered,
constitutes more reliable evidence.
Thus, in the context of evidence based
practice, neither traditional literature
reviews nor meta-analyses are especially
useful. First, traditional literature reviews
are open to many forms of bias. For
example, reviewers do not make clear how
they have selected the studies they have
included, do not critically appraise them
in an explicit or systematic way, and do
not usually pull them together or synthesize
findings across studies. Second, traditional
reviews do not usually focus on
a specific research, practice question, or
problem. It is this latter point that also
differentiates a systematic review from the
quantitative meta-analysis used traditionally
in I–O psychology. The process of
making evidence-based decisions requires
more focused and tailored reviews of evidence
where both a practice question or
problem and the conditions to which the
evidence might be applied are taken into
account. For example, if the study is on “high absence”
of employees, a systematic review
would attempt to find evidence about the
relative effectiveness of different forms of
absence management interventions given
the current and desired absence rates and
taking into account as much as possible
aspects of the context such as the type of
employees involved, the sector, and the
existing work arrangements and absence
policies. In the context of evidence-based
practice, systematic reviews can take forms
akin to phenomena-oriented evidence or
practice-oriented evidence, depending on
the review questions and their intended
use as well as the kinds of research available.
In evidence-based fields, an important
result of systematic reviews is guidelines for
practice.
Systematic reviews can be useful for
purely academic research purposes too.
We may, for example, be interested in
collecting all available evidence about
absence-management interventions to provide
a more general overview about what
is known, and not known, about the efficacy
of such interventions. In this respect,
a systematic review might differ from the
traditional meta-analysis in that it would
also consider qualitative information and
descriptions, not being limited to effect
sizes alone depending on the review question
(Rousseau, Manning, & Denyer, 2008).
All systematic reviews follow a process of
clearly specified stages. One example of this
process (adapted from Petticrew & Roberts,
2006) contains seven stages.
1. Identify and clearly define the question
the review will address. The question
needs to be sufficiently specific so
that it is clear, in principle, what types
of data would be relevant. Aspects of
the context (e.g., population, sector,
and organizational type), the interventions
(what qualifies as a relevant
intervention?), the mechanisms linking
intervention to outcomes (e.g.,
processes, mediators, and moderators),
and the outcomes themselves
(which data are the outcomes of interest)
are also clearly specified.
16 R.B. Briner and D.M. Rousseau
2. Determine the types of studies and
data that will answer the question.
The criteria used to decide which
studies will be selected or excluded
from the review are identified. For
example, a review that addresses a
causal question might exclude studies
with cross-sectional designs. The aim
is to increase the chances that all
relevant studies are included and all
those that are irrelevant are excluded.
3. Search the literature to locate relevant
studies. A clear search strategy is used
specifying, for example, key words,
the databases to be searched, and
how, and whether unpublished data
will be found and included.
4. Sift through all the retrieved studies to
identify those that meet the inclusion
criteria (and need to be examined
further) and those that do not and
should be excluded. Each study is
examined, usually by two review
team members, and checked against
the inclusion and exclusion criteria.
Where agreement is not possible, a
third reviewer assesses the study. At
this stage, it is not uncommon to find
that only a fraction of the initial pool
of studies can be included.
5. Critically appraise the studies by
assessing the study quality determined
in relation to the review question.
The quality of each study is
critically appraised or evaluated in
relation to the review question as
research quality can only be judged in
relation to the question. Even where
studies meet the inclusion criteria,
they are still likely to vary in terms
of quality. Assessing quality allows
the review conclusions to clearly state
how many of the studies included
were, for example, of very high,
medium, and low quality.
6. Synthesize the findings from the studies.
A key part of any systematic
review is the pulling together of findings
from across the studies to represent
what is known and not known.
Synthesis may be quantitative, qualitative,
or both. Review findings are
often described in terms of the overall
number of studies found, the quality
profile of this group of studies, and
the number of studies that obtained
particular results.
7. Disseminate the review findings. A
full report of a systematic review can
be quite large. In addition, shorter
journal article length versions or even
shorter summaries may be produced.
Dissemination is often planned at the
outset of a systematic review given
the aim is often to inform practice.
The underlying logic of systematic
review is similar to that of many psychological
research methods and is similar
to meta-analyses. Meta-analysis’ exclusive
use of quantitative data and statistical rather
than other forms of synthesis sets it apart
from a systematic review, which often uses
different types of data and different forms
of synthesis. In addition, meta-analyses
can only address questions that have been
addressed many times in more or less the
same way by researchers (e.g., the correlation
between job satisfaction and performance)
rather than questions that arise
from practice problems, where an array of
data types may be required to formulate an
answer.

Common questions

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A systematic review involves seven steps: 1) Identifying and clearly defining the review question to focus on specific data types needed; 2) Determining and stating the studies and data types that will be included to avoid irrelevant data; 3) Conducting a thorough literature search using a clear strategy to ensure comprehensive study retrieval; 4) Sifting and selecting studies based on pre-defined criteria to include only relevant studies; 5) Critically appraising the studies to assess their quality concerning the review question; 6) Synthesizing findings from these studies to summarize the known and unknown; 7) Disseminating findings to ensure they inform practice . Each step is designed to minimize bias by using explicitly defined and replicable methods, ensuring that the conclusions drawn from the review are reliable and applicable .

Synthesizing both qualitative and quantitative data in systematic reviews provides a more holistic understanding of the research topic. Quantitative data offers measurable evidence of relationships or effectiveness, while qualitative data provides deeper insight into contextual variables and experiences that numbers alone cannot capture. This mixed-method approach can lead to more nuanced conclusions about the evidence, allowing conclusions about both what works and why it works, which is crucial for practice-oriented questions . Such comprehensive syntheses can guide more informed decision-making by including diverse types of evidence relevant to different aspects of a question .

Systematic reviews impact guidelines for practice by providing comprehensive, unbiased syntheses of available research that inform best practices. In evidence-based fields, practitioners rely on systematic reviews to discern effective interventions based on aggregated results from numerous studies, overriding limitations of individual studies' biases. This rigorous synthesis aids in formulating evidence-based guidelines that are applicable across various contexts and sectors . By informing practitioners about both the effectiveness and context-specific applicability of interventions, systematic reviews ensure that practice guidelines are not only informed by robust evidence but also tailored to the specific needs of different environments .

In systematic reviews, appraising study quality is a structured process that is directly linked to the review question. Each study is evaluated for its methodological soundness and relevance to the review, using pre-defined criteria, which allows for a transparent assessment of the evidence's reliability . In contrast, traditional literature reviews often lack this level of systematic appraisal, with no standardized criteria to evaluate the inclusion or exclusion of evidence. This absence of critical appraisal processes in traditional reviews increases susceptibility to biases, as inclusion criteria might not be consistently applied across studies . Systematic reviews, by contrast, enhance objectivity and reliability through detailed quality assessments that are explicitly documented .

Systematic reviews differ from traditional literature reviews in several key ways. Traditional literature reviews are often subject to bias since they may not explicitly state their selection criteria, lack a critical appraisal of studies, and generally do not synthesize findings methodically. They tend to be unfocused on a specific research question . In contrast, systematic reviews are designed to minimize bias by using explicit, pre-defined methods to locate, appraise, and synthesize evidence, thus providing reliable evidence for evidence-based decisions . Systematic reviews focus on specific practice questions and solutions, making them more suitable for evidence-based practice since they consider the applicability of evidence to specific contexts, such as different types of employees and sectors . They are structured methodologies aiming to provide comprehensive answers to specified research questions, something not typically achieved by traditional reviews .

A meta-analysis is a subset of systematic reviews focusing solely on quantitative data and statistical synthesis. It answers questions repeatedly investigated in a similar manner, often concerning correlations or relations between variables such as job satisfaction and performance . In contrast, systematic reviews may incorporate both qualitative and quantitative data and different synthesis methods, making them more flexible in addressing practice-oriented questions, which often require diverse data types to formulate comprehensive answers . Systematic reviews are therefore more informative when considering variables like intervention outcomes within specific organizational contexts, something meta-analyses may not account for effectively .

Systematic reviews are essential for evidence-based practice because they consolidate evidence from multiple studies, offering a more comprehensive and reliable basis for decision-making. Single empirical studies are limited by individual biases and methodological weaknesses and do not provide a broad view necessary for general application . Systematic reviews counteract these limitations by synthesizing all relevant studies using explicit methods, which help to assess and integrate the available evidence on a particular issue fully. This comprehensive approach allows practitioners to make well-informed, evidence-based decisions that reflect a robust understanding of the research landscape .

Synthesizing findings in systematic reviews presents several challenges: the diversity of study designs and quality can complicate the synthesis, as data must be integrated without losing the nuances of individual studies. Variability in methodological approaches and interventions across studies further complicates the synthesis, requiring careful consideration to ensure findings are comparable. Moreover, the synthesis process must contend with potential publication bias, as published studies may reflect only positive results, impacting the aggregation's generalizability . Additionally, synthesizing qualitative data requires nuanced interpretation, as it entails contextual and often subjective insights that are not as easily quantified as quantitative data .

Clearly defining the review question in systematic reviews is crucial because it sets the scope and boundaries of the review, ensuring relevance and precise focus on the necessary data. A well-defined question incorporates the context, such as population and sector, types of interventions, mechanisms linking intervention to outcomes, and desired outcomes. This specificity helps to identify relevant studies, refine search strategies, and guide the synthesis process to align with the review's objective . The clarity in question formulation aids in selecting appropriate studies and methods for critical appraisal, thus contributing to reliable and valid conclusions that can directly inform practice .

The dissemination of systematic review findings plays a critical role in evidence-based practice by ensuring that the synthesized evidence reaches practitioners and stakeholders who need it for informed decision-making. It ensures that the extensive analysis and conclusions derived from the systematic reviews are put to practical use. Typical formats for dissemination include comprehensive reports, shorter journal articles, and concise summaries that are tailored to different audiences' needs . Dissemination is often a planned component of a systematic review to maximize its impact and facilitate the evidence's application across various fields, thereby bridging the gap between research and practice .

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