SYSTEMATIC REVIEW it’s all about training

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1. SYSTEMATIC REVIEW RESEARCH TRAINING COURSE A hybrid research platform RESEARCH PIONEER

2. Dr Sami Salahia MBBCh Ain Shams University Hospital Medical Residency- Dermatology – Ain Shams University Hospital Master’s Degree S- Dermatology and Andrology GP DHA [email protected] [phone]

3. Systematic Review and meta-analysis: the complete guide

4. Learning objectives:

5. Evidence-Based medicine “Clinical decisions should rely on Best Available Evidence.” “The integration of Best Research Evidence with Clinical Expertise and Patient Values.” Simple Introduction to Evidence Based Medicine .

6. Evidence Based medicine conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information.

7. EBM Hierarchy

8. SR+MA Cohort CC/CS/CR Expert Opinion RCTs Evidence-Based Medicine Pyramid

9. Clinical Study Design

10. Primary Research studies OBSERVATIONAL INTERVENTIONAL RCTS/NRCTS DIAGNOSTIC Descriptive / Analytical

11. OBSERVATIONAL Descriptive Analytical Cohort Case Control Cross-sectional Case Report/Case Series

12. Secondary Research studies Reviews Secondary Analysis Literature/Narrative/Systematic Reviews Post hoc analysis/ meta-analysis

13. OBSERVATIONAL Descriptive Analytical Cohort Case Control Cross-sectional Case Report/Case Series

14. Case Report Case Series

15. Clinical study design Case Report Rare condition Unexplained condition New symptom for a known disease. A case report describes one patient Case Series report ≥2 cases.

16. Cohort Case Control Cross Sectional Study

17. Cross Sectional Study Describes the prevalence of a disease or a specific condition in the population at one point in time in the defined population. Introduction to Clinical Study Design.

18. COHORT Examines the population at least at two points of the time. In the first point, we classify the population according to exposure to a certain risk factor into “exposed” or “not exposed” while in the second point of the time we classify the population according to the development of the outcome to “positive” and “negative.” Introduction to Clinical Study Design. CAse Control A retrospective, analytical, observational study often based on secondary data in which the proportion of cases with a potential risk factor are compared to the proportion of controls (individuals without the disease). The common association measure for a case-control study is the odds ratio. Most of the cohort studies include a follow-up period to allow for the outcome to develop after exposure to a certain risk factor.

19. Diagnostic Test Accuracy Studies assess the accuracy of a new diagnostic test compared to a reference standard diagnostic test. The term is abbreviated as DTA studies. Introduction to Clinical Study Design.

20. Clinical trials Experiments that are done in clinical research. These studies are designed Patients are exposed to the risk factor intentionally To establish a causative relationship between exposure to a certain risk factor and an outcome. Also, to prove the safety and efficacy of interventions

21. Clinical trials Types According to randomization : randomized vs. non-randomized studies According to the control group : single-arm vs. controlled studies According to phase : phase I, phase II, phase III, and phase IV

22. A comparative clinical trial where patients are allocated to the study groups in a random manner (see later, the random allocation and allocation methods) A comparative clinical trial where patients are NOT allocated to the study groups in a random manner but using a quasi-random method. RCTs Quasi-Experimental Trial

23. Single-arm vs. controlled trials Single-arm study: A study includes one experimental group only Controlled study: A study that includes more than one group (experimental vs. control).

24. is your research topic, it is the wide, less specific –hence less operational- research problem that you are interested in. is your specific, simple and meaningful question that you are interested to find its answer Research question Research Idea Re search Searching for a valid Research Idea.

25. Research Idea Re search

26. Research Databases Books Conferences and Meetings Searching the medical literature

27. Developing a Research Question Participants Intervention Control/Comparison Outcomes 01 02 03 04

28. Evidence-Based Medicine Pyramid

29. What makes a proper literature search? Good keywords Good search strategy Relevant database Searching the Literature.

30. SCOPUS COCHRANE SCIENCE DIRECTS PUBMED OVID WEB OF SCIENCE SEARCHING DATABASES

31. SEARCHING DATABASES

32. MESH Terms Comprehensive database of controlled vocabulary that is used the purpose of indexing journal articles and books in the life sciences; it serves as a thesaurus that Facilitates searching

33. KEYWORD B KEYWORD C KEYWORD A KEYWORD D 1 2 4 3 Participants Intervention Control/Placebo Outcomes

34. Boolean operators ("Lidocaine"[Mesh]) OR "Ropivacaine"[Mesh]) ("Lidocaine"[Mesh]) AND “Dental implant"[Mesh]) (" Dementia "[Mesh])  NOT " alzheimer "[Mesh])

35. Good Clinical Practice (GCP)

36. Systematic review Type of Literature review that uses systematic methods to collect secondary data . Systematic reviews formulate research questions that are broad or narrow in scope and identify and synthesize studies that directly relate to the review question. They are designed to provide a complete, exhaustive summary of current evidence , published and unpublished 1 3 4 2 A B C 5 A B C

37. A review of the evidence on a clearly formulated question that uses systematic and explicit methods to identify select and critically appraise relevant primary research It helps to make clear what is Known and Not Known about the potential benefits and harms of alternative drugs, devices, and other healthcare services. A B Systematic review ? Pre-defined Eligibility Criteria for studies.

38. Types of Systematic Review

39. 01 02 03 04 05 06 07 Steps of SYSTEMATIC REVIEW SEARCHING FOR IDEA AND CHECKING ITS VALIDITY SEARCHING DATABASES SORTING AND FILTERING ARTICLES Screen and select studies Manage data extraction AND QUALITY ASSESSMENT ANALYSIS WRITING THE MANUSCRIPT +

40. Standards for Conducting a Systematic Review. Establish a team with appropriate experience to conduct the systematic review 1 +

41. Who? Participants-population Intervention (surgery or drug) or Exposure to risk factor. INTERVENTION Control group (another drug, placebo, or unexposed group). COMPARISION Outcome OUTCOMES Design a research question using PICO. Study design RCTS,NRCTS?

42. Choose the right topic and recruit the right team members.

43. Register a review with PROSPERO.

44. ENDNOTE INSTALLATION AND PROTOCOL WRITING

45. IDEA TEAM Databases Systematic review Analysis Data Extraction Screening

46. NEW SR +MA PREVIOUS SR+MA RCTS PUBMED PICOTS PICOS PUBMED RCTS PREVIOUS SR+MA NEW SR +MA CHECKING VALIDITY VALIDITY

47. O C I P PARTICIPANTS STUDY DESIGN OUTCOME INTERVENTION COMPARISON PICOS

48. TEAM

49. EXPERT MEMBER BEGINNERS RESEARCH TEAM LEADER 1 2 3 TEAM

50. SCOPUS COCHRANE SCIENCE DIRECTS PUBMED OVID WEB OF SCIENCE SEARCHING DATABASES

51. SEARCHING DATABASES

52. KEYWORD B KEYWORD C KEYWORD A KEYWORD D 1 2 4 3

53. A+B A+B+C A+B+C+D Exporting Data Screening title/abstracts Screening Full texts

54. DATA EXTRACTION BASELINE PRIMARY OUTCOME SECONDARY OUTCOMES QUALITY ASSESSMENT

55. SEARCHING FOR IDEA AND CHECKING ITS VALIDITY (STEP 1)

56. How to search for an idea? And checking for its validity? After designing a research question using PICOS Criteria, you can start working on checking its validity using your browser For example: Participants : Postoperative Dental Pain Intervention : Diclofenac Comparison : Placebo /Control Outcomes : Efficacy/ Safety Study design : Randomised Controlled Trials

57. See Our Ideas Folder

58. Checking for validity

59. Define inclusion and exclusion criteria. Inclusion vs. Exclusion Criteria

60. sAMPLE

61. How to search for an idea? And checking for its validity? After designing a research question using PICOS Criteria, you can start working on checking its validity using your browser For example: Participants : Third Molar Extraction Intervention : Ropivacaine Comparison : Placebo /Control Outcomes : Efficacy/ Safety Study design : Randomised Controlled Trials

62. https://www.ncbi.nlm.nih.gov/

63. Search for research idea+ check its validity

64. SEARCHING DATABASES (STEP 2)

65. SEARCHING DATABASES

66. SORTING AND FILTERING ARTICLES (STEP 3)

67. video

68. SORTING AND FILTERING ARTICLES

69. Screen and select studies (STEP 4)

70. 4.screening title and abstract Choose your topic and try to do it You can make it Only what you need is to focus and work with few tips (as an experienced member and Leader

71. 5.downloading full texts

72. 6.screening full texts