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Physician Assistant Systematic Review

Systematic Review Description

Systematic Reviews attempt to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making. (Cochrane Handbook for Systematic Reviews of Interventions, Section 1.2)

 A systematic review focuses on peer-reviewed publications about a specific health problem and use rigorous, standardized methods for selecting and assessing articles. A systematic review may or may not include a meta-analysis, which is a quantitative summary of the results. ( CEBM)

Attempts to answer the following:

  • What is known about the topic?
  • Are there any gaps in the literature?
  • Is there a consensus/debate on the issues? 

Systematic Review vs. Narrative Review

  Traditional Literature Review Systematic Review
The Review Question                  Topics may be broad in scope; the goal of the review may be to place one's own research within the existing body of knowledge, or to gather information that supports a particular viewpoint Starts with a well-defined research question to be answered by the review. Reviews are conducted with the aim of finding all existing evidence in an unbiased, transparent and reproducible way.
Searching for Studies searches may be ad hoc, and based on what the author is already familiar with. Searches are not exhaustive or fully comprehensive.  Attempts are made to find all existing published and unpublished literature on the research question. The process is well-documented and reported. 
Study Selection Often lack clear reasons for why studies were included or excluded from the review.  Reasons for including or excluding studies are explicit and informed by the research question. 
Assessing the Quality Often do not consider study quality or potential biases in study design.  Systematically assess the risk of bias of individual studies and overall quality of the evidence, including sources of heterogeneity between study results. 
Synthesis of Research Conclusions are more qualitative and may not be based on study quality.  Conclusions based on a quality of studies, and provide recommendations for practice or to address knowledge gaps. May include a Meta-analysis which scientifically compares the included studies


Key Characteristics

  • A clearly stated set of objectives with pre-defined criteria for which studies are included
  • An explicit, reproducible search strategy that attempts to identify all studies that would meet the eligibility criteria. 
  • An assessment of the validity f the findings
  • a systematic presentation and synthesis of the characteristics and findings of the included studies. 
  • An assessment of the credibility of the findings
  • A systematic presentation of the findings