Systematic reviews are comprehensive, structured reviews of the evidence on therapies or diagnostic tests.
Jan. 27, 2023 − Virtual Workshop
8 a.m. − Noon, via Zoom
- Learn to use the Cochrane methodology and RevMan software to generate a focused question around a clinical topic
- Perform a comprehensive literature search
- Critically appraise published studies, grade the evidence, and pool the quantitative results of studies using meta-analysis
Interactive, hands-on methods will be used to promote effective learning. Resources and tools to perform systematic reviews will be provided.
Mohan Pammi, M.D., Ph.D., MRCPCH
Roger F. Soll, M.D.
Professor, University of Vermont, coordinating editor of Cochrane Neonatal Review Group, and president of Vermont Oxford Network
Prakesh Shah, M.D., MSc, M.B.B.S.
Professor, pediatrician-in-chief, University of Toronto and editor, Cochrane Neonatal Review Group
Mohan Pammi, M.D., Ph.D., MRCPCH
Associate professor, Division of Neonatology, Baylor College of Medicine and Texas Children's Hospital and associate editor, Cochrane Neonatal Review Group
Ganga Gokulakrishnan, M.B.B.S.
Assistant professor, Division of Neonatology, Baylor College of Medicine and Texas Children's Hospital
Nirica Borges, M.D., FAAP, CMQ
Assistant professor, Pediatrics-Critical Care, Baylor College of Medicine
Format: Virtual workshop by zoom with break out sessions for small group discussions. ‘Poll everywhere’ app will be used as needed to gauge audience perceptions and knowledge
Systematic reviews comprise the highest level in the hierarchy of evidence to inform clinical practice. Authors of systematic reviews first generate a protocol with the relevant clinical question, specify objectives, delineate the search strategy to identify all relevant publications and prespecify methodology of the review and meta-analysis, ‘a priori’. Once the protocol is registered with Cochrane or other registries, the review is performed first searching for studies that are eligible for inclusion and performing critical appraisal of included studies. A systematic review may be performed with only qualitative synthesis when meta-analysis, the statistical synthesis of data is not appropriate. Retrieving, appraising, and synthesizing literature, fulfils ACGME core competencies of patient care, medical knowledge and practice-based learning and promotes educational scholarship.
This workshop will enable learners to develop a roadmap for performing a systematic review using Cochrane methodology. The session will lead learners through each of the steps of creation of a protocol and systematic review. Knowledge and skills imparted will relate to formulating the clinical question in PICOT format (Population, Intervention, Comparators, Outcomes and Trial design), crystallizing the objectives of the review, developing a comprehensive search strategy, identifying studies eligible for inclusion in the review using the PRISMA flow diagram, appraising the evidence using accepted methods for evaluating risk of bias, extract data and perform analysis and meta-analysis of relevant data. Participants will learn to present results in summary findings tables, rate the quality of evidence using ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and derive conclusions for clinical practice and research. The workshop will close with a question and answer session and discussion of ideas for participants to perform systematic reviews at their home institutions.
Who Should Participate?
Faculty and trainees at any stage in their career who would like to perform systematic reviews
(8 to 8:10 a.m.)
|Welcome, introductions, icebreaker and review workshop agenda
||Interactive||Identify the diversity of the audience and the current state of knowledge regarding systematic reviews||Mohan Pammi/Roger Soll/Prakesh S Shah
|A roadmap for performing systematic reviews, formulating the PICOT question and stating the review objectives||Didactic/ poll everywhere||Develop a roadmap for a protocol||Roger Soll|
|15 min: (10 min and 5 min comeback)
|Formulate the PICOT question and objectives for a systematic review||Group and discuss
Handouts with sample scenarios for PICOT questions
|In a group , write a PICOT question and objectives for a review you would like to do. Discuss with your group|
(8:50 -9:05 a.m.)
|Why do we need an information specialist to develop the search strategy? and search databases||Didactic video||Ganga Gokulakrishnan and Nirica Borges|
|15 min (9:05- 9:20 a.m.)||How to search?||Didactic video||Amy Sisson, Librarian|
|Appraise studies and risk of bias in included studies||Didactic/poll everywhere||Prakesh S Shah|
|Appraise studies and risk of bias in included studies||Small group activity
Handouts of a study
|Work as a group to appraise risk of bias||Break out session|
(10:05- 10:15 a.m.)
|Get back questions and discussion|
(10:15 to 10:45 a.m.)
|Revman software: Data entry and meta-analysis||Didactic||Mohan Pammi|
|Break -5 mins|
(10:50 to 11:20 a.m.)
|GRADE approach to rate certainty of evidence||Didactic||Roger Soll|
|Discuss results, discussion and conclusions||Large group interactive session||Didactic||Roger Soll/Prakeshkumar Shah/Mohan Pammi/facilitators|
|Final Q & A session- 10 mins
11:50 a.m. to noon
|Development of an action plan for individual reviewers to work at their home institutions
Point to resources that assist in performing a systematic review
Handouts with folders
Roadmap for performing a systematic review
- 5As of evidence-based medicine
- PICOT question and objectives
- How to formulate a good search strategy
- Comprehensive search strategy including databased commonly searched
- PRISMA flow diagram
- GRADE approach to rate certainty of evidence and strength of recommendations
Appraisal of evidence
- Assessing risk of bias in randomized controlled studies
- Template for data extraction
- Types and methods of meta-analyses
- Scoring sheets
- How to conclude well
Action plan to perform systematic reviews