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Systematic Reviews: Step-by-Step

Basic Steps

  1. Assemble a team 
  2. Develop a specific question (PICO)
  3. Specify inclusion/exclusion criteria
  4. Choose a standard (IOM, MECIR)
  5. Develop a protocol (PRISMA-P)
  6. Construct individual search strategies for Medline, Embase, Cochrane, PubMed and any other relevant databases (PsychINFO,, ICTRP, CINAHL, etc.)
  7. Run your searches in all databases on the same day
  8. Search grey literature (association websites, conference proceedings, theses and dissertations, contact researchers in the field) 
  9. Export all citations to a citation manager (EndNote, Rayyan, Covidence, DistillerSR)
  10. De-duplicate records, keeping track of original numbers found, duplicates, and numbers kept after de-duplicating (PRISMA Flow Diagram)
  11. Screen citations by title/abstract using inclusion/exclusion criteria 
  12. Obtain full-text of possibly relevant citations 
  13. Screen citations a second time by full-text. Record reasons for each excluded study. (PRISMA Flow Diagram)
  14. Extract data from studies 
  15. Evaluate the quality (Risk of Bias) of studies (Cochrane's RoB Tool)
  16. Tabulate characteristics of included studies
  17. Extract data and summarize findings 
  18. Write article (PRISMA checklist, IThenticate) 
  19. Update searches if it's been more than 6 months and add relevant studies 
  20. Submit to journal

Time Line

Writing a systematic review often takes more time than many people expect. The Cochrane Collaboration estimates it can take up to a year.