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Shimberg Health Sciences Library & Florida Blue Health Knowledge Exchange

Evidence Synthesis / Systematic Reviews

Introductory Step-by-Step Process for Systematic Reviews

Assemble your team. Develop your question. Check if this question has already been answered by a recent, high quality SR.
Establish eligibility criteria. Make a detailed plan, including rationale. Register your protocol.
Identify databases (minimum 3) and search terms needed to find all relevant literature.  Consider meeting with a librarian. Conduct searches including unpublished/grey literature. Record numbers in PRISMA flow chart.
Identify and remove duplicate records Review title/abstract for each record based on criteria (minimum 2 independent reviewers) Obtain full articles for all records that met criteria Review full articles (minimum 2 independent reviewers) to determine studies that will be included in your review Record numbers in PRISMA flow sheet Consider searching references of included studies.
Complete data extraction form for each included study. Minimum two researchers are needed for extraction.
Assess quality of included studies using appropriate validated appraisal tools
Summarize findings and make recommendations.  Consult PRISMA reporting standards and author guidelines of potential journals.

Timeline for a Review

A systematic review is a lengthy process and you should be sure you have the time to commit to the process. Completing the systematic review can take from 12-18 months or more!

It takes time to develop exhaustive and comprehensive searches and additional time to review the results.   Large citation retrievals (many thousand!) are possible depending on the topic.

Estimated timeline for completing a Cochrane systematic review:


          Month                   Activity

           1 – 2                   Preparation of protocol.

           3 – 8                   Searches for published and unpublished studies.

           2 – 3                   Pilot test of eligibility criteria.

           3 – 8                   Inclusion assessments.

           3                        Pilot test of ‘Risk of bias’ assessment.

           3 – 10                 Validity assessments.

           3                        Pilot test of data collection.

           3 – 10                 Data collection.

           3 – 10                 Data entry.

           5 – 11                 Follow up of missing information.

           8 – 10                 Analysis.

           1 – 11                 Preparation of review report.

           12 –                    Keeping the review up-to-date.



Source: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.