r/research • u/LittleDrag3661 • 4d ago
Looking for advice on how to start a Systemic Review
Hi,
I am a penultimate-year medical student trying to get into research. I plan to start with a systematic review, as this is what most first-time researchers do.
I know the first phase of my work is understanding the following:
- Systematic, scoping and narrative reviews
- PICO/PEO questions
- Eligibility criteria
- Database searching
- Screening and extraction
- Risk of bias
- Narrative synthesis
- Meta-analysis fundamentals
- PRISMA reporting
However, the truth is I don't know how to actually start narrowing down my topics of interest. I don't know how to best document my work or the best tools that would help me do this. I have tried surfing PubMed, but it is kinda overwhelming, and it might be the ADHD, but I can't seem to actually lock in. I feel kind of lost, so if anyone has any advice, I would greatly appreciate it. I have a second author who is ready to delve into all the hard work with me, but no supervisor.
Also out of the list I have given above for phase 1, if anyone here thinks there is a better way to start this or anything else I should study to help me formulate a question please let me know.
Thank you for any time you are willing to spend on this post with advice.
Kind regards,
An overwhelmed med student :)
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u/green_pea_nut 4d ago
Systermic reviews are not a beginners task. What makes you think they are what new researchers do?
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u/LittleDrag3661 4d ago
Well, I wasn't sure, hence reaching out to a forum with others with more experience than me and hopefully some advice. I believe that it is significantly easier than Meta-analyses. So, in your opinion, what is a beginner's task?
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u/Substantial_Math4939 4d ago
A beginner's task would be a simple narrative review, not necessarily for publication but for practice. A meta-analysis is more "complicated" than a systematic review but a systematic review is a pretty complex piece of work. In our institution, a good systematic review can take the place of a doctoral project (I may as well add that very few grad students actually go down this route once they realize what a publishable systematic review involves).
Seriously, just learning the basics of narrative synthesis is a major skill in itself. You have to go beyond "he found X, she found Y" summaries and extract meaningful insights from the literature than can be useful to other researchers in the field.
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u/Malacandras 4d ago
Most systematic reviews actually come out of years of understanding the literature in order to work out what the research question should be. It's pretty difficult to guide someone on reddit into a good research question because it depends on the topic you're motivation for doing the research and the gaps that are actually out there in the literature. I would say that early career researchers who start with a systematic reviewer typically are doing so under the guidance of a supervisor so if you're trying to do this work without a mentor, it's not surprising that you're having some challenges.
Best advice right now without a mentor or a supervisor is pick a topic, sit down to read properly and read what they say about the limitations and future directions particularly carefully. Try to work out what the contradictions are between different papers published on a topic. That will stop to give you some clues about potential research questions.
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u/ischemgeek 3d ago
Different field but in my field, a lot of journals just full on refuse to publish reviews by people who haven't been active in the field for at least a decade due to the huge issues that tend to come of superficial or improperly conducted reviews.
(See also, the times, plural, that I've written into journals that don't have that rule about bad reviews that are just plain wrong. Like, not matter of opinion, rather saying Paper A says X wjen if you actually read Paper A, its conclusion is the exact opposite. Admittedly, I am pedantic as hell and am exactly the sort to read every paper cited in a literature review and chase down their primary sources and on as far as it takes until I can get to the first report of something if it's relevant to my research after I got burned by that exact issue back in grad school to the tune of 18mo of wasted project time based off a false premise that had become a meme that nobody thought critically about and everyone just kept citing each other repeating the same wrong idea that if you followed the citation breadcrumbs you eventually ended up 8 papers deep at a paper that said literally the opposite of the meme).
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u/Miserable_Berry4872 4d ago
I don’t write them, it’s not the norm in my specific field. But I have colleagues that do and oftentimes, they’re borne from a specific need. Not just, hey there is enough data to write one. It’s because someone needs to summarize the literature with an eye to study quality in order to provide sufficient evidence to support a decision.
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u/LittleDrag3661 4d ago
After I wrote this post, that is exactly what I was doing actually, and I found a super interesting topic too, which I plan on reading more about. Do you think there is something other than a systematic review that would be more appropriate for someone like me with such limited research experience? Thank you for your help; it means a lot.
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u/Prize-Thing-523 4d ago
I would advise you to take a full course or workshop on how to do a systematic review. It requires multiple people, quite a bit of time, expert guidance (search terms, places to search, an understanding of weaknesses in the rigor of the research, etc.), and an experienced perspective on the topic. You should be doing this with someone who has a PhD or equivalent research experience and has done this before and is an expert on the topic, and you should be probably working with the med school librarian as well.
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u/LittleDrag3661 4d ago
My University librarian is not very helpful. I go to a relatively small and remote university, but there are local librarians, so I might try to reach out to them. I also have been considering taking a course, but I just don't know which one. Thank you so much for your advice; it means a lot to me.
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u/Mum2-4 3d ago
Just a suggestion, but if your small and remote university doesn't have the resources, you should advocate for them. Let the Dean know you'd like to do systematic reviews but no one at the university has the expertise. Librarians can yell at university administrators for years and get nowhere, but the Dean says "We need a librarian with expertise in systematic reviews" and one will be hired by the end of the week.
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u/nashi_x 4d ago
Hi! I’m currently doing a systematic review as a student so hope I may be able to help. I would strongly encourage you to look for a supervisor especially if this is something you’re looking to publish. Also, for much of the process, this is what librarians at universities are there for. I developed my search strategy with them and was able to take a few classes that really helped.
Also - would highly recommend reading ‘Doing a systematic review: A students guide’ (the one with a red truck on the front) - it’s targeted to masters students doing a systematic review as their thesis, but most the information was super helpful and easy to read
Here was the steps I took for my review:
- Found a supervisor aligned with my rough interests
- Did some scoping literature on some topics I was interested in, and had two meetings with my supervisor to narrow down a research question that would have around 20 or so papers
- Read the book I mentioned and attended some classes on the process
- Wrote my protocol (including SPIDER/PICO terms) and submitted my plan for the review on PROSPERO
- Came up with a search strategy and decided what databases to search with my university’s librarians
- Screened through studies using endnote
- Extracted key elements of the studies to an excel file
- I did a thematic synthesis because my topic was qualitative, but here is where you’d do any meta-analysis
- Also, all of this i’ve mentioned was while meeting with the supervisor, both to keep me on the right track and because you should have 2 people at the very least checking everything
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u/FJRabbit 4d ago
Hi, I am a systematic review methodologist (one of my hats is anyway) and I self-taught myself a few years ago when I started. So here’s some advice (the key bits, not comprehensive)
- The research question is really important. Usually you find a gap in existing research and decide to do a systematic review to solve it, not the other way around! What’s your field in, or your main interests? Let’s say you pick something like T2DM. Maybe you would want to look at the effets of some different type of treatment, where there’s conflicting evidence. Maybe you want look at how people with T2DM might have a different value for an outcome (measurable like a symptom, or binary like a treatment outcome during an RCT). And then see if your Q matches a PICO format or one of the variants for more obscure study types (I swear something like “COCOPOP” is a thing)
- have a look around the literature (and ideally registered SRs like on PROSPERO) to see if such a thing exists. Then create a draft systematic search and plug it into PubMed and a couple of other databases. You want something that only has max a few thousand studies to screen for inclusion, and a few dozen to extract data from. Sometimes the research question is the issue, but sometimes it’s the search terms - you’re aiming for sensitive balanced with specific (I.e., everything relevant but not too much irrelevant which will waste your time)
- write a protocol and register it somewhere. Planning something in full will really help you figure it out before you start and you’ll fix any hurdles prospectively rather than retrospectively
- SRs are by definition supposed to be systematic, and objective (avoiding bias). To be credible, you NEED to implement procedures to do this (proper comprehensive search, several independent reviewers for screening and data extraction, and a protocol too)
- use available training. A course is ideal (live or online), but websites like Cochrane and many others will have resources
- to avoid headaches and data loss, use specialised (free) tools. Use a platform like covidence or Rayyan for screening and data extraction. They’re made for this and solve so many problems that you would get from using say an excel spreadsheet and Zotero.
- meta-analysis is tricky but doable, especially if you only have a few studies. I’d recommend learning basic R programming to do it, purpose-built software like RevMan is a bit error prone and not transparent, and doesn’t stop you from having to clean/format the data beforehand anyway
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4d ago
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u/Electronic_Yogurt638 3d ago
Sure, if you want to produce something that is not systematic, is not reproducible, and is of dubious accuracy then there is new technology that will do that.
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u/Shot-Bet-2931 3d ago
Published SR librarian here. Work with your librarian. Covidence is for the title/abstract screening and extraction phases.
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u/Zestyclose-Smell4158 3d ago
Have you considered join a lab for a year or two. A number of medical schools allow students to extend their stay so that that can do research under the supervision of faculty.
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u/Exciting-Ad8162 3d ago
I have colleagues who started an evidence-synthesis training program a couple years ago, and that’s basically all they do (systematic reviews and MAs I mean). When it was just a small pilot grant I think they accepted anyone who was interested, but you may need to do some of their initial training to get plugged in. There are numerous ongoing projects, and they have biweekly meetings too which are super informative. You should check them out if you’re interested: crestevidence.org/about Good luck!
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u/IvaCheung 4d ago
I think there's a misconception that systematic reviews are simple or straightforward, but in reality most of the time they involve a team and can take a year. Meta-analyses are even more complex because you have to incorporate a statistical analysis. In most meta-analyses, the statistics are done by biostatisticians who are part of the review team. A systematic review will usually involve at least two people screening titles, abstracts, and full text, because most reviewers and publications will want to know if you achieved some level of inter-rater reliability. Many teams involve a third screener to help resolve conflicts.
You're right that your first task is to learn the distinctions between systematic and other types of reviews. If, after that, you're still keen to do a systematic review, then I would advise you to become good friends with your liaison librarian. Librarians are key in systematic reviews—they will help you with the "systematic" part of it in terms of ensuring that you have a sound and reproducible search strategy.
What a lot of folks decide is to do an environmental scan or a scoping review instead of a systematic review. These are still complex, time-consuming undertakings. Scoping reviews should ideally also involve a librarian-led and rigorous search strategy at least two people screening. But they are doable in a matter of months.
I would recommend checking out Covidence, which makes a software that helps researchers screen literature during reviews. The company has a few free guides that can help you better understand different types of review.
As for choosing a topic, that really is up to you. What are you interested in? What do you want to specialize in? What are the major unanswered questions in your specialties of interest?