My standing recommendation for Inquiry Projects is to consider conducting a systematic review on a topic of interest, which dually serves as preparation for future work and collaboration beyond the project scope. Benefits of a systematic review are that it can be largely self-paced, collaborative, publishable in a peer-reviewed journal and there is medical librarian support available for medical school projects via the health system Library Services team (links below).
Samples of published systematic reviews in other domains are attached. For Systematic Reviews as work products, up to two (2) students can share project/program credit. In addition to the Inquiry Research Mentor collaboration, additional students can partner for authorship credit, with an informal recommendation to cap student author collaborations a total of 3-4 (e.g., 1-2 for project/program credit and 1-2 not for project/program credit).
If it’s helpful to meet for questions or advising, I’m available to meet for office hours. If scheduling time for office hours, it’s the most helpful to send a resume/CV and background information on the data or interest areas a few days prior to meeting to allow for pre-review.
PROSPERO: Systematic review registration (free)
https://www.crd.york.ac.uk/prospero/
BSWH Libraries: Systematic Reviews
https://bswhealth.libguides.com/SystematicReviews
Covidence: Screening and data extraction tool for systematic reviews (access is free via the health system and university services)
As part of the preparation process, I recommend reading 3-10 systematic reviews sourced from journals in your specialty/sub-specialty areas (e.g., neurology, orthopedics). Your project mentor is an ideal source for recommending leading journals in their field. Some examples are below as well. In the meantime, two examples of systematic reviews in critical care topics are included as samples:
Many of these publications are freely accessible via PubMed. Full-text PDFs of publications are provided here for personal use and not for distribution. Publications are posted with the intent to increase accessibility to science.
Short, A., McPeake, J., Andonovic, M., McFee, S., Quasim, T., Leyland, A., . . . MacTavish, P. (2023). Medication-related problems in critical care survivors: a systematic review. European Journal of Hospital Pharmacy, ejhpharm-2023-003715. doi:10.1136/ejhpharm-2023-003715
Tieges, Z., Maclullich, A. M. J., Anand, A., Brookes, C., Cassarino, M., O'connor, M., . . . Galvin, R. (2021). Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. Age & Ageing, 50(3), 733-743. doi:10.1093/ageing/afaa224
Timeline durations and activities vary by project and by team. This is simply an example.
Step 1
Preliminary library search and refinement/selection of topic
Complete by the end of Week 3
- Introduction to primary sources
- Navigate electronic resources with librarian
- Draft and finalize manuscript purpose statement to guide the search. Journals are increasingly requiring (or prefer) pre-registration of the systematic search protocol. PROSPERO is a free platform to pre-register protocols.
- Conduct the literature search (after PROSPERO registration)
- Initial screening of articles returned in the search. Typically this is a 2-step process of screening 1) titles/abstracts; and then 2) full-text reviews. Many teams opt to use an electronic platform (e.g., Covidence, Rayyan) for managing the journal files and 'votes' on inclusion/exclusion for the screening stages.
Step 2
Reading list and preliminary paper outline
Complete by end of Week 6
- Deep analysis of selected articles
- Organize notes by grouping results of the deep analysis. This is nearly always in the form of a Table that will be included in the systematic review manuscript.
Step 3
I recommend reviewing Viglianti 2019 CHEST for practical advice on common team-related aspects and advice on style/framing of manuscript components.
First draft of paper
Complete by end of Week 12
- Synthesize trends and patterns
- Write first draft
Step 4
Revised final draft of paper
Complete by end of Week 15
- Revisions with writing team
- Formatting for submission
- Submission
What information should be included in the study plan section of the project form for initial approval?
I recommend using the PROSPERO registration form to write the study plan section of the initial approval form.
Does a systematic review project require IRB approval?
In most cases, systematic review projects do not require IRB approval because they involve analyzing and synthesizing data from already-published and publicly available studies. There is usually no participant-level individual data collection involved and any meta-analysis is using aggregated/grouped and publicly available data. IRB oversight is generally not needed for systematic reviews or meta-analysis projects. Of note, if your project involves any additional components beyond the review of published literature (e.g., surveys of experts, secondary analysis of unpublished data, or use of identifiable records), then IRB review may be necessary. The IRB, advisors and/or mentors are available to confirm expectations.
After submitting the initial approval form for a systematic review, can the project be modified? For example, by focusing on a different variable or sociodemographic factors?
Yes, but I recommend writing a protocol for the planned systematic review as the first step. I recommend pre-registration with PROSPERO, and their format has specific prompts that help with compiling content in a structured manner.
Our PICO question is [redacted]. We were unsure how to respond to the PROSPERO prompts on risk of bias and study quality assessments. Do you have any recommendations?
As part of the overall preparation process, I recommend reading 3-10 systematic reviews sourced from journals in your specialty/sub-specialty areas (e.g., neurology, orthopedics). Examples of systematic reviews in critical care topics are included on this webpage.
Your project mentor is an ideal source for recommending leading journals in their field. Some examples are below as well.
General Medicine: JAMA, NEJM, The Lancet, BMJ
Internal Medicine: JAMA IM, Journal of Hospital Medicine, Journal of General Internal Medicine
Neurology: Neurology, General Hospital Psychiatry
Critical Care: Americal Journal of Respiratory and Critical Care Medicine, Critical Care Medicine
For the risk of bias questions, those are methods decisions with multiple options. As a first step, I recommend doing a search in PROSPERO for 3-4 similar studies to see examples that others have used. Similarly, I also strongly recommend reading some systematic reviews published in reputable scientific journals in your chose specialty area to gain exposure to how risk of bias and study quality assessments are reported and used.
We also wanted to ask whether the PROSPERO registration needs to be submitted before we begin our article search?
Yes, the PROSPERO registration is designed to be completed prior to the start of the search, though oftentimes people do 'test searches' as they're preparing the PROSPERO registration to help with making decisions on the type of risk of bias tools planned.
Our PICO question is [redacted]. We were hoping for guidance on how best to approach data extraction and organization once we complete our screening using Covidence?
There are tradeoffs and advantages to any approach - to extract and manage data in Covidence vs Excel vs Word, etc. I'm happy to meet via office hours to talk about more specifics or for a Q&A session on the topic of data management for systematic reviews.
Clinical Practice Guidelines (CPG) and systematic reviews are both critical tools in evidence-based medicine, but they serve distinct purposes and differ in their structure, objectives, and applications. Comparison descriptions and examples are provided at Clinical Practice Guidelines.