J Korean Med Assoc.  2014 Jan;57(1):49-59. 10.5124/jkma.2014.57.1.49.

An introduction to systematic review

Affiliations
  • 1Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea. ahnhs@korea.ac.kr

Abstract

Systematic review had become one of the important research area in medicine. Systematic review can be demonstrating benefit or harm of an intervention when results of individual studies are inconclusive. While narrative reviews can often include an element of selection bias, systematic reviews typically involve a comprehensive plan and search strategy with the goal of reducing bias by identifying, appraising, and synthesizing all relevant studies on a particular topic and investigation of heterogeneity among included studies. Systematic reviews typically include a meta-analysis component which involves using statistical techniques to synthesize the data from several studies into a single quantitative estimate or summary effect size. Systematic review overcomes the limitation of small sample sizes by pooling results from a number of individual studies to generate a single best estimate. Although systematic reviews are published in academic forums, the Cochrane Collaboration is a widely recognized international and not-for-profit organization that promotes, supports, and disseminates systematic reviews and meta-analyses on the efficacy of interventions in the health care field. Systematic review has become a popular and powerful tool. If rigorously conducted, it is essential for evidence-based decision making in clinical practice as well as on the health policy level.

Keyword

Systematic Review; Meta-analysis; Evidence-based medicine; Medical literature search; Publication bias

MeSH Terms

Bias (Epidemiology)
Cooperative Behavior
Decision Making
Delivery of Health Care
Evidence-Based Medicine
Health Policy
Meta-Analysis as Topic
Population Characteristics
Publication Bias
Sample Size
Selection Bias

Figure

  • Figure 1 Number of systematic reviews (meta-analysis) MEDLINE from 1985 to 2010.

  • Figure 2 Relationship of review studies; narrative review, systematic review, meta-analysis, and individual patient data (IPD) meta-analysis.

  • Figure 3 Example of forest plot; effect of antiviral prophylaxis after kidney transplantation. CI, confidence interval.

  • Figure 4 Example of funnel plot (hypothetical). (A) symmetrical plot in absence of bias. (B) asymmetrical plot in presence of reporting bias.


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