What’s Your Reference Question?
Systematic Reviews Process
I hear quite frequently from various library users “I need to do a systematic review. Can you help me?” The same question is posed to most of the librarians staffing the Public Services areas.
The first step is to clarify what the user understands about a systematic review, in terms of languages to be included, and the number of articles to be retrieved. Often, what is needed is only a relatively complete overview of the English language literature over the last five to ten years for an article.
But not always. A systematic review can be the basis for clinical guideline development, procedural change, or as the foundation for a thesis or dissertation. A recent request for physical therapy management of the multiple sclerosis patient exemplified all of the elements for a systematic review: documentation of the searches performed, years covered, and a detailed understanding of what “physical therapy management” actually entailed. It was quite eye-opening; I had not had occasion to look at all the aspects of care woven into that short phrase.
The requestor explained to me the concepts involved in care – physical assessment, weakness, fatigue, strengthening exercises, skin integrity, gait and balance, assistive devices, sensation disorders, mental fatigue, pain management, motor skills, psychomotor performance, as well as general rehabilitation for the disease.
She provided me with articles which she knew were relevant, giving me the opportunity to check for the subject headings attached to the articles, but also providing a benchmark to check whether my search strategies would retrieve them. I also checked for existing systematic reviews, to use their documented strategies to strengthen mine, as well as using Web of Science to check for articles citing the benchmarked articles and the systematic review.
Once I had the basic strategy for MEDLINE/PubMed, I “translated” the terminology for EMBASE and CINAHL. Different databases use different terminology. For example, in MEDLINE the terminology is “physical therapy modalities”, in EMBASE the term is “physiotherapy”. CINAHL has a far more detailed vocabulary for physical therapy modalities. For example, rather than just decubitus ulcers/prevention and control, diagnosis CINAHL uses (MH “Impaired Skin Integrity (NANDA)”) OR (MH “Risk for Impaired Skin Integrity (NANDA)”) OR (MH “Skin Integrity Alteration (Saba CCC)+”) OR (MH “Skin Integrity Component (Saba CCC)+”) OR (MH “Skin Integrity Impairment Risk (SabaCCC)”) OR (MH “Tissue Integrity: Skin & Mucous Membranes (IowaNOC)”)
Each strategy was saved separately, to provide complete documentation of the searches. This also allows the requestor to update the search at a later date, and gives the requestor a sound understanding of the techniques, so she could explain them if needed. The searches themselves were downloaded into EndNote X4, so duplicates could be removed.
Patricia “Pat” Erwin
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