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Systematic Reviews

A guide for researchers beginning a medical systematic review or meta-analysis.

Relevant PRISMA Checklist Items

#8 Selection Process - Specify the methods used to decide whether a study met the inclusion criteria of the review, including how many reviewers screened each record and each report retrieved, whether they worked independently, and if applicable, details of automation tools used in the process.

#9 Study selection - Describe the results of the search and selection process, from the number of records identified in the search to the number of studies included in the review, ideally using a flow diagram. Cite studies that might appear to meet the inclusion criteria, but which were excluded, and explain why they were excluded.

Relevant Chapters from Cochrane Handbook for Systematic Reviews of Interventions

Team Members Involved

Primary responsibility for organizing the results is the role of the librarian, who will deliver results to rest of the team.

Primary responsibility for screening the results for inclusion/exclusion falls to the content experts on the team.

If there is a disagreement about whether a particular study belongs in the analysis, the Tie Breaker makes the call.

Citation Organization & Management

The Librarian will deliver results to the team in the format that they prefer.  A convenient format for reviewing results is the EndNote Citation Management software.  This tool allows for removing duplicates (identical items found in more than one database source), as well as searching and sorting the results and organizing them into folders that can be set up for each exclusion criteria or for further screening.  PDF files can be attached directly to the records in the EndNote library, and the library can be shared with collaborators.  EndNote libraries can be exported as Excel files, if that format is preferred.

The librarian will typically share a folder on the UToledo OneDrive system with the team leader that contains:

  • The EndNote Library with duplicates removed and (some) full text attached.
  • The beginning of a flow diagram showing the number of results retrieved by source, and the number after duplicates are removed.
  • An Excel spreadsheet with all original search strategies for each database searched
  • A Methods section for the final publication, with a sample search strategy in an Appendix


Content experts will review the list of citations (and abstracts) generated by the comprehensive literature search.

An initial screening may be done on the basis of title and abstract alone to exclude items that, while found in the comprehensive search, are clearly not relevant.  These 'false positives' are inevitable when designing a search for comprehensiveness rather than precision.

After this initial screening, remaining studies will need to be looked at in full.  Some full text will already be attached to the EndNote citation, but you can configure EndNote to use OpenURL technology (see the EndNote Libguide) and then use the URL > OpenURL Link to search for full text through the library subscriptions, Google Scholar, or to order through Interlibrary Loan.

At this level of screening, you should note the reasons for exclusion, referring back to the Protocol developed for the review.