Results Conclusion The first step is to formulate a research question. This stage forms part of a larger stage of devising the research protocol. The question should be clearly focussed, neither too narrow nor too broad. The acronym PICO has been devised to summarise the four parts a question should take into account the population or patient group studied, the intervention, treatment or test, a comparison or alternative intervention, and the outcome of the intervention see figure 1 for an example The research protocol covers the methods for searching the literature and extracting and analysing the data.
Siston,z PhD, and David C. The role of evidence-based medicine in sports medicine and orthopaedic surgery is rapidly growing.
Systematic reviews and meta-analyses are also proliferating in the medical literature. The steps of a successful systematic review include the following: An outline to understand and conduct a systematic review is provided, and the difference between meta-analyses and systematic reviews is described.
Systematic reviews or meta-analyses critically appraise and formally synthesize the best existing evidence to pro- vide a statement of conclusion that answers specific clinical questions. Readers and reviewers, however, must recognize that the quality and strength of recommendations in a review are only as strong as the quality of studies that it analyzes.
Without advanced education on the topic, the reader may follow the steps discussed herein to perform a systematic review.
Thus, systematic reviews strength of clinical recommendations. When diagnosing and meta-analyses are powerful in their ability to combine and treating patients, practitioners employ evidence-based patient outcomes from distinct, yet similar, trials.
There- guidelines to advocate for or against an intervention. Meta- fore, they have the potential to provide sufficient patient analyses and systematic reviews critically appraise and numbers and generalizable population information to formally synthesize the best existing evidence to provide make more powerful evidence-based conclusions.
The qual- a statement of conclusion that answers specific clinical ity and strength of recommendations in a review are only questions. Conduct of performance of this type of investiga- as strong as the quality of studies that are analyzed.
Harris, MD, The Methodist findings to translation to clinical practice. The authors declared that they have no conflicts of interest in the very useful in that they synthesize and present large bod- authorship and publication of this contribution. The purpose of this review is to provide an outline for a practitioner to properly The American Journal of Sports Medicine, Vol.
Incorporation of PRISMA guidelines in sports medi- cine and orthopaedic surgery literature is being increas- ingly recognized through support and promotion by high- quality publications.
Hierarchy triangle of evidence-based medicine. The Journal of Bone and Joint Surgery, Clin- ical Orthopaedics and Related Research, and Journal of Although commonly used interchangeably, systematic Pediatric Orthopaedics have recently proposed an expecta- reviews and meta-analyses are not the same.
The tion of all authors of systematic reviews or meta-analyses Cochrane Collaboration defines a systematic review as to identify any similar reviews and justify why a new inves- a comprehensive high-level summary of primary research tigation is unique and illustrates different findings than on a specific research question that attempts to identify, prior reviews.
Thus, on February 22,PROSPERO, the online, reviews collate all evidence pertinent to a priori selected free, prospective international systematic review register, criteria for eligibility to address the specific research ques- was launched for any and all health care—related tion.
Additionally, they identify and minimize bias via research. Individual studies are tion is expected to reduce that bias, which preferentially assigned a weight based on the sample size. Familiarity in reading and interpreting a forest plot is essential in understanding the effect of the analyzed treatment s and their magnitudes.
Thus, not all meta-analyses are systematic important answerable clinical question or identify areas of reviews.
Likewise, not all systematic reviews are meta- high clinical importance that are underreported in the med- analyses unless all studies are identified, included, and ana- ical literature. An appropriate question Systematic Reviews and Meta-analyses guidelines and should be original and focused on the precise identification Vol.
According to the PubMed database, over the past 20 years, the number of systematic reviews and meta- analyses has increased each year. A meticulous Figure 3. It is the to generate a final number of studies for analysis in the sys- information within PICOS that establishes the inclusion tematic review.
The highest level of evidence should always be Once the study purpose is identified and an answerable sought. However, important studies that evaluate the clini- question posed, the reviewer must determine the study cal question should not necessarily be excluded to meet the inclusion and exclusion criteria.
Leaving this information out the final number of studies included for analysis. Further, nal validity limits the heterogeneity review external valid- depending on the relevant topic, it may be discovered that ity of the studies in the final analysis.How to Write a Systematic Review lication in a sports medicine journal.
Study Design: Review. Methods: The steps of a successful systematic review include the following: identification of an unanswered answerable ques- lyzed (systematic review) quantitatively (meta-analysis). The QUORUM (Quality of Reporting of Meta-analyses) statement. Systematic reviews and meta-analyses are also proliferating in the medical literature.
Purpose: To provide the outline necessary for a practitioner to properly understand and/or conduct a systematic review for publication in a sports medicine journal. Study Design: Review. Purpose: To provide the outline necessary for a practitioner to properly understand and/or conduct a systematic review for publication in a sports medicine journal.
Study Design: Review. The purpose of this review is to provide an outline for a practitioner to properly The American Journal of Sports Medicine, Vol.
XX, No. X understand and/or conduct a systematic review for publica- DOI: / Ó The Author(s) tion in a sports medicine journal. A systematic review answers a defined research question by collecting and summarising all empirical evidence that fits pre-specified eligibility criteria.
A meta-analysis is the use of statistical methods to summarise the results of these studies. A systematic literature review attempts ‘to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a .