Overview

Review Articles
Prof. dr, Mohammad Hakimi, SpOG(K), PhD.
 Review
• Any attempt to synthesize results and
conclusions of 2 or more publications on a
given topic
• Can be grouped into 2 main categories; the
‘traditional’ review and the ‘systematic’
review with major differences between them.

2
 Traditional Reviews
• Traditional reviews provide a broad overview of a
research topic with no clear methodological
approach.
• Information is collected and interpreted
unsystematically with subjective summaries of
findings.
• Authors aim to describe and discuss the literature
from a contextual or theoretical point of view.
• Although the reviews may be conducted by topic
experts, due to preconceived ideas
or conclusions, they could be subject to bias.
 Systematic Reviews
• Systematic reviews are overviews of the
literature undertaken by identifying, critically
appraising and synthesising results of primary
research studies using an explicit,
methodological approach.
• They aim to summarise the best available
evidence on a particular research topic.
 Traditional Reviews vs Systematic Reviews
Traditional reviews
1. Authors One or more authors
usually experts in the topic
of interest
2. Study protocol No study protocol
3. Research Question Broad to specific question,
hypothesis not stated
Systematic reviews
Two or more authors are
involved in good quality
systematic reviews, may
comprise experts in the
different stages of the
review
Written study protocol
which includes details of
the methods to be used
Specific question which
may have all or some of
PICO components
(Population, Intervention,
Comparator, and
Outcome). Hypothesis is
stated
 Traditional Reviews vs Systematic Reviews
Traditional reviews
4. Search strategy No detailed search
strategy, search is probably
conducted using keywords
5. Sources of literature Not usually stated and
non-exhaustive, usually
well-known articles. Prone
to publication bias
6. Selection criteria No specific selection
criteria, usually subjective.
Prone to selection bias
7. Critical appraisal Variable evaluation of
study quality or method
Systematic reviews
Detailed and
comprehensive search
strategy is developed
List of databases, websites
and other sources of
included studies are listed.
Both published and
unpublished literature are
considered
Specific inclusion and
exclusion criteria
Rigorous appraisal of study
quality
 Traditional Reviews vs Systematic Reviews

Traditional reviews Systematic reviews

8. Synthesis Often qualitative synthesis Narrative, quantitative or
of evidence qualitative synthesis
9. Conclusions Sometimes evidence based Conclusions drawn are
but can be influenced by evidence based
author’s personal belief
10. Reproducibility Sometimes evidence based Accurate documentation of
but can be influenced by method means results can
author’s personal belief be reproduced
11. Update Cannot be continuously Systematic reviews can be
updated periodically updated to
include new evidence
 Problem: Retrieval Bias
• A retrieval bias arises if not all available
publications on a subject can be found in a
database.
 Problem: Publication Bias
• The publication bias is a distorted
representation of empirical data on a subject.
 Problem:
Conflict of Interest

• Transparency and objectivity are essential in

scientific research and the peer review process.
• When an investigator, author, editor, or reviewer has
a financial/personal interest or belief that could
affect his/her objectivity, or inappropriately influence
his/her actions, a potential conflict of interest exists.
• Such relationships are also known as dual
commitments, competing interests, or competing
loyalties.

12
 Conflicts of Interest:
Trials Funded by
Pharmaceutical
Companies

Why Olanzapine Beats Quetiapine, Quetiapine

Beats Risperidone, and Risperidone Beats
Olanzapine:
An Exploratory Analysis of Head-to-Head
Comparison Studies of Second Generation
Antipsychotics.
Heres S, Davis J, Maino K, et al. Am J Psychiatry 163: 185-194, February
2006.
 The perils of ‘cherry
picking’ literature to
include in your
literature review

• The work of Linus Pauling (1986), the world

accredited scientist, who wrote a book entitled
How to Live Longer and Feel Better, was later
heavily criticized by academics who undertook
further study into the area.
• In his book, Pauling quoted from a
selection of articles that supported
his opinion that vitamin C contains
properties that are effective
against the common cold.
• This book makes an interesting
and convincing read.
• You have probably heard many
people espouse the virtues of
vitamin C for a variety of ailments.
• At first glance, Pauling’s book
might look like a literature review.
• He cites various studies and
authors and all point to the
positive benefits of vitamin C.
 Knipschild P. Systematic reviews: some
examples. BMJ 1994 309:719–21.

• However, the arguments presented in the book

were challenged some years later by Knipschild
(1994) among others, who undertook a
systematic review of all the evidence surrounding
the effectiveness of vitamin C and came to very
different conclusions.
• He argued that Pauling had not looked
systematically at all the research and had only
selected articles that supported his view, while
apparently ignoring those that did not.
 Lesson Learned
• This example illustrates why such a rigorous
approach is so important because, without it,
your review is likely to be biased.
• This also explains why, when you read a report by
an expert in a particular area, you should
remember that his or her report represents just
an expert view that might not be substantiated by
evidence.
• This is why ‘expert’ opinion is generally not
considered to be a strong form of evidence.
 Grant MJ & Booth A. A typology of reviews: an
analysis of 14 review types and associated
methodologies. Health Info Libr J 2009 26:91–108.

Main Review type:

1. Critical review
2. Literature review
3. Mapping review/systematic map
4. Meta-analysis
5. Mixed studies review/mixed methods
review
 Grant MJ & Booth A. A typology of reviews: an
analysis of 14 review types and associated
methodologies. Health Info Libr J 2009 26:91–108.

Main Review type:

6. Overview
7. Qualitative systematic review/qualitative
evidence synthesis
8. Rapid review
9. Scoping review
10.State-of-the art review
 Grant MJ & Booth A. A typology of reviews: an
analysis of 14 review types and associated
methodologies. Health Info Libr J 2009 26:91–108.

Main Review type:

11.Systematic review
12.Systematic search and review
13.Systematized review
14.Umbrella review
 Integrative Review
• An integrative review is a specific review method
that summarizes past empirical or theoretical
literature to provide a more comprehensive
understanding of a particular phenomenon or
healthcare problem (Broome 1993).
• Well-done integrative reviews present the state
of the science, contribute to theory development,
and have direct applicability to practice and
policy.
 Integrative Review
• The integrative review method is an approach
that allows for the inclusion of diverse
methodologies (i.e. experimental and non-
experimental research) and has the potential to
play a greater role in evidence-based practice.
• However, the complexity inherent in combining
diverse methodologies can contribute to lack of
rigour, inaccuracy, and bias (Beck 1999,
O’Mathuna 2000).
 Integrative Review
• An updated integrative review method has the
potential to allow for diverse primary research
methods to become a greater part of
evidence-based practice initiatives
(Whittemore, 2005).
 Scoping Review
• Scoping studies (or scoping reviews) represent an
increasingly popular approach to reviewing health
research evidence (Davis, Drey, Gould 2009).
• Definitions commonly refer to ‘mapping,’ a process of
summarizing a range of evidence in order to convey
the breadth and depth of a field.
• Scoping studies differ from systematic reviews because
authors do not typically assess the quality of included
studies.
• Scoping studies also differ from narrative or literature
reviews in that the scoping process requires analytical
reinterpretation of the literature.