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Systematic Reviews

Reviews: Narrative vs Systematic

From: Pae C. U. (2015). Why Systematic Review rather than Narrative Review?. Psychiatry investigation12(3), 417–419. https://doi.org/10.4306/pi.2015.12.3.417, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/)

Table of main review types characterized by methods used

Reproduced from: Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. 

Health Info Libr J. 2009 Jun;26(2):91-108. doi: 10.1111/j.1471-1842.2009.00848.x. Review. PubMed PMID: 19490148.

Label

Description

Search

Appraisal

Synthesis

Analysis

Critical Review

Aims to demonstrate writer has extensively researched literature and critically evaluated its quality. Goes beyond mere description to include degree of analysis and conceptual innovation. Typically results in hypothesis or model.

Seeks to identify most significant items in the field.

No formal quality assessment. Attempts to evaluate according to contribution.

Typically narrative, perhaps conceptual or chronological.

Significant component: seeks to identify conceptual contribution to embody existing or derive new theory

Literature

review

Generic term: published materials that provide examination of recent or current literature. Can cover wide range of subjects at various levels of completeness and comprehensiveness. May include research findings.

May or may not include comprehensive searching.

May or may not include quality assessment

Typically narrative.

Analysis may be chronological, conceptual, thematic, etc.

Mapping review/

systematic map

Map out and categorize existing literature from which to commission further reviews and/or primary research by identifying gaps in research literature.

Completeness of searching determined by time/scope constraints.

No formal quality assessment.

May be graphical and tabular.

Characterizes quantity and quality of literature, perhaps by study design and other key features. May identify need for primary or secondary research.

Meta-analysis

Technique that statistically combines the results of quantitative studies to provide a more precise effect of the results.

Aims for exhaustive searching. May use funnel plot to assess completeness.

Quality assessment may determine inclusion/exclusion and/or sensitivity analyses.

Graphical and tabular with narrative commentary.

Numerical analysis of measures of effect assuming absence of heterogeneity.

Mixed studies review/mixed methods review

Refers to any combination of methods where one significant component is a literature review (usually systematic). Within a review context it refers to a combination of review approaches for example combining quantitative with qualitative research or outcome with process studies.

Requires either very sensitive search to retrieve all studies or separately conceived quantitative and qualitative strategies.

Requires either a generic appraisal instrument or separate appraisal processes with corresponding checklists

Typically both components will be presented as narrative and in tables. May also employ graphical means of integrating quantitative and qualitative studies.

Analysis may characterize both literatures and look for correlations between characteristics or use gap analysis to identify aspects absent in one literature but missing in the other.

Overview

Generic term: summary of the [medical] literature that attempts to survey the literature and describe its characteristics.

May or may not include comprehensive searching (depends whether systematic overview or not).

May or may not include quality assessment (depends whether systematic overview or not).

Synthesis depends on whether systematic or not. Typically narrative but may include tabular features.

Analysis may be chronological, conceptual, thematic, etc.

Qualitative systematic review/qualitative evidence synthesis

Method for integrating or comparing the findings from qualitative studies. It looks for ‘themes’ or ‘constructs’ that lie in or across individual qualitative studies.

May employ selective or purposive sampling.

Quality assessment typically used to mediate messages not for inclusion/exclusion

Qualitative, narrative synthesis.

Thematic analysis, may include conceptual models.

Rapid review

Assessment of what is already known about a policy or practice issue, by using systematic review methods to search and critically appraise existing research.

Completeness of searching determined by time constraints

Time-limited formal quality assessment

Typically narrative and tabular.

Quantities of literature and overall quality/direction of effect of literature.

Scoping review

Preliminary assessment of potential size and scope of available research literature. Aims to identify nature and extent of research evidence (usually including ongoing research).

Completeness of searching determined by time/scope constraints. May include research in progress.

No formal quality assessment.

Typically tabular with some narrative commentary.

Characterizes quantity and quality of literature, perhaps by study design and other key features. Attempts to specify a viable review.

State-of-the-art review

Tend to address more current matters in contrast to other combined retrospective and current approaches. May offer new perspectives on issue or point out area for further research.

Aims for comprehensive searching of current literature.

No formal quality assessment.

Typically narrative, may have tabular accompaniment.

Current state of knowledge and priorities for future investigation and research.

Systematic review

Seeks to systematically search for, appraise and synthesis research evidence, often adhering to guidelines on the conduct of a review.

Aims for exhaustive, comprehensive searching.

Quality assessment may determine inclusion/exclusion

Typically narrative with tabular accompaniment.

What is known; recommendations for practice. What remains unknown; uncertainty around findings, recommendations for future research.

Systematic search and review

Combines strengths of critical review with a comprehensive search process. Typically addresses broad questions to produce ‘best evidence synthesis’.

Aims for exhaustive, comprehensive searching.

May or may not include quality assessment.

Minimal narrative, tabular summary of studies.

What is known; recommendations for practice. Limitations.

Systematized review

Attempt to include elements of systematic review process while stopping short of systematic review. Typically conducted as postgraduate student assignment.

May or may not include comprehensive searching.

May or may not include quality assessment.

Typically narrative with tabular accompaniment.

What is known; uncertainty around findings; limitations of methodology.

Umbrella review

Specifically refers to review compiling evidence from multiple reviews into one accessible and usable document. Focuses on broad condition or problem for which there are competing interventions and highlights reviews that address these interventions and their results.

Identification of component reviews, but no search for primary studies.

Quality assessment of studies within component reviews and/or of reviews themselves.

Graphical and tabular with narrative commentary.

What is known; recommendations for practice. What remains unknown; recommendations for future research

Types of Systematic Review

Table 1 Types of reviews

From: What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences

Review Type

Aim

Question Format

Question Example

Effectiveness

To evaluate the effectiveness of a certain treatment/practice in terms of its impact on outcomes

Population, Intervention, Comparator/s, Outcomes
(PICO) [23]

What is the effectiveness of exercise for treating depression in adults compared to no treatment or a comparison treatment? [69]

Experiential (Qualitative)

To investigate the experience or meaningfulness of a particular phenomenon

Population, Phenomena of Interest, Context (PICo) [13]

What is the experience of undergoing high technology medical imaging (such as Magnetic Resonance Imaging) in adult patients in high income countries? [70]

Costs/Economic Evaluation

To determine the costs associated with a particular approach/treatment strategy, particularly in terms of cost effectiveness or benefit

Population, Intervention, Comparator/s, Outcomes,
Context (PICOC) [14]

What is the cost effectiveness of self-monitoring of blood glucose in type 2 diabetes mellitus in high income countries? [71]

Prevalence and/or Incidence

To determine the prevalence and/or incidence of a certain condition

Condition, Context,
Population (CoCoPop) [15]

What is the prevalence/incidence of claustrophobia and claustrophobic reactions in adult patients undergoing MRI? [72]

Diagnostic Test Accuracy

To determine how well a diagnostic test works in terms of its sensitivity and specificity for a particular diagnosis

Population, Index Test,
Reference Test, Diagnosis of Interest (PIRD) [16]

What is the diagnostic test accuracy of nutritional tools (such as the Malnutrition Screening Tool) compared to the Patient Generated Subjective Global Assessment amongst patients with colorectal cancer to identify undernutrition? [73]

Etiology and/or Risk

To determine the association between particular exposures/risk factors and outcomes

Population, Exposure,
Outcome (PEO) [17]

Are adults exposed to radon at risk for developing lung cancer? [74]

Expert opinion/policy

To review and synthesize current expert opinion, text or policy on a certain phenomena

Population, Intervention or Phenomena of Interest,
Context (PICo) [18]

What are the policy strategies to reduce maternal mortality in pregnant and birthing women in Cambodia, Thailand, Malaysia and Sri Lanka? [75]

Psychometric

To evaluate the psychometric properties of a certain test, normally to determine how the reliability and validity of a particular test or assessment.

Construct of interest or the name of the measurement instrument(s), Population,
Type of measurement instrument, Measurement properties [3132]

What is the reliability, validity, responsiveness and interpretability of methods (manual muscle testing, isokinetic dynamometry, hand held dynamometry) to assess muscle strength in adults? [76]

Prognostic

To determine the overall prognosis for a condition, the link between specific prognostic factors and an outcome and/or prognostic/prediction models and prognostic tests.

Population, Prognostic Factors (or models of interest), Outcome
(PFO) [2034,35,36]

In adults with low back pain, what is the association between individual recovery expectations and disability outcomes? [77]

Methodology

To examine and investigate current research methods and potentially their impact on research quality.

Types of Studies, Types of Data, Types of Methods, Outcomes [39] (SDMO)

What is the effect of masked (blind) peer review for quantitative studies in terms of the study quality as reported in published reports? (question modified from Jefferson 2007) [40]