How to Produce a Systematic Review or a Meta Analysis













How to Produce a Systematic Review or a Meta Analysis






Systematic Reviews and Meta-Analyses: A Step-By-Step Guide


Centre for Cognitive Aging and Cognitive Epidemology


“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.”


Step 1: Why do a systematic review?


Step 2: Who will be involved?


Step 3: Formulate the problem. Has it been done before?

Registering your review.


Step 4: Perform your search.


Step 5: Data extraction.


Step 6: Critical appraisal of studies (quality assessment).


Step 7 Data synthesis.


Step 8: Presenting results (writing the report).


Step 9: Archiving and updating.


Useful Resourses:


Useful Lectures:


Lecture 1: Introduction to systematic reviews


Lecture 2: Systematic literature searching


Lecture 3: Systematic review hints and tips


Lecture 3: Introduction to meta-analysis








From Wikipedia




“In statistics, meta-analysis comprises statistical methods for contrasting and combining results from different studies in the hope of identifying patterns among study results, sources of disagreement among those results, or other interesting relationships that may come to light in the context of multiple studies.[1] Meta-analysis can be thought of as "conducting research about previous research." In its simplest form, meta-analysis is done by identifying a common statistical measure that is shared between studies, such as effect size or p-value, and calculating a weighted average of that common measure. This weighting is usually related to the sample sizes of the individual studies, although it can also include other factors, such as study quality.




The motivation of a meta-analysis is to aggregate information in order to achieve a higher statistical power for the measure of interest, as opposed to a less precise measure derived from a single study. In performing a meta-analysis, an investigator must make choices many of which can affect its results, including deciding how to search for studies, selecting studies based on a set of objective criteria, dealing with incomplete data, analyzing the data, and accounting for or choosing not to account for publication bias. [2]




Meta-analyses are often, but not always, important components of a systematic review procedure. For instance, a meta-analysis may be conducted on several clinical trials of a medical treatment, in an effort to obtain a better understanding of how well the treatment works. Here it is convenient to follow the terminology used by the Cochrane Collaboration,[3] and use "meta-analysis" to refer to statistical methods of combining evidence, leaving other aspects of 'research synthesis' or 'evidence synthesis', such as combining information from qualitative studies, for the more general context of systematic reviews.”






1 History

2 Advantages

3 Pitfalls

3.1 Publication bias: the file drawer problem

3.2 Agenda-driven bias

4 Steps in a meta-analysis

5 Methods and assumptions

5.1 Approaches

5.2 Statistical models

5.2.1 Fixed effects model

5.2.2 Random effects model

5.2.3 Quality effects model

5.2.4 IVhet model

6 Applications in modern science

7 See also

8 References

9 Further reading

10 External links

10.1 Software







Systematic Review Methods


The Community Guide


“What is a systematic review?

A systematic review is a review of scientific studies on a specific topic. It uses a formal process to:


Identify all relevant studies

Assess their quality

Summarize the evidence

Why do a systematic review?

Systematic reviews help make sense of large bodies of scientific literature by applying the scientific process to:


Reduce bias in how conclusions are reached

Improve the power and precision of results

Summarize evidence about the effectiveness of particular approaches for addressing a public health problem

Analyze generalizability of findings

Identify knowledge gaps and need for additional research”







Five steps to conducting a systematic review

Khalid S Khan, MB MSc, Regina Kunz, MD MSc,1 Jos Kleijnen, MD PhD,2

and Gerd Antes, PhD3

J R Soc Med. Mar 2003; 96(3): 118–121.

PMCID: PMC539417







Report at a Glance


Standards for Systematic Reviews


Institute of Medicine of the National Academies









Education And Debate


Meta-analysis: Principles and procedures


BMJ 1997; 315 doi:


(Published 06 December 1997)


Cite this as: BMJ 1997;315:1533



Observational study of evidence

Standardised outcome measure

Statistical methods for calculating overall effect

Bayesian meta-analysis

Heterogeneity between study results

Graphic display

Relative and absolute measures of effect

Sensitivity analysis








About Cochrane Systematic Reviews And Protocols


“What is a systematic review?


A systematic review attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making. (See Section 1.2 in the Cochrane Handbook for Systematic Reviews of Interventions.)


What is a Cochrane Review?


Cochrane Reviews are systematic reviews of research in healthcare and health policy that are published in the Cochrane Database of Systematic Reviews. There are three types of Cochrane Review:


1. Intervention reviews assess the benefits and harms of interventions used in healthcare and health policy.


2. Diagnostic test accuracy reviews assess how well a diagnostic test performs in diagnosing and detecting a particular disease.


3. Methodology reviews address issues relevant to how systematic reviews and clinical trials are conducted and reported.


Cochrane Reviews base their findings on the results of trials which meet certain quality criteria, since the most reliable studies will provide the best evidence for making decisions about health care.”







Systematic review and meta-analysis methodology


Mark Crowther1, Wendy Lim2, and Mark A. Crowther2






Systematic reviews and meta-analyses are being increasingly used to summarize medical literature and identify areas in which research is needed. Systematic reviews limit bias with the use of a reproducible scientific process to search the literature and evaluate the quality of the individual studies. If possible the results are statistically combined into a meta-analysis in which the data are weighted and pooled to produce an estimate of effect. This article aims to provide the reader with a practical overview of systematic review and meta-analysis methodology, with a focus on the process of performing a review and the related issues at each step.”



The Clinical Question

Search Strategy

Electronic databases

Conference abstracts


Contacting investigators


Study Selection

Study design


Date of publication

Duplicate data

Assessing The Quality Of Studies

Data Extraction

Combining The Data (Meta-Analysis)

Making Conclusions

Concluding Remarks








The Process Writing Approach: A Meta-analysis




Steve Grahama and Karin Sandmela


pages 396-407


Published online: 17 Oct 2011


The Journal of Educational Research


Volume 104, Issue 6, 2011







From the APA Science Student Council


Top Ten Tips for Graduate Students Who Want to Conduct a Meta-analysis


American Psychological Association







Systematic Reviews and Meta Analysis 


Paul Bain


Harvard University Libraries


Countway Library of Medicine


Guides and Standards

Databases and Sources

Methodology Filters Arrow

Software, Tools, and Organizations








Research article


Meta-analysis: Neither quick nor easy


Nancy G Berman1* and Robert A Parker2


BMC Medical Research Methodology 2002, 2:10  doi:10.1186/1471-2288-2-10


The electronic version of this article is the complete one and can be found online at:







Systematic Reviews - King's College London







Introduction to Systematic Reviews


Table of Contents


Module A: Overview of Systematic Reviews


Module B: Evaluating Systematic Reviews


Module C: Steps for Conducting a Systematic Review


Step 1: Assembling the team

Step 2: Develop the protocol or work plan

Step 3: Question/topic refinement

Step 4: Systematic and comprehensive searches for evidence

Step 5: Inclusion/exclusion rules

Step 6: Critical appraisal of relevant literature

Step 7: Data abstraction

Step 8: Data Synthesis

Step 9: Communication of results



Elizabeth O'Connor, Ph.D.

Evelyn Whitlock, M.D., M.P.H.

Bonnie Spring, Ph.D., ABPP







The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration

Alessandro Liberati mail,


 Douglas G. Altman,


 Jennifer Tetzlaff,


 Cynthia Mulrow,


 Peter C. Gøtzsche,


 John P. A. Ioannidis,


 Mike Clarke,


 P. J. Devereaux,


Jos Kleijnen,


 David Moher


Published: July 21, 2009DOI: 10.1371/journal.pmed.1000100









Study Design 101




George Washington University







How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care


Users’ Guides to the Medical Literature


Mohammad Hassan Murad, MD, MPH1; Victor M. Montori, MD, MSc2; John P. A. Ioannidis, MD, DSc3; Roman Jaeschke, MD, MSc4; P. J. Devereaux, MD, PhD5; Kameshwar Prasad, MD, DM, FRCPE6; Ignacio Neumann, MD, MSc7; Alonso Carrasco-Labra, DDS, MSc8; Thomas Agoritsas, MD9; Rose Hatala, MD, MSc10; Maureen O. Meade, MD11; Peter Wyer, MD12; Deborah J. Cook, MD, MSc13; Gordon Guyatt, MD, MSc14


JAMA. 2014;312(2):171-179. doi:10.1001/jama.2014.5559.


July 9, 2014, Vol 312, No. 2







Methods for Conducting Systematic Reviews - EPPI-Centre












1 Where should I start?

2 What is a meta-analysis?

2.1 Definition

2.2 Three Basic Questions

2.3 Five Basic Steps

3 How do I conduct a meta-analysis?

3.1 First, choose which statistical approach suits your needs

3.2 Second, choose which effect size index to calculate

3.3 Third, choose your statistical software

4 websites you may find interesting or helpful...







Review Article


Systematic reviews and meta-analysis of preclinical studies: why perform them and how to appraise them critically


Emily S Sena1,2, Gillian L Currie1, Sarah K McCann2, Malcolm R Macleod1 and David W Howells2


Journal of Cerebral Blood Flow & Metabolism (2014) 34, 737–742;


doi:10.1038/jcbfm.2014.28; published online 19 February 2014







October – 2008


Meta-Analysis: The preferred method of choice for the assessment of distance learning quality factors


Mickey Shachar


TUI University


College of Health Sciences and College of Education









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