After you have completed your database and grey literature searches, and identified other papers through hand-searching, you will need to screen the titles and abstracts to determine if they meet the criteria for inclusion. These screening criteria should be pre-defined (i.e. stated in your protocol before you begin the searches). Inclusion criteria might relate to the following:
Generally articles are screened against these criteria independently by at least two authors. Initially you should screen the titles and abstracts, which will leave you with three groups of articles: Include (those which meet all inclusion criteria), Exclude (those which do not meet at least one of the inclusion criteria) and Doubt (those for which it is unclear from their title and abstract if they meet all inclusion criteria). Once you have screened the titles and abstracts in this way, the full text for each article in the Doubt group should be obtained, and the same procedure applied. Therefore, at the end of the screening process you will be left with two groups of articles: Included, and Excluded.
There are a range of systematic review screening software options available, such as Covidence (requires you or your department to purchase a subscription; link opens in new window) or Rayyan (most features free; link opens in new window). There is a good guide to using Rayyan (link opens in new window) produced by Carrie Price, Health Professions Librarian at Towson University.
These can be helpful to organise and streamline your systematic review. They denote progress, assign and distribute work between team members, and checklist through the process to ensure no elements are missing, as well as that all procedures are followed.
Screening large numbers of articles can be complicated and time-consuming. It is a good idea to establish a well-structured, clear process for all reviewers to follow. This journal article: Best practice guidelines for abstract screening large-evidence systematic reviews and meta-analyses (link opens in new window) suggests some best practice processes to follow when screening for a systematic review.
Systematic review searches will typically yield thousands, or even tens of thousands of search results. Of these, it is likely only a small handful will be relevant and ultimately included in the review. This journal article: Precision of healthcare systematic review searches in a cross-sectional sample (link opens in new window) finds that on average most systematic reviews only include 3% of all results found in the search, with the majority being discarded at the screening stage. This is why it's so important to have robust screening criteria, and a well-organised system for doing the screening.
Signing up to do a Cochrane review is a very onerous task. However, the Cochrane Crowd (link opens in new window) offers a way to "dip your toe in the water". It is a 'collaborative volunteer effort to help categorise and summarise healthcare evidence so that we can make better healthcare decisions.' Get involved if you want to gain experience in the systematic review process without committing to a full scale systematic review immediately.
When writing up your systematic review, you will need to include a flow diagram indicating the number of papers found, and the number removed after various stages of screening, including during the deduplication process. There is a standard PRISMA template for this diagram, and an online tool (link opens in new window) you can use to generate PRISMA flow diagrams.
There are a number of referencing software packages available. These include Endnote (link opens in new window), Mendeley (link opens in new window) or Zotero (link opens in new window) and RefWorks. Two versions of RefWorks are available - for NHS Scotland (link opens in new window) and from UHI (link opens in new window). NB The University supports Endnote and RefWorks only.
For any assistance/advice required please contact the Library Team at: hhsl@uhi.ac.uk