Systematic review and meta-analysis: Main points

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Abstract

The growth of the scientific medical community publication activity has led to the emergence of large volumes of disparate, often contradictory information of varying degrees of methodological quality. In such circumstances, a single tool for processing the results of numerous clinical trials was only a matter of time, reflecting the needs of practitioners. Such a tool within the framework of the principles of evidence-based medicine was the conduct of systematic reviews, in some cases supplemented by meta-analyses. The Cochrane is now the leading scientific organization that sets the tone for all research of this kind, providing most of the research of this design every year. Without taking into account the possible negative consequences of such a monopoly, it should be noted that this organization offers a detailed algorithm for writing systematic reviews, which is in the public domain along with the necessary software. This highly transparent methodology makes writing systematic reviews a task within the reach of any professional, regardless of supervision by the Cochrane, whose guiding resource is limited. This work is based on the methodological recommendations of the Cochrane and focuses on the main stages of writing systematic reviews.

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About the authors

Badri V. Sigua

North-Western State Medical University named after I.I. Mechnikov

Email: dr.sigua@gmail.com
ORCID iD: 0000-0002-4556-4913
SPIN-code: 5571-8893

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Pavel A. Kotkov

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: kotkovdr@mail.ru
ORCID iD: 0000-0002-9762-9854
SPIN-code: 3802-2076

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Aleksey A. Kurkov

North-Western State Medical University named after I.I. Mechnikov

Email: dok.kurkov@gmail.com
ORCID iD: 0000-0002-2128-8651
SPIN-code: 6396-4386

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Vyacheslav P. Zemlyanoy

North-Western State Medical University named after I.I. Mechnikov

Email: decsurg@maps.spb.ru
ORCID iD: 0000-0001-7368-5926

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

References

  1. Higgins JPT, Thomas J, Chandler J, editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane; 2022.
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Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. An example of a flowchart, containing the results of the search strategy implementation

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3. Fig. 2. Individual and pooled odds ratios of death (elective versus on-demand relaparotomies) in the selected studies.The left side of the chart (1) demonstrates a summary of bibliographic information about the included studies. The next block (2) shows extracted data, that contains the number of deaths (Events) in the groups of patients with elective relaparotomy (ПР) or on-demand relaparotomy (РПТ), as well as the weight (Weight) of each of the included studies, determined by the sample size and the value of the standard error. The right side of the scheme (3) describes the results of measure of effect calculating (in this case, the death risks ratio) for each of the included studies and a graphical representation in the form of a proper forest diagram. The intersection of the 95% confidence interval (95% CI) of the odds ratio (Odds ratio) of the central axis indicates the absence of a statistically significant effect. Box 4 displays the generalized effect of the intervention as a 95% confidence interval numerical value and a diamond graphic symbol in a forest diagram. Box 5 describes an assessment of the included studies statistical heterogeneity

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4. Fig. 3. Funnel plot for mortality rate (elective relaparotomy versus on-demand relaparotomy). Measure of effect — hazard ratio. HR — hazard ratio; SE — standard error

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Copyright (c) 2022 Sigua B.V., Kotkov P.A., Kurkov A.A., Zemlyanoy V.P.

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