Standards for Initiating a Systematic Review

Abstract: This chapter describes the initial steps in the systematic review (SR) process. The committee recommends eight standards for ensuring a focus on clinical and patient decision making and designing SRs that minimize bias: (1) establishing the review team; (2) ensuring user and stakeholder input; (3) managing bias and conflict of interest (COI) for both the research team and (4) the users and stakeholders participating in the review; (5) formulating the research topic; (6) writing the review protocol; (7) providing for peer review of the protocol; and (8) making the protocol publicly available. The team that will conduct the review should include individuals with appropriate expertise and perspectives. Creating a mechanism for users and stakeholders—consumers, clinicians, payers, and members of clinical practice guideline panels—to provide input into the SR process at multiple levels helps to ensure that the SR is focused on real-world healthcare decisions. However, a process should be in place to reduce the risk of bias and COI from user and stakeholder input and in the SR team. The importance of the review questions and analytic framework in guiding the entire review process demands a rigorous approach to formulating the research questions and analytic framework. Requiring a research protocol that prespecifies the research methods at the outset of the SR process helps prevent the effects of bias.