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KCE ProcessBook

Systematic literature review

To conduct systematic reviews, KCE refers to the Cochrane Handbook for Systematic Reviews of Interventions:
  • it describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions
  • it includes guidance on the standard methods applicable to every review (planning a review, searching and selecting studies, data collection, risk of bias assessment, statistical analysis, GRADE and interpreting results), as well as more specialised topics (non-randomized studies, adverse effects, complex interventions, equity, economics, patient-reported outcomes, individual patient data, prospective meta-analysis, and qualitative research).
However, the protocol will be tailored for each project at the protocol meeting (see Project Guide).

Table of contents

Part 2: Core methods

  1. Starting a review
  2. Determining the scope and questions
  3. Inclusion criteria & grouping for synthesis
  4. Searching & selecting studies
  5. Collecting data
  6. Effect measures
  7. Bias and conflicts of interest
  8. Risk of bias in randomized trials
  9. Preparing for synthesis
  10. Meta-analyses
  11. Network meta-analyses
  12. Synthesis using other methods
  13. Bias due to missing results
  14. ‘Summary of findings’ tables & GRADE
  15. Interpreting results

Tools

Critical appraisal of the evidence:
  • GRADE book: to assess the certainty of evidence 
Critical appraisal of practice guidelines: 
  • AGREE II: to assess the methodological rigour and transparency in which a practice guideline is developed
  • AGREE Reporting Checklist: intended to assist practice guideline developers to improve the completeness and transparency of reporting in practice guidelines
Critical appraisal of systematic reviews: 
  • AMSTAR checklist: to assess the methodological quality of a review
  • ROBIS tool: to assess the level of bias present within a systematic review
  • ROB-ME tool: to assess the Risk Of Bias due to Missing Evidence
Critical appraisal of RCTs for interventions:
  • RoB 2 tool: to assess risk of bias in randomized trials
  • ROBUST-RCT tool (Risk Of Bias in Understanding the Strength of Trials—Randomised Controlled Trials): tool intended to address some of the practical limitations encountered with RoB 2 
Critical appraisal of diagnostic accuracy studies:
  • QUADAS-2 tool: instrument to assess the risk of bias and applicability of primary test accuracy studies for diagnosis, screening or staging disease (NB: This has now been superseded by the QUADAS-3 tool)
  • QUADAS-C: extension to QUADAS for assessing risk of bias in comparative accuracy studies
  • QUAPAS: extension of the QUADAS-2 tool to assess risk of bias in systematic reviews of prognostic test accuracy studies
Critical appraisal of observational studies:
  • ROBINS-I: preferred instrument for non-randomized studies of interventions
  • ROBINS-E tool: extends the ROBINS framework to observational epidemiological studies (cohort studies) that examine the effects of non-manipulable exposures
  • JBI Critical Appraisal tools: assist in assessing the trustworthiness, relevance and results of published papers

Files

NB: to see the list of tools for critical appraisal, please click on the title above