What is a 2weekSR?
A 2 week systematic review (2weekSR) is a full systematic review (SR) done to a high methodological standard following all the normal systematic review processes, completed in a vastly shortened time frame. The award-winning 2weekSRs combine the following elements: a team with complementary SR skills, previous SR experience, systematic review automation (SRA) tools, and agile development processes. These factors allow for the completion of an accelerated SR in extremely shortened time frames – generally in 2 weeks.
Advancing systematic reviews to the point where they can be completed in two weeks has long been a dream of Paul Glasziou, Director of the Institute for Evidence-Based Healthcare (IEBH). When he mentioned that goal again in late 2018, several members of the IEBH team felt that IEBH’s automation and methodological development programmes were sufficiently advanced to attempt to complete a full systematic review in 2 weeks (2weekSR).
Therefore, a team of four experienced systematic reviewers with complementary skills attempted to complete a 2weekSR in January 2019: an epidemiologist (Anna Mae Scott), an information specialist (Justin Clark) and two clinician-researchers (Chris Del Mar and Paul Glasziou).
A topic was chosen, the team was set loose, and the clock started ticking at 9:30am on 21 January 2019.
The final product was a full systematic review using standard methodology, completed at 12:10pm on Friday, 1 February - 9 working days (11 calendar days) later. After taking a well-earned long weekend off, the team submitted the systematic review for publication on 5 February - 14 calendar days after starting the systematic review.
The results of this methodological race against the clock were written up and published in the British Journal of General Practice (the systematic review itself), and the Journal of Clinical Epidemiology (the processes and methods paper).
A Full Systematic Review Was Completed in 2 Weeks Using Automation Tools: A Case Study
https://pubmed.ncbi.nlm.nih.gov/32004673/
Abstract Our aim was to describe the process, facilitators, and barriers to completing the first 2-week full SR. We systematically reviewed evidence of the impact of increased fluid intake, on urinary tract infection (UTI) recurrence, in individuals at risk for UTIs. The review was conducted by experienced systematic reviewers with complementary skills (two researcher clinicians, an information specialist, and an epidemiologist), using Systematic Review Automation tools, and blocked off time for the duration of the project. The SR was completed in 61 person-hours (9 workdays; 12 calendar days); accepted version of the manuscript required 71 person-hours. In conclusion, a small and experienced team, using Systematic Review Automation tools, who have protected time to focus solely on the SR can complete a moderately sized SR in 2 weeks.
|
Task no. |
Tasks |
SR Domain |
Skill needed |
Description |
|
a1 |
Lead in time |
Planning |
N/A |
Time spent completing other work to allow SR authors to focus on the 2weekSR |
|
a2 |
SR design meetings |
Planning |
SR methodologist & content expert |
Time spent refining the idea, determining feasibility, assembling the team, planning timelines, deciding on roles (who is responsible for oversight, coordination and documentation) and provide information on SRA tools |
|
0 |
Daily administrative meetings |
Planning |
SR methodologist |
Short daily meetings to review progress, discuss issues and document decisions |
|
1 |
Formulate SR question |
Writing |
Content expert & SR methodologist |
Final decision on the research question (PICO) |
|
2 |
Find and review existing or upcoming SRs |
Data collection |
Information specialist & content expert |
Search for and review existing SRs that answer the same or a similar question. |
|
3 |
Write the SR protocol |
Writing |
Content expert & SR methodologist |
Provide an objective, reproducible, sound methodology for the SR, then register the protocol |
|
4 |
Obtain set of relevant studies |
Data collection |
Content expert & information specialist |
Identify a small sample of studies relevant to the review, to aid with designing the search and data extraction form. |
|
5 |
Design data extraction form |
Data analysis |
Content expert & SR methodologist |
Design forms for extracting study characteristics and test their usefulness/applicability |
|
6 |
Design systematic search strategy |
Data collection |
Information specialist & content expert |
Design search strategy to find all relevant information (choose databases; develop search string) |
|
7 |
Run systematic search strings |
Data collection |
Information specialist |
Run search strings in databases, trial registries, collate results in reference management system (e.g. EndNote) |
|
8 |
Deduplicate results |
Data collection |
Information specialist |
Remove duplicate citations |
|
9 |
Screen abstracts |
Data selection |
Content expert & SR methodologist |
Screen titles and abstracts, exclude irrelevant citations, resolve disputes |
|
10 |
Obtain full text |
Data collection |
Information specialist |
Download full text studies, request copies from authors, interlibrary loan |
|
11 |
Screen full text |
Data selection |
Content expert & SR methodologist |
Screen full text of articles, exclude irrelevant citations, resolve disputes |
|
12 |
Screen trial registries |
Data selection |
Content expert & SR methodologist |
Based on title and text in the trial registry entry: exclude irrelevant citations, resolve disputes |
|
13 |
Citation analysis |
Data collection |
Content expert & SR methodologist |
Follow citations, cited and citing, from included studies to find additional relevant studies |
|
14 |
Screen citation analysis |
Data selection |
Content expert & SR methodologist |
Screen titles and abstracts, and full texts exclude irrelevant citations, resolve disputes |
|
15 |
Extract data |
Data analysis |
Content expert & SR methodologist |
Extract study characteristics and relevant outcomes |
|
16 |
Risk of Bias assessment |
Data analysis |
SR methodologist |
Assess the potential biases in included studies |
|
17 |
Plan to synthesise data |
Data analysis |
SR methodologist & statistician |
Convert extracted outcome data to common representation (usually mean and SD) |
|
18 |
Meta-analysis or narrative synthesis |
Data analysis |
SR methodologist & statistician |
Statistically combine the results using meta-analysis or other statistical synthesis |
|
19 |
GRADE evidence |
Data analysis |
SR methodologist & statistician |
Optional: rate the certainty of evidence for a treatment efficacy from high to very low |
|
20 |
Summary of findings |
Data analysis |
Content expert & SR methodologist |
Optional: summarise the main findings of the SR in a table |
|
21 |
Update systematic search strategy |
Data collection |
Information specialist |
Optional: repeat the search to find new studies published since the initial search, especially if search more than a year old |
|
22 |
Write introduction |
Writing |
Content expert |
Revise the introduction section from the SR protocol |
|
23 |
Write methods |
Writing |
SR methodologist |
Revise the methods section from the SR protocol |
|
24 |
Write results |
Writing |
Content expert & SR methodologist |
Write the results section of the SR |
|
25 |
Write discussion |
Writing |
Content expert |
Write the discussion and conclusion sections of the SR |
|
26 |
Obtain external feedback |
Planning |
Some friends |
Circulate to colleagues for external feedback, and take a break from the SR to allow thinking time about the manuscript |
|
27 |
Submit manuscript |
Writing |
Authorship experience |
Format manuscript to meet journal requirements, complete online forms and submit manuscript |
|
28 |
Reformat and resubmit manuscript |
Writing |
Authorship experience |
If rejected, reformat manuscript to meet new journal requirements and standards, and submit (if accepted skip this task) |
|
29 |
Manuscript revisions |
Writing |
Authorship experience |
Revise manuscript to respond to comments from peer reviewers, and resubmit it |
|
30 |
Manuscript accepted |
Writing |
Authorship experience |
Review manuscript, and copy edit any errors or issues |
|
31 |
Manuscript published |
Writing |
Authorship experience |
Send the details around to everyone you know, and enjoy the kudos |
|
SRA tool |
SR Step |
Description |
|
SRA Word Frequency Analyser |
Design the systematic search |
Counts the number of times a word or phrase appears in a selected group of articles. Words relevant to your research question, that appear frequently, should be used in the systematic search. Link to help guide |
|
|
Design the systematic search |
Displays the recall (number of relevant studies found) and precision (number of irrelevant studies found) for each term in the search string. Used to quickly determine which terms may be removed from the search string. |
|
SRA Polyglot Search Translator |
Run the systematic search |
Converts a PubMed or Ovid Medline search to the correct syntax to be run in other databases. Link to help guide |
|
SRA Deduplicator |
Deduplicate |
Identifies and removes duplicate studies from database searches. Link to help guide |
|
Screen abstracts and obtain full texts |
Assists with selecting relevant studies by utilising user-defined hotkeys and super-fast browser response time to substantially improve time for include/exclude decisions to be made. |
|
|
Screen abstracts and full texts |
Assists with selecting relevant studies by automatically detecting include/exclude disagreements between reviewers. |
|
|
Screen abstracts |
Identifies and removes studies that are obviously not RCTs from a group of search results. (Marshall, 2018*). |
|
|
Screen abstracts, obtain full texts and citations for SR |
Used in multiple steps of the SR process to assist with reference management. Useful for storing search results, finding full texts, sorting into groups during screening and to insert references into the manuscript. (N.B. proprietary software) |
|
|
Obtain full texts |
Sends multiple document delivery requests to the Bond library in a single request. Normally these requests need to be processed and sent one at a time (available within SRA). |
|
|
Assess risk of bias |
Provides an assessment for 4 of the 7 risk of bias domains from the Cochrane risk of bias tool and highlights the supporting phrases in the PDF of the original paper. A careful check of the assessments produced by RobotReviewer is recommended (Marshall, 2015**). |
|
|
|
Write up SR |
Writes a draft of the results section of the review from the forest plots in a RevMan file (RevMan is a program for performing meta-analyses). This draft can then be used as a start point to accurately write the results (available within SRA). |
* Marshall IJ, Noel‐Storr A, Kuiper J, Thomas J, and Wallace BC, 2018. Machine learning for identifying randomized controlled trials: an evaluation and practitioner's guide. Research synthesis methods, 9(4), pp.602-614.
** Marshall, I.J., Kuiper, J. and Wallace, B.C., 2015. RobotReviewer: evaluation of a system for automatically assessing bias in clinical trials. Journal of the American Medical Informatics Association, 23(1), pp.193-201.
Follow us on @2weekSR for live-tweets of our 2weekSRs!
The 2weekSR author team you need
- An experienced systematic reviewer: to be in charge of the majority of SR tasks (e.g. screening, extracting)
- A second systematic reviewer: to work with the first reviewer on the majority of SR tasks (e.g. screening, extracting)
- Information specialist: to ensure a high precision search is designed and run in a fast time
- Systematic review methodologist: to provide advice on what is needed to perform the SR to a high quality
- Content expert: to ensure the SR is done in a way of interest to its potential user base, also to provide content specific information to the protocol and manuscript
- Epidemiologist/Statistician: to make sure your stats are done properly
Videos
Timely evidence syntheses: introducing MethodsWizard - a semi-automated 2weekSR tool to assist with systematic review protocol writing
Validating the 2weekSR methodology on 10 systematic reviews: Our recent presentation at the Evidence-Based Research (EVBRES) 2021 conference, on extending and validating the 2weekSR methodology on more complex reviews.
2weekSRs
#1
SR itself:
Scott, A.M., Clark, J., Del Mar, C. and Glasziou, P., 2020. Increased fluid intake to prevent urinary tract infections: systematic review and meta-analysis. British Journal of General Practice, 70(692), pp.e200-e207.
Processes paper:
Clark, J., Glasziou, P., Del Mar, C., Bannach-Brown, A., Stehlik, P. and Scott, A.M., 2020. A full systematic review was completed in 2 weeks using automation tools: a case study. Journal of Clinical Epidemiology, 121, pp.81-90.
Clark, J., Scott, A.M. and Glasziou, P., 2020. Not All Systematic Reviews Can Be Completed in 2 Weeks-But Many Can Be (And Should Be). Journal of Clinical Epidemiology, pp.S0895-4356.
#2
Albarqouni, L., Sanders, S., Clark, J., Tikkinen, K.A. and Glasziou, P., 2021. Self-management for men with lower urinary tract symptoms: a systematic review and meta-analysis. The Annals of Family Medicine, 19(2), pp.157-167.
#3
Albarqouni, L., Byambasuren, O., Clark, J., Scott, A.M., Looke, D. and Glasziou, P., 2020. Does Copper treating of commonly touched surfaces reduce healthcare acquired infections? A Systematic Review and meta-analysis. Journal of Hospital Infection
#4
Byambasuren, O., Cardona, M., Bell, K., Clark, J., McLaws, M., and Glasziou, P. 2020. Estimating the extent of true asymptomatic COVID-19 and its potential for community transmission: systematic review and meta-analysis. JAMMI
#5
Byambasuren, O., Dobler, C.C., Bell, K., Rojas, D.P., Clark, J., McLaws, M.L. and Glasziou, P., 2021. Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: systematic review. Plos one, 16(4), p.e0248946.
#6
Bakhit, M., Krzyzaniak, N., Scott, A.M, Clark, J., Glasziou, P., Del Mar, C. 2021. Downsides of face masks and possible mitigation strategies: a systematic review and meta-analysis. BMJ Open. 11:e044364.
#7
Albarqouni, L., Moynihan, R., Clark, J., Scott, A.M., Duggan, A. and Del Mar, C., 2021. Head of bed elevation to relieve gastroesophageal reflux symptoms: a systematic review. BMC family practice, 22(1), pp.1-9.
#8
Bakhit, M., Krzyzaniak, N., Hilder, J., Clark, J., Scott, A. and Del Mar, C., 2020. Does methenamine hippurate decrease urinary tract symptoms in community adult women: a systematic review and meta-analysis. British Journal of General Practice.
#9
Moynihan, R., Sanders, S., Michaleff, Z.A., Scott, A.M., Clark, J., To E.J., Jones M., Kitchener, E., Fox, M., Johannson, M., Lang, E., Duggan, A., Scott, I. and Albarqouni, L., 2021. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021 Mar 16;11(3):e045343
#10
Bakhit, M., Baillie, E., Krzyzaniak, N., van Driel, M., Clark, J., Glasziou, P., & Del Mar, C. (2021). Antibiotic prescribing for acute infections in synchronous telehealth consultations: a systematic review and meta-analysis. BJGP open. https://doi.org/10.3399/BJGPO.2021.0106
#11
Krzyzaniak, N., Forbes, C., Clark, J., Scott, A.M., Del Mar, C., & Bakhit, M. Antibiotics versus no treatment for asymptomatic bacteriuria in aged care residents: a systematic review and meta-analysis. Accepted in the British Journal of General Practice (available online end May 2022).
#12-20
Telehealth 2weekSR
Telehealth provision of primary and allied healthcare was temporarily enabled in Australia during the COVID pandemic. In the first 12 months, over 46 million telehealth care services were delivered to Australians.
In October 2020, the IEBH team was commissioned by the Commonwealth Department of Health to conduct systematic reviews on the safety and effectiveness of the telehealth.
We prepared 9 systematic reviews in 12 weeks (an average of 1 systematic review completed in 1.33 week, i.e., 7 workdays), on the following topics:
- Telehealth vs. face-to-face delivery of care for anxiety disorders: a systematic review and meta-analysis (published, J Telemed Telecare, DOI: 10.1177/1357633X211053738)
- Telehealth vs. face-to-face delivery of care for depression (published, Psychological Medicine, pp. 1 - 9, DOI: https://doi.org/10.1017/S0033291722002331)
- Telehealth vs. face-to-face delivery of care for diabetes
- Telehealth vs. face-to-face delivery of care for insomnia (under review)
- Telehealth vs. face-to-face delivery of care for less common mental health conditions (published, JMIR Mental Health, 9(3), e31780. DOI: 10.2196/31780)
- Telehealth vs. face-to-face delivery of care for musculoskeletal conditions (under review)
- Telehealth vs. face-to-face delivery of care for pain
- Telehealth vs. face-to-face delivery of care for PTSD (published, Journal of Clinical Psychiatry, 83(4), [21r14143]. DOI: 10.4088/JCP.21r14143)
- Telehealth vs. face-to-face delivery of speech pathology care (under review)
2weekSRs on Telehealth informed the decision about permanently implementing telehealth in Australia ($106M investment), increasing healthcare access for 26M Australians, especially in rural/remote areas, and has led to its widespread adoption (see: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/permanent-telehealth-to-strengthen-universal-medicare).
Resources
Please click on the link below to download the template:
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