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.

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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

The Search Refiner

 

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

Screenatron

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.

Disputatron

Screen abstracts and full texts

Assists with selecting relevant studies by automatically detecting include/exclude disagreements between reviewers.

RobotSearch

Screen abstracts

Identifies and removes studies that are obviously not RCTs from a group of search results. (Marshall, 2018*).

EndNote

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)

SARA

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).

RobotReviewer

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**).

SRA RevMan Replicant

 

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!

Core team

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

Projects

#1 (2019): Increased fluid intake to prevent UTIs

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 (2019): Self-management of lower urinary tract symptoms

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 (2020): Impact of copper-treated surfaces on healthcare-acquired infections

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 (2020): Asymptomatic people and COVID

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 (2020): Estimating the seroprevalence of SARS-CoV-2 infections: a systematic review

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 one16(4), p.e0248946.

#6 (2020): Harms and adverse events associated with wearing face masks

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 (2020): Head of bed positioning for Gastroesophageal Reflux Disease (GERD)

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 (2020): Does methenamine hippurate decrease urinary tract symptoms in community adult women: a systematic review and meta-analysis

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 (2020): Healthcare utilisation changes during the COVID pandemic: a systematic review

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 (2021): Antibiotic prescribing in synchronous telehealth consultations: a systematic review and meta-analysis

Under review - Mina Bakhit, Emma Baillie, Natalia Krzyzaniak, Mieke van Driel, Justin Clark, Paul Glasziou, and Chris Del Mar

Resources

Please click on the link below to download the template:

2 week systematic review task list

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