Background: The role of evidence-based medicine in sports medicine and orthopaedic surgery is rapidly growing. Systematic reviews and meta-analyses are also proliferating in the medical literature.
Purpose: To provide the outline necessary for a practitioner to properly understand and/or conduct a systematic review for publication in a sports medicine journal.
Study design: Review.
Methods: The steps of a successful systematic review include the following: identification of an unanswered answerable question; explicit definitions of the investigation's participant(s), intervention(s), comparison(s), and outcome(s); utilization of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and PROSPERO registration; thorough systematic data extraction; and appropriate grading of the evidence and strength of the recommendations.
Results: An outline to understand and conduct a systematic review is provided, and the difference between meta-analyses and systematic reviews is described. The steps necessary to perform a systematic review are fully explained, including the study purpose, search methodology, data extraction, reporting of results, identification of bias, and reporting of the study's main findings.
Conclusion: Systematic reviews or meta-analyses critically appraise and formally synthesize the best existing evidence to provide a statement of conclusion that answers specific clinical questions. Readers and reviewers, however, must recognize that the quality and strength of recommendations in a review are only as strong as the quality of studies that it analyzes. Thus, great care must be used in the interpretation of bias and extrapolation of the review's findings to translation to clinical practice. Without advanced education on the topic, the reader may follow the steps discussed herein to perform a systematic review.
Keywords: PRISMA; PROSPERO; evidence-based medicine; meta-analysis; systematic review.
© 2013 The Author(s).
DiSilvestro KJ, Tjoumakaris FP, Maltenfort MG, Spindler KP, Freedman KB. DiSilvestro KJ, et al. Am J Sports Med. 2016 Feb;44(2):533-8. doi: 10.1177/0363546515580290. Epub 2015 Apr 21. Am J Sports Med. 2016. PMID: 25899433 Review.
Gagnier JJ, Kellam PJ. Gagnier JJ, et al. J Bone Joint Surg Am. 2013 Jun 5;95(11):e771-7. doi: 10.2106/JBJS.L.00597. J Bone Joint Surg Am. 2013. PMID: 23780547
Ruano J, Gómez-García F, Gay-Mimbrera J, Aguilar-Luque M, Fernández-Rueda JL, Fernández-Chaichio J, Alcalde-Mellado P, Carmona-Fernandez PJ, Sanz-Cabanillas JL, Viguera-Guerra I, Franco-García F, Cárdenas-Aranzana M, Romero JLH, Gonzalez-Padilla M, Isla-Tejera B, Garcia-Nieto AV. Ruano J, et al. Syst Rev. 2018 Mar 9;7(1):43. doi: 10.1186/s13643-018-0709-6. Syst Rev. 2018. PMID: 29523200 Free PMC article.
Manchikanti L, Datta S, Smith HS, Hirsch JA. Manchikanti L, et al. Pain Physician. 2009 Sep-Oct;12(5):819-50. Pain Physician. 2009. PMID: 19787009
Harris JD, Brand JC, Cote MP, Dhawan A. Harris JD, et al. Arthroscopy. 2017 Aug;33(8):1594-1602. doi: 10.1016/j.arthro.2017.01.055. Epub 2017 Apr 27. Arthroscopy. 2017. PMID: 28457677 Review.
Ventura CAI, Denton EE, David JA. Ventura CAI, et al. Med Devices (Auckl). 2024 May 23;17:191-211. doi: 10.2147/MDER.S467146. eCollection 2024. Med Devices (Auckl). 2024. PMID: 38803707 Free PMC article. Review.
Leung WKC, Cheung J, Wong VCC, Tse KKL, Lee RWY, Lam SC, Suen LKP. Leung WKC, et al. BMC Public Health. 2024 Apr 30;24(1):1201. doi: 10.1186/s12889-024-18703-7. BMC Public Health. 2024. PMID: 38689284 Free PMC article. Review.
Schwartz J, Rodriguez AN, Banovetz MT, Braaten JA, Larson CM, Wulf CA, Kennedy NI, LaPrade RF. Schwartz J, et al. Orthop J Sports Med. 2024 Apr 25;12(4):23259671241246197. doi: 10.1177/23259671241246197. eCollection 2024 Apr. Orthop J Sports Med. 2024. PMID: 38680218 Free PMC article.
Zhang Q, Li S, Wu Y. Zhang Q, et al. Innov Aging. 2024 Feb 17;8(3):igae015. doi: 10.1093/geroni/igae015. eCollection 2024. Innov Aging. 2024. PMID: 38618517 Free PMC article. Review.
Amobonye A, Lalung J, Mheta G, Pillai S. Amobonye A, et al. ScientificWorldJournal. 2024 Jan 17;2024:7822269. doi: 10.1155/2024/7822269. eCollection 2024. ScientificWorldJournal. 2024. PMID: 38268745 Free PMC article. Review.