Home

User Manual: Version 5.0 - Joanna Briggs Institute

1. ener rrr nnn nnn nnns 159 40 1 OPENING AN EXISTING REVIEW 222222222 2 2 2 2 2 160 40 2 NEW REVIEW 2222222222222 22 161 40 3 ASSIGNING REVIEWERS v un pb 161 40 4 EDITING ACREVIEW ccce ER er Re rr mach etw ees 162 40 5 DEBETINGJA ut utet e ee ce tees en eet 162 40 6 CREATING A NON JBI REVIEW IN 162 SUMARI JBI 7 41 41 1 41 2 41 3 41 4 42 42 1 42 2 42 3 42 4 43 43 1 43 2 43 3 43 4 43 5 44 44 1 44 2 44 3 444 44 5 45 45 1 45 2 45 3 45 4 45 5 8 JBI NOTARI Publications ener nnn nu uuu nnn 164 IMPORTING A PUBLICATION FROM CREMS 165 MANUALLY ADDING A NEW PUBLICATION TO JBI CREMS OR JBI NOTARI 165 s s 1 308 anim Pn fusos 166 DELETING A 166 JBI NOTARI Assessment 111 eereer ee enn nena nnn nnn 167 CONDUCTING AN ASSESSMENT lesse 167 THE CRITICAL APPRAISAL 22 171 FILTERING PUBLICATIONS isses RR 173 ASSESSMENT IN A NON JBI REVIEW II 174 JBI NOTARI Extraction 1 cene erre ener 174 EXTRACTION F
2. 106 MASTARI 27 Introduction to JBI MAStARI enn 109 28 Accessing JBI MAStARI ener nnne nnnm 110 29 JBI MASIARI Getting started 111 29 1 LOGGING 0 22 2 2 2 RR s 111 292 LOGGINGOEE 112 30 JBI MASIARI Main menu eren nnn nun nn 112 31 JBI MASIARI Reviews enne nn nn nn nu unn n 112 311 ADDINGIA NEW REVIEW 522222222429 CER BERE em 113 31 2 ADDING A NEW REVIEW VIA JBI MASTARI 113 31 3 ADDING A NEW REVIEW VIA JBI CREMS ssssssse n RR 113 31 4 OPENING AN EXISTING REVIEW isssssssse RR RR RR 114 9125 JEDITING A REVIEW se eet RUPEE Sed 114 31 6 EDITING REVIEWER DETAILS 115 3147 DELEMNGA REVIEW 2a tette tee e tele a Date e ete dodi 115 31 8 CREATING A NON JBI REVIEW IN 116 32 JBI MASIARI Studies eere nn 117 32 1 IMPORTING A STUDY INTO 118 32 2 MANUALLY ADDING A NEW STUDY INTO 5 118 32 3 ASSIGNINGA STUDY DESIGN ssssssse RR RR RI 119 32 4 JEDITINGUA STUDY otto Re eR cet Deeper
3. 185 46 3 EDITING A SYNTHESIZED 22 22 2 22 2 186 46 4 DELETING A SYNTHESIZED FINDING nnn 0 0 00 cece I 186 47 NOTARI View nnne rennen nnne nnn nnn nnn nnn nnn 186 47 1 VIEWING META AGGREGATION 2 187 47 2 SAVING AND EXPORTING A SYNTHESIS 187 48 JBI NOTARI erre 188 48 1 REPORTINGBY CATEGORY 24 ne esee xen ee Ge ee 188 48 2 REPORTING BY SYNTHESIS isses 188 ACTUARI 49 Introduction to JBI ACTUARI eee 191 50 Accessing nnnm 191 50m LOGGING ON imini edu teer ta m EU dw SU EUR tum dust Se a EUR 191 50 2 LOGGING OFE 2 193 50 3 SWITCHING SERO tre 06 0646 193 51 JBI ACTUARI Main nnn nnn nnn 194 52 JBI ACTUARI Reviews eneeeeen rennen enne nnn nnn nnn nnn 194 52 1 ADDING A NEW REVIEW ut nett tr bore e Pe e rh e 196 52 2 DELETING A REVIEW FROM THE ACTUARI ANALYTICAL 197 SPESE Dai C 198 524 EDIT REVIEWER DETAILS ek reete ere Met 199 52 5 CREA
4. Interventions intracervical prostaglandin outpatient setting Comparator intracenical prostaglandin inpatient setting In Setting Outpatient setting versus Inpatient setting Geographical USA Participants expectant mothers on the day before labor was to be induced Source of effectiveness data Single study different participants kl Authors Conclusion Greater costs for intervention in inpatient setting Reviewers Comments We agree with the authors conclusions x Complete Yes Ij Erg The extraction details page lists a range of fields which describe the study the economic evaluation method interventions comparator setting geographical location participants source of effectiveness data author s conclusion reviewer s comments and a field for whether the extraction details are complete More details about the extraction details fields are provided below Once you have completed the extraction details page click on lt Update gt 214 SUMARI Economic evaluation method You must select one of the four options available in the Economic Evaluation Method field scroll down menu The four options are Cost minimization Cost effectiveness Cost utility Cost benefit Interventions and comparator The Interventions field relates to the new treatment or intervention whose cost and effectiveness is being compared to the standard or control or
5. Clinical Effectiveness results Friction Study design Study date Sample size 0 Analysis used Clinical outcome results Economic Effectiveness results Date s of economic data Link between effectiveness and cost data Measure of benefits used in economic evaluation Drect costs Indrect costs Currency Senetbwity analysis Estmated benefits used n FE Cost results Synthesis of costs and results ACTUARL Analysis of Cost Iedhnology and Utiisation Assessment and Review Instrument Select New Outcome for Mumus et al Health Policy 2009 Edit Extraction Details Sample size 100 Analyms used outcome results Economic Effectiveness results Date s of economic data Link between effectiveness and cost data Measure of benefits used in economic evaluation Direct costs Indirect costs Currency Sensitivity analysis Estimated benefits used EE Cost results Synthesis of costs and results Outcome category Clinical effectiveness o a c Costo D OR T Emm SUMARI JBI 217 Multiple studies meta analysis TUARI Analysis of Cos New Outcome for Mumus et al Health Policy 2009 Edit Extraction Details Multiple studies meta analysis Clinical Effectiveness results Study designs Year range of primary studies Analysis used Measure of benefits used in economec evaluation Direct costs indirect costs Currency
6. To mantan competency in both general surgery and specialty area Recommendation Continuous education to develop both Edit dntroducooo of consultant led model recommended Introducnon of consultant lead model is highty Edu recommended Delete 3 10 records per page Click on Add at the bottom of the screen to add a category NOTARI Narrative Opinion and Text Assessment and Review Instrument Putdicntion This page allows the addition of a Catagory Cal enor synths Assign a Name to the category and summarize the meaning of the category name in the Summary field Click on Insert to save 182 SUMARI 45 2 Assigning conclusions to categories a JBI Review NOTARI Narrative Opinion and Text Assessment and Review Instrument utilia tit pm Conclusionsfor Harders M Malangoni MA Weight 5 Sidhu T Surgery 2006 Assessment OR process redesign may be associated with improved ewe Conclusion pazient satisfaction and staff satisfaction ES Wustration Y male improving on time performance whicn I think does lt eric ead vc improved patient satisfaction well better satisfaction for those who work in the OM p i Reference Evidence Credible n OR Category Coordinaten of resource is necessary to perbrme during ofica hours Yes When you have completed both extracting all of
7. 222222222 2 2 2 2 2 145 35 15 DETERMINING THE SIGNIFICANCE OF THE OVERALL EFFECT 52 145 35 16 INTERPRETING A FOREST PLOT MASTARI VIEW DICHOTOMOUS 145 35 17 RESULTS FROM INDIVIDUAL STUDIES isses eee ane 146 3518S TUDY WEIGH Pr 147 35 19 HETEROGENEITY OF INCLUDED 5 0 0 147 35 20 DETERMINING THE SIGNIFICANCE OF THE OVERALL EFFECT 52 148 META ANALYSIS REFERENCES 0 0 0c cece cece Hm 149 NOTARI 36 Introduction to JBI NOTARI ern 153 36 1 JBI NOTARI AND ITS USE IN THE SYSTEMATIC REVIEW OF EVIDENCE 153 36 2 ICRIMIGALAPPRAISALS dote ea eite Datei adiac tib Rd 154 36 3 DATA 2 224 2 155 36 4 META AGGREGATION 0 0 ccc 156 30 5 LEVELS OF EVIDENCE Gea Maeda eder bae erc 156 37 Accessing nnn nnn 157 38 JBI NOTARI Getting started 157 38 10 LOGGING ON dd be VUL EY pic xus vu 157 30 2 entr eme tbe P EPPETSPG e ReleRbEPIezerer erestris 158 39 JBI NOTARI Main 158 40 Reviews
8. User Manual Version 5 0 System for the Unified Management Assessment and Review of Information THE JOANNA BRIGGS E INSTITUTE OS Q QUAM servare MENS Welcome to Joanna Briggs Institute s User Manual for Sumari System for the Unified Management Assessment and Review of Information Version 5 AAR SUMARI JBI 1 Contents 2 Introduction to JBI and JBI SUMARI enn nnn 11 ACCESSING JBI SUMARI isses 12 CREMS 3 Introduction to JBI CReMS eer 15 4 Downloading and Installing JBI CReMS 15 4 1 CONNECTING VIA A PROXY SERVER isses 16 5 JBI CReMS Getting Started 17 5 1 INTRODUCTION 0 oc ccc cece reece ees 17 52 1000 00 2 22222222222 2 4 19 6 Creating a Review or opening an existing review in JBI CReMS 20 6 2 DELETING A REVIEW IN JB CREMS isse 24 6 3 CREATING A NON JBI REVIEW isses 24 6 4 SUMMARY SCREEN 22222222222222 2 2 2 4 26 65 SAVNGAREVIEW isses 29 7 Defining the Protocol nee 31 7 1 SELECTING THE JBI SUMARI ANALYTICAL MODULE AND TYPE OF EVIDENCE 32 7 2 INSERTING THE JBI SET 32 7 3 PROTOCOL DEVELOPMENT USING THE JBI QARI 33 7 4 PR
9. changes and involves a substantial initial commitment and ecd Se poe ecran vo A trong leadership management and TH ratas motivatia persoriul and k avery step of the paint care A strong leadership and support system can process I wher excep mre TW He ited developing their organisabonal support are motivate OR personnels renee saat oe es eee eee crucial to introduce changes and factitare team and leadership supported by superiors p596 Marjamaa 2008 94 OR management work By clicking on Categories in the menu on the LEFT of your screen the page where categories can be added will open SUMARI JBI 181 NOTARI Narrative Opinion and Text Assessment ond Review Instrument Punkication Categorias Synt heic Categories for A comprehensive literature review on emergency surgery This page allows categenes to be managed Eat Delete Use of cSnical protocols and robust handover system are highly Recommendation Standard care Edit f commeoded to mantain consmstency in care Ambulance service should inchide coordinated pre hospital and smooth Recommendabon Ambulance Edit Delate Establishing 3 regions clinica network in necessary to provide timely Recommendation Network of local health care facsities Edit effective emergency surgical care for the commuruty
10. redesign with no additional to add any nurses or other health care staff throughout our implementation project p515 1 records per page 44 3 Editing conclusions Within the Conclusions page select the conclusion to edit by clicking the link under the Conclusion column This loads the information from the conclusion into the edit area of the Conclusions page After the information is edited press the lt Update gt button and the conclusion will be saved and the Conclusions view updated Pressing the lt Cancel gt button will cancel the edit 44 4 Deleting conclusions Users will notice that in NOTARI v 5 0 a new column has been added to the Conclusions page titled Actions with an Edit and Delete function available Qa NOTARI Narrative Qomion Text Assessment and Heview Insteument aa eoru Conclusions for Harders M Malangoni MA Weight 5 Sidhu Surgery 2006 net ail AlConusions People are done sooner in the day they have more tene for other noncleucal dubes and Credible you may save some overtime while mprovng on time performance which I thnk dows lead to improved patent satefachon as well as better sabslacton for those who work m the We try to use the philosophy of working smarter and not harder This very important when Credibin you do one of these redesigns We dii e
11. 14 5 Meta aggregation The most complex problem in synthesizing textual data is agreeing upon and communicating techniques to compare the findings of each study Drawing from the literature as well as input from a panel of experts an approach to the meta aggregation of qualitative data was developed for JBI QARI This involves 72 JBI SUMARI e translating themes metaphors or concepts into findings e transferring actual text or summarized text that illustrates the finding and e categorizing and re categorizing the findings obtained to arrive at a synthesized finding In order to pursue this before carrying out data synthesis reviewers need to establish e their own rules for setting up categories e how to assign findings to categories and e how to aggregate categories into synthesized findings Reviewers need to document these decisions and the rationale for these in the systematic review report The JBI QARI approach to synthesizing the findings of qualitative studies requires reviewers to consider the validity of each study report as a source of guidance for practice identify and extract the findings from papers included in the review and to aggregate those findings into synthesized findings It is important to note here that JBI QARI does not involve a reconsideration and analysis of the findings from included studies as if they were primary data JBI QARI focuses only on the combination of findings 14 6 Levels
12. If you select Yes from the drop down menu you will see the following warning message appear on your screen SUMARI JBI 199 The page at www jbiconnect org says SS Tf you select skip the appraisal step and not use the JBI appraisal instruments this review will not be considered for publication in the JBI Library of Systematic Reviews Contact the Synthesis Science Unit at JBI for further information ak Selecting Yes here will effectively allow users to skip the subsequent critical appraisal step using the JBI appraisal instruments in the review process As a user intending to submit a systematic review to the JBI library you should only select this if you have had a different appraisal tool approved by the Synthesis Science Unit SSU with the approval of your protocol for your review This step will otherwise generally only be Selected by reviewers who are using the free JBI SUMARI software but who don t have the intention of submitting a systematic review to the JBI Library 52 6 Opening an existing review To open an existing review click on the title link under the Review Title column in the review page eg Cost Effectiveness of inhaled corticosteroids in asthma a systematic review By opening the review in this manner you are automatically Selecting it This will take you to the studies page 200 JBI SUMARI ACTUARI Analysis of Cost Technology and Utilisation Assessme
13. myproxy mycompany com without quotes proxyPort Proxy port a number between 0 and 65535 requireAuthentication true if the proxy needs user password to be entered false if they are not required userPasswordEnteredByUser true if each user will enter user and password false if there is only one user and password proxyUser If userPasswordEnteredByUser is false proxyUser is the user required by the proxy proxyPassword If userPasswordEnteredByUser is false proxyPassword is the user required by the proxy Example Here an example of the configuration file for a proxy called myproxy mycompany com port number 3500 authentication required and user password entered by the user lt xml version 1 0 encoding UTF 8 standalone yes gt lt Configuration gt lt useProxy gt true lt useProxy gt lt proxylP gt myproxy mycompany com lt proxylP gt lt proxyPort gt 3500 lt proxyPort gt lt requireAuthentication gt true lt requireAuthentication gt lt userPasswordEnteredByUser gt true lt userPasswordEnteredByUser gt lt proxyUser gt lt proxyPassword gt lt Configuration gt 3 Start the application 4 If a further change is required go to menu lt File gt lt Connection Settings and change the parameters The xml file can also be modified manually as explained previously 5 If the parameter userPasswordEnteredByUser is set to true a proxy login form will appear each time the application is started
14. 54 6 Non JBI Reviews Users may select to do a non JBI review whilst entering or editing the review ACTUARI Analysis of Cost technology and Utilisation Assessment and Review Instrument systematic review of cosz effeciiveness cf paciicanel and cisplazin versus cyclophosphamide Review Tithe and cisplatin systematic review of cosz effeciiveness Review Question Year commenced 2010 Primary Reviewer catalina Secondary Reviewer Search Status Studes Non Revew Yes LI DL IL Version 5 0 Copyright Joanna Briggs Institute 2011 212 SUMARI On the study page if you click on the study name hyper link and if you click on lt Assessment gt button on the left you will be directed to select from the lt Include gt drop down menu simply if the study is to be included lt Yes gt excluded lt No gt or remain lt Undefined gt on the basis of quality assessment ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Assessment for Covens Cancer 1996 Include Ye E Keason Version 5 0 Copyright Joanna Briggs Institute 2011 If the study is to be included in the review Yes should be selected from the drop down menu and the reason can be entered Selecting Yes will allow the reviewer to progress to data extraction for the study If No is selected the study citation and the reaso
15. EZ EZI Version 5 0 Copyright Joanna Briggs Institute 2011 N B If you create your review in one of the analytical modules and then proceed to use the Insert Set Text function from within CReMS v 5 0 when the review project is saved in CReMS v5 0 the question entered there will overwrite any description 198 JBI SUMARI entered from within the analytical modules 52 4 Edit Reviewer details To change the secondary reviewer for the project click on lt Search gt To search for find and select your Secondary Reviewer you will need to enter both their username and email address registered via the SUMARI registration page for new users at http www jbiconnect org tools services sumari reg php and existing users at http www jbiconnect org tools services update profile php 52 5 Creating a Non JBI Review from the ACTUARI Analytical Module You will notice on the review edit screen there is also reference to the non JBI Review The default setting here is No ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument EL Econcesc Systexatic Review Rewew Title Mnat is the cost effectiveness of X compared with Y for Z patients Review Queston Year commenced 201 Primary Reviewer Secondary Reviewer catain3 Rewiew Status Studies Non Review No e E mc Version 5 0 Copyright Joanna Briggs Institute 2011
16. If you wish to edit your Review Title or Year that you entered initially it is editable at any stage in the review process by clicking in the text box and editing the text or value The review question will be blank and is not editable here This can be modified in the Protocol tab potentially after the JBI Set text has been inserted to aid in formulating the review question 26 JBI SUMARI 6 4 2 Editing Primary and Secondary Reviewer Details The selected Primary and Secondary reviewers will appear with their names as recorded with their login details If you click lt Details gt alongside either name you are able to edit details of the review team in a dialogue box P n nm Crems Version 5 0 Review title inserted here e o Edit user details l Reviewer trainee30 idies Report Builder Repo First Name s trainee30 Last Name s Trainee Qualifications PhD Affiliations Joanna Briggs Institute Faculty of Health Sciences af Contact Information Display Order 1 Update Cancel m Primary Reviewer trainee30 Details Secondary Reviewer trainee29 Details Full details entered here will appear in both the protocol and review report e Edit the text for the First Last Name Qualifications and Contact Information as it should appear on th
17. Unsupported US from the Evidence drop down list users will find that the ability to select categories to assign the finding to has been disabled in QARI v 5 0 Unsupported findings should not be included in syntheses that appear in reviews published in the JBI Library of Systematic Reviews 23 3 Assigning findings to categories a Non JBI Review The procedure for assigning findings to categories in a non JBI review see Section 18 5 is the same as described in Section 23 2 above however users will be able to assign Unsupported US findings to categories if they wish 23 4 Editing a category An Actions column has been added to the Categories screen in QARI v 5 0 Click on lt Edit gt to modify or edit details related to the category As was the case in SUMARI v 4 0 the same function can be accessed via clicking on the hyper linked name of the finding The length of a category title is limited to 255 characters Team and social factors Team and social factors Team and social 23 5 Deleting a category Under the Action column click on lt Delete gt to delete a category A prompt asking for confirmation will be displayed Pressing the lt OK gt button will delete the category and return you to the Categories page If findings are already allocated to a category then the allocation changes back to Undefined These findings can now be assigned to another existing category or to a n
18. You can click on lt Assessment gt or the hyper linked name of the paper to proceed to use the JBI tools for critical appraisal of each publication that meets the inclusion criteria for your review Click lt Add Primary gt or lt Add Secondary gt to perform the assessment Note that in NOTARI v 5 0 users are not constrained to have the primary reviewer complete the appraisal process prior to the secondary reviewer being able to commence the appraisal for a particular paper The screenshot below shows that the assessment by the primary reviewer has not been completed yet the secondary reviewer is still able to commence the appraisal process SUMARI JBI 167 NOTARI Opinion ond Text Assessment and Instrument Reviews Pubilcation Categories Synthasi Logout Select Assossmant for Briggs 3 Opinion Papers 2011 SS Detail Primary Assessment Assessment Assessmunt Extrpction Primary assesment 12 not done assessment is not done Conclusions User fie mjatt pem Final assessment is not dane 1225 On the main Publications screen the Assessment of studies is no longer indicated by Awaiting secondary as in SUMARI v 4 0 rather Primary Completed or Secondary Completed will appear in the Assessment column Please note the final assessment is still required to be completed by the primary reviewer Awaiting Final indicates th
19. 64 SUMARI QARI 14 Introduction to JBI QARI The Joanna Briggs Institute Qualitative Assessment and Review Instrument JBI QARI was developed in recognition of the need to acknowledge that the results of non quantitative research represent legitimate evidence for health care practitioners and that this evidence has been largely overlooked as a source of data for evidence synthesis Over a period of two years a project that used participatory processes at three consensus workshops explored the synthesis of qualitative evidence and the outcomes of this project led to the development of JBI QARI JBI QARI has been designed to enable reviewers to systematically review the findings of qualitative research The underlying premise of the development of JBI QARI was to design a system that would enable health scientists and health practitioners to review and synthesize evidence from an inclusive position The purpose of this developmental process was to determine how evidence generated through qualitative research could be systematically reviewed and to identify how qualitative evidence of appropriateness meaningfulness and feasibility can augment evidence of effectiveness in evidence based health care An in depth discussion of the premises on which JBI QARI is based how JBI QARI was developed and the processes of the critical appraisal extraction and synthesis of qualitative data using JBI QARI are presented in the publication Bal
20. Adequate consultant to consultant communication is vital An illustration of that conclusion might be Transparent and timely communication between referring and receiving medical officers is vital This should occur at the consultant specialist level and should include the relevant surgeons from the referring and receiving hospitals p 21 44 1 Adding conclusions When extraction has been completed selecting a publication from the Publications page will automaticaly take the reviewer to the Conclusions page To insert conclusions click on the Add button in the Conclusions page SUMARI JBI 177 NOTARI Narrative Opinion and Text Assessment and Review Instrument kavines Puhlicatou Categories Syxtt brenda Condusions for Pearson A International Journal of Evidence Based Healthcare 2012 All Cosclutson 10 7 records per page There are two fields that require text to be added The first Conclusion is a summary of the conclusion as determined by the reviewer The second Illustration from Publication is a short quotation or pr cis from the text including relevant page numbers that supports the conclusion NOTARE Narrative Opinion and Text Assessment and Review Instrument Publication Cotequries Synthesis Conclusions for Pearson A International Journal of Evidence Based Healthcare 2012 15 is possible tc implement process redesign with no Conclusion addicional sta
21. Report View in CReMS v 5 0 Selecting Save graph to disk will allow users to save a jpg image of the figure on screen to their local drives To interchange between the two views which can presented users need simply click on the Filter by Outcome dropdown menu and select the outcome of interest default presentation will always be without the overall meta analysis of the data until Analyse Results is selected 35 3 Results Screen new reviews only created using SUMARI v 5 0 Extra exciting features have been added to SUMARI v 5 0 extending the analytical capability of the software 35 4 Adding a Subgroup s to a Review Outcome Once a review outcome is entered if the Review Outcome Title hyperlink outcome label is clicked on again or if the existing outcome title is selected when entering the results for a subsequent study for comparison in meta analysis further options to complete sub group analysis of the outcome will appear on the screen In the text field alongside New Subgroup enter a name for the subgroup Click on Save to assign this study to this subgroup within this outcome label MAStARI Meta Analysis of Statistics Assessment and Review Instrument Outcome title for ed Zac Alan Craig Journal of Computing Studies 2011 Drop down menu will display existing Titles from studies of the currently selected review Select an existing title to maintain consistency A new title can b
22. Statistical analysis of costs Sensitivity analysis Estimated benefits used in EE Cost results Synthesis of costs and resuits Outcome category effectiveness Key 9 Effectweness Cost ACIUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument New Outcome for Mumus et al Health Policy 2009 Edit Extraction Details Multiple studies no meta analysis Clinical Effectiveness results Study designa Vea range of pomery studas Analyes used Chrecal outcome results Economic Effectiveness results Date s of economic data Modeling used Measure of benefits used in economic evallation Direct costs Indirect costs Currency Statistical analysis of costs Sersitraty analyses Estmated benefits used in EE Cost results Synthese of costs and rents Outcome category Cirocal effectreeness Kay 8 s FHectivenass Cost tha 2 Better Lower 0 Equal Equal 1 Power LITT Clinical effectiveness results This section relates to evidence on the clinical effectiveness of the intervention versus the comparator or control group The five fields in this section are designed for 218 SUMARI numbers and free text relating to the study design eg randomized controlled study cohort study case control the study date in years the sample size in numbers combining both treatment and comparator groups if relevant the type of analysis used eg in
23. The drop down box can be used to filter studies as new inciuded excluded extraction or finished All fer Pearson A Lived expenences of workang for Intemabonal Journal of Evidence 2012 New Secondary Eds emergency urut Based Healthcare Completed Delete Peacen A B Internatonal Joumal of Nursing 2013 Primary Completed Edif ic Emergency Surgery Practice Pearson A amp Emergency surgery part 2 rg rr bon 2011 New Awaiting Final Ext 1 2 W v records per page The assessment review screen will now display an Add Final button in the Final Assessment box Click on Add Final to complete the final appraisal process Assessment for Pearson Ann Surg 2011 Primary Assessment Secondary Assessment User ayeaye User ne Included Yes Included Yes Reason The study is of adequate quality to include Reason Adequate quality Edit Primary Final Assessment Fina assessment is not done User ayeaye Md Final SUMARI JBI 87 appraisal screen now displays both the primary secondary assessment in addition to the radio buttons to perform the final assessment Assessment for Pearson Ann Surg 2011 Type Final User ayeaye Criteria Primary Secondary Yes Undear arabe COMMENT There congn ty between the stated 1 phiosoptwcal perspective and the research Yes Unclear methodology There i congruity batwean the research 2 methodology and the r
24. This is particularly So for OR which are widely considered to be more difficult to comprehend and are SUMARI JBI 241 more open to mis interpretation due to their reliance a solid understanding of probability and odds 1 2 Note that the Cochrane Handbook has a helpful discussion on the complexity of interpreting odds and risks 8 2 1 1 Therefore the reporting of OR from prospective studies such as RCTs and in systematic reviews can be misleading if the OR is mis interpreted as RR especially when the outcome is common 3 4 For this reason reporting of RR is preferred particularly in prospective studies In general OR are most useful in case control studies where events or outcomes are usually uncommon and the RR cannot be validly calculated as there is no information about the incidence of the event in exposed and non exposed persons 2 5 Additionally OR are especially useful when adjusting for confounding variables in logistic regression 2 However in the example above the outcome was relatively common with infections occurring in 2696 26 out of 100 of participants If an outcome is relatively uncommon ie less than 2096 OR and RR actually provide similar estimates and in these circumstances the OR is commonly used as an estimate of the RR in a case control study 5 58 3 7 Three criteria for choosing a summary statistic for meta analysis Situations for reporting an OR or RR from a primary study have been discussed
25. by how much while the weight is indicative of how much information a study provides to the overall analysis when all studies are combined together While meta analysis is the ultimate goal of a systematic review of quantitative studies a number of criteria must first be met before the results of different studies can be validly combined 58 3 1 Similarity between studies Studies to be included in meta analysis should be similar to each other so that generalization of results is valid The four main criteria that must be considered are patient population e g is it valid to combine the results of studies on different races of people or different aged people outcome e g is it valid to combine studies that have measured pain via a visual analogue scale with those that have used a pain diary e intervention e g are the interventions being given to the treatment group in each study similar enough to allow meta analysis control e g are the control groups in each study receiving treatment similar enough to warrant combination and meta analysis The questions raised above can be very difficult to answer and often can involve subjective decision making Involvement of experienced systematic reviewers and or researchers with a good understanding of the clinical question being investigated Should help in situations where judgment is required These situations should be clearly described and discussed in the systemati
26. clear the entire appraisal form also including the details added to the Comment field Click on the Update button to save the assessment or Cancel Both buttons will return the user to the Assessment screen Following assessment by each reviewer the Add Primary and Add Secondary buttons will become Edit Primary and Edit Secondary respectively allowing the reviewer to make alterations to their assessment After the primary and secondary reviewers have completed their assessments the primary reviewer is required to complete a final assessment At this stage the Assessment column on the list of publications page will state Awaiting Final to show that the primary reviewer can now perform their final assessment SUMARI JBI 169 NOTARI Narrative Opinion and Text Assessment and Review Instrument Review Pumi anon eal zi Sym eis About me EM Publications comprehensive literature review on emergency surgery This used to the retrieved Publicabons From this page Pubbcatons can be selected to perform assessment and extraction and to nip Ties coop pwn ak con bo ba proton 29 new ONRANSA Gaskell patrem or um of Citations 73 mmm Bref review Fast track Review from the Royal Australasian College of 2009 New Awaitng surgery Surgeons Final WSES SM World Society World J Emerg Surg 2000 Awaiteg Evidence based o
27. click the Save graph to disk button at the bottom of the screen and chose the location where to save the image as a jpg file to The output will appear for example as shown under Section 35 9 142 JBI SUMARI 35 11 Interpreting the forest plot MAStARI view continuous data The data table and forest plot presented below are included for illustrative purposes only The forest plot resulted from a meta analysis of three studies which compared student s scores on the California Critical Thinking Skills test between groups that had received an undergraduate nursing curriculum integrated with problem based learning PBL and control groups receiving a traditional curriculum control The results of these three studies are summarized in Table 1 Table 1 Results extracted from three studies on the effect of problem based learning integrated into the undergraduate curriculum of nursing students on the California Critical Thinking Skills Test Sample size n mean and standard deviation SD are presented Sus n PBL Mean so n Control Mean o Spellic Parsons 18 5 5 9 16 3 9 7 Hercinger et al 2001 Beckie Lowery and 50 20 4 45 17 0 4 0 Barnett 2001 Jansen and Morse 2004 35 12 Results from individual studies The three studies are identified at the far left of the forest plot by the author s and year of publication The r
28. protocol and subsequent report to the Synthesis Science Unit for peer review MAStARI Meta Analysis of Statistics Assessment and Review Instrument review Review Title lon state oute Review Question More specifically the objectives are to identify The effectiveness of insert text lan diinsart The objective s of this review is are to identify the effectiveness of state intervention 2 Year commenced 2011 Primary Reviewer Ed Aromataris Secondary Reviewer dnaevol1 Search Review Status Non JBI Review No M No Version 5 0 Copyright Joanna Briggs Institute 2011 124 JBI 33 7 Including and excluding studies When deciding which studies to include in a review If Yes is selected from the drop down menu when users enter a study within such a review they will not have to assign the type of study design via the Detail menu from the menu box at the left of the screen or the Edit action at the right rather when they click on the study name hyper link they will be directed to select from the drop down menu simply if the study is to be included excluded or remain undefined on the basis of quality assessment in the review MAStARI Meta Analysis of Statistics Assessment and Review Instrument T LIT 281 Assessment for Melanie te al The Journal of international studies 2010 Include ma
29. t lon state outcome Review Question More specifically the objectives are to identify effectiveness of finsert text lam insart tavk Year commenced 2011 Primary Reviewer Ed Aromataris Secondary Reviewer dnaevoli Search Review Status Non JBI Review i EE Version 5 0 Copyright Joanna Briggs Institute 2011 114 JBI SUMARI 31 6 Editing reviewer details in MAStARI To change the secondary reviewer for the project click on lt Search gt The process to change secondary reviewer from within the analytical modules is the same as that described for CReMS v5 0 Section 6 1 To search for find and select your secondary reviewer you will need to enter both their username and email address registered via the SUMARI registration page for new users at http www jbiconnect org tools services sumari reg php and existing users at http www jbiconnect org tools services update profile php 31 7 Deleting a review Click Delete from within the Action column to delete the entire review project from the JBI database When you click on Delete a dialogue box will appear prompting you for the primary reviewer s password When entered click Confirm and the review will be permanently deleted If the primary reviewers login details are not entered accurately the delete operation will not proceed SUMARI JBI 115 31 8 Creating a Non JBI Review MAStAR
30. they supply more information WMD is the weighted mean difference a form of meta analysis suited to continuous data measured on the same scale 226 SUMARI 57 Appendix Il Systematic Review Protocol Development Please refer to the Joanna Briggs Institute Reviewers Manual for detailed protocol development guidance The systematic review is a form of secondary research Primary research involves the design and conduct of a study including the collection of primary data from patients and clients and its analysis and interpretation The systematic review also collects and analyses data but usually from published and unpublished reports of completed research Thus the systematic reviewer uses secondary sources of data As in any research endeavor the first step in the systematic review process is the development of a proposal or protocol Protocol development begins with an initial search of the Cochrane Collaboration Library of Systematic reviews the Joanna Briggs Institute Library of Systematic reviews and the Database of Abstracts of Reviews of Evidence DARE databases to establish whether or not a recent review report exists If the topic has not been the subject of a systematic review a review protocol is developed 571 The review protocol As in any research endeavor the development of a rigorous protocol is vital for a high quality systematic review The review protocol provides a predetermined plan to
31. to the category and summarize the meaning of the category name in the Summary field Click on Update to save 23 2 Assigning findings to categories in a JBI Review Findings for Cioffi J 3 Adv Nurs 2000 A feeling amp gut feeling and Mixth sense one Finding nurses described how they recognized patients seeding MET cell me patients you have 4 sort of gut feeling that are not quite zight with thems their observations have not become compromised but you feel things are not Evidence Credibie Category SE ee ee Clescians indicated attenbon to abeormal vital signs was expected practice 3 Add new category dnctude Ya Update Undo Cancel When you have completed both extracting all of the findings from the studies included in your review and creating the categories findings must then be assigned to categories When you click on the finding name hyper link the screen will appear as above detailing the finding and allowing selection of a category to which the finding can be assigned Simply select from amongst the categories in the Category drop down menu SUMARI JBI 101 QARI v 5 0 allows assignment of an individual finding to multiple categories This can be done by holding down the lt Ctrl gt key and making multiple selections from the list or by repeating the assignment process multiple times for the one finding Where a finding has been designated as
32. using the data extracted above on both the clinical effectiveness and cost of the intervention In comparing the clinical effectiveness of two alternatives there are three possibilities i the intervention of interest is better or more effective ie a than the comparator ii the intervention is equally effective i e 0 or iii the intervention is less effective i e a Similarly in terms of cost there are three possibilities i the intervention is more expensive ie a ii the intervention and comparator s costs are the same i e a 40 or iii the intervention is less expensive i e a SUMARI JBI 219 Outcome category Clinical effectiveness Key 7 0 Effectiveness Cost OA OB OC Better Higher CostO p OE OF 0 Equal Equal Of Oi Poorer Lower Update outcome Note that each of the comparisons between intervention and comparator can only be classed as one of nine options 1 For example an intervention that was shown to be more effective and less expensive would be scored as G whereas an intervention that was less effective and of equal cost would be scored as F Once the matrix has been completed for that study click on the lt Update outcome gt button and you will be taken to the results page which lists the comparison of interest the score from the three by three matrix Dominance rating and the study citation ACTUARI Analysis
33. 0 Once the form is saved click lt Update gt upon re entering the assessment when the mouse is lt hovered gt over the text box all of the text entered will appear for easy reference Click lt Undo gt to clear all of the information entered from the screen NB This will clear the entire appraisal form also including the details added to the Comments field MAStARI Mata Analysis of Statistics Assessment and Review Instrument Assessment for Briggs et al Journal of the Joanna Briggs institute 2010 Type Primary User Ed Aromataris Design Randomised Control Trial Pseudo randomised Trial Criteria 1 Was the assignment to treatment groups truly random 2 Were participants blinded to treatment allocation Was allocation to treatment groups concealed from the allocator 4 es ee ca cti Serna ge oooof ooo 5 Were those assessing outcomes blind to the treatment allocation C 6 Were the control and treatment groups comparable at entry 7 Were groups treated identically other than for the named interventions 5 D B Were outcomes measured in the same way for all groups D 9 Were outcomes measured in a reliable way 10 Was appropriate statistical analysis used Include _vegetnes 72 Reason E CL IN After all criteria have been addressed the reviewer must decide on whether to include or exclude the study from the review The deci
34. 21 3 21 4 21 5 22 22 1 22 2 22 3 22 4 22 5 23 23 1 23 2 23 3 23 4 23 5 24 24 1 24 2 24 3 24 4 JBI QARI Studies erre a n n au uuu nn 82 IMPORTING A STUDY FROM 222222 2 2 2 2 83 MANUALLY ADDING A NEW STUDY TO JBI CREMS OR JBI QARI 83 EDITING STUDY redu Shae PR 83 DELETING STUDY 84 JBI QARI Assessment nennen nnne nennen nnn 85 CONDUCTING AN 55 55 2 2222 85 THE CRITICAL APPRAISAL CRITERIA csse 89 FILTERING SLUDIES Gin dona Stoke ru ace 92 ASSESSMENT IN A NON JBI REVIEW 0 0 eee tee eens 93 JBI QARI Extraction 11 ene nnn enn nnne nennen 93 EXTRACTION FIELDS cu ctii gai as aa RU ci e n e ete 94 VIEWINGAN EXTRAGTION xa rio tte fe lee rete c eter 96 SAVING AN EXTRACTION ciis 96 CANCELLING CHANGES TO AN EXTRACTION 97 COMPLETING EXTRACTIONS 97 JBI QARI FindingS sccseccssecsssessseesseessseessseesnseesseeeesnesssnesseesses 97 ADDING FINDINGS rei pitake aon OR RUBER o dere we 97 VIEWING FINDINGS mI 98 EDITING FINDINGS od Sak rer ur eer IESU RR Parte RE 98 DELETING
35. 31 Lassen et ai 2002 56 11 0 50 0 290 860 Favours Treatmam00 10 24 avours Contro If you select to change either the comparison being analysed for a particular outcome by opening the Filter by comparison dropdown menu and selecting a previously defined comparison intervention or the outcome being analysed by opening the Filter by outcome dropdown menu and selecting a previously defined outcome the meta view graph will change accordingly Similarly if different statistical models Fixed vs Random or methods Peto etc are selected the graph will update accordingly Selecting Analyse Results will complete the meta analysis and calculate and present an overall summary measure of effect which can also be transferred to CReMS v 5 0 or saved to the user s computer as above Fiter Results Statistical results to use Teter by outcome Incidence DVT Effect Filter by comparison drug vs placebo Meta analytical method Confidence interval Preterred meta view Incidence DVT Study Mantel Haenszel Relative Risk Risk Ratio Weight CI 95 Fixed Lapidus et al 2007 43 69 0 78 0 46 1 31 Lassen et al 2002 55 115 0 50 0 29 0 465 4 100 00 0 62 0 43 0 90 Favours 1reatmemo 0 12 2 0 vouts Control Z 2 48 P2 4000 Heterogeneity Chi square 33 2270341 4I 4 136 JBI SUMARI Clicking lt Save to Report gt will export the figure on screen to the
36. 6 is the same as described in Section 45 2 above however users will be able to assign Unsupported US findings to categories if they wish 45 4 Editing a category An Actions column has been added to the Categories screen NOTARI v 5 0 Click on lt Edit gt to modify or edit details related to the category As was the case in SUMARI v 4 0 the same function can be accessed via clicking on the hyper linked name of the finding The length of a category title is limited to 255 characters NOTA Narrative Opinion and Text Assessment aod Hewew Insmument Reviews PubBcstion Categories for comprehensive literature review on emergency surgery This page allows categones to be managed of clinica model i recommended with a consideration of local clinical Recommendation Models chmate Umehy And effective emergency surgical for the community Io mantan competency in both general surgery and area continuous Recommendation Continuous education to develop amp ducaton should be e0c0ur3924 and supported both general surgery and speciality area Edt Delete Delete Bolero Bacommendation Establubsg regional cinsal network x necessary te grade Recommendation Netweck of local health care Edi facies slate Qalata Introduction of consultant ked model i highly recommended Introduction of consultant lead model is hoghy Edt recommended 123 10 7 records per page Pres
37. Appropriate sources of such evidence are therefore any text in which an informed opinion on the benefits or otherwise of an intervention or practice is expressed that is any statement in textual form such as in a journal article book report or guideline which could potentially inform practice and emanates from a source which is regarded as authoritative by practitioners The assessment of validity within the JBI NOTARI process focuses on examining the opinion e identifying the credibility of the source of the opinion e establishing the motives that underlie the opinion and e locating alternative opinions that give credence to it or conversely question it Validity in this context therefore relates to what is being said the source and its credibility and logic and consideration of the overt and covert motives at play A general set of criteria for appraising the validity of text as described by Pearson has been incorporated into the JBI NOTARI module in the form of a series of questions to be addressed for each paper retrieved see Section 42 2 Based on the standard approach promoted by the Cochrane Collaboration and adopted by the Joanna Briggs Institute two reviewers are expected to critically appraise the data independently and to then confer 36 3 Data extraction Data extraction involves transferring conclusions from the original paper using an approach agreed upon and standardized for the specific review Thus an
38. Comparator treatment The first time that you add information to either the Interventions or Comparator fields the scroll down menus will be blank However once you have entered some text into these fields these options will be available in the scroll down menu of any future data extraction from other studies ACTUARI Analyses x ogy and Utilisation Assessment and Review Instrument LLLA Extraction Details farmer et al Clinical Therapeutics 1996 7 denotes field which will appear in report appendix Economic Evaluation Method Cast Minimisation e Interventions intraceracai prestagiandin outpatient sette v Comparator Iniracenacal prostagiandin patent petting Sarting Outpatient setting versus Inpationt Geographical usa Participants expectant mothers on the day before labor was to be induced Source of effectiveness data Single study dfferent participants v Authors Conckision Greater costs for interventaon m inpatient setting Reviewers Comments We agree with the authors conclusions Complete Version 5 0 Copyright Joanna Briggs Institute 2011 Setting The Setting field relates to the location that the study took place For example was the study in a hospital community or residential aged care setting Geographical The Geographical field relates to the region city state country in which the study took place Participants The Participants
39. Conducting an assessment You can click on lt Assessment gt or the hyper linked name of the paper to proceed to use the JBI tools for critical appraisal of each study that meets the inclusion criteria for your review Click lt Add Primary gt or lt Add Secondary gt to perform the assessment Note that in QARI v 5 0 users are not constrained to have the primary reviewer complete the appraisal process prior to the secondary reviewer being able to commence the appraisal for a particular paper The screenshot below shows that the assessment by the primary reviewer has not been completed yet the secondary reviewer is able to commence the appraisal process QARI Qualitative Assessment and Review Instrument Reviews Study Categories Assessment for Briggs J Journal of the Joanna Briggs Institute 2011 Primary Assessment Secondary Assessment Primary assessment is not done Secondary asxessment is not dono User ne ser mpalt Add Sacondary Final Assessment Vial assussment is not dane User rie On the main studies screen the Assessment of studies is no longer indicated by Awaiting secondary as in SUMARI v 4 0 rather Primary Completed or Secondary Completed will appear in the Status column Please note the final assessment is still required to be completed by the primary reviewer Awaiting Final indicates this in the Assessment column SUMARI JBI 85 QARL Qualitat
40. Copyright Joanna Briggs Institute 2011 204 SUMARI If there is information that has been extracted from the study being deleted and that is included in analysis you will be advised in the warning message I uthor Title Journal 2011 Extraction Complete Ed et al Cost Effectiveness of inhaled corticosteroids in asthma adult patients JAMA 2009 Extraction Complete Buxton et al Cost Effectiveness of inhale The page at wwwjbiconnectorg says M 2009 Extraction Complete Mumus etal Cost Effectiveness There are outcomes related to this study Policy 2009 New None Are you sure you wish to delete this study Version 5 0 Copyright Joanna Briggs Institute 2011 53 6 Filtering studies The filter function on the studies page allows studies to be sorted For example you can filter studies so that you only view new studies included or excluded studies studies that have been extracted or that have finished the review process The status column on the studies page indicates what stage of the review the study is SUMARI JBI 205 54 JBI ACTUARI Assessment A study is critically appraised or assessed to determine if it is of sufficient quality for inclusion in the systematic review Studies of low quality are then excluded from the review A study must be read and fully understood by each reviewer before it can be critical appraised The assessment column indicates what stage the assessment process is
41. FINDINGS sia RR Pod e 99 RETURNING TO THE STUDIES PAGE tt oe tdt ertet e e c na 99 JBI QARI Categorizing eere rrr 100 CREATING 2 4 4 4 100 ASSIGNING FINDINGS TO CATEGORIES 101 ASSIGNING FINDINGS TO CATEGORIES IN A NON JBI REVIEW 102 EDIMING AcCATEGORY s dice Seat era PY RES 102 DELETING A GATEGORY 2525556 102 JBI QARI Synthesizing Categories 103 CREATING SYNTHESIZED FINDINGS 1 0 0 ccc ccc eens 103 ALLOCATING CATEGORIES TO A SYNTHESIZED 103 EDITING A SYNTHESIZED FINDING is i iorn x be 104 DELETING A SYNTHESIZED 2 2 222222222 22 2 2 104 JBI SUMARI 25 JQARI VIeW 104 25 1 VIEWING META AGGREGATION 105 25 2 SAVING AND EXPORTING A SYNTHESIS 2 2 2 2 105 26 JBI QARI Reporting 11er rere rr nnn nnne rn nnn nnns 106 201 REPORTING BY CATEGORY 255225 0 106 26 2 REPORTING BY SYNTHESIS rrr tex Ree
42. JBI Set text and JBI MAStARI As detailed in Section 7 5 1 above if the Quantitative evidence MAStARI tick box was selected above upon scrolling further down the protocol screen three 3 more tick boxes will have appeared above the Assessment of Methodological Quality text field labelled with the different tools available based on the differences in quantitative study design Selecting the Set text tick box for MAStARI and then clicking the lt Set gt button introduces the same options related to the design of the studies to be included in the review project see above above the Types of Studies text field within the Inclusion criteria section of the protocol screen Please select quantitative study design s to be included 11 Experimental e g RCT quasi expt _ Descriptive e g Case Series Studies Observational e g Cohort Case control 2 Set Type of Study Above the Types of Studies text field select the tick box next to the quantitative study design s appropriate for your research question This will insert the appropriate Set text and assessment extraction tools that will be appended to your protocol and report based on the design s selected Please note as the study design selected here determines both the text inserted and the matching JBI tools you will use you will no longer need to select again from the same options above Assessment of Methodological Quality see Section
43. JBI 235 58 Appendix Ill Quality and Statistical Considerations in 581 Forms of bias The best study design in terms of excluding bias in systematic reviews of effectiveness is the randomized controlled trial RCT Nevertheless there are four main forms of bias that can affect an RCT selection bias performance bias attrition bias and detection bias Selection bias refers chiefly to whether or not the assignment of participants to either treatment or control groups e g in a comparison of only two groups has been made So that all potential participants have an equal chance of being assigned to either group and that the assignment of participants is concealed from the researchers at least until the treatment has been allocated Performance bias refers to differences in care provided to patients if the caregiver is aware of whether a patient is in a control or treatment group Attrition bias refers to differences between control and treatment groups in terms of patients dropping out of a study or not being followed up as diligently Detection bias occurs if an assessor evaluates an outcome differently for patients depending on whether they are in the control or treatment group it is particularly important if a subjective outcome measure is used 58 1 2 Bias in observational studies Observational or non experimental studies are those in which participants are not directly allocated to a treatment rather the effec
44. JBI SUMARI analytical modules JBI CReMS is essential for reviewers who wish to incorporate varied forms of evidence data through the use of multiple JBI SUMARI modules SUMARI JBI 17 review protocol and details of the review and the reviewers are entered into JBI CReMS and the results of the search ie the bibliographic information on papers reports located by the search particularly those selected for retrieval are also documented in JBI CReMS The reviewers then appraise the selected papers and extract and synthesize the data from those papers that are included in the review through one of the four JBI SUMARI analytical modules JBI QARI JBI NOTARI JBI MAStARI and JBI ACTUARI When this analysis is complete the data from these modules are automatically uploaded into JBI CReMS and a draft report is generated through JBI CReMS 5 1 1 JBI Reviewers Note JBI Reviewers are required to enter their protocol into JBI CReMS and to request assessment and approval from the Synthesis Science Unit at JBI When JBI assessment processes are complete the systematic review itself can commence The first step to compile a systematic review project in JBI CReMS is to either open a current and saved review or begin a new one For new reviews the next step is to define a protocol before adding studies Existing reviews can be worked on from the point they were last saved The final stages of the systematic review process in JBI CReMS involve
45. Limited 1997 3 Pearson A Balancing the evidence incorporating the synthesis of qualitative data into systematic reviews JBI Reports 2003 2 45 64 188 JBI SUMARI ACTUARI 49 Introduction to JBI ACTUARI The Joanna Briggs Institute Analysis of Cost Technology and Utilization Assessment and Review Instrument JBI ACTUARI has been designed to enable reviewers to systematically review and combine the results of economic evaluation healthcare primary research The JBI ACTUARI software facilitates the management appraisal extraction and analysis of the results of studies that investigate the economic evaluation of two or more alternatives of healthcare intervention or program It is integrated into the Joanna Briggs Institute Comprehensive Review Management System software JBI CReMS as a web based database and incorporates a critical appraisal instrument data extraction forms the synthesis of similar studies function and a reporting function The structures and processes for the systematic review of economic evaluations of healthcare interventions embedded in JBI ACTUARI have been particularly informed by the works of Michael Drummond et al Centre for Health Economics University of York and John Nixon et al Centre for Reviews and Dissemination University of York 50 Accessing JBI ACTUARI As JBI ACTUARI is web based software browser compatibility has been extensively tested JBI ACTUARI will run on all common web
46. Review If you have chosen to do a Non JBI Review you will not use the JBI critical appraisal instrument in Instead the Assessment screen will appear as below Norrotive Opinion and Text Assessiment and Review Instrument Include After quality assessment if the publication is to be included in the review Yes should be selected from the Include drop down menu and the reason can be entered Selecting Yes will allow the reviewer to progress to data extraction for the study If No is selected the publication citation and the reason entered will appear in the table of excluded studies in the final review report in CReMS v 5 0 Click on lt Update gt to save any information entered on this screen Click on lt Undo gt to remove any text entered in the Reason text field 43 JBI NOTARI Extraction Included publications that have been appraised are automatically made available for data extraction At this point a reviewer can perform the Extraction for each publication An extraction is a summary of the main details of the publication and should be conducted after carefully reading the publication An extraction includes ten different fields relating to the type of text its authors and participants and the content of the paper Extraction must be performed on a publication before it can have conclusions allocated to it Either the primary or secondary reviewer can perform the extract
47. Within the Reviews page click the Edit button to edit the Review Modify the relevant information in the edit area Pressing Update saves the information and returns the user to the Reviews page Pressing Cancel returns the user to the Reviews page and does not save changes that have been made Pressing the Close button will change the status of the review to Closed this means it will no longer appear amongst your Opened review titles in the Reviews page Qu QARI Qualitative Assessment and Review Instrument Reviews study ntegor A comprehensive literature review on emergency surgery Review Title What are the common meanings and shared experiences the physicians encounter in relation Review Question O Regency surgery Year commenced 7009 Primary Rewewer ayeaye Secondary Reviewer na Search Review Status Non Review Undo 18 5 Deleting a review Within the Reviews page click on lt Delete gt from within the Action column to delete the entire review project from the JBI database When you click on lt Delete gt a dialogue box will appear prompting you for the primary reviewer s password When the primary reviewer s password is entered click lt Confirm gt Pressing the lt Delete gt button will display a prompt asking for confirmation Pressing the lt OK gt button will delete the Review pressing the lt Cancel gt button will cancel the delete acti
48. a systematic review Can have several dimensions such as clinical e g the studies are clinically similar or comparable or statistical e g the studies are statistically similar or comparable An illustration an example of textual data from a primary qualitative research study that supports a finding in the meta synthesis process It can be in the form of a direct quote observations or statements Indirect costs refer in economics to the productivity gains or losses related to illness or death An intervention in general is a form of healthcare provided to individual patients or groups communities it may also be used when describing a particular form of treatment being tested see treatment JBl is the Joanna Briggs Institute JBI Affiliation is an association with a JBI collaborating entity such as a collaborating centre or an evidence synthesis group JBI ACTUARI is the Joanna Briggs Analysis of Cost Technology and utilization Assessment and Review Instrument JBI CReMS is the Joanna Briggs Institute Comprehensive Review Management Software used for conduct and management of a JBI systematic review There are four component analytical modules JBI MAStARI JBI NOTARI JBI QARI and JBI ACTUARI JBI MAStARI is the Joanna Briggs Institute Meta Analysis Statistics Assessment and Review Instrument The analytical module designed for JBI systematic reviews of effectiveness evidence JBI NOTARI is the Joanna Briggs Institute Narrative Opin
49. agreed format is essential to minimize error and to provide a historical record of decisions made about what constitutes data for the purposes of the review and what is to become the dataset for extraction and synthesis A data extraction instrument is incorporated into the JBI NOTARI module SUMARI JBI 155 36 4 Meta aggregation most complex problem synthesizing textual data is agreeing upon and communicating techniques to compare the conclusions of each publication Drawing from the literature the meta aggregation of text facilitated by JBI NOTARI involves categorizing the conclusions or recommendations and then synthesizing these categories In order to categorize conclusions or recommendations reviewers need to establish e their own rules for setting up categories e how to assign conclusions to categories and e how to aggregate categories into synthesized findings The intent is that the conclusions or recommendations are grouped on the basis of similarity in meaning Reviewers need to document these decisions and the rationale for these in the systematic review report The JBI NOTARI approach to synthesizing the conclusions of narrative opinion and text papers requires reviewers to consider the validity of each publication as a source of guidance for practice identify and extract the conclusions from papers included in the review and to aggregate those conclusions into synthesized findings It is important t
50. allocation 6 Were the control and treatment groups comparable at entry e gy Were groups treated identically other than for the named interventions 6 Were outcomes measured in the same way for all groups E 9 Were outcomes measured m a reliable way 10 Was appropriate statistical analyss used a Include Yes T Reason scores 26 Luz bol LZ 33 4 Critical appraisal criteria for comparable cohort case control studies There are nine critical appraisal criteria for comparable cohort case control studies In the example listed below the reviewer made the decision to include the study because there were more than four yes scores Assessment for Hill 2002 Type Primary User lungca Design Comparable Cohort Case Control Studies Not Criteria Yes No Unclear Applicable Comment 1 Is sample representative of patients in the population whole 2 Aro the patients at a similar point in the course of their condibon ilness Has bias been minimised in relation to selection of cases and of controis 4 Are confounding factors identifed and strategies Lo deal with them stated 5 Are outcomes assessed using objective criteria B 6 Was follow up carried out over sufficient time period LI 7 Were the outcomes of people who withdrew described and included in the analysis 8 Were outcomes measured in a rekable way 9 Was appropriate stabstcal analysis used include Yes Y Reason score
51. between the primary and secondary assessments and in collaboration with the Secondary Reviewer determine the final assessment for each of the critical appraisal criteria If agreement between the two reviewers cannot be reached a third reviewer should be engaged to assist in the final assessment Use the drop down box to allocate Yes No Undefined status in the final assessment The reason for excluding a study must be outlined in the final assessment Included studies will now show Included in the Status column and Complete in the Assessment column Ed etal Cost Effectiveness of inhaled corticosteroids in asthma adult patients JAMA 2009 Extraction Complete Edit Delete Buxton etal Cost Effectiveness of inhaled corticosternids in adult asthma patients NEM 2009 Extraction Complete Edit Delete Mumus ot a Cost Effectiveness Health Policy 2009 Included Complete Edit Delete John eral Cost effectiveness BM 2008 New Primary Completed Edit Delete 1 v records per page 545 How to edit an existing assessment To edit an existing assessment select the study from the studies page Press the Assessment page on the left hand menu and the assessment page will appear Click on the Edit Primary Edit Secondary or Edit Final buttons and edit the assessment as appropriate Pressing the Update button will save any changes made Pressing the Cancel button will cancel the action and return you to the assessment page
52. browsers including Microsoft Internet explorer Firefox Safari and Google Chrome This range of platforms and browsers is designed to ensure that the majority of users will have access to the system You will need a network or Internet connection to access the JBI ACTUARI server JBI ACTUARI can be accessed through a firewall as it uses standard web protocols i e HTTP port 80 JBI ACTUARI has been designed to operate on low bandwidth connections such as a dial up modem 50 1 Logging on Direct access to JBI ACTUARI is available at the following URL adaress http www jbiconnect org sumari actuari index cfm Alternatively access is available through the JBI web site at http www joannabriggs edu au Click on the Directory button This will take you to the resources web page http www joannabriggs edu au Default aspx Click on the link JBI SUMARI systematic review software FREE SUMARI JBI 191 This will take you to the JBI SUMARI webpage Click on the link Analysis of Cost Technology and Utilization Assessment and Review Instrument You will be presented with the JBI ACTUARI logon screen This screen prompts you to enter your username and password Enter your username and password and click lt Logon gt to connect Analysis of Cost Technology and Utilisation Assessment and Review Instrument Change Language z Users of SUMARI v5 0 online modules should download CReMS v5 0 to complete th
53. building the report and viewing the final result Throughout this guide the uppermost options are referred to as the Menu Bar File Studies Modules Export Help The options below the Menu Bar are referred to as Tabs 1 Review Summary Protocol Studies Report Builder Report View 18 JBI SUMARI 5 2 Logging on Double click on the JBI CReMS icon which presents the JBI CReMS splash screen After a moment the log on screen will appear Enter your Username and Password This will take you to the Welcome to JBI CReMS page fiis en CReMs Login Enter username and password to login to Crems Username Password C ok Ca Cancel Work offline 2004 Tha Joanne Bri Displaying login screen SUMARI JBI 19 6 Creating a Review or opening an existing review in JBI CReMS The first step toward building anew report using JBI CReMS is to create anew review Click on lt New Review gt to create a new review project or select an existing review from the list and click lt Open gt amo eoc Welcome to Crems Select existing review from list or click the New Review button to create new 7 New Review Open Delete Quit HPEFEEPIEIRPCERCUIEEE O Please note this same dialogue box to Add a new review will open if you wish to Add a new review when you already have a review project op
54. click the appropriate link Secondary UMa Iha Ao SERAN Soi of Reviews Closed i ee SR of self What is the best available evidence of the appropriateness Of self monitonng of blood in pabents crag glusoss in pabents with type 2 diabetes 2008 Dan diabetes Msaningiviness of What are the meaningfuhes of assisted bathing for older adults with lt a s 2010 Cindy Stem Delete caregivers 552102 What are the issues in relation to the management strategy of management emergency department 2010 emergency Sapartment 1 1 records per page Version 5 0 Copyright Joanna Briggs Institute 2011 NOTARI Narrotive Opinion and Test Assessment imd Rewew Instrument Review Synthesis Publications in Meaningfulness of assisted bathing for older adults with dementia and their caregivers Ths m used to the retneved Publicabons From ths Pubbcabons can be selected to perform agsesement and extracbon and to develop Conciumons The down bex can be used to filter as naw included excluded extraction or finished of Citations 14 mem Skenes S M Journal of 1997 Extraction Complete Rdg Bathing It s a tough job Gerontological Delete Murang Gorher Wai M Canadian 1998 Extraction Complete Siberfeld et al the need for uniform bathing policy c meds Main LS Developing C R A F T approach t
55. comprehensive descnpbon of altematwes 3 Are af important and relevant costs and outcomes for each altemative identified 4 clinical effectiveness been established 5 Are costs and outcomes measured accurately 6 Are costs and outcomes valued credibly 7 Are costs and outcomes adyusted for differential 8 1 there an incremental analysss of costs and consequences 9 Were sensitrity analyses conducted to investigate uncertamty in esbmates of cost or consequences 10 09 study results include af issues of concem to users 11 Are the results generalisable to the setting of interest in the review Include Undefned Reason LJ Gm Version 5 0 Copyright Johan Briggs Institute 2011 A new column has been added to the form Not Applicable Select this option if the question asked in the JBI tool is clearly not applicable to the paper being appraised Alongside each appraisal question a text field Comment has also been introduced for users to insert a comment of up to 200 characters If this field is populated with text it is maintained here in the online module for user reference This text will not appear in any part of the review report in CReMS v 5 0 Click Undo to clear all of the information entered from the screen This will clear the entire appraisal form also including the details added to the Comment field Each of the critical appraisal criteria must be addressed using th
56. conditions for fellows surgical Delete tranaes and esu tn aos graduates Mahonal Confidential Enquiry intg Emergency Admissions A journey in Report fom 2007 included Complete Patient Outcome and Death the nght direction Execubve Delete 78 SUMARI 18 2 Adding anew review Within the Review page pressing the lt Add gt button opens the Details page where new review can be added If you are using JBI CReMS in conjunction with JBI QARI whenever a protocol is logged into JBI CReMS and is allocated to JBI QARI it will automatically create a new review in JBI QARI Review Titio Review Question Year commenced Primary Reviewer ne Secondary Reviewer Search Non Review No ove Undo Cancel 18 3 Assigning reviewers The name of the person who has logged in will automatically be entered as primary reviewer The process to select the secondary reviewer from within QARI is the same as that described in the CReMS chapter of this user guide see Section 6 1 search for find and select your secondary reviewer you will need to enter both their username and email address registered via the SUMARI registration page for new users at http www jbiconnect org tools services sumari_reg php and for existing users at http www jbiconnect org tools services update_profile php The data fields for a new review are all mandatory SUMARI JBI 79 18 4 Editing a review
57. document Refresh Reload the screen contents SUMARI JBI 59 number of tables will be automatically uploaded into the report and reviewers should check these Note that the analytical modules generate these tables If reviewers wish to edit them this requires making changes in the appropriate analytical module 10 2 1 JBI Reviewers Note JBI Reviewers are required to submit a draft report to JBI for peer review To do this forward the pdf or rtf of the report to the Synthesis Science Unit at JBI The full review report can be exported in either rtf or odf format as described above in Section 7 9 1 11 Work Mode Scroll over Work Mode in the dropdown File menu The Online radio button will be highlighted Online is the default operating Mode for JBI CReMS v 5 0 Software Studies Modules Export Help Mode Onine hary Protocol Studies Report Builder Report View gt Online Offline Title me effectiveness of SUMARI v5 0 versus v4 0 for producing a systematic review A review Question The objective s of this review is are to identify the effectiveness of state interventions jon state outcome More specifically the objectives are to identify The effectiveness of insert text lon frinseittexr _ Year 2011 Select the Offline radio button to work on the review project whilst disconnected from the Wo
58. fields should be completed and serve as a valuable template directing the important information that should be included in a Systematic review protocol If you do opt to use the standardized text this will automatically generate text in some of the Protocol fields At this point the review question s objective s can be revised In the Background field enter your initial literature review also detailing the rationale for the review and its relevance to health care The specific criteria related to the participants intervention and comparator and outcomes of the review can also be entered and edited Read the text carefully throughout Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash 4 characters 42 JBI SUMARI Review Summary Protocol Studies Report Builder Report View Review title inserted here Qualitative 11 QARI Set Texi Textual 1 1 NOTARI 3 Set Text Economic ACTUARI Set Text Set Review Question More specifically the objectives are to identify the evidence on The cost effectiveness cost benefit cost minimisation cost utility modify text as appropriate of insert text compared to insert text on insert text in insert text Background Inclusion Criteria Types of Participants This review will consider studies that include describe participants Types of Intervention s Th
59. loca ng the researcher culturally or theorebcaly 2 3 5 The influence of the researcher on the research and vice versa is 7 addressed B Participants and ther are adequately represented B The research is ethical according to current criteria or for recent studies there is evidence of ethical approval by an appropriate body 10 Conclusions drawn in the research report do appear to flow from the e analysis or interpretation of the data Include Yes Reason The study of adequate quality to include Use the radio buttons to answer Yes No Unclear Not Applicable to each of the questions This process is mandatory for all questions before being able to progress If the question asked in the JBI tool is clearly not applicable to the paper being appraised select Not Applicable Often an appraisal question will be not applicable to all of the papers of a particular study design which meet the inclusion criteria for a particular review The assessment of a study can result in a study being either included or excluded from the review Use the Include drop down menu to select whether the study is to be included or excluded 86 SUMARI Alongside each appraisal question a text field lt Comment gt has been introduced for users to insert a comment of up to 200 characters If this field is populated with text it is maintained here in the online mod
60. of Cost Technology and Utilisation Assessment and Review Instrument Reviews Study Logout o Results For A systematic review of cost effectiveness of paclitaxel and cisplatin versus cyclophosphamide and cisplatin Comparison Dominance rating studies 27277 Paclitaxel plus cisplatin vs cyclophosphamide plus cisplatin 6 Berger et al 1998 1 Covens 1996 1 ACTUARI VIEW Results Version 5 0 Copyright Joanna Briggs Institute 2011 55 3 ACTUARI Data Synthesis Repeat the process for all other studies that have conducted economic evaluation of the same intervention and comparator Once this is complete click on the ACTUARI VIEW hyperlink on the Results page 220 SUMARI ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Results For A systematic review of cost effectiveness of paclitaxel and cisplatin versus cyclophosphamide and cisplatin paclitaxel plus cisplatin vs cyclophosphamide plus cisplatin Cost Studies No of Clinical Decision Studies effectiveness Don t use Further analysis required Neutral Further analysis required Use 0 00 Wit 0 0 0 Berger et al 1996 Covens 1996 The synthesis in ACTUARI brings together the individual studies in a visual tabular format From the data extraction particularly the outcome specific data per included paper reviewers are able to generate a matrix which lis
61. of evidence Current approaches to evaluating evidence utilize a hierarchy of evidence designed to assess the validity of recommendations for clinical guidelines focusing on the effectiveness of treatment and ranking only quantitative evidence according to the rigor of the research design used to limit bias Drawing from the literature as well as input from a panel of experts an approach to categorizing the validity of qualitative findings was developed for JBI QAHI This is based on three levels of credibility Degrees of credibility Unequivocal evidence beyond reasonable doubt that may include findings that are matter of fact directly reported observed and not open to challenge Credible albeit an interpretation plausible in light of the data and theoretical framework The interpretations can be logically inferred from the data but because the findings are essentially interpretive they can be challenged Unsupported when neither of the other level descriptors apply and when most notably findings are not supported by the data These three levels of credibility are incorporated into the QARI software SUMARI JBI 73 15 Accessing JBI QARI As JBI QARI is web based software browser compatibility has been extensively tested JBI QARI will run on all common web browsers including Microsoft Internet explorer Firefox Safari and Google Chrome This range of platforms and browsers is designed to ensure that the majority
62. or coping with breast cancer An intervention is a planned change made to the research situation by the researcher as part of the research project Qualitative research does not usually rely on interventions as they are traditionally understood in quantitative research hence the information to be recorded here is generally in relation to the phenomena of interest of the review 21 1 4 Setting The Setting describes where the research was conducted the specific location For example at home in a nursing home in an acute care hospital in a dementia specific ward in a sub acute hospital some research will have no setting at all e g discourse analysis 21 1 5 Geographical context The Geographical Context is the location of the research it is useful to be as specific as possible in describing the geographical context by including not just the country but whether it was a rural or metropolitan setting 21 1 6 Cultural context Cultural Context seeks to describe the cultural features in the study setting such as but not limited to time period 19 century ethnic groupings Indigenous people age groupings older people living in the community or socioeconomic groups working class When entering information be as specific as possible This data SUMARI JBI 95 should identify cultural features such as employment lifestyle ethnicity age gender socioeconomic class location time etc 21 1 7 Participants Infor
63. or cross products ratio is the ratio of the odds of an event occurring in one group to it occurring in another group it is the primary measure of association in case control studies A primary study is a research publication which forms the basis of the data set of a systematic review A protocol is a pre determined plan for the conduct of a systematic review It provides details of how the review will be conducted and reported QALY quality adjusted life year is a generic measure of health related quality of life that takes into account both the quantity and the quality of life generated by interventions treatments QARI View is a meta aggregation table created by JBI QARI which includes the categories and findings from which the synthesized findings originated SUMARI JBI 225 Qualitative research is broad term used to describe the various research methodologies including ethnography phenomenology narrative analysis and grounded theory Review authors are the authors of a systematic review for a JBI systematic review there are at least two review authors at least one of whom has undertaken CSR training with JBI or the Cochrane Collaboration RR is the relative risk or risk ratio is the ratio of the risk of an event occurring in one group to the risk of it occurring in another group it is the primary measure of association in cohort studies SD is the standard deviation a measure of the variance of data points around a me
64. or using standard errors instead of standard deviations 2 Do not proceed with the meta analysis Consider alternatives such as summarizing the results of included studies in a narrative summary 3 Explore the heterogeneity either through a stratified analysis also known as sub group analysis or meta regression In stratified analysis you would theoretically analyze a sub set of the included studies which have an aspect in common For example you may be looking at the effectiveness of an intervention which includes a range of different sub types underneath it In a systematic review of the effectiveness of moist wound healing products on healing outcomes sub group analysis was conducted on the effectiveness of hydrocolloids versus calcium alginates Alternatively sub group analysis can be conducted using specific outcomes e g rather than looking at the healing rate of all wounds you could specify an examination of burns wounds only or on studies that use a specific methodology e g only including studies in which the wound assessor was blinded to the treatment Sub group analysis should only be conducted on pre specified comparisons of interest and does not represent an opportunity to fish through the results for comparisons showing significant differences Meta regression allows a similar examination as sub group analysis for variables which are continuous as well as categorical In meta regression the effect of a variable thought
65. primary care a systematic review Executive Summary Background Objectives Inclusion Criteria Types of Participants Types of Intervention s Phenomena of Interest Types of Outcomes Types of studies Search Strategy Methodological quality Refresh The Refresh button at the bottom of the Report Builder page is used when you are working within the analytical modules JBI QARI JBI NOTARI JBI MAStARI and JBI ACTUARI and have JBI CReMS open at the same time After making the necessary changes or additions in the analytical modules press lt refresh gt when you return to JBI CReMS Text entered into the protocol will automatically be transferred to the text boxes in the main report see Section 7 9 2 Background Objectives Inclusion Criteria Search Strategy Method of Review Data collection and Data synthesis Please note it is important to edit this transferred text as the protocol describes what the reviewers intended to do and is in future tense Editing to change the text to the past tense is essential 10 1 1 Description of Studies and Assessment of Methodological Quality In the results section the reviewer is required to enter text under the heading Description of studies The results of the search will automatically be uploaded to the tables in the appendices 56 JBI SUMARI Results Heecriptforr of Table of studies found and selected for retrieval Number o
66. report problem to JBI Note You need to dovnload CReMS v5 0 to work with this QARi version Version 5 0 Copyright Joanna Briggs Institute 2011 SUMARI JBI 75 16 2 Logging off When logged on the main menu bar remains across the top of each page Clicking on the lt Logout gt button on the main menu logs the user out after a quick confirmation and ends the session 17 Main menu The main menu is always across the top of the screen Qu QARI Qualitative Assessment and Review Instrumen Reviews Study ategories lt Reviews gt shows the list of systematic reviews you have created in QARI or allocated to QARI from CReMS The titles of each review appear to the left of page as links that you can click to open and work on or update lt Study gt cannot be selected until you have clicked on a particular review title Once a review has been opened the Study button will show the list of papers that have been allocated to the review see Section 18 1 The Categories menu item also requires that a review be selected before you can view or add categories see Section 23 The Synthesis menu item will display the available syntheses or enable users to add a synthesis once a review has been selected and the prior steps in data extraction undertaken see Section 24 Logout will take users to a confirmation screen before exiting the QARI program About links to a summary of the review p
67. review When creating a new review you will notice a Non JBI Review option in the Add New Review dialogue box This feature is explained in more detail for each analytical module in other sections of this manual In short this feature removes the need for reviewers to use the JBI critical appraisal instruments in the online analytical modules Use of these tools is a pre requisite of submission of a review to the JBI Library of Systematic Reviews http connect jbiconnectplus org JBlReviewsLibrary aspx unless another appraisal instrument has been pre approved by the JBI Synthesis Science Unit at the time of protocol submission hence the default setting of No This feature also disables the use of the JBI CREMS Set text which can be selected during protocol development to aid in the writing of the protocol for a JBI systematic review see Section 7 2 24 SUMARI This feature also be useful for those users who have intention of submitting the systematic review to the JBI Library but rather are simply taking advantage of the software capabilities to aid in the conduct of a systematic review of varied forms of evidence Add New Review Title of second review Year 2011 Primary Reviewer Secondary Reviewer e Non JBI Review No Eset Undo Cancel When the new review is added a review summary will appear SUMARI JBI 25 64 Review Summary Screen
68. samuel lapkin newcastle edu au The University of Newcastle Faculty of Health School of Nursing and Midwifery Australia and University of Newcastle Evidence Synthesis Group a collaborating centre of the Joanna Briggs Institute Review question objective The objective of this review is to critically appraise and synthesize the best available evidence based on primary studies comparing debriefing to no debriefing or different types of debriefing as it relates to simulation based learning for health professionals in order to address the following question What is the effectiveness of debriefing as it relates to simulation based learning for health professionals Background Abridged Simulation is defined as a technique used to replace or amplify real experiences with guided experiences that evoke or replace substantial aspects of the real world in a fully interactive manner 19129 The use of simulation for educational purposes began decades ago with the use of low fidelity simulations and has evolved at an unprecedented pace Debriefing is considered by many to be an integral and critical part of the simulation process 2 However different debriefing approaches have developed with little objective evidence of their effectiveness While the debriefing approaches outlined above vary in terms of process and terminology they each include structured and purposive discussions about prior experiences However in health care this disc
69. selection can be made at any stage during the protocol development More than one study design can be selected Please select quantitative study design s to be included C Experimental e g RCT quasi expt Observational e g CohortiCase control Descriptive e g Case Series Studies Assessment of Methodological Quality Data Collection For example if a reviewer is conducting a review informing the effectiveness of an intervention or therapy they may wish to include only experimental study designs and therefore will select only the first tick box labelled experimental e g RCT quasi expt Only the appraisal tools and extraction instruments relevant to experimental studies will appear appended to the protocol and review reports exported Conversely this selection does not need to be made here at all as if the option to insert JBI Set text is lt Set gt see Section 7 2 and 7 5 2 a similar choice based on study design is offered so the text inserted regarding the Assessment Extraction and Synthesis is relevant to the Type of Study being targeted by the review see below If you prefer not to use the JBI Set text feature of JBI CReMS selecting study design alongside the Assessment of Methodological Quality text box will append the appropriate JBI assessment extraction instruments to your exported pdf or rtf export see Section 7 9 1 38 JBI SUMARI 75 2 Inserting
70. site manually At this stage in the review reviewers proceed with critical appraisal data extraction and data pooling i e meta analysis or meta aggregation If these processes are pursued using one or more of the analytical modules the results are automatically uploaded to Report Builder in JBI CReMS 10 Building and Viewing the Systematic Review Report Data entered into the Protocol when transferred to the report see Section 7 9 2 and in JBI SUMARI modules is transferred to the Report Builder and Report view see Section 11 pages of JBI CReMS Report Builder is editable and is the screen in JBI CReMS where reviewers actually write the review report Please note that although JBI CReMS does not have functions to edit text accessible via the mouse common keyboard controls such as copy lt ctrl c gt and past lt ctrl v gt command rather than ctrl in Mac are functional 10 1 Report Builder To open click on the Report Builder tab The review title will be entered automatically into Report Builder but the reviewer must enter data in all of the text boxes under the heading Executive Summary Note you can cut and paste elements from the main report fields and edit them in the Executive Summary fields SUMARI JBI 55 File Studies Modules Export Help Current Working Mode Online l Review Summary Protocol Studies Report Builder Report View The relationship between error and harm in
71. studies using a number of statistical approaches Joanna Briggs Institute Narrative Opinion and Text Assessment and Review Instrument JBI NOTARI This module accessible through CReMS is designed to facilitate critical appraisal data extraction and synthesis of expert opinion texts and of reports Joanna Briggs Institute Analysis of Cost Technology and Utilisation Assessment and Review Instrument JBI ACTUARI This module accessible through CReMS is designed to facilitate critical appraisal data extraction and synthesis of economic data LP Accessing JBI SUMARI You will however need to register your details for a primary and secondary reviewer username and password Direct access to the JBI SUMARI registration form is available via JBI at LWW which you can access through http evidencebasedpracticenetwork nursingcenter com 12 JBI SUMARI CREMS 3 Introduction to JBI CReMS JBI CReMS is designed to guide the reviewer in the systematic review process from the protocol development to final report stage and to archive all components of the review JBI CReMS can be used as a stand alone program to manage and archive a review or alongside the four analytical modules developed to articulate with it Whenever a protocol is entered and confirmed in JBI CReMS the review details and the details of studies and or papers selected for critical appraisal are automatically uploaded into the analytical modules selected by the reviewer Sim
72. study doss not nave data meaoctated With Win Ihe Inked mnatyncal Modules 11 ieformamon win ter iout 0 Selecting Papers for Critical Appraisal Those papers that have been inserted in the list that have been established through the selection process to match the inclusion criteria for the review project now need to be assigned to the appropriate analytical module of JBI SUMARI JBI QARI JBI NOTARI JBI MAStARI and JBI ACTUARI Critical appraisal is conducted through one or more of the analytical modules To allocate papers selected to an analytical module click on the appropriate tick box at the right of the paper selected Review Summary Protocol Studies Report Builder Report View of Citations 54 Title Journal Volum Issue Pagels Qari Notari Mastari Actuari Reference Deleted a ke 2 46430 Missed and 7 488 3 v H 3 El 46981 Outpatient 9 837 41 v 3 E 46982 Gandhi Te Drug Compl Journal 15 3 149 1 g 3 Ej 46983 Gandhi 2003 Adverse Dru NewEn 348 16 1556 41 M Ll 3 5 46425 Garfield S 2009 Quality of m BMC 7 50 4 T E LI E 46431 Mitigation o Quality 17 3 201 2 T Ej 3 Ej 46990 Incidence Journal 289 9 11027 i LJ 3 Ei 46410 Ambulatory Journal 26 1 63 82 fa Q m E T 46416 HicknerJ 2008 Testing pro Qual
73. test review Detal This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop 222222 findings The drop down box can be used to filter studies as new included excluded extracted or finished Extraction Weste A m of Cations 8 SE EEE EE ES oe Eee I Alexa et al quiaitative study DNA 2010 None Edit Delete Ed et i about this DNA 2010 Induded Compiate Delete zac gta RCT DNA 2010 Included Complete dr Ed and Mel something new DNA 2010 Excluded Complete tat Deiste Googenstatter et al Aviation Ayling high 2009 Induded Complete td Qeiete me blah biah 2008 Induded Complete fd siete dessrin blog biog 2006 Included Complete td angther whatever that one 2003 New None tat Delete 1 36 records per page 20 EN Version 5 0 na Briot I etituta 2811 Amongst the changes on this screen an Actions column has been added with functions alongside each study At the bottom of the page you will also see you are able to select the number of studies to display on each page Click on the 10 value box to indicate how many studies you would like to appear on each page This value can be increased to 20 50 or 100 prior to any re pagination Whilst assessing or extracting studies in the system the module will now return to the page displaying the last paper assessed extracted rather than returning to the first study as was the cas
74. the SMD using fixed effects Cohen s SMD and Hedges SMD Both options produce a similar result although Hedges SMD is generally preferred as it includes an adjustment to correct for small sample size bias As per WMD the DerSimonian and Laird method is used for random effects models calculations for SMD see 58 3 16 for a discussion of fixed effects models and random effects models 58 3 14 Combining continuous and dichotomous data Occasionally review authors may include different studies that have examined the same outcome using both continuous and dichotomous measures For example one study may measure the mean blood pressure as a continuous variable in mm Hg whereas another study may only report the blood pressure data according to whether patients were hypertensive In this case if the raw data are available from the study authors it could be possible to convert the continuous data into a dichotomous scale whether patients were hypertensive or not using the same cut off blood pressure to define hypertension It is also possible to re express odds ratios as standardised mean differences and vice versa More information about this is provided in the Cochrane Handbook for Systematic Reviews of Interventions 58 3 15 Heterogeneity When used in relation to meta analysis the term heterogeneity refers to the amount of variation in the results of included studies For example if you have three studies to be included in a meta a
75. the above example where P 0 50 suggests that meta analysis is valid however note that this test is underpowered i e it will often miss a statistically significant difference when one is actually present and this must be considered during interpretation 35 15 Determining the significance of the overall effect size The overall effect size of the treatment versus the control 2 45 Section 35 12 example suggests that the treatment does provide superior results on average those in the treatment group scored 2 45 units more than those in the control group This impression is confirmed by examination of the confidence intervals that clearly do not include 0 0 The relatively narrow confidence intervals of the overall effect compared to the individual studies indicate how meta analysis works to decrease variability around an overall result thereby increasing confidence in the overall result The graphical result of a significant overall effect is confirmed by the large size of the Z score 4 35 calculated for the overall effect size The probability P associated with this Z score is calculated according to the Z distribution In this case P lt 0 0001 indicating a highly significant overall effect size 35 16 Interpreting a forest plot MAStARI view dichotomous data The following example is a meta analysis of three hypothetical randomized controlled trials that evaluated the effectiveness of Panadol treatment versus a placebo c
76. the conclusions from the studies included in your review and creating the categories conclusions must then be assigned to categories When you click on the conclusion name hyper link the Conclusion Details page will appear see above detailing the conclusion and allowing selection of a category to which the conclusion can be assigned Simply select from amongst the categories in the Category drop down menu NOTARI v 5 0 allows assignment of an individual conclusion to multiple categories This can be done by holding down the Ctrl key and making multiple selections from the list or by repeating the assignment process multiple times for the one conclusion Where a finding has been designated as Unsupported US from the Evidence drop down list users will find that the ability to select categories to assign the conclusion to has been disabled in v 5 0 Unsupported conclusions should not be included in syntheses that appear in reviews published in the JBI Library of Systematic Reviews Clicking Update will save this information and take you back to the Categories page with the new category information visible in the Category column Clicking Delete will erase the conclusion and clicking Cancel will exit without saving the SUMARI JBI 183 data entered 45 3 Assigning conclusions to categories in a Non JBI Review The procedure for assigning conclusions to categories in a non JBI review see Section 40
77. the entire review project from the JBI database When you click on lt Delete gt a dialogue box will appear prompting you for the primary reviewer s password When the primary reviewer s password is entered click Confirm Pressing the Delete button will display a prompt asking for confirmation Pressing the OK button will delete the Review pressing the Cancel button will cancel the delete action 40 6 Creating a Non JBI Review in NOTARI You will notice on the review edit screen there is also reference to the Non JBI Review The default setting here is Qu NOTARI Narrative Opinion ond Assessment ond Review Instrument Latenonie comprehensive literature review on emergency surgery Review Title What are the common meanings and shared experiences the physicians encounter in relation Review Question emergency surgery Yaar commanced 2000 Primary Reviewer Secondary Reviewer Search Review Status Non 381 Review No m LZ C cra 162 JBI SUMARI If you select Yes from the drop down menu you will see the following warning message appear on your screen Windows Internet Explorer If you select to skip the appraisal step and not use the JBI appraisal instruments this review will not be considered for publication in the JBI Library of Systematic Reviews Contact the Synthesis Science Unit at JBI for further infor
78. the majority of users will have access to the system You will need a network or Internet connection to access the JBI MAStARI server JBI MASIAHRI can be accessed through a firewall as it uses standard web protocols i e HTTP on port 80 Due to the java applet functions that process the meta analytical calculations described later in this chapter JBI MAStAHI requires fast internet connection to perform optimally Please ensure that you have the latest versions of java installed and that JavaScript is enabled and active in your browser and that browsers will accept cookies at least for the period that you wish to work on JBI MASTtARI If you experience problems running the java applet it is recommended you open your java control window and clear the java cache 110 JBI SUMARI 29 JBI MASIARI Getting started 29 1 Logging on MAStAHRI can either be accessed via CReMS v 5 0 or directly through the JBI website Direct access to JBI MASTARI is available at the following URL address http www jbiconnect org sumari index cfm Alternatively access is available through the JBI web site at http www joannabriggs edu au Click on the JBI SUMARI link under the Appraise Evidence drop down menu on the left hand side of the webpage The JBI SUMARI home page will then appear in the centre of the page Click on the JBI MAStARI logo You will be presented with the JBI MAStARI logon screen This screen prompts you to enter your username and passw
79. the management strategy of management emergency department ox atarategy of 2010 ne ayeaye emergency department 12 records per paga Each review has a Primary and Secondary reviewer A primary reviewer leads the review and has rights to add edit or delete reviews To access reviews for which you are the primary reviewer click on the Primary radio button Before a secondary reviewer can work on a project they must be assigned to the review either when the review is first created or later by editing the review A secondary reviewer assesses every paper selected for critical appraisal and assists the primary reviewer in conducting the review To access reviews as the secondary reviewer click on the Secondary radio button SUMARI JBI 159 Ongoing and completed reviews be viewed clicking on the lt Opened gt and lt Closed gt radio buttons respectively on the left of screen 40 1 Opening an existing review To open an existing review click on the review title By opening the review in this manner you are automatically selecting it and are able to see the publications listed by citation that have been allocated to the review NOTARL Narrative Opaon and Fext Assessment and Keview Instrument severe LE Filter Reviews Reviews Synthesis 9 Pnmary This Wats the Reviews that in the system To add a review click on the Add button below To edit or delete Review
80. the review process The status column on the studies page indicates what stage of the review the study is at All All studies can be viewed New The study has no assessment performed Included The study has had final assessment done and is included in the review Excluded The study has had final assessment done and is excluded from the review Extracted The study data has been extracted Finished The study data has been included in meta analysis 33 JBI MAStARI Assessment A study is critically appraised or assessed to determine if it is of sufficient quality and has included the correct patient population interventions and outcomes for inclusion in the systematic review Studies of low quality or which have not included the correct patient population intervention or outcome are excluded from the review A study must be read and fully understood by each reviewer before it can be critically appraised Critical appraisal is first conducted by the primary reviewer and then conducted independently by the secondary reviewer The primary reviewer will then conduct the final assessment based on the two previous assessments to determine whether the study is included or excluded Any disagreement between reviewers should be resolved by a third reviewer 331 How to start critical appraisal The primary reviewer must start the critical appraisal process From the studies page click on the authors hyperlink of a study which has New in th
81. theoretical orientation A high quality report will include a statement that clarifies this 20 2 7 Influence of the researcher on the research and vice versa Is the potential for the researcher to influence the study and for the potential of the research process itself to influence the researcher and her his interpretations acknowledged and addressed For example s the relationship between the researcher and the study participants addressed Does the researcher critically examine her his own role and potential influence during data collection s it reported how the researcher responded to events that arose during the study SUMARI JBI 91 20 2 8 Representation of participants and their voices Generally reports should provide illustrations from the data to show the basis of their findings and to ensure that participants and their voices are represented in the report 20 2 9 Ethical approval by an appropriate body A statement on the ethical approval process followed should be in the report 20 2 10 Relationship of conclusions to analysis or interpretation of the data This criterion concerns the relationship between the findings reported and the conclusions In appraising a paper appraisers seek to satisfy themselves that the conclusions drawn by the researcher are based on the results of analysis or key findings 20 3 Filtering studies In reviews with large numbers of studies it is useful to use the filter fu
82. to and therefore the type of review being conducted Select the tick box alongside the analytical module you will use type of evidence you will address for your review Select one or more of the SUMARI Analytical Module s you will use dependent on the type of evidence Evidence Module Quantitative V MASTARI JSettext Qualitative QARI Settext Textual NOTARI Set text Economic C ACTUARI C Set text This is an important step selection here will automatically append the appropriate JBI appraisal and extraction tools for each type of evidence to your exported protocol and your review document can be viewed in Report View tab or with selection of Export from the menu items and then selecting Protocol see Section 7 9 1 By selecting only this tick box and not the option for Set text users can append the appraisal tool without using the JBI CReMS set text if they do not wish to Simply un tick the selection if the incorrect box is ticked Once or more of the Analytical modules types of evidence is selected the tick box alongside with the label Set text will highlight This option function of JBI CReMS is explained in Section 7 2 below 7 2 Inserting the JBI Set text Once the analytical module type of evidence has been selected see Section 7 1 Select the Set text tick box one or more and then click the Set button if you wish to populate the fields in the protocol w
83. to be influencing a study s effect size can be examined Meta regression should not be conducted on less than ten studies Sub group analysis is possible in JBI MAStARI however the data would need to be re entered from the study s results page using a unique outcome name Meta regression is not currently possible in JBI MAStARI Further information about sub group analysis and meta regression is included in the Cochrane Handbook for Systematic Reviews of Interventions SUMARI JBI 247 4 Perform random effects meta analysis random effects model does not assume homogeneity and thus can be used as a way of examining the meta analysis of heterogeneous studies Note however that the studies results are still heterogeneous with all of the implications about whether it is valid to combine the results of heterogeneous studies other words the random effects model does not analyze out the heterogeneity and the results of random effects meta analysis of heterogeneous studies should be interpreted very cautiously 5 Change the effect measure You should check that you have used the correct effect measure For example if you are combining the effects of continuous studies that have measured the same outcome using a different measurement scale the standardised mean difference is the appropriate effect measure Similarly check that the effect measure selected for dichotomous outcomes odds ratio and relative risks is app
84. will be considered for inclusion in this review Studies published insert dates will be considered for inclusion in this review The databases to be searched include insert text The search for unpublished studies will include insert text Initial keywords to be used will be insert text for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute Analysis of Cost Technology and Utilisation Assessment and Review Instrument JBI ACTUARI Appendix V Any disagreements that arise 4 between the reviewers will be resolved through discussion or with a third 7 Assessment of Methodological Quality Papers selected for retrieval will be assessed by two independent reviewers Data Collection Data will be extracted from papers included in the review using the standardised data extraction tool from JBI ACTUARI Appendix The data extracted will include specific details about the interventions populations cost currency study methods and outcomes of significance to the review question and specific objectives Data Synthesis Economic findings will where possible be pooled using JBI ACTUARI and presented in a tabular summary Where this is not possible findings will be presented in narrative form Standardized text is automatically inserted in these fields when JBI ACTUARI is chosen This text can be edited from here up to the poin
85. you click lt Delete gt a dialogue box will appear prompting you for the Primary Reviewer s password When entered click Confirm and the review will be permanently deleted If the primary reviewers login details are not entered accurately the delete operation will not proceed Primary Reviewer Login Username catalini Password 52 3 Edit Reviews From the main Reviews screen click on Edit in the Actions column alongside the appropriate review to modify review details From here you can edit the Review Title Review Question and Year To save any changes click the Update button To exit without saving changes selecting Cancel will take you back to the reviews page Pressing the Close button will change the status of the review to closed Click Undo to remove any text just added to any field on the screen ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Reviews Study Cost minimization analysis of intracervical prostaglandin for cervical ripening in an Review Title outpatient versus inpatient setting Systematic review This is a systematic review of cost minimization studies of intracervical prostaglandin for Review Question cervical ripening in an outpatient versus inpatient setting Year commenced 2010 Primary Reviewer catalint Secondary Reviewer ct Review Status Studies Non 281 Review No v
86. 0 5272924 35 13 Study weight The size of the symbols on the forest plot is also important as it indicates the amount of information that each study has contributed to the meta analysis and hence the weighting that is accorded to the studies results The weight for each study is given under the Weight heading in the forest plot for example the Jansen and Morse 2004 study contributed the least 28 6 to the meta analysis and the Spellic et al 2001 study contributed the most 40 8 The sum of the weights of all studies must equal 100 0 this value is shown in the overall result For continuous variables the magnitude of the weight is greater in studies with larger sample sizes and or smaller standard deviations 144 SUMARI 35 14 Heterogeneity of included studies JBI CReMS also calculates the heterogeneity chi square and generates a probability associated with this test based on the appropriate degrees of freedom The heterogeneity calculation is based on the inverse variance method and provides an indication of whether or not it is appropriate to conduct meta analysis on the data set A significant P value i e P lt 0 05 indicates that the results of the included studies are different from each other this is an important signal to the reviewer that the results of the meta analysis are most likely not valid and other tests and investigations should be considered A non significant P value i e P gt 0 05 as per
87. 119 325 HLTERING STUDIES rii probni reremen RR RR IRR RR 120 SUMARI JBI 5 33 33 1 33 2 33 3 33 4 33 5 33 6 33 7 33 8 33 9 3310 34 34 1 34 2 34 3 34 4 34 5 34 6 34 7 34 8 34 9 34 10 35 35 1 35 2 35 3 35 4 35 5 35 6 35 7 35 8 35 9 35 10 JBI MAStARI Assessment eere nnnm nnn 120 HOW TO START CRITICAL APPRAISAL 120 THE CRITICAL APPRAISAL CRITERIA sisse 121 CRITICAL APPRAISAL CRITERIA FOR A RANDOMIZED CONTROLLED TRIAL PSEUDO RANDOMIZED TRIAL p rc nt t PER ER Y e Y qe ore 123 CRITICAL APPRAISAL CRITERIA FOR COMPARABLE COHORT CASE CONTROL STUDIES 123 CRITICAL APPRAISAL CRITERIA FOR DESCRIPTIVE CASE SERIES STUDIES 124 CRITICAL APPRAISAL CRITERIA FOR NON JBI 124 INCLUDING AND EXCLUDING STUDIES 222222222 2 2 2 22 125 SECONDARY ASSESSMENT aralara rk RE RE raara 125 HOW TO DO A FINAL 5 125 HOW TO EDIT AN EXISTING ASSESSMENT 126 JBI MAStARI Data extraction e 127 EXTRACTION SCREENS s s 3a ird tome mte aca e nel 127 EXTRACTION DETAILS csse I 128 ASSIGNING OUTCOME AND 5 128 ADDING OUTCOMES xem exe e e
88. 23068 1 36 0 8 2 21 29 37 0 97 0 621 529 B Daniel F 20131 Favours Trevimema0 49 55 0 96 0 68 1 35 38Favours Control e Alongside each subgroup is a button for users to select for lt Presentation gt of the results of the individual studies in the Forest Plot without meta analysis of the subgroup 140 JBI SUMARI Select the lt Analysis gt button to select which of the subgroups to analyze and have presented in the Forest Plot f some studies under the outcome have been assigned to an subgroup title and others have not these will appear in the above Choose Subgroup window as unassigned This label will not appear on the Forest Plot however e By default the subgroup entered first will appear on top of the figure except where some studies within a meta analysis remain unassigned to a particular subgroup in this case these unassigned studies will default to the top of the figure Once selected users select lt ok gt to complete the function An example of such an analysis appears in Section 35 9 below 35 9 Analysis of all Subgroups The previous section Section 35 8 describes how to present and analyze the results of each of the individual subgroups To analyze all of the subgroups together click the lt Analyse Results gt button and this will produce a summary measure of all of the studies included in the entire Forest Plot This can be done whether indivi
89. 321 34 7 mre o o A SN TAARA E A NS Add Study Click on Insert when all the details have been entered To edit any of the details of a paper once it has been added double click the text box you wish to change and make the appropriate adjustments Click on Clear to remove any information added to any of the fields All of the fields will be cleared of information When you have finished entering studies click on lt Cancel gt or close the dialogue box 8 2 2 Import studies from citation manager software Alternatively studies can be imported from citation manager software such as Endnote Reference Manager and Procite To do this you must first export the studies or just the selected studies see Section 8 1 from your search results The following instructions are detailed using Endnote as an example but the same procedure applies irrespective of the software used Please note to enable successful import of citations into JBI CReMS the Citation Manager Software must be set to display a Record number as the first display field this can usually be modified in settings or preferences of most software and the list of citations must be sorted or ordered on the basis of record number prior to export If this is not done JBI CReMS will not recognise the results of the export and the import of citations will not be successful Note also that the settings used to import into bibliogra
90. 7 5 1 above The standardized text inserted into the of Study field and the Data Synthesis field will vary depending on which type of quantitative study designs are selected to appropriately reflect differences between those study designs Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash 8 characters SUMARI JBI 39 7 5 3 Review question s objective s background and inclusion criteria You have the option to complete all fields in the protocol without opting to use standardized text If you do so all of the fields should be completed and serve as a valuable template directing the important information that should be included in a Systematic review protocol If you do opt to use the standardized text this will automatically generate text in some of the Protocol fields At this point the review question s objective s can be revised In the Background field enter your initial literature review also detailing the rationale for the review and its relevance to health care The specific criteria related to the participants intervention and comparator and outcomes of the review can also be entered and edited Read the text carefully throughout Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash 4 characters 40 SUMARI 75 4 Search Str
91. 98 3 Higgins JPT Green S Cochrane Handbook for Systematic Reviews of Interventions 4 2 6 updated September 2006 In the Cochrane Library Issue 4 Chichester John Wiley amp Sons Ltd 2006 4 Jackson Ameratunga S Broad J Connor J Lethaby A Robb G et al The GATE frame critical appraisal with pictures ACP Journal Club 2006 Mar 144 2 8 11 SUMARI JBI 237 5 Katrak P Bialocerkowski Massy Westropp Kumar 5 Grimmer KA A systematic review of the content of critical appraisal tools BMC Medical Research Methodology 2004 4 1 22 6 Moher D Jadad A Nichol G Penman M Tugwell T Walsh S Assessing the quality of randomized controlled trials an annotated bibliography of scales and checklists Controlled Clinical Trials 1995 16 62 73 7 Moher D Jadad AR Tugwell P Assessing the quality of randomized controlled trials Current issues and future directions Int J Tech Assess in Health Care 1996 12 195 208 8 Moher D Pham Jones Cook DJ Jadad AR Moher et al Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta analyses Lancet 1998 352 609 13 9 Parkes J Hyde C Deeks J Milne R Teaching critical appraisal skills in health care settings Cochrane Database of Systematic Reviews 2001 3 0001270 58 2 Appendix IV Data extraction Data extraction refers to the process of sourcing and recording relevant results from the o
92. BI critical appraisal instrument in QARI Instead the Assessment screen will appear as below QARI Qualitative Assessmen Assessment for Perason A Internaitonal Journal of Nursing Practice 2011 include Undefmed Reason pan Late Version 5 0 Copyright tonne Briggs Institute 2011 After quality assessment if the study is to be included in the review Yes should be selected from the Include drop down menu and the reason can be entered Selecting Yes will allow the reviewer to progress to data extraction for the study If No is selected the study citation and the reason entered will appear in the table of excluded studies in the final review report in CReMS v 5 0 Click on lt Update gt to save any information entered on this screen Click on lt Undo gt to remove any text entered in the Reason text field 21 JBI QARI Extraction Included studies that have been appraised are automatically made available for data extraction At this point a reviewer can perform the Extraction for each study An Extraction must be done on a Study before it can have Findings allocated to it The extraction form in QARI v 5 0 serves two purposes 1 to be an online saved record of the details abstracted from the included paper and 2 to rapidly generate the appendices included in any final review report Users will notice an asterix has been included alongside certain field labels on the extraction form
93. Determining the significance of the overall effect size The overall effect sizes generated by the two tests conducted were 0 38 0 31 0 47 95 Cl Mantel Haenszel RR fixed effects and 0 42 0 26 0 68 95 DerSimonian and Laird RR random effects As shown the random effects model attributes a greater weight to smaller studies than the fixed effects model a feature of random effects models that may not be desirable However the random effects model produces wider confidence intervals for the overall effect size and thus results in a more conservative test a feature of random effects models that may be desirable However the fixed and random methods indicate similar overall effects 0 38 vs 0 42 and the conclusion to be drawn from both analyses is similar as they are both highly significantly different from zero P lt 0 001 Thus if meta analysis is valid for this data set then the overall result changes little whether fixed or random effects is used Whether or not the meta analysis itself is valid depends on the data set itself and involves some judgment about what is the source of the heterogeneity for example publication bias whether the heterogeneity is related to clinical or methodological differences between the studies and how should the heterogeneity be interpreted clinically These issues need to be considered on a case by case basis and may require input from experienced reviewers 148 SUMARI Meta ana
94. For further ease of use denotes which of the fields in the extraction form will be transferred to the table of included studies automatically generated for inclusion in the final review report in CReMS 5 0 SUMARI JBI 93 Select Extraction Details Abbott Burns Gleadell Gunnell British Journal of Community Nursing 2007 Detail peu denotes field which will appear in report appendix Extraction Methodology Qualitative no spectic mention of pliosophical framework Findings Method qualitate semi structured interview Phenomena of Interest community nurses perspective of SBGM Setting community nursing Geographical Essex in the UK Cultural community nurses in the UK Participants 7 community nurses Data Analysis qualitative thematic analyses it appears to be Authors Conclusion Nurses working in the community setting may need to update their knowledge nati Reviewers Comments Tl s paper provides a unique insight of community nurses toward SBGM Complete Yes Update Undo Cancel 211 Extraction fields The extraction fields illustrated above begin by seeking to identify the details of the methodology methods setting and contextual factors such as the geographical and cultural features of significance the participants and methods of data analysis and a summary of the findings before moving on to examine the textual data in more detail 21 1 1 Methodology methodology
95. Fr hted mean differences for continuous data and their 95 confidence intervals will be calculated for analysis Heterogeneity will be assessed using the Conflicts of Interest BMG As mentioned this operation should only be performed once reviewers have received final feedback for the JBI Synthesis Science Unit and the protocol has been approved for upload to the JBI Systematic review protocols database http joannabriggs edu au AcessEvidence SystematicReviewProtocols Users will not be able to make further edits to the protocol page once transferred This process locks the protocol fields so that no further editing of the protocol fields can be done Locked fields are coloured pale blue to indicate that they are locked When the Protocol is finalized formulating the Search Strategy can then commence When search results become available and have been screened during the study Selection phase of the review the bibliographical details of papers found in the Search and selected for retrieval are entered into JBI CReMS 79 3 Printing the Protocol The protocol of the review with appendices attached can be printed at any stage by selecting File and then print from the menu bar and the clicking Protocol This will open a dialogue box with print options for you to select from Once selected click Print SUMARI JBI 49 8 Entering the Search Results and Located Studies in JBI CReMS
96. I You will notice on the review edit screen there is also reference to the review The default setting here is No Wan MAStARI Meta Analysis of Statistics Assessment and Review Instrument review Review Title fhe objective s of this review is are to identify the effectiveness of state intervention state outc Review Question More specifically the objectives are to identify In The effectiveness of insert text Ie n tauki Year commenced 2011 Primary Reviewer Ed Aromataris Secondary Reviewer dnaevoll Review Status Non JBI Review No T ON Version 5 0 Copyright Joanna Briggs Institute 2011 If you select Yes from the drop down menu you will see the following warning message appear on your screen The page at http www jbiconnect org says If you select to skip the appraisal step and not use the JBI appraisal instruments this review will not be considered for publication in the JBI Library of Systematic Reviews Contact the Synthesis Science Unit at JBI for further information Selecting Yes here will effectively allow users to skip the subsequent critical appraisal step using the JBI appraisal instruments in the review process As a user intending to submit a Systematic review to the JBI Library you should only select this if you have had a different appraisal tool approved by the Synthe
97. IELDS oii rut um rS tara rata care 175 VIEWING AN 222 2 176 SAVING AN 2 2222222 2 177 CANCELLING CHANGES TO AN EXTRACTION 177 COMPLETING EXTIRAGTIONS 2204 de e 177 JBI NOTARI Conclusions 111 eren 177 ADDING CONCLUSIONS iisssssssssse e teen tenes 177 VIEWING CONCLUSIONS isssssssssse RH 178 EDITING CONCLUSIONS saan t na pte cte d entum 179 DELETING CONCLUSIONS s depen dot hee wera has 179 RETURNING TO THE PUBLICATIONS 180 JBI NOTARI Categorizing eere 180 CREATING CATEGORIES acit ere tree toe dca rr allie tole Mw eee ro 181 ASSIGNING CONCLUSIONS TO CATEGORIES IN A JBI REVIEW 183 ASSIGNING CONCLUSIONS TO CATEGORIES IN A NON JBI REVIEW 184 EDITING A CATEGORY 222 222 22 22 lt 4 6 Rr SRI 184 DELETING CATEGORY epe ac 184 JBI SUMARI 46 JBI NOTARI Synthesizing Categories 185 46 1 CREATING SYNTHESIZED 6 2 2 2 185 46 2 ALLOCATING CATEGORIES TO A SYNTHESIZED
98. Intervention B Crems functonality CREMS MS Word Results Delete Outcome Ads Hociew Oacome Version 3 0 Copyright Joanna Briggs Institute 2011 The title of the screen which appears for the user to define a label for the outcome s is now called Outcome Title for This modification reflects the fact that once the outcome for the review is defined for the first time and data is entered for a single outcome with similar comparison for the first paper users should assign to existing titles selected from the drop down menu 128 JBI SUMARI 34 4 Adding outcomes This will take you to the results page where you will be invited to add an outcome that has been measured in the study If you have not previously conducted data extraction on your outcome of interest you will need to generate a new outcome You need to include a title for the outcome e g California Critical Thinking Skills Test a description of the outcome the units or scale that the outcome is measured in and whether the data is dichotomous i e can only take two possible entities for example yes no dead alive disease cured not cured or continuous i e measured on a continuum or scale using a number for example body mass in kg blood pressure in mm Hg number of infections per year Note the title of the outcome and its description for future reference Click on Save Details once this is complete Results For Alavanja M C Field R w S
99. Issue if relevant and Page number The Tab key can be used to move to the next field holding down the Shift and Tab keys together will move backwards between fields Pressing Insert adds and saves the information and returns the user to the Publications page Publications manually entered into JBI NOTARI will be automatically uploaded into the JBI CReMS field for that review NOTARI Narrative Opinion and Text Assessment and Review Wistriment Publication Details Author Tite Journal Year Volume Issue Page No Status New Coco EC Publications can also be manually entered into JBI CReMS Again once the publications are assigned to JBI NOTARI they will be automatically exported into JBI NOTARI SUMARI JBI 165 413 Editing a publication Click on lt Edit gt to modify publication details NOTARI Narrative Opinion and text Assessment and Review Instrument New fa coy c This will bring you through to the same screen accessible via selecting the publication name hyperlink and then clicking Detail from the left hand box menu Once the relevant citation details have been modified press Update to save the information and return to the Publications page Pressing Cancel will return you to the Publications page without saving any of the changes made 414 Deleting a publication Click on Delete to delete an item from the list of publications s can be selected to uded exc
100. JBI CReMS is designed for all of the papers found in the search to be entered into the studies list including titles the reviewers ultimately choose not to retrieve in full text format Studies found in the search but not retrieved in full text format are detailed in a table located in the appendices of the final report 81 Study Selection Study selection or selecting those studies that match the inclusion criteria stipulated in the protocol of the review can be conducted on the titles of papers alone within JBI CReMS itself Conversely some authors may decide to enter studies only selected for retrieval following the process of study selection already conducted in bibliographic citation software such as Endnote M Study selection performed in such software allows you to scan both titles and abstracts concurrently 8 2 Entering Studies in JBI CReMS To enter and navigate the Studies page click the Studies tab at the top of the JBI CReMS screen When adding a study there are a number of fields that must be filled in Each column presents different information in the Studies screen in JBI CReMS A system ID number is visible alongside each citation This is to aid users for their own record keeping if necessary The number itself reflects the order of entry into the entire JBI CReMS database therefore users can use the ascending or descending order of these values to establish order of entry into the review list Please note t
101. OTOCOL DEVELOPMENT USING THE JBI NOTARI 35 7 5 PROTOCOL DEVELOPMENT USING THE JBI MASTARI 38 7 6 PROTOCOL DEVELOPMENT USING THE JBI ACTUARI MODULE 42 7 7 PROTOCOL DEVELOPMENT USING MULTIPLE 2 44 7 8 INSERTING CITATIONS ciis 45 7 9 COMPLETING THE 22222222222 47 8 Entering the Search Results and Located Studies JBI CReMS 50 81 5 222222222 222222 2 4 4 2 50 8 2 ENTERING STUDIES IN JB CREMS iis 50 8 3 DELETING STUDIES IN JBI CREMS isse 53 2 JBI SUMARI 9 Selecting Papers for Critical Appraisal 54 9 1 ACCESSING THE JBI ANALYTICAL MODULES FROM 55 10 Building and Viewing the SystematicReview Report 55 REPORT BUILDER gt iiic er a don Spe Weed 55 10 2 SYSTEMATIC REVIEW 2 59 11 Work Mode osisssa 60 11 1 FUNCTIONALITY IN OFFLINE MODE 1 IRI 61 12 Appendices in Report eere nre 63 13 Configuring Proxy Server Settings JBI CReMS 64 QARI 14 Introduction to JBI QARI 1 1 eren nnne 67 14 1 JBI QARI AND ITS USE IN THE SYSTEMA
102. RI Meta Analysis of Statistics Assessment and Review Instrument Study Details Author Ed et al Title about this Journal DNA Year 2010 Volume 2 Issue 2 Page No 1 10 Study Design Randomised Control Trial Pseudo randomised Trial 7 Status Included mz ELTE Version 5 0 Copyright Joanna Briggs Institute 2011 118 JBI SUMARI 32 3 Assigning study design All studies whether exported from JBI CReMS or manually entered into JBI MAStARI must be assigned a study design This is important because the study design will determine the critical appraisal checklist that will be used to appraise the study There are three options for study design that can be selected from the pull down menu These are e Randomized Controlled Trials Pseudo randomized trial e Comparable Cohort Case Control studies e Descriptive Case Series studies If a study is not assigned a study design it will not be possible to critically appraise the study In this case clicking on the study will take you to the assessments page Clicking on the lt Detail gt button on the left hand side menu will take you back to the study details page You will see the following error message You must choose a study design before doing the assessment It is simple to assign a study design by selecting the appropriate option from the lt Study Design gt drop down box and clicking lt Update gt Assigned studies that have been ex
103. ReMS Joanna Briggs Institute Comprehensive Review Management Software 31 2 Adding a new review via JBI MAStARI Within the Reviews page pressing the Add button will add a new review and open the review details page Enter the relevant information review name review description and the year the review commenced Your name will automatically be entered as primary reviewer Select the secondary reviewer from the drop down box titled Secondary Reviewer Click the Update button to save Pressing Cancel returns the user to the Reviews page and does not save the information 31 3 Adding a new review via JBI CReMS All studies included in a review must be assigned to one of the four analytical modules of the SUMARI software JBI QARI JBI NOTARI JBI MASTARI JBI ACTUAR via the Studies page in CReMS Assigning a study to an analytical module will facilitate the assessment appraisal and extraction of the study in that analytical Section 32 1 module A new review viewable in JBI MAStAHI will be automatically created when CReMS review has at least one of the studies included in the review assigned to JBI MAStAHI SUMARI JBI 113 More information about creating new reviews and assigning studies to analytical modules in CReMS is available in the CReMS section of this user manual 31 4 Opening an existing review To open an existing review click on the title link under the Review Title column in the revi
104. TIC REVIEW OF EVIDENCE 67 14 2 THE ROLE OF QUALITATIVE EVIDENCE IN SYSTEMATIC 5 70 TANS CRMCALAPPRAISAL sation etr ph onore ede oer Ti 14 4 DATA EXTRACTION rr esee Reemi 44 ees 72 14 5 META AGGREGATION 2 72 1446 LEVELS OF EVIDENCE e ded v ded edes 73 15 Accessing 0 74 16 Getting eene 75 LOGGING ON 75 16 2 cu hoe s bem rhe 76 17 JBI QARI Main menu 1 nennen nnnm nnn nennen nnn nnn nnn 76 18 Reviews 1e rennen nennen nnn nnn nnnm nnn anna nnn 77 18 1 OPENING AN EXISTING REVIEW II 78 18 22 ADDING A NEW REVIEW bere RII 4 eo ee 79 18 3 ASSIGNING REVIEWERS isisisi einar r a mee dre eer de oic e hae Rp 79 19 4 EDITING A REVIEW i12 ied tede en ete dr tre eite dence 80 105 DELETINGA REVIEW etcetera t nn te nee er t ttn tec 80 18 6 X CREATING A NON JBI REVIEW IN QARI nn sse teens 80 SUMARI JBI 3 19 19 1 19 2 19 3 19 4 20 20 1 20 2 20 3 20 4 21 21 1 21 2
105. TING A NON JBI REVIEW FROM THE ACTUARI ANALYTICAL MODULE 199 52 6 OPENING AN EXISTING REVIEW ete ber tees 200 SUMARI JBI 9 53 53 1 53 2 53 3 53 4 53 5 53 6 54 54 1 54 2 54 3 54 4 54 5 54 6 55 55 1 55 2 55 3 56 57 574 57 2 58 58 1 58 2 58 3 10 JBI ACTUARI n 202 IMPORTING A 5 202 MANUALLY ADDING A NEW STUDY isses IK 202 S seu att at aan nates Faq ira FUSE 203 EDITING A SID eden ero rom Pr dre teen deron dm Bankes 204 DELETING STUDIES FROM THE ACTUARI 204 FILTERING STUDIES 205 JBI ACTUARI Assessment 111 eerenr ee enn nena nnn nnn 206 HOW TO START CRITICAL APPRAISAL 206 THE ACTUARI CRITICAL APPRAISAL 208 SECONDARY ASSESSMENT eect mH 211 HOW TO DO A FINAL 5 211 HOW TO EDIT AN EXISTING ASSESSMENT 212 5 iom Tasse der aetna 212 JBI ACTUARI Data extraction and Synthesis 214 EXTRAG HON DETAILS chere epe Dira
106. When a new review is added or an existing review opened JBI CReMS will open to the Review Summary tab screen This page is presented for you to rapidly organise important details of your review Users will note the red text Current Working Mode Online beneath the menu items This text is indicative of whether or not the current work session is operating with JBI CReMS connected to the World Wide Web or not In online mode default changes made to the review project will be saved to the JBI server Working in Offline Mode will allow users to work on their review project in JBI CReMS whilst not connected to the World Wide Web Please note an Internet connection is still required to access and work in the online analytical modules of the JBI SUMARI software package Any changes made to the document will be saved to the local drive This functionality of JBI CReMS in Offline Mode is explained in more detail in Section 11 File Studies Modules Export Help Current Working Mode Online ReviewSummary Protocol Studies Report Builder Report View Title Review title inserted here Question Year 2011 Author information Primary Reviewer trainee 30 Details Secondary Reviewer trainee29 Details Associate Reviewers Search Details Delete Summary of Studies Number of studies found Refresh Qari Notari Mastari Actuari Number of studies retrieved 0 0 9 9 6 41 Editing the Review Title and Year
107. action taken A report may state that the study adopted an interpretive perspective and that a survey methodology was followed There is incongruence between an interpretive view focusing on knowledge arising out of studying what phenomena mean to individuals or groups and surveys an approach that focuses on asking standard questions to a defined study population SUMARI JBI 89 e A report may state only that the study was qualitative or used qualitative methodology such statements do not demonstrate rigor in design or may make no statement whatsoever about philosophical orientation or methodology 20 2 2 Congruity between the research methodology and the research question or objectives Is the study methodology appropriate for addressing the research question For example e A report may state that the research question was to seek understandings of the meaning of pain in a group of people with rheumatoid arthritis and that a phenomenological approach was taken Here there is congruity between this question and the methodology e A report may state that the research question was to establish the effects of counseling on the severity of pain experience and that an ethnographic approach was pursued A question that tries to establish cause and effect cannot be addressed by using an ethnographic approach ethnography sets out to develop understandings of cultural practices and thus this would be incongruent 20 2 3 Congr
108. an the conventional 0 05 value to protect against the possibility of falsely stating that there is no heterogeneity present 58 3 16 Fixed effects or random effects models Meta analysis can be based on either of two assumptions a fixed effects model it is assumed that any differences between treatment and control is the same or fixed in each study Thus any observed differences among the studies results are due solely to chance and there is no heterogeneity between the studies However when there is heterogeneity apparent for example the test of homogeneity is significant the validity of the assumption of a fixed effect is questionable and thus another approach is to consider that the treatment effects for the individual studies are not identical and in fact follow a distribution related to an overall average treatment effect That is the effect size is random and is assumed to follow a Normal distribution and consequently has a mean and variance Essentially the test for homogeneity is asking the statistical question is the variance around the estimate of the effect size zero or non zero If the variance around the estimate of the effect size is zero then there is no heterogeneity present and the results of the fixed and random effects models will be similar There is no consensus about whether fixed or random effects models should be used in meta analysis In many cases when heterogeneity is absent the two methods
109. ance in providing the raw data Most researchers are obliging when it comes to these sorts of requests providing that records are still available 58 2 4 Data extraction references The following citations are provided for further information about data extraction 1 10 Berlin JA Does blinding of readers affect the results of meta analyses University of Pennsylvania Meta analysis Blinding Study Group Lancet 1997 Jul 19 350 9072 185 6 Buscemi Vandermeer B Hartling L Tjosvold L Klassen TP Comparison of single versus double data extraction a pilot study abstract 12th Cochrane Colloquium Bridging the Gaps Oct 2 6 2004 Ottawa Ontario Canada 2004 p 113 Feuerbach RD Panniers TL Building an expert system a systematic approach to developing an instrument for data extraction from the literature Journal of Nursing Care Quality 2003 18 2 129 38 Haywood KL Hargreaves J White R Lamb SE Reviewing measures of outcome reliability of data extraction Journal of Evaluation in Clinical Practice 2004 10 2 329 37 Higgins JPT Green S Cochrane Handbook for Systematic Reviews of Interventions 4 2 6 updated September 2006 In the Cochrane Library Issue 4 Chichester John Wiley amp Sons Ltd 2006 Jadad A Hillier T Fowler GD Enkin M Manipulating the type timing and amount of input from reviewers with different expertise to reduce bias in Systematic reviews a case report Second International Conference Scie
110. ancing the Evidence Incorporating the synthesis of qualitative data into systematic reviews The JBI QARI software is designed to manage appraise analyze and synthesize the findings of studies that utilize any qualitative approach as part of a systematic review of evidence JBI QARI has been designed as a web based software and incorporates a critical appraisal scale data extraction forms a data synthesis function and a reporting function The software was developed by a group of Australian academics and has been internationally peer reviewed 141 JBI QARI and its use in the systematic review of evidence The systematic review process is essentially an analysis of all of the available literature that is evidence and a judgment on the validity and reliability or otherwise of the evidence Currently the dominant approach to the systematic review of evidence focuses on evidence of effectiveness and therefore emphasizes the meta analysis of the results of randomized controlled trials Classically because of this focus on statistically significant results the systematic review process involves the following steps SUMARI JBI 67 1 The development of a rigorous proposal or protocol setting a predetermined plan to ensure scientific rigor and minimize potential bias Stating a review question or hypothesis Establishing the criteria that will be used to select the literature Detailing a strategy to identify all relevant lite
111. and over who have been diagnosed with hay fever Language of publication for example English only or English German Spanish and Japanese The time period for example study reports published or made available 1970 2011 228 SUMARI 57 1 4 Search Strategy Consulting a research librarian or information specialist is recommended for each systematic review topic The protocol should provide a detailed strategy that will be used to identify all relevant literature within an agreed time frame This should include databases and bibliographies that will be searched and the search terms that will be used The search strategy should be clearly described in the review protocol Determining rigorous procedures for the search before commencing the review reduces the risks of error and bias The first step in any search strategy is defining preliminary search terms or keywords and then using these to search appropriate electronic databases This preliminary search enables the reviewers to identify other keywords and to modify them according to the thesaurus used in each data based Databases most frequently used are e Medline CINAHL e Current Contents Cochrane Central Register of Controlled Trials DARE e AustRom PsycINFO Science Citation Index e Embase e Dissertation Abstracts MEDNAR Because searching electronic data bases is complex and requires a great deal of skill it is important to work closely with a l
112. antel Haenszel methods the calculation of study weights and effect sizes and overall effect sizes differs slightly between OR and RR The Mantel Haenszel method is generally preferred in meta analysis to another method inverse variance because it has been shown to be more robust when data are sparse in terms of event rates being low and or the number of trials being small 58 3 11 Peto s odds ratio Peto s odds ratio is an alternative method for meta analysis of OR using a fixed effects method It employs an approximation that can be inaccurate if treatment affects are very large and when the sample sizes between treatment and control groups are unbalanced However the method is appropriate when event rates are very low and effect sizes are not overly large 58 3 12 DerSimonian and Laird DerSimonian and Laird methods are used in the meta analysis of OR and RR using a random effects model Although the study effect sizes and heterogeneity statistics are calculated as for the fixed effects model the study weights and overall effect sizes in DerSimonian and Laird random effects models are calculated slightly differently to fixed models 58 3 13 Meta analysis of continuous data When the outcomes of included studies are continuous JBI MAStARI can be used to generate two overall effect size calculations using weighted mean differences WMD or standardised mean differences SMD The WMD measures the difference in means of each study whe
113. anually entered into JBI ACTUARI using the lt Add gt button at the bottom of the studies page Studies manually entered into JBI ACTUARI will be automatically uploaded into the JBI CReMS file for that review 202 SUMARI Fill out the standard bibliographic details of the publication Author Title Journal Year Volume Issue and Page number The Tab keyboard key can be used to move to the next field holding down the Shift and Tab keyboard keys together will move backwards between fields ACTUARI Analysis of Cost Fechnology and Utilisation Assessment and Review Instrument ET Study Details t a Author Asics mant Ekteseti n 3 Volume 12308 Page No Status Now Version 5 0 Copyright Joanna Briggs Institute 2011 53 3 Listing the studies When you select a review as in the previous version you will progress to the display listing the studies in the review selected To aid in navigating amongst the studies the list can be sorted in ascending or descending alphabetical order by clicking on the heading of either the lt Author gt or lt Title gt column Title Journal 2011 Extraction Complete Edit Delete Buxton etal Cost Effectiveness of inhaled corticosteroids in adult asthma patients NEJM 2009 Extraction Complete Edit Delete etal Cost Effectiveness of inhaled corticosteroids in asthma adult patients JAMA 2009 Extraction Complete Edit Delete Mumus etal Cost Effecti
114. aper article or a Best Practice Information Sheet 43 1 2 Those represented To whom the paper refers or relates to 43 1 3 Stated allegiance position A short statement summarizing the main thrust of the publication 43 1 4 Setting Setting is the specific location from which the opinion has emerged for example a nursing home a hospital or a dementia specific ward in a sub acute hospital 43 1 5 Geographical Context The geographical context is the location of the author It is useful to be as specific as possible in describing the geographical context by including not just the country but whether it was a rural or metropolitan setting if possible SUMARI JBI 175 43 1 6 Cultural Context The cultural context is the cultural features in the publication setting such as but not limited to time period 16 century ethnic groupings Indigenous Australians age groupings e g older people living in the community or socioeconomic groups e g working class When entering information be as specific as possible This data should identify cultural features such as employment lifestyle ethnicity age gender socioeconomic class location time period etc 43 1 7 Logic of argument An assessment of the clarity of the presentation and logic of the argument Is other evidence provided to support assumptions and conclusions 43 1 8 Author s conclusion The main finding of the publication 43 1 9 Reviewer s comments su
115. arning in the healthcare setting Inclusion criteria Types of participants The review will consider studies that include any health professional participants involved in debriefing as a part of simulation Types of intervention s phenomena of interest The phenomenon of interest for this review is debriefing for the purpose of simulation based learning Types of outcome Any objectively measured outcomes related to debriefing conducted as part of simulation based learning will be considered Examples include clinical reasoning situation awareness communication skills teamwork knowledge acquisition and performance of psychomotor skills Type of studies The systematic review will primarily consider randomised controlled trials RCTs however in the absence of RCTs other research designs such as non randomised controlled trials and quasi experimental will be considered Search strategy The search strategy aims to find both published and unpublished studies limited to the English language All databases will be searched from inception to current date September 2011 using a three step search strategy An initial search of MEDLINE and CINAHL databases will be undertaken followed by analysis of text words contained in the title and abstract and of the index terms used to describe the article A second search using all identified keywords and index terms will then be undertaken across all databases SUMARI JBI 233 Initial
116. asure of central tendency SE is the standard error or standard error of the mean a measure of the variance of data points around a measure of central tendency Sensitivity analyses refers to mathematical calculations that isolate factors involved in a decision analysis or economic analysis to indicate the degree of influence each factor has on the outcome of the entire analysis SMD is the standardized mean difference a method used to compare the mean difference between studies The mean difference in each study is divided by the SD of that study to create an index which can be compared across studies Study authors are the authors of a primary study Summary effect is a statistical combination of effect sizes Synthesis is term to describe the combining or pooling of the findings of qualitative research studies A synthesized finding is a group of categories combined together on the basis of similarity of meaning Treatment is in general a form of healthcare provided to patients or groups communities however throughout this manual it is often used to designate a specific form of healthcare the effectiveness of which is being tested compared to a placebo or a standard or control healthcare In this capacity treatment and intervention may be used interchangeably Weighted mean is a method of assigning the importance of mean of a study to a meta analysis can be adjusted often used when certain values are more important than others
117. at 54 1 How to start critical appraisal From the studies page click on the authors hyperlink of a study which has New in the Status column and None in the Assessment column This will take you to the assessment page If you are the Primary Reviewer click on the Add Primary button ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Version 5 0 Copyright Joanna Briggs Institute 2011 If you are Secondary Reviewer click Add Secondary Users are now no longer constrained to have the Primary Reviewer complete the appraisal process prior to 206 JBI SUMARI the Secondary being able to commence the appraisal for a particular paper To illustrate this in the screenshot below the assessment by the primary reviewer has not been completed yet the secondary reviewer is able to commence the appraisal process ACTUARI Analysis of Cost Lechnology and Utilisation Assessment and Review Instrument Version 5 0 Copyright Joanna Briggs Institute 2011 Similarly to reflect this change in process on the main studies screen the Status of studies is no longer indicated by Awaiting secondary as in SUMARI v4 0 rather Primary Completed or Secondary Completed will appear in the Status column Please note the final assessment is still required to be completed by the Primary Reviewer Awaiting Final indicates this in the Asses
118. ategy Assessment of Methodological Quality Data Collection and Data Synthesis Selecting Set text will also generate standardized text options in the remainder of the protocol dialogue boxes Read the text carefully throughout Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash characters additional studies Studies published insert lang considered for inclusion in this review Studies publi be considered for inclusion in this review The databases to be searched include insert text The search for unpublished studies will include slinsert text Initial keywords to be used will be insert text Please select quantitative study design s to be included v Experimental e a RCT quasi exot Dbservational fe o Cohont Case cnnrrol Desc Assessment of Methodological Quality Papers selected for retrieval will be assessed by two for methodological validity prior to inclusion in the r standardised critical appraisal instruments from the Meta Analysis of Statistics Assessment and Review Ir Appendix V Any disagreements that arise between resolved through discussion or with a third reviewer Data Collection Data will be extracted from papers included in the re standardised data extraction tool from JBI MAStARI extracted will include specific details about the inter study methods and outcomes of significanc
119. be made in advance and be agreed upon by all participating reviewers before critical appraisal commences 58 1 4 JBI critical appraisal tools Critical appraisal tools are included in the MAStARI program and can be completed electronically for RCTs case control cohort studies and descriptive case series studies Examples of the three critical appraisal tools are provided in section 37 2 58 1 5 Number of critical appraisers JBI MAStARI has been designed with the intention that there will be at least two reviewers a primary and a secondary independently conducting the critical appraisal The secondary reviewer is blinded to the findings of the primary reviewer Once the Secondary reviewer has conducted their appraisal the primary reviewer compares the two appraisals and conducts a final overall appraisal The two reviewers should discuss cases where there is disparity between the appraisers in terms of whether a study should be included if the situation is deadlocked it is appropriate to seek assistance from a third reviewer 58 1 6 Critical appraisal references The following citations are provided for further information about critical appraisal 1 Begg C Cho M Eastwood S Horton R Moher D Olkin et al Improving the quality of reporting of randomized controlled trials The CONSORT statement JAMA 1996 276 637 9 2 Elwood M Critical appraisal of epidemiological studies and clinical trials Oxford Oxford University Press 19
120. c review report 58 3 2 Selecting the right test There are a number of meta analytical techniques available the use of these different techniques is governed by the study type and the data recorded and the assumptions underlying the meta analysis The following sections will introduce the tests that are available in JBI MAStAHI and when it is appropriate to use each of the tests 240 JBI SUMARI 58 3 3 Dichotomous data background When the outcomes of included studies are dichotomous JBI MAStAHI can be used to generate two overall effect sizes odds ratios OR and relative risks also known as risk ratios RR The choice of whether OR or RR are calculated is important and should be carefully considered with due reference to three criteria These criteria will be discussed in more detail a little later 71 1 3 4 First it is important to define the differences and similarities between OR and RR 58 3 4 Odds ratios The odds of an event are calculated as the number of participants experiencing an outcome divided by the number of participants who do not For example in a study of 100 patients 10 of 50 patients receiving treatment A develop an infection while 16 of 50 patients receiving treatment B develop an infection The odds of developing infection are calculated as 10 40 0 250 for treatment A and 16 34 0 471 for B The OR for developing an infection on treatment A compared to treatment B is calculated by dividing the odds o
121. cdise they actually meet the MET call chtena taken also led to non But thay thought because the patient was fine and awake and alert thay didnt need to tell Click Delete to erase a finding previously entered for a study A prompt asking to confirm the operation will appear prior to deletion QARI Qualitative Assessment and Review Instrum Findings for Cioffi 3 Salter C Wilkes L All Findings mter Staff could recognize respiratory rate has increased from 40 to 70 over last two hours wa need to help hm Credibla Edit abnormal vital signa out RN Bj p68 Delete Tt unlikely that most staff would take a vital mgn for something that s been abnormal and Credibla Edit expected practice just move onto the next patient and ignore it MO 4 Delete Fuffereneca in Thie ie an AVG and wrai mei dn anmathinn t Thie ie roal inte taft Credle 225 Returning to the Studies page Within the Findings page pressing the Return button closes the Findings page and returns the user to the Studies page If there is unsaved information in the edit area of the Findings page a prompt will open asking whether the user wants to discard the unsaved information Pressing the Yes button returns the user to the Studies Page pressing the No button cancels the action to leave the Findings page SUMARI JBI 99 23 JBI QARI Categorizing Once all of the information on a st
122. ce identify and extract the conclusions or recommendations made messages conveyed from papers included in the review and to determine how these conclusions or recommendations have been influenced by the particular historical social and political perspectives of the author s It is important to note that JBI NOTARI does not involve a reconsideration and analysis of the text reviewed as if it were primary data JBI NOTARI focuses only on the combination of conclusions or recommendations Published opinion text such as review papers and discussion papers and consensus guidelines are all shaped by the social norms of the context from which the text has arisen and they are political in the sense that they carry the power that reflects the interests of those who have written them Opinion leaders professional organizations and learned bodies such as professional academies etc have a powerful influence in shaping the way in which health professionals frame and discuss ways of practicing effectively and appropriately The features of content analysis that JBI NOTARI draws on include 1 the need to read and re read the text to identify the meaning of the content and 2 the formation of Statements that accurately describe that content The features of discourse analysis that JBI NOTARI draws on are the steps pursued to identify the degree to which the text being reviewed has authority insofar as its purpose and its focus is on serving th
123. ce for health related phenomena The two dominant opposing views that characterize the ongoing debate surrounding the meta synthesis of qualitative evidence focus on integration or aggregation versus interpretation Integrative Aggregative Synthesis Integration aggregation involves assembling the findings of studies variously reported as themes metaphors categories etc and grouping the findings through further aggregation based on similarity in meaning Those who oppose this approach suggest that synthesis represents new knowledge and that aggregation is not synthesis Integrative syntheses focus on summarizing data where the concepts or variables under which those data are summarized are assumed to be largely secure and well specified 68 SUMARI Interpretive Synthesis Interpretive synthesis involves both induction and interpretation and is concerned not to predict but to anticipate what might be involved in analogous situations and to understand how things connect and interact The JBI Approach JBI recognizes the usefulness of interpretive approaches such as meta ethnography narrative synthesis and thematic synthesis The usefulness of meta ethnography lies in its ability to generate theoretical understandings that may or may not be suitable for testing empirically textual narrative synthesis is useful in synthesizing different types of research evidence e g qualitative quantitative economic and themat
124. ch study p 369 Qualitative research findings cannot be synthesized using quantitative techniques and although it is possible to mirror the systematic process used with respect to quantitative research reviewers are required to exercise some degree of judgment when appraising studies and assessing the quality or validity of the findings Criteria for judging the rigor of qualitative studies are addressed in the literature but the findings of qualitative studies are often not adequately reported and the nature of a finding for practice is poorly understood Reports of qualitative studies frequently present study findings in the form of themes metaphors or categories In JBI QARI the units of extraction are specific findings reported by the author s of the paper as themes categories or metaphors and illustrations from the text that demonstrate the origins of these findings For the purpose of extracting data using JBI QARI a finding is therefore defined as a conclusion reached by the researcher s and often presented as a theme or metaphor Because the process relates to findings rather than data the need for methodological homogeneity so important in the meta analysis of the results of quantitative studies is not a consideration The meta aggregation of findings from qualitative studies can legitimately aggregate findings from studies that have used radically different competing and antagonistic methodological claims and assump
125. citation with those selected in alphabetical order When the Protocol is complete feedback has been provided by the JBI Synthesis Science Unit and addressed if the review is to be published in the JBI Library and reviewers are ready to move into the search click the Transfer to Report gt button at the bottom of the screen 48 SUMARI 7 9 2 Transferring the Protocol to the Report If the Transfer to Report is clicked a warning message is now provided to confirm the action that will lock the current version of the protocol and will transfer the text to the appropriate sections of the Report Builder for presentation in the systematic review itself When clicked a warning message will appear asking you to confirm the operation Assessment of Methodological Quality Quantitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the 0 review using standardised critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument JBI MAStARI Appendix V Anv disaareements that arise between the reviewers will he resolved Data Collection Transferring Protocol t sing as Do this once final approval has been received from JBI Synthesis Science Unit You will not longer to be able to edit your protocol Data Synthesis Yes
126. cular study design addresses potential bias This focus on limiting bias to establish validity is not appropriate when appraising narrative opinion papers or text Expert opinion whether expressed by an individual by a learned body or by a group of experts in the form of a consensus guideline draws on the experience of practitioners Thus validity in this context relates to the soundness of opinion in terms 154 JBI SUMARI of its logic and its ability to convince the authority of the source and the quality of the opinion that renders it supportable Whilst it is rightly claimed that expert opinion is not a product of good science it is empirically derived and mediated through the cognitive processes of practitioners who have typically been trained in scientific method This is not to say that the superior quality of evidence derived from rigorous research is to be denied rather that in its absence it is not appropriate to discount expert opinion as non evidence The synthesis of expert opinion findings within the systematic review process is not well recognized in the mainstream evidence based health care movement It is acknowledged that efforts to appraise the often conflicting opinions are tentative However in the absence of research studies the use of a transparent systematic process to identify the best available evidence drawn from text and opinion can provide practical guidance to practitioners and policy makers
127. d 4 SUMARI JBI 123 33 5 Critical appraisal criteria for descriptive case series studies There are nine critical appraisal criteria for descriptive case series studies In the example below the reviewer made the decision to exclude the study because there were only two yes scores Assessment for Zar 2001 Primary User Design Descriptive Case Series Studies Criteria Yes No Unclear Comment 1 Was study based on random or pseudo random sample 2 Were the cnteria for inclusion in the sample clearly defined 3 MV Onana feckorg Vientihed Wo roe o vau 4 Were outcomes assessed using objectve critena 5 Tf comparisons are being made was there sufficient descriptions of the groups 6 was follow up carned out over a sufficient tme period 7 Were ihe outcomes of people who withdrew described and the analysis 8 Were outcomes measured a reliable way o 9 Was appropriate statistical analysis used a Inciude No Reason only scored 2 33 6 Critical appraisal criteria for non JBI Review Users may select to do a non JBI review whilst entering or editing the review details see Section 31 8 and this will mean that JBI critical appraisal tools are not automatically uploaded to the review Authors who do not use JBI critical appraisal tools need to attach to the end of the report as an appendix prior to submitting the
128. d for that review QARI Qualitative Assessment and Review Instrument ategortes Status Naw den Undo Cane Studies can also be manually entered into JBI CReMS Again once the studies are assigned to JBI QARI they will be automatically exported into JBI QARI 19 3 Editing a study Click on lt Edit gt to modify study details Select Study Details Detail Author Abbott Bums Gleadell Gunnel Titles Community Nurses and Self mo Journal British Journal of Community Nu Year 2007 Volume 12 Issue 1 Page No 6 11 Status Extraction Update Undo Cancel SUMARI JBI 83 This will bring you through to the same screen accessible via selecting the study name hyperlink and then clicking lt Detail gt from the left hand box menu You may edit citation details from this screen 19 4 Deleting a study from JBI QARI Click on lt Delete gt to delete an item from the list of studies QARI Qualitative Assessment and Review Instrument Studies in Comprehensive lite This page is used to manage the retnevd Findings The drop down box can be use of Gtatons 6 offi 2 Salter ua Ginicians responses to abnormal vital signs gt a an emergency department Aust Cnt Care 2006 Extraction Complete Edt Delete A dialogue box will open asking for confirmation by the user prior to completion of the operation Once confirmed the study record and any asses
129. d single reported meanings This would not be appropriate in phenomenological work 20 2 5 Congruity between the methodology and the interpretation of results Are the results interpreted in ways that are appropriate to the methodology For example e A report may state that the study pursued a phenomenological approach to explore people s experience of facial disfigurement and the results are used to inform practitioners about accommodating individual differences in care There is congruence between the methodology and this approach to interpretation e A report may state that the study pursued a phenomenological approach to explore people s experience of facial disfigurement and the results are used to generate practice checklists for assessment There is incongruence between the methodology and this approach to interpretation as phenomenology seeks to understand the meaning of a phenomenon for the study participants and cannot be interpreted to suggest that this can be generalized to total populations to a degree where standardized assessments will have relevance across a population 20 2 6 Astatement locating the researcher culturally or theoretically Are the beliefs and values of the researcher s and their potential influence on the study declared The researcher plays a substantial role in the qualitative research process and it is important when appraising evidence that is generated in this way to know the researcher s cultural and
130. d studies tor module Mastari No of Inctuded studies 2 of excluded studies The output and appearance of this table can be viewed in the Report View screen A separate table will be produced for each of the different analytical modules used in the review project For JBI MAStAHI a separate table will be created for each of the different appraisal tools utilised SUMARI JBI 57 MASTARI Number of studies included and excluded Number of studies included Number of studies excluded 5 0 Randomised Control Trial Pseudo randomised Trial Citation 01 02 04 05 06 08 09 010 Yifan X Moola S 2010 Y Y Y Y N u u Y Y Y Melania B Daniel F 2011 Y Y Y N u Y merema ee pee ee Alan Zac Craig ed 2011 Y u Y The results section also displays a list of Synthesized findings created in the analytical module s used JBI QARI JBI NOTARI The reviewer can add comments to each Synthesized Finding There is also an analysis field provided for each analytical module used Once saved this information will be transferred to the Final Report under Appendix IX List of Study Findings Conclusions Reviewers enter their own text under the headings Discussion Conclusions Implications for Practice Implications for Research and Acknowledgements Conclusion Implications for Practice Implications for Research Ackn
131. dd button below To edit delete a Review chick the appropriate link under the Actions column Opened 6 of Raviewes 3 7 Oosed The quantitative objective s is are to identify the effectiveness of intervention on state outcome y the objectives are LPIWGR S DT to identity The effectiveness of Binser texts on sinsert texta in amo Aomatoris 0 specifically the ob texte on insert text in texte The economic objective s is are to identify the economic effectiveness of estate intervention amp amp state outcomes More specifically the DNA test review 2 2010 objectives are to identity The economic insert texte of insert texte On insert text in insert texte 1 ww E records per page Version 5 0 Copyright Joanna Briggs Institute 2011 31 JBI MAStARI Reviews Accessed by clicking on the lt Reviews gt tab on the main menu Each review has a primary and secondary reviewer A primary reviewer leads the review and has rights to add edit or delete reviews a secondary reviewer assesses every paper selected for critical appraisal and assists the primary reviewer in conducting the review The secondary reviewer is assigned to the review by the primary reviewer The lt Reviews gt page lists all reviews that are in the system for that username This page is used to add new edit existing or delete reviews When a new Review is entered into the sy
132. de to approximate market values SUMARI JBI 209 Are costs and outcomes adjusted for differential timing e Were costs and consequences that occur in the future discounted to their present values e Was there any justification given for the discount rate used Is there an incremental analysis of costs and consequences Were the additional incremental costs generated by one alternative over another compared to the additional effects benefits or utilities generated Were sensitivity analyses conducted to investigate uncertainty in estimates of cost or consequences f a sensitivity analysis was employed was justification provided for the range of values or for key study parameters Were the study results sensitive to changes in the values within the assumed range for sensitivity analysis or within the confidence interval around the ratio of costs to consequences Do study results include all issues of concern to users Were the conclusions of the analysis based on some overall index or ratio of costs to consequences e g cost effectiveness ratio If so was the index interpreted intelligently or in a mechanistic fashion Were the results compared with those of others who have investigated the same question If so were allowances made for potential differences in study methodology Did the study allude to or take account of other important factors in the choice or decision under consideration e g
133. describe the study method setting participants number of participants interventions author s conclusions and reviewer conclusions These fields are present in each of the three different study design types that can be included in a systematic review using JBI MAStARI however the exact details differ slightly for different study designs It is particularly important that the Participants i e the number of participants field is completed as this data is used in later calculations Also in the interventions field note that in cases where a new or modified intervention the treatment is being compared to a traditional or existing procedure the control it is conventional to include the treatment s as intervention A whose participants are in group A and the control as intervention B whose participants are in group B Once these fields are filled out click on the Complete drop down menu at the bottom of the page and then click on the Save Details button 34 3 Assigning outcome and intervention labels Labels to some functions and titles have been updated to remove ambiguity Add Review Outcome now replaces Add New Outcome from MAStARI v 4 0 The functionality of this feature is unchanged MAStARTI Meta Analysis of Statistics Assexament and Review Instrument Results For zac et al DNA 2010 Randomised Contro Trial Pseudo randomised Trial Review Outcome Intervention A
134. disagreement over the assessment status of a publication between the primary and secondary reviewers should be resolved through discussion with a third reviewer If it is agreed that a publication should be excluded the primary reviewer documents the rationale for exclusion this along with the citation details will automatically form an appendix to the review report when it is being prepared for publication Once decisions on assessments are completed the Publications screen will Show that each completed paper has been either included or excluded and that assessment has been finalized The Status column describes whether the paper is New Included or Excluded When the data extraction process for included studies is completed Extraction will appear in the Status column NOTARI Narrative Opinion and Tod Assessment wad Review Instrument fsiblscateon Catequres Synt Boers Publications in comprehensive literature review on emergency surgery This page is used to manage the retrieved Publications From this page Publications can be selected to perform assessment and extraction and to develop The drop down box can be used to filter studies new included excluded extraction or finished of Citabons 73 777 1 Australian Safety and Brief review Fast track Review from the Royal Australasian College of 2009 Extraction Complete Efficacy Register
135. distribution of costs and consequences or relevant ethical issues Did the study discuss issues of implementation such as the feasibility of adopting the preferred program given existing financial or other constraints and whether any freed resources could be redeployed to other worthwhile programs Are the results generalizable to the setting of interest in the review Did the study discuss the generalizability of the results to other settings and patient client groups After all criteria have been addressed the reviewer must decide on whether to include or exclude the study from the review The decision to include or exclude is based on pre determined requirements for example has clinical effectiveness been established or are the results generalizable to the setting of interest in the review The reviewer then selects Yes No or Undefined from the Include drop down box 210 JBI SUMARI 54 3 Secondary assessment The secondary assessment is conducted as per the primary assessment 54 4 How to do a final assessment It is the responsibility of the Primary Reviewer to conduct the final assessment Clicking on the authors hyperlink from the studies page will open the Assessment page showing both Edit Primary and Add Final buttons ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Assessment for Mumus et al Health Policy 2009 Primary Assessm
136. du au aqr offer papers HSuri htm 7 Sandelowski M Docherty S Emden C Qualitative metasynthesis issues and techniques Research in Nursing and Health 1997 20 365 371 106 JBI SUMARI MASTARI 27 Introduction to JBI MAStARI The Joanna Briggs Institute Meta Analysis Statistics Assessment and Review Instrument JBI MAStARI has been designed to enable reviewers to systematically review and combine the results of quantitative healthcare research The JBI MAStAHI Software facilitates the management appraisal extraction and analysis of the results of studies that utilize a quantitative approach as part of a systematic review of evidence It is integrated into the Joanna Briggs Institute Comprehensive Review Management Software JBI CReMS as a web based database and incorporates a critical appraisal scale data extraction forms a meta analysis function and a reporting function The systematic review process is essentially an analysis of all of the available literature that is evidence and a judgment on the validity and reliability or otherwise of the evidence The dominant approach to the systematic review of evidence focuses on evidence of effectiveness and therefore emphasizes the meta analysis of the results of randomized controlled trials Classically because of this focus on statistically significant results the systematic review process involves the following seven steps The development of a rigorous proposal or protocol se
137. dual subgroup analyses have been included or not Software speed Unassigned Study WMD Weight 95 Fixed Jordan B Melanie B Daniel F 2010 95 30 0 30 0 28 0 88 Yifan X Moola S 2010 4 70 1 40 1 23 4 03 Favours Treatment 5 0 0 0 5 0Favours Control RCT Study WMD Weight 95 Fixed Alan Zac Craig ed 2011 Melania B Daniel 2011 Favours Treatment 5 0 Overall Overall Favours Treatment 5 0 Overall Z 1 67 P 0 0950 68 62 0 70 1 08 2 48 31 38 2 10 0 53 4 73 5 Control 100 00 0 45 0 08 0 99 5 0Favours Control Heterogeneity Chi squared 2 34 P 0 5067981 35 10 Saving the output of the Meta analysis To send the figure that is on screen through to JBI CReMS click the lt Save to Report gt button SUMARI JBI 141 Filter Results Statistics rneroyoutcome ean score T pBEvscomoi v Parsons Here Connaenco menar Prererea Mean score Study WMD Weight CI 95 Fixed Spellic Parsons Hercinger et 2001 f 40 75 2 20 0 44 3 96 Beckie Lowery and Barnett 2001 30 62 3 40 1 37 5 43 Jansen and Morse 2004 28 63 1 80 0 30 3 90 Favours Treatment 6 0 0 0 6 0Favours Control 4 Ji m SavetoReport save graph to disk In CReMS in the Report View tab the figure will now appear in the results section as shown below Conversely
138. e For insertion into systematic review reports QARI users who are also using JBI CReMS will be able to automatically export these tables into the Final Report in CReMS Synthesis This is the QART viewdisplaying the syntheses for the Reviews Comprehensive literature review on Recognising and Responding to the Deteriorating Patient in Acute Note that only these syntheses that have had valid categories allocated to them are shown hare 25 2 Saving and exporting a synthesis Click on lt Export gt for instructions on how to save the synthesis flow diagram as an image to insert into other programs or to save as a png file MM Spit Expert SUMARI 105 26 JBI QARI Reporting When writing the final systematic review report there are numerous ways to present the information 26 1 Reporting by category To report information related to the categories select the Categories button in the top menu bar and click on Findings in the left hand menu The information displayed includes the finding with the supporting illustration from the study as well as the category assigned to it QARI allows filtering of the findings of a particular review by category such that all of the findings relating to a particular category can be viewed together To view filtered findings click the Findings button on the left hand menu to bring up the list of categories Select the desired filter from the drop down menu next to Fil
139. e Status column and None in the Assessment column This will take you to the assessment page When you click on Assessment or the hyper linked name of the paper to proceed to use the JBI tools for critical appraisal of a study that meets the inclusion criteria for your review users are now no longer constrained to have the primary reviewer complete the appraisal process prior to the secondary being able to commence the appraisal for a particular paper 120 JBI SUMARI MAStARI Meta Analysis of Statistics Assassment and Review Instrument Version 5 0 Copyright Joanna Briggs Institute 2011 To illustrate this in the screenshot below the assessment by the primary reviewer has not been completed yet the secondary reviewer is able to commence the appraisal process Similarly to reflect this change in process on the main studies screen the Status of studies is no longer indicated by Awaiting secondary as in v4 0 rather Primary Completed or Secondary Completed will appear in the Status column Please note the final assessment is still required to be completed by the primary reviewer Awaiting Final indicates this in the Assessment column S MASEARI Mets Analysis of Statistics Assessment and Review Instrument prn rapa apio ao or ae Me e This page is used to manage the E199 WM SaMbPNRV Sod Suan P
140. e Yes No Unclear Not applicable radio buttons next to the criteria There are eleven critical appraisal criteria The first ten of these are sourced from a key economic evaluation textbook written by Drummond et al These criteria have been adopted as guidelines by the British Medical Journal for peer review and reporting of economic studies and have been incorporated into online training on economic evaluation provided by the United States National Information Center on Health Services Research and Health Care Technology NICHSR Each of the criteria is discussed in some detail below listing range of questions sourced from Drummond et aP that will assist you in addressing each of the criteria The eleventh criterion was added by the Joanna Briggs Institute to expand on the tenth criteria 208 SUMARI Is there a well defined question e Did the study examine both costs and effects of the service s or program s e Did the study involve a comparison of alternatives e Was a viewpoint for the analysis stated and was the study placed in any particular decision making context Is there comprehensive description of alternatives e Were there any important alternatives omitted e Was should a do nothing alternative be considered Are all important and relevant costs and outcomes for each alternative identified e Was the range wide enough for the research question at hand e Did it cover all relevant viewpoints Possible view
141. e best interests of health care recipients Both content analysis and discourse analysis are subjects of an extensive literature and JBI NOTARI merely draws on the techniques of these approaches rather than subscribing to or committing to their philosophical bases Content analysis includes a broad range of approaches stemming from diverse theoretical foundations Essentially the focus is on reviewing content and categorizing it through a process of interpretation Discourse analysis is also characterized by a wide range of approaches stemming from a number of theoretical bases The SUMARI JBI 153 term discourse itself refers to expressing oneself using words discourse analysis attempts to describe interpret analyze and critique positions reflected in text Critical discourse analysis more particularly studies written texts to uncover discursive sources of power dominance inequality and bias JBI NOTARI draws on these perspectives to pragmatically Assess the validity of the conclusions or recommendations by ascertaining the degree of authority that should be invested in the text using simplified discourse analysis techniques in the critical appraisal process e Identify and extract conclusions or recommendations using content analysis techniques in the extraction process and e Synthesize conclusions or recommendations The process of meta aggregation facilitated by JBI NOTARI reflects that employed in t
142. e esa eda ge 129 DELETING OUICOMES ea eot tt ec etra e epu egt 129 ADDING INTERVENTIONS Y 2 rt rto eto e eto d ale nee esos 131 m araro Pater as ER ESTER S O an ra 131 ADDING REOUITS 3 5 3 8i ocean fr su oreet aed anaes iom Ret 132 NUMERICAL DATA ENTRY INTO 5 0 132 EXTRACTING DATA AND ADDING RESULTS FROM OTHER STUDIES 133 JBI MAStARI Meta analysis eren 134 STARTING JBI CREMS i esses e aa ERR Yr Rn 134 META ANALYSIS IN MASTARI isses e 134 RESULTS SCREEN NEW REVIEWS ONLY CREATED USING SUMARI 5 0 137 ADDING A SUBGROUP S TO A REVIEW OUTCOME 137 DELETING A SUBGROUP FROM A REVIEW OUTCOME 138 META ANALYSIS SCREEN NEW REVIEWS ONLY CREATED USING SUMARI V 5 0 138 SENSITIVITY ANALYSIS USING 5 139 SUBGROUP ANALYSIS USING 140 ANALYSIS OF ALL 5 222222222222222 2 141 SAVING THE OUTPUT OF THE META ANALYSIS 141 JBI SUMARI 35 11 INTERPRETING THE FOREST PLOT MASTARI VIEW CONTINUOUS 143 35 12 RESULTS FROM INDIVIDUAL STUDIES er er eerte 143 SENI 144 35 14 HETEROGENEITY OF INCLUDED STUDIES
143. e final versions of the protocol and review e f the primary reviewer login details first dropdown box are changed your access to the review will be disabled Alternative primary reviewers can only be selected from those registered amongst your organization see Section 6 1 The identity status of the secondary reviewer can be changed at any time by clicking on Search and selecting from any registered JBI SUMAHI users see Section 6 1 above for how to assign a secondary reviewer searching with their username and registered email address The default order of appearance of the authors on both the protocol and review documents will be in order of entry This can be changed at any stage by simply changing the value in the Author Sequence box whilst modifying the author s details The primary reviewer will be assigned the number 1 and the secondary reviewer the number 2 SUMARI JBI 27 6 4 3 Adding Associate Reviewers and Editing their details From the Review Summary page users are also able to add multiple Associate Reviewers Please note that Associate Reviewers must be registered JBI SUMARI users Adding an Associate Reviewer to a review project does not enable access to the review project via their individual login details to JBI CReMS or the JBI SUMARI online analytical modules JBI QARI JBI NOTARI JBI MAStARI and JBI ACTUARI Addition of authors here will simply add their name and de
144. e in SUMARI 4 0 SUMARI JBI 117 321 Importing a study into JBI CReMS Studies can be imported directly into JBI CReMS from EndNote Thomson bibliographic software Studies should be exported in author date format from Endnote in and be saved as a xml file Once these studies have been assigned to JBI MAStARI CReMS they will be automatically exported into JBI MAStAHI Note however that studies exported into JBI MAStARI from JBI CReMS will require assignment of the study design before they can be critically appraised This is done by linking them and ticking the MAStARI check boxes 322 Manually adding a new study into JBI CReMS Alternatively studies can be manually entered into JBI CReMS Again once the studies are assigned to JBI MAStARI through CReMS they will be automatically exported into JBI MAStARI Studies be manually entered into JBI MAStARI using the Add button at the bottom of the studies page Fill out the standard bibliographic details of the publication Author s Title Journal Year Volume Issue if relevant and Page number The study design should also be assigned to each new study and there are notes in the following section The tab key can be used to move to the next field holding down the shift and tab keys together will move backwards between fields Studies manually entered into JBI MAStARI will be automatically uploaded into the JBI CReMS file for that review MAStA
145. e inserted using the field below Existing titles Software functionality 2 Select new title if you want to add a new outcome New Title Software functionality Data Type Dichotomous Continuous Description eae scale Measure Scale 11 2 poor and 3 4 good New Subgroup Existing Subgroup E Delete er Save Details I Cancel Any other studies assigned to this existing outcome can be added to the same subgroup by selecting from the existing Subgroup menu Please note that multiple subgroups can be created with one review outcome but each study can only be assigned to one subgroup within each outcome SUMARI JBI 137 35 5 Deleting Subgroup from Review Outcome Select the name of the subgroup from the dropdown list click on lt Delete gt if you wish to delete the subgroup from the analysis Users will be asked for confirmation of this action The page at http www jbiconnect org says Are you sure you wish to delete this subgroup for this If other studies are using this subgroup the link will be removed as well Conc ED Outcome title for ed Zac Alan Craig Journal of Computing Studies 2011 Drop down menu will display existing Titles from studies of the currently selected review Select an existing title to maintain consistency A new title can be inserted using the field below Existing tities unenonainy 2 Select new titie if you want to add a new outc
146. e is used to add new edit existing reviews or delete reviews Information about a review including its title a description of the review the year the review was commenced and the usernames of Primary and Secondary reviewers are all presented An Actions column has been introduced which replaces the Edit column that was in the SUMARI v 4 0 modules The status column of the review that was in the SUMARI v 4 0 has been removed from the Reviews page This is a systematic review of cost minimization studies of intracervical Prostaglandin for cervical ripening in an outpatient vereut inpabent setting 2010 catalint catalin Edit Quiere A systematic review of cost affectiveness studies of effectiveness of inhaled corticosteroids in asthma 2010 catalni catehn2 Edi Delete systematic review of cost effectiveness 2010 catalni cataln2 Delete The number of reviews is now also displayed 194 JBI SUMARI This page lists the Reviews that are in the system To add a review click on the Add button below To edit or delete Review click the appropriate link under the Actions column of Reviews 8 At the bottom of the page you will also see you are able to select the number of reviews to display on each page 10 records per page Only a reviewer can view the information on this page and only reviews that correspond to the selected Reviews radio buttons will be displayed In the example be
147. e of evidence e g both qualitative and quantitative evidence Continuous data that can be measured on a scale that can take any value within a given range such as height weight or blood pressure A control in general refers to a group which is not receiving the new intervention receiving the placebo or receiving standard healthcare and is being used to compare the effectiveness of a treatment Cost benefit analysis CBA is an analytic tool for estimating the net social benefit of a program or intervention as the incremental benefit of the program less the incremental costs with all benefits and costs measured in monetary units e g dollars Cost effectiveness analysis CEA is an analytic tool in which costs and effects of a program and at least one alternative are calculated and presented in a ratio of incremental costs to incremental effect Cost effectiveness ratio is the incremental cost of obtaining a unit of health effect such as dollars per year or life expectancy from a given health intervention when compared with an alternative Cost minimization analysis CMA is an analytic tool used to compare the net costs of programs that achieve the same outcome Costs in an economic evaluation studies refer to the value of resources that have an opportunity cost as a result of being used in the provision of an intervention 222 SUMARI Cost utility analysis CUA is economic evaluation study in which costs are measur
148. e opinion papers and reports select Textual Evidence and the NOTARI analytical Module and then select to insert set text le of evidence Done Textual 77 NOTARI Set Text Economic 71 ACTUARI Set Text Review Question If you select option 2 you are required to enter a description of the study participants you wish to focus on in the first dialogue box and the phenomena of interest in the second box then click on lt Done gt If you select option 3 enter a description of the phenomena activity or issue you wish to focus on in the dialogue box then click on Done SUMARI JBI 33 7 31 Review question s objective s background and inclusion criteria You have the option to complete all fields in the protocol without opting to use standardized text If you do so all of the fields should be completed and serve as a valuable template directing the important information that should be included in a systematic review protocol If you do opt to use the standardized text this will automatically generate text in some of the Protocol fields At this point the review question s objective s can be revised In the Background field enter your initial literature review also detailing the rationale for the review and its relevance to health care The specific criteria related to the participants phenomena of interest and context outcome of the review also be en
149. e protocol click the Protocol tab This will display the Protocol Screen The title of the open review project will appear at the top of the screen If you wish to edit your title you may do so within the Review Summary screen see Section 6 4 1 The review authors will also appear in the order they were entered in the Author s Information section Any changes made in the Review Summary tab to the Sequence of authors See Section 6 4 2 will appear in any exported version of the protocol and once the protocol is transferred to the report see Section 7 9 2 in your review The changes to sequence will not appear updated here File Studies Modules Export Help Current Working Mode Online Review Summary Protocol Studies Report Builder Report View Review title inserted here rAuthors Information Primary Reviewer trainee30 Secondary Reviewer trainee29 Associate Reviewers Select one or more of the SUMARI Analytical Module s you will use dependent on the type of evidence Evidence Module Quantitative 1 MASTARI Qualitative 1 Qari Textual 1 NOTARI Economic LL ACTUARI Set Review Question Background SUMARI JBI 31 71 Selecting the JBI SUMARI Analytical Module and Type of Evidence At the top of the Protocol screen you are asked to select which of the JBI SUMARI analytical modules you will use This will depend on the type of evidence your topic question lends itself
150. e software package Username Password Logon Reset If you experience any difficulty please report problem to JBI Version 5 0 Copyright Joanna Briggs Institute 2011 If you experience difficulty logging on you can access help by emailing jbi adelaide edu au Once you are logged on you will be taken to the main JBI ACTUARI page This page consists of three parts the main menu reviews radio buttons and a summary of all reviews in the system These parts will be described in more detail later This will take you to the main JBI ACTUARI page 192 JBI SUMARI ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Study Filter Reviews Reviews Primary This page lists the Reviews that are in the system To add a review click on the Add button below To edit or delete a Review click the appropriate link Secondary under the Actions column of Reviews 8 eor ure Cost minimization This is a systematic review of cost minimization studies of intracervical analysis of prostaglandin for cervical ripening in an outpatient versus inpatient intracervical setting 9 Opened Closed EA 2010 catalint catalin2 Edit cervical ripening in an outpatient versus inpatient setting A PS Io io Cost Effectiveness A systematic review of cost effectiveness studies of effectiveness of of inhaled inhaled corticosteroids in asthma cortico
151. e to the specific objectives Data Synthesis Quantitative data will where possible be pooled in 6 using JBI MAStARI All results will be subject to dou sizes expressed as odds ratio for categorical data a differences for continuous data and their 95 confi calculated for analysis modify text as appropriate assessed statistically using the standard Chi square Standardized text is automatically inserted in these fields when JBI MAStAHI is chosen This text can be edited from here up to the point where the protocol is approved by the JBI Synthesis Science Unit and transferred to the report section of JBI CReMS see Section 7 9 2 It is important to check the text and edit it appropriately as once the protocol is transferred to the report it cannot be edited any further SUMARI JBI 41 7 6 Protocol development using the JBI ACTUARI module If the review focuses on evidence arising out of economic evalutation studies and you wish to conduct the review using JBI ACTUARI click on the tick box between Economic ACTUARI to append the appropriate appraisal and extraction tools to your protocol and report then select the Set text tick box and click Set if you wish to use the JBI Set Text see Section 7 1 and 7 2 above 7 6 1 Review question s objective s background and inclusion criteria You have the option to complete all fields in the protocol without opting to use standardized text If you do so all of the
152. ection of JBI CReMS see Section 7 9 2 It is important to check the text and edit it appropriately as once the protocol is transferred to the report it cannot be edited 7 8 Inserting Citations To add citations to protocol fields they must first be added or imported to the studies page see section 8 To insert the reference within the text of a protocol field place your cursor over the required location and click the left button to confirm the position for the citation then click the right button on your mouse control click for Mac A dialogue box will appear with the list of available references Select the required reference and click Insert Multiple references be placed at the same insertion point Click Done to return to the protocol page The following is relevant to insertion of references in the text in either the Protocol Screen or the Report Builder In the text where the reference should be inserted click the right mouse button Background Globally the majority of the research and development strategies ai error and harm health care and its impact on patient safety has bi inpatient setting including both the secondary despite the fact that in many healthcare system the largest proportion of health care services provided 2 3 Although primary or ambulatory care is diffuse it can simply be considered a Insert reference Inclusion Criteria This will open another window on the screen
153. ed in monetary units and consequences are typically measured as quality adjusted life years QALYs Critical appraisal is the process of comparing potentially relevant studies to pre defined criteria designed in order to assess methodological quality Usually checklists are used with items designed to address specific forms of bias dependent on study design DALY Disability adjusted Life year A measure of the burden of disability causing disease and injury Age specific expected life years are adjusted for expected loss of healthy life during those years Dichotomous data that can be divided into discrete categories such as male female or yes no Direct costs represent the value of all goods services and other resources that are consumed in the provision of an intervention or in dealing with the side effects or other current and future consequences linked to it Economic evaluation is a study that compares the costs and benefits of two or more alternative interventions or programs or services An effect size is a value that reflects the strength of a relationship between two variables Examples include differences in means mean difference correlation coefficients relative risk and odds ratio Effectiveness refers to the effect of a particular treatment or intervention drug or procedure on defined outcomes when used in actual practice Efficacy concerns the effect of a particular treatment or intervention or procedure on outcomes unde
154. eec tete tr sere teet etre 214 TADDINGIOUIGOMES sudant np BR npe Ice 216 AGTUARIDATA SYNTHESIS 1 ba bed eae Panis 220 inre M 222 GEOSSARY OF TERMS seata attt tor ate e ce ete m dee det 222 Append gem et 227 SYSTEMATIC REVIEW PROTOCOL 227 TEEREVIEW PROTOCOL acti Ro cie to Rn Ro c 227 EXAMPLE PROTOGOL ania a ti occa soa de alk ec P s 231 nra mcm 236 QUALITY AND STATISTICAL CONSIDERATIONS IN 236 FORMS OF tos theater eir e t cute recede regen ud 236 APPENDIX IV DATA 2 22 2 238 APPENDIX V META ANALYSIS isses 240 JBI SUMARI 2 Introduction to JBI and JBI SUMARI The Joanna Briggs Institute is a major international agency for evidence based health care The Institute aims to facilitate evidence based practice globally through being a leading international organization for the Synthesis Transfer and Utilization of evidence of the feasibility appropriateness meaningfulness and effectiveness of health care practices through developing methods to appraise and synthesis evidence conducting systematic reviews and analyses of the research literature evidence synthesis globally disseminating information in diverse formats to inform health systems health pr
155. een correctly entered for a second time lt Save gt button appears and the data can be saved Click on lt Delete Results gt to clear all values from the screen 34 10 Extracting data and adding results from other studies JBI MAStARI is designed to combine the results of similar studies that have compared the effectiveness of an intervention or treatment on one group of patients compared to a control group of patients Combining studies is only valid if the treatments being given to both the intervention group and the control group are similar between the studies and the outcomes being measured between the groups are the same The decision as to what constitutes sufficient similarity between studies in terms of the interventions actually being given to either the treatment or SUMARI JBI 133 control groups or the outcomes being measured must be made by the reviewers during the development of the systematic review protocol and are not included as functions in JBI MAStAHI If you wish to combine the results of data from other studies it is important that you use exactly the same outcomes and interventions as you specified when the outcome or intervention was first extracted from a previous study This can be simply achieved by keeping careful records and always using the lt Existing titles gt drop down box on the New Interventions page and the lt Existing descriptions gt drop down box on the New Intervention A and New I
156. en and running in JBI CReMS To do this select File from the menu bar and then select New or to open an existing review select Open from File Regardless of whether you Add a new Review when you launch the software whilst working on another project this will open a dialogue box on screen with Several fields to be filled in e Title Enter the title of the new review e Year Enter the year of the new review Primary Reviewer The primary reviewer will be automatically set as the person who has logged onto JBI CReMS To change to a different primary reviewer select the name from the drop down list You will only be able to select from names that have been linked to a single organization Linking primary reviewers to a single organization can be done upon request to jbi adelaide edu au Secondary Reviewer To create new review project in JBI CReMS it is essential to assign a secondary reviewer to the project see Section 6 1 below 20 JBI SUMARI 3208 Add New Review p 54 f n E Title Review title inserted here Year 2011 Primary Reviewer trainee30 A SecondayReviewer Non JBI Review No E insert 0 Undo Cancel ace F In JBI CReMS you will only prompted to enter the title of the review when it is created Click lt Undo gt to clear any of the information just entered Once you have completed entering the information in the dialogue box c
157. enna T Reason Undo Version 5 0 Copyright Joanna Briggs Institute 2011 If the study is to be included in the review Yes should be selected from the drop down menu and the reason can be entered Selecting Yes will allow the reviewer to progress to data extraction for the study If No is selected the study citation and the reason entered will appear in the table of excluded studies in CReMS v 5 0 Click on lt Undo gt to remove any text entered in the Reason text field 33 8 Secondary assessment The secondary assessment is conducted as per the primary assessment and should be conducted blind to the assessment of the primary reviewer Studies which have been assessed by the primary reviewer will appear in the studies page with Primary Completed under the Assessment column The secondary reviewer can conduct the secondary assessment by clicking on the authors hyperlink from the studies page this will bring up the assessment page with the lt Add Secondary gt button available The secondary reviewer will be unable to see the assessment of the primary reviewer 33 9 How to do a final assessment It is the responsibility of the primary reviewer to conduct the final assessment Clicking on the authors hyperlink from the studies page will open the Assessment page showing both lt Edit Primary gt and lt Add Final gt buttons Clicking on the lt Add Final gt button will bring up the final ass
158. enshwacnder Peteet JR Stomper PC Ross DM Cotton V Truesdell P Moczynski W Emotional _ Quirk ME Letendre AJ Ciottone RA Lingley JF Anxiety in patients undergoing M 4 Rhodes LC et al The power of the visible the meaning of diagnostic xm chr gt 3 4 Background through illness and D res Magnetic Emission Y Inclusion Criteria Types of Partic be receiving medical M limaging fora wide range of lidicat ons and may have any pre existing leenditinn nr ers pote qualitative component of this review will consider studies that If the final output of the reference citation needs to be modified for presentation in the report for a book chapter for example where the publisher s details or edition number should be included select a reference by clicking on it click edit and another window will open to allow users to edit the citation riggs J et al How to use JBI MASTARI Journal of the Joanna Briggs institute 2010 1 3 35 Any modifications made here will not change the presentation of the citation in the Studies screen see Section 8 Changes made will only be reflected in the exported protocol or report or in the case of the review report modification to citations can also be viewed on the Report View screen under the Reference List subheading 46 SUMARI Please note DO NOT edit the ci
159. ensure scientific rigor and minimize potential bias It also allows for periodic updating of the review if necessary Protocol development involves 57 1 1 Background Review The initial step is to undertake a general evaluation of the literature to determine the Scope and quantity of the primary research to search for any existing reviews and to identify issues of importance The background for a systematic should include discussion of the review question an assessment of the significance of the topic to health care an overview of the review question an overview of previous reviews of the review topic or of topics related to it and a description of any controversies related to the review topic SUMARI JBI 227 57 1 2 Review Question Objectives As with any research it is important to have a clear objective and or question The protocol should state in detail the questions or hypotheses that will be pursued in the review Questions should be specific regarding for example the patients setting interventions or phenomena and outcomes to be investigated This will vary according to the purpose of the review When a review focuses on the effect of an intervention on specific outcomes or the prognosis diagnosis or risk precise descriptions of the interventions and outcomes are required If the review is more concerned with the evidence on the subjective experience of a phenomenon activity or intervention outcomes ma
160. ent Secondary Assessment User catalin1 User catalin2 Reason No reason given Included Yes Reason No reason given Final Assessment lFinal assessment is not done User catalini Add Final Version 5 0 Copyright Joanna Briggs Institute 2011 Clicking on the lt Add Final gt button will bring up the final assessment page which shows the results of both the primary and secondary assessments already conducted 1 15 there a well Gefined question Yes Yes 2 is thera comprehensive dascnpbon of altemativas ves Yes Are all important and r levant costs and outcomes for 3 each alternative identified vee Yes 4 Has clinical effectiveness been established Yes Yes 5 Are costs and outcomes measured accurately Yes Yes 6 Are costs and outcomas valued credibly vas ves 7 Are costs and outcomes adjusted for differenbal tng Yes Yes Is there an incremental anshysis of costs and 8 cos ces Yes Yes 9 Were sensitivity analyses Conducted to investigate Yes yes uncertainty in estimates of cost or consequences 10 Do study results include all issues of concem to users Yes Yes Are the results generalizable to the setting of interest in 11 ine review vas ver include Undefined v Reason oo LL Version 5 0 Copyright Joanna Briggs Institute 2011 SUMARI JBI 211 Primary Reviewer must consider any discrepancies
161. esearch question or Yes Yes B objectives There is congruty between the research 3 methodology and the methods used to collect yes Yes gt data There is congruity between the research 4 methodology and the representation and analysis Yes Yes gj There is congruity between the research methodology and the interpretation of results There a statement locatng the researcher culturally or theoretically ns oe influence of the researcher on the research and vice versa is a Participants and ther voices are adequately represented Tha research is ethical according to current mw 9 cr for recent studios there avidence of Yes ethical approval by an appropriate body 6 7 ves Yes 8 Conclusions drawn in the research report do 10 appear to flow from the analysis or Yes Yes interpretation of the data include Undefined Reason Undo Any disagreement over the assessment status of a study between the primary secondary reviewers should be resolved through discussion with a third reviewer If it is agreed that a study should be excluded the primary reviewer documents the rationale for exclusion this along with the citation details will automatically form an appendix to the review when it is being prepared for publication Once decisions on assessments are completed the Studies screen will show that each completed paper has been either
162. essment page which shows the results of both the primary and secondary assessments already conducted The primary SUMARI JBI 125 reviewer must consider any discrepancies between the primary and secondary assessments and in collaboration with the secondary reviewer determine the final assessment for each of the critical appraisal criteria If agreement between the two reviewers cannot be reached a third reviewer should be engaged to assist in the final assessment Use the drop down box to allocate included or excluded status in the final assessment The reason for excluding a study must be outlined in the final assessment Included studies will now show Included in the Status column and Complete in the Assessment column 33 10 How to edit an existing assessment To edit an existing assessment select the study from the studies page Click on the lt Assessment gt page on the left hand menu and the assessment page will appear Click on the lt Edit Primary gt lt Edit Secondary gt or lt Edit Final gt buttons and edit the assessment as appropriate Pressing the lt Update gt button will save any changes made Pressing the lt Cancel gt button will cancel the action and return you to the assessment page 126 JBI SUMARI 34 JBI MAStARI Data extraction The data for a systematic review are made up of the results from the included studies Data extraction is the process of taking the results from included studies in a
163. esults for each study are reported adjacent to the study identification in graphical and numerical format and the overall result when all three studies are combined using a fixed effects model weighted mean difference WMD is shown as the bottom row square symbols represent an individual study and a round symbol represents the overall result The units along the horizontal axis in this case ranging from 6 to 6 indicate the direction and size of any difference in the means of the treatment versus the control The default setting in JBI CReMS is that an increase in either a continuous or dichotomous outcome indicates a poorer outcome for patients Whilst this is true in many types of studies particularly those that measure morbidity and mortality it is not correct in the example presented here For example in the Spelic et al 2001 study the mean California Critical Thinking Skills Test score was greater in the treatment group 18 5 5 9 compared to the control group 16 3 3 7 In this case a greater score means a better result i e students fared better in the treatment group however by default JBI CReMS interprets the increase in the outcome variable compared to the control group as favoring the control which is why all of the figures are on the right hand side of the graph It is up to the user to be aware of this default Setting and include this in their interpretation of any output in JBI CReMS SUMARI JBI 143 The rectan
164. ew page e g comprehensive systematic review of evidence on the effectiveness and appropriateness of undergraduate nursing curricula By opening the review in this manner you are automatically selecting it and clicking on the title will take you to the studies page see section 32 31 5 Editing a review Within the reviews page clicking on the edit column will open the review details page From here you can edit the Review Name Review Question and Review Year as well as the Secondary Reviewer and whether or not the review is going to be a JBI Review To save any changes select the Update button To exit without saving changes selecting Cancel will take you back to the reviews page Pressing the Close button will change the status of the review to closed N B If you create your review in one of the analytical modules and then proceed to use the Insert Set Text function from within CReMS v 5 0 when the review project is saved in CReMS v5 0 the question entered there will overwrite any description entered from within the analytical modules Click Undo to remove any text just added to any field on the screen MAStARI Meta Analysis of Statistics Assessment and Review Instrument The effectiveness of SUMARI v5 0 versus v4 0 for producing a systematic review A systematic review Review Title The objective s of this review is are to identify the effectiveness of state intervention p
165. ewly created one 102 JBI SUMARI 24 JBI QARI Synthesizing Categories To synthesize the categories the reviewer needs to consider the full list of categories and identify categories of sufficient similarity in meaning to generate synthesized findings A synthesis is defined as a group of categorised findings that allows for the generation of recommendations for practice To view all listed categories click on Categories on the top toolbar and then Categories on the left hand menu Categories for Comprehensive literature review on Recognising and Responding to the Deteriorating Patient in Acute Hospitals Tha page allows categones to bs managed Team and social factors Team and social factors Team and soca factors The wav in which observation charts and patient case notes are desianed and used contnbute to poor Oraanisatonal 24 1 Creating synthesized findings To create a synthesized finding click on Synthesis on the top menu bar and then click on Add Synthesis Alternatively in the Category Details page click on the link Add Synthesis Each will take the user to the Synthesis Details page QARI Qualitative Assessment and Review Instrument Categories Synthesis Details This page allows tha edting of a Synthesis actors relating tc clinical process decision making Name Enter the name of the synthesized finding as well as details into the Summary field a
166. ext will automatically require you to select options that define the types of qualitative studies you intend to include in your review project Select one of these three options by clicking one of the three radio buttons If you select option 1 click on Done ene The review will consider 681 Studies that focus on qualitative data including but not limited to designs such as phenomenology grounded theory ethnography action research and feminist research Report View In the absence of research studies other text such as opinion papers and reports will be considered 17 you wish to include opinion papers and reports select Textual Evidence and the NOTARI analytical Module and then select to insert set text now 9z interpretive studies that draw on the experiences of with 7 including but not limited to designs such as phenomenology grounded theory ethnography action research and feminist research In the absence of research studies other text such as opinion papers and reports will be considered sf you wish to include opinion papers and reports select Textual Evidence and the NOTARI analytical Module and then select to insert set text nowt O 3 critical studies thatexplore 9 including but not limited to designs such as action research and feminist research In the absence of research studies other text such as opinion papers and reports will be considered 17 you wish to includ
167. f 2008 New wee rper a sutgenr Applying cirvcal process Medical Journal of Australia 20080 New Awaiting methods Final Australian Safety and Efficacy Resister of Nen Interventional Procedures Surgical ORSERNIP S al Kehler 5 Wimore Douglas W DG es al The assessment review screen will now display an Add Final in the Final Assessment box Click on Add Final to complete the final appraisal process Assessment for Pearson A International Journal of Evidence Based Healthcare 2012 Primary Assessment Secondary Assessment User ne percer per Reason gt This a good publication Reason a high quakty paper Final Assessment Final assessment is not done luser The appraisal screen now displays both the primary and secondary assessment in addition to the radio buttons to perform the final assessment 170 JBI SUMARI Not Criteria Primary Secondary Yes No Unclear applicable Comment 1 Is the source of the opinion clearly identified Yes Yes e 2 MEET the opinion have standing in the Yes Ved 3 e aic of patients clients the central focus 00 Yes e 6 2 4 ci E basis in logic experience clearly No Yes a 5 Is the argument developed analytical Yes Yes LJ payers eris uinci o e 7 Is the opinion supported by peers Yes Yes 2 e Any
168. f SUMARI v5 0 online modules should download CReMS v5 0 to complete the software package Username Alan Pearson Password If you experience any difficulty please report problem to JBI Note You need to download CReMS v5 0 to work with this NOTARI version Version 5 0 Copyright Joanna Briggs Institute 2011 38 2 Logging off When logged on the main menu bar remains across the top of each page Clicking on the Logout button on the main menu logs the user out after a quick confirmation and ends the session 39 JBI NOTARI Main menu The main menu is always across the top of the screen NOTARI Narrative Opinion and Text Assessment and Review Instrument ES Pubtication Synthesis lt Reviews gt shows the list of systematic reviews you have created in NOTARI or allocated to NOTARI from CREMS see Section 40 The titles of each review appear to the left of page as links that you can click to open and work on or update lt Publications gt cannot be selected until you have clicked on a particular review title Once a review has been opened the lt Publications gt button will show the list of papers that have been allocated to the review see Section 41 The lt Categories gt menu item also requires that a review be selected before you can view or add categories see Section 45 158 SUMARI lt Synthesis gt menu item will display the available syntheses or enable users to add a s
169. f infection on treatment A by the odds of infection on treatment B ie 0 250 0 471 or 0 531 Because the OR is less than 1 it is apparent that the odds of infection are less on treatment A than B An OR greater than 1 would indicate that the odds of infection are greater on treatment A than B An OR of 0 531 is equivalent to a reduction in the odds of infection of 46 996 ie 100 x 1 0 531 58 3 5 Relative risks The risk of an event is calculated as the number of participants experiencing an outcome divided by the total number of participants In the same example as above the risk of infection for treatment A is 10 50 0 20 while the risk for treatment B is 16 50 0 32 The RR for developing an infection on treatment A compared to treatment B is calculated by dividing the risk of infection on treatment A by the risk of infection on treatment B ie 0 20 0 32 or 0 625 Again because the RR is less than 1 the risk of infection on treatment A is 0 625 times the risk on treatment B This is equivalent to a reduction in risk of 37 596 ie 100 x 1 0 625 a smaller reduction than that shown by the OR 58 3 6 When to report an OR or RR In the example above the OR and RR calculated were quite different 0 531 and 0 625 respectively This can lead to some confusion for example in interpreting the results of a cohort study which could validly present either the OR or RR as a measure of association between the treatment and the outcome
170. f statements that represent that aggregation throug findings rated according to their quality and categori the basis of similarity in meaning These categories a meta synthesis in order to produce a single compreh Conflicts of Interest Standardized text is automatically inserted in these fields when JBI QARI is chosen This text can be edited from here up to the point where the protocol is approved by the JBI Synthesis Science Unit and transferred to the report section of JBI CReMS see Section 7 9 2 It is important to check the text and edit it appropriately as once the protocol is transferred it cannot be edited any further 7 4 Protocol development using the JBI NOTARI module If the review focuses on evidence arising out of opinion and you wish to conduct the review using JBI NOTARI click on the tick box between Textual NOTARI to append the appropriate appraisal and extraction tools to your protocol and report then select the lt Set text gt tick box and click lt Set gt if you wish to use the JBI Set Text see Section 7 1 and 7 2 above SUMARI JBI 35 7 41 Review question s objective s background and inclusion criteria You have the option to complete all fields in the protocol without opting to use standardized text If you do so all of the fields should be completed and serve as a valuable template directing the important information that should be included in a systematic review protocol If yo
171. f studies selected for retrieval 6 Number of studies found e Methodological quality Show Summary of Asssessment Studies included reporting on the functionality and presentation of ther new SUMARI y 5 0 software package were of good overall Full results of the appraisals can be viewed in the Summary of Methodological Assessment Table Table of included and excluded studies for module Mastar No of included studies 5 No of excluded studies 0 Similarly the reviewer is required to enter text describing the methodological quality of the papers found under the heading Methodological quality and a table showing included and excluded studies is automatically uploaded from the analytical module s used In the Results section of the review report underneath the Methodological quality subheading users will find a tick box alongside Show Summary of Assessment If this tick box is selected a table s summarising the results of the critical appraisal s performed in the analytical modules will appear in the appropriate section of the Report View screen see Section 1 1 Methodological quality Show Summary of Asssessinert Etudes mchuded on the and presentation of ther new SUMARI 5 0 software package were of pood quinty overall Full results of theapprnsils joan be viewed in the Summary of Methodological Assessment Table Table of included and exchide
172. ff 15 wes necessary tc add personnel an order to make this work We did sot need to add any nurses or other neeith care Wustration from Publication Page Refi staff throughout our implementation project ip5i5 Evidence Credible None Category incide Yes v A credibility level see Section 36 5 can be assigned to each conclusion using the Evidence drop down box The Include menu allows a reviewer to either include Yes or exclude No a conclusion based mainly on the credibility of the conclusion This defaults to Yes The Category drop down menu allows the allocation of each conclusion to a category this process will be dealt with in the next section Pressing the Insert button will save the Conclusions view Pressing the Cancel button will take you back to the previous screen without saving any of the changes made 44 2 Viewing conclusions Within the Publications page select a publication and press the Conclusions 178 JBI SUMARI button the left hand column This opens the Conclusions page NOTART Narrative Opinion and Text Assissment and Review Instrument Reviews punon Conclusions for Pearson A International Journal of Evidence Based Healthcare 2012 Conclusions Ll Iti nossibie to introduce 3 new OR 1t was not necessary to add personnel in order to make this work We Gd not need Credible
173. field should list the age gender race or cultural groupings of the people included in the study You should also include the basis of why people were excluded from the study SUMARI JBI 215 Source of effectiveness data There are four options available to select from the scroll down menu in this field relating to the original location of the information from which the effectiveness of the intervention compared to the comparator was derived For example was it a single study involving either the same or different participants Or was the information about effectiveness gained from multiple studies perhaps involving a meta analysis Author s conclusion In one sentence summarize the main findings of the study from the author s perspective Reviewer s comments In one sentence summarize your interpretation of the study and its significance 55 2 Adding outcomes Once the data extraction page is complete and you have clicked on lt Update gt you will be taken to the New Outcome page There are three main sections to this page each of which will be discussed below The New Outcome page changes slightly depending on the source of the effectiveness data 216 JBI SUMARI Single Study same participants ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument mm New Outcome for Mumus et al Health Policy 2009 Edit Extraction Details Single study same participants
174. first study as was the case in SUMARI v 4 0 53 4 Editing a study Click on lt Edit gt to modify study details This will bring you through to the same screen accessible via selecting the study name hyperlink and then clicking lt Details gt from the left hand box menu You may edit citation details from this screen Select Study Details Author Buston of al Title Cost Efectieness of inhaled g NEM Joumal Year 2008 Volume 5 Issue 45 Page No 37375 Status Extraction E Version 5 0 Copyright Joanna Briggs Institute 2011 53 5 Deleting Studies from the ACTUARI Click on lt Delete gt to delete a study from the list of studies A dialogue box will open asking for confirmation by the user prior to completion of the operation Once confirmed the study record and any assessment extraction results associated to the study within the analytical module will be erased Once erased this operation cannot be undone Ed et al Cost Effectiveness of inhaled corticosteroids in asthma adult patients JAMA 2009 Extraction Complete Edit Delete Buxton et al Cost Effectiveness of inhaled corticosteroids in adult asthma patients NEJM 2009 Extraction Complete Edit Dele Mumus et al Cost Effectiveness 6 The page at wwwjbiconnectorg says Policy 2009 None Edit Delete John et al Cost effectiveness 2008 New None Edit Delete Are you sure you want to delete this study Cancel Version 5 0
175. fy existing citations from the Studies screen See Section 8 This has been done to ensure that when the review is subsequently reconnected or synced to the JBI server important information which has been entered online for example by the secondary reviewer is not lost if the primary reviewer deleted the study citation whilst in Offline Mode SUMARI JBI 61 Studies Modules Export Help Current Working Mode Offline Review Summary Protocol Studies Report Report View Sof Citabons 2 Systema umor Year volume Issue Papes G Noan Mats acuan Reference Existing Studies in the review will appear in a dark grey colour to indicate they cannot be modified New studies can be added individually or via citation import See Section 8 whilst in Offline Mode Studies which are added in Offline Mode may also be deleted whilst remaining in this mode see Section 8 3 11 1 1 Opening JBI CReMS and Offline functionality If users attempt to open JBI CReMS when there is no Internet connection detected by their computer they will be automatically prompted to work in Offline Mode Please note if users click Yes however have not yet saved a version offline to their local drive of any review project a new review cannot be created in offline mode From the Add New Review window which appears you will have to select Quit Similarly
176. g a gut fesing and a suth Making complex decision sense was one way nurses 1some patients you have a sort of a gut feeling that things are not quite nyht the basis of clinicians described how they recognized with thema ther observations have not bacome compromised but you feet experience may pahents needing MET call things ara not quite nght with them P 110 amp just something inside that sort of contribute to the qut feelings they meet the MET criteria as all the observabons are development of within normal lits but there ie something wrong P 110 strategies for best practice A Jack of knowladgg and Lrauung may Having an educated and peasibty contribute to the problem of suitability skilled and A nurse may not pick up the signs because of a lack of traning or understanding Or they might not be seeing it they writing it down and not seeing what s in front of them staff nurse p19 essential to provide appropriate care to patients who deterionate A lack of team work contributes to Lack of collaborative datencraton problems Teams may you know the people you re working with then you can better trust ther Geckion making when Wagment junior doctor Knowing your team and your doctors helps Often nurses are not sure about turnover of nursing staff and the things don t Work as wed in the first week after doctors change because people how best to respond to
177. ghlight the user details that appear and click lt select gt Cee Add New Review Title A new test review Year 2011 Primary Reviewer traini HJ Secondary Reviewer Non JBI Review Once complete click lt insert gt to finish the process and enter into your review project You will see the details of the primary you and secondary reviewer in the Review Summary tab SUMARI JBI 23 6 2 Deleting a Review in JBI CReMS This option allows you to delete a review in its entirety You will see this option displayed when you launch JBI CReMS or when you are already working on a review and attempt to lt Open gt a new review from the file menu You may select the title of the project you wish to delete from those listed in the dialogue box and click lt Delete gt You will be prompted to enter the primary reviewer s login details to complete this action Once complete the entire review project will be erased from the JBI server You cannot delete a review project in its entirety whilst you are working on it despite seeing it in the list for selection amongst other review titles of yours The review will have to be closed and then selected from the list and deleted rom list or cl he Ne Primary Reviewer Login 1 Drugs for DVT Title of my review Advising doctoral s Username Ed Aromataris Password 6 3 Creating a Non JBI
178. gle adjacent to the Spelic et al 2001 study is located at a difference means of 18 5 16 3 2 20 and this figure is provided next to the weighting given to the study The horizontal lines emanating out of the rectangle are the confidence intervals in this case calculated at 9596 confidence associated with that study the numerical values for the lower and upper confidence intervals 0 44 and 3 96 respectively for this study are presented in brackets next to the difference in means Note that the confidence intervals do not include the vertical line marked at 0 0 on the forest plot The O O vertical line is equivalent to no difference in means A confidence interval which does not include 0 0 for example in the Spelic et al 2001 and Beckie et al 2001 studies indicates that there is a significant difference in the effectiveness of the treatment compared to the control A confidence interval that does include zero e g Jansen and Morse 2004 indicates no significant difference between the groups Mean score Study WM Weight CI 95 Fixed Spellic Parsons Hercinger et al 2001 40 75 2 20 0 44 3 96 D Beckie Lowery and Barnett 2001 L 30 62 3 40 1 37 5 43 Jansen and Morse 2004 cF 28 63 1 80 0 30 3 90 0 0 Favours Treatment 6 0 6 0Favours Control Overall Overall 100 00 2 45 1 33 3 58 Favours Treatment 6 0 00 6 0Favours Control Overall Z 4 27 P 0 0001 Heterogeneity Chi squared 1 28 P
179. hat when the study is first entered into the system a 1 tag will appear in the System ID column The number will update when the review is next saved to the JBI server This can be done by selecting File from the menu items and clicking on Save 43312 Alam Zac 2011 System iD Author s Year 12317 Craig ed 2011 DREMS v journal Ad 100 43309 Zac A 2011 Ana analy Journal of 78 50 JBI SUMARI The default ordering for the list of citations in the studies screen is by alphabetical order of the Author s list The list can be re ordered in either ascending or descending order by the information listed in the System ID Author s Year Title and Journal columns displayed simply by clicking on the title of each column Please note this feature is not available for Apple Mac users with Mac OS 10 5 x or below e All citation fields on the studies screen can be edited by double clicking on the text box The Volume Issue and Page fields have been modified to allow entry of text as opposed to simply numerical information to allow more flexibility for recording citations such as web pages or book chapters for example There are two methods for adding studies in JBI CReMS You can add a single study by clicking the button at the bottom right of the Studies page You can also add a study by selecting Add Study from Studies on the menu bar Crem
180. he JBI QARI module and is based on the work of the QARI Development Group Meta aggregation is a term that has been adopted to refer to a higher order form of synthesis In the context of evidence based practice meta aggregation is used to describe a pooling of the results or findings of qualitative research and is seen to correspond with meta analysis which is the term applied to the pooling of the results of quantitative research The process of meta aggregation facilitated by JBI NOTARI involves the aggregation or synthesis of conclusions related to the intervention activity or phenomenon that is the subject of the systematic review There are three steps incorporated in this process The first step aims to generate a set of statements that represent the aggregated data through assembling the conclusions rated according to their quality The second step involves categorizing these findings on the basis of similarity in meaning These categories are then subjected to a meta aggregation in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence based practice 36 2 Critical appraisal The major aim in critically appraising experimental or quantifiable data is to limit bias and thus establish the validity of a study From a quantitative perspective sources of bias include selection bias performance bias and attrition bias and validity is assessed by establishing the extent to which a parti
181. he number of participants dying or developing an infection and N is the total number of participants in the group MAStARI Meta Analysis of Statistics Assessment and Review Instrument Dichotomous Results for zac et al DNA 2010 Intervention Result n N Meta Analysis CREMS 35 000 60 000 v MS Word 45 000 60 000 Dsi Dara Enry 132 JBI SUMARI Continuous Data For continuous data required data are the sample size this is entered during the extraction process the mean and the standard deviation Users who are entering continuous data will see a third entry field for the number of participants has appeared on the results screen Previously in v 4 0 these values used in the meta analysis calculation were taken from the data extraction form To remain consistent and have all of the values used in the meta analysis in one entry screen they have been moved here Click on lt Delete Results gt to clear all values from the screen MAStARI Meta Analysis of Statistics Assessment and Review Instrument control EIS Ee Both dichotomous and continuous data needs to be double entered to reduce any data entry errors Users will notice the predictive function in the data input fields which was in v 4 0 has been disabled to make the Double Data Entry function more robust Once the data has been added click on the DBL Data Entry button Once the same values have b
182. he treatment group that are not experiencing the outcome 654 35 19 Heterogeneity of included studies The heterogeneity chi square calculated from the meta analysis 9 96 gives rise to a probability equal to 0 007 indicating significant heterogeneity As discussed in section 35 14 there are a number of options to consider when heterogeneity is encountered Assuming that the data have been correctly entered into JBI MAStARI and that the same effects measure has been used across studies there are not enough studies included to consider sub group analysis or meta regression Other options include not conducting further analysis and summarizing the results in a narrative Summary however it is also appropriate to conduct a random effects analysis and compare this with the results of the fixed model A random effects model can be simply generated by clicking random under the lt Effect gt drop down box and then clicking the lt Analyse results gt button The random effects meta analysis is presented below Pain Study Mantel Haenszel Relative Risk Risk Ratio Weight 95 Fixed Zar 2001 19 80 0 60 0 42 0 86 Fripp 2003 59 57 0 28 0 21 0 39 Hill 2002 20 62 0 43 0 27 0 70 1 Favours Treatmento 0 0 10 0Favours Control Overall Overall 4 100 00 0 38 0 31 0 47 Fayours Treatment0 0 1 0 10 0Favours Control Overall Z 9 00 P 0 0001 Heterogeneity Chi squared 9 96 0 0068741 SUMARI JBI 147 35 20
183. his is no longer the case This configuration will need to be deactivated this can be done simply in JBI CReMS by 16 JBI SUMARI selecting the File menu clicking lt Connection Settings gt and un checking the tick box at the upper right of the dialogue box labelled Use Proxy It can be reactivated at any time by re checking this same tick box eoo Edit Connection Settings Use Proxy Proxy Settings Port 0 _ Require Authentication r Authentication Details v User and password entered by user s User and password User Password l Ok Cancel O R 5 JBI CReMS Getting Started 5 1 Introduction JBI CReMS is designed to manage a systematic review and incorporates the ability to import data from bibliographic citation management software such as EndNote or Procite for example includes fields to enter a full systematic review protocol and search results and has the capacity to generate publishing house standard reports using the data entered in any or all of the four analytical modules of JBI SUMARI JBI QARI JBI NOTARI JBI MAStARI and JBI ACTUARI The use of JBI CReMS is a requirement for reviewers conducting systematic reviews that comply with the JBI approach and who wish to publish in the JBI Library It can be used as a stand alone systematic review management tool or in conjunction with one or more of the
184. his opens the Findings page Findings for Abbott Burns Gleadell Gunnell British Journal of Community Nursing 2007 All Findings Miel Some patients prefer not sure how ethical it is But it gave her peace of mind Abott et al 2007 p 10 There Credible Edit to use unne testing tp a few patients that 1 have been to who have urne sticks But that is very much thei own SGM business and I don t get involved Abort at al 2007 p 10 1 10 records per page 22 3 Editing findings Within the Findings page select the finding to edit by clicking the link under the Finding column This loads the information from the finding into the edit area of the Findings page After the information is edited press the Update button and the finding will be saved and the Findings view updated Pressing the Cancel button will cancel the edit 98 SUMARI 22 4 Deleting findings Users will notice that in QARI v 5 0 a new column has been added to the Findings page titled Actions with an Edit and Delete function available QARI Qualitative Assessment and Review Instrument EM Findings for Cioffi 1 Salter C Wilkes L Vonu Boriceanu Scott J Aust Crit Care 2006 Al Findings gt Staff coved respratory rate has increased from 40 to 70 over last two hours we need to help him Credible far abaormal wstal agos out RN 8 p68 Dasta A
185. ibrarian in deciding which databases to search and what search terms to use in each of these A number of potential problems can be avoided if a skilled librarian is involved For example differences in spelling conventions such as randomised versus randomized and paediatric versus pediatric can be overcome by using the thesaurus of specific databases and using various techniques The same applies when different terms are used in different countries such as the terms mucositis and stomatitis There are also variations in controlled vocabulary between databases Medline for example uses the term Cerebrovascular Accident whereas Cerebral Vascular Accident is used in CINAHL Thus in doing the search it is important to utilize the aids available in SUMARI JBI 229 databases Truncation is an aid some databases that can be used to search for a number of words with the same stem In some databases if an asterisk is inserted at the end of such a word for example restrain then the search will include words that contain that stem such as restraint restrained restraining etc Another useful aid is that of the wildcard A wild card can be inserted in the place of a letter to pick up words that have different spellings In some databases the wildcard is used by inserting a question mark for example randomi ed and any word with that spelling will be searched for such as randomised and rand
186. ic synthesis is of use in drawing conclusions based on common elements across otherwise heterogeneous studies All of these approaches do not however seek to provide guidance for action and aim only to anticipate what might be involved in analogous situations and to understand how things connect and interact Meta aggregation is useful in developing recommendations for action and may also include claims about generalisability JBI QARI is designed to facilitate meta aggregation although it can be used in meta ethnography and other interpretive processes as a data management tool JBI QARI is designed to provide reviewers with a framework to systematically review qualitative evidence of appropriateness meaningfulness and feasibility The process of meta aggregation facilitated by JBI QARI is based on the work of the QARI Development Group Meta aggregation is a term that has been adopted to refer to a higher order form of synthesis In the context of evidence based practice meta aggregation is used to describe a pooling of the results or findings of qualitative research and is seen to correspond with meta analysis which is the term applied to the pooling of the results of quantitative research The process of meta aggregation facilitated by JBI QARI involves the aggregation or synthesis of findings related to the intervention activity or phenomenon that is the subject of the systematic review There are three steps incorpo
187. icit and 3 The relationship between what the participants are reported to have said and the conclusions drawn in analysis Drawing from the literature as well as input from a panel of experts a critical appraisal instrument for qualitative research studies has been developed and extensively piloted and refined this has been incorporated into the QARI software Based on the standard approach promoted by the Cochrane Collaboration and adopted by the Joanna Briggs Institute two reviewers are expected to critically appraise the data independently and to then confer In qualitative research critical appraisal may assist reviewers to engage with the data by providing a series of prompting questions for consideration In JBI reviews this is extended to the consideration of the quality of the data and its suitability for inclusion in the review 14 4 Data extraction Data extraction involves transferring findings from the original paper using an approach agreed upon and standardized for the specific review Thus an agreed format is essential to minimize error and to provide a historical record of decisions made about what constitutes data for the purposes of the review and what is to become the dataset for categorization and synthesis Drawing from the literature as well as input from a panel of experts a data extraction instrument has been developed and extensively piloted and refined this has been incorporated into the QARI software
188. ifference SMD Cohen s SMD and the weighted mean difference For continuous data under a random effects model there are two options DerSimonian and Laird SMD and DerSimonian and Laird WMD 134 JBI SUMARI For dichotomous data using a fixed effects model there are three options the Mantel Haenszel Relative Risk RR the Mantel Haenszel Odds Ratio OR and the Peto Odds Ratio There are only two options for dichotomous data using a random effects model these are DerSimonian and Laird OR and RR In terms of confidence intervals JBI CReMS default setting is to calculate 95 confidence intervals This can be adjusted to either 90 or 99 as required using the lt Confidence Interval gt drop down box In the current version of JBI CReMS the preferred meta view field defaults to Forest plot and there are no other options currently available Once all of the appropriate settings have been selected clicking on the lt Analyse results gt button will generate the forest plot summarizing the results of the individual studies and their combined meta analysis The forest plot can be saved as a jpeg file using the Save graph to disk button and specifying an appropriate name and location for the file This new menu item has been added to MAStAHI v 5 0 to reflect the inclusion of the feature to do statistical meta analysis of data users previously performed in CReMS v 4 0 Please note that the statistical package runs
189. ifications affiliations and professional standing of the author s identified in the paper Reviewers may wish to follow up the standing of the source by consulting with experts in the particular field checking accreditation rolls or contacting the source for further information 42 2 3 Are the interests of patients clients the central focus of the opinion Does the paper take a stance that advantages a profession or a specific institution or body rather than patients clients communities or for some health gain 172 JBI SUMARI 42 24 Isthe opinion s basis logic experience clearly argued Does the opinion make sense and demonstrate an attempt to justify the stance it takes 42 2 5 Is the argument developed analytical Is the opinion the result of an analytical process drawing on experience or the literature 42 2 6 ls there reference to the extant literature evidence and any incongruency with it logically defended What extant literature does the author present to support the arguments Is incongruence addressed and justified 42 2 7 Is the opinion supported by peers To what extent does the opinion coincide with rather than conflict with the current knowledge and practice base of the specific field of expertise 42 3 Filtering publications In reviews with large numbers of publications it is useful to use the filter function to view groups of publications based on what stage of assessment or extraction the
190. ilarly as studies and papers are appraised data extracted from them and then synthesized the results are transferred to JBI CReMS to generate an ongoing editable report JBI CReMS users can edit the draft report on the report builder component of JBI CReMS and generate a report in both rtf and pdf format to comply with the requirements of The JBI Library of Systematic Reviews Bibliography Reviewers Not selected Search Strategy Studies Search Results Bibliography Selected Studies Ability to print Critical Appraisal Critical Appraisal Critical Appraisal Inclusion Exclusion i i Inclusion Exclusion Inclusion Exclusion bibliography bibliography bibliography Data Extraction Data Extraction Data Extraction Data Synthethis Data Synthethis Data Synthethis Interpretation Interpretation Interpretation Interpretation MAStARI ACTUARI Review report 4 Downloading and Installing JBI CReMS JBI CReMS is easy to download and suitable for both Windows and Macintosh computers You will need a network or Internet connection to download and install JBI CReMS Download the appropriate software to your computer depending on the operating system you use visit the JBI CReMS installation page at SUMARI JBI 15 JBI CReMS version 5 0 released 29 08 2011 update is mandatory Existing users Please click here to update your SUMARI profile This is essential to use CReMS v5 0 New users Please click here to reg
191. ilized to generate knowledge for practice in these fields Evidence in its most generic sense has been defined as being the available facts circumstances etc supporting or otherwise a belief proposition etc or indicating whether a thing is true or valid The concept of evidence plays a key role in clinical decision making and health professionals draw on beliefs and understandings that are seen as rational and based on adequate evidence even if that evidence is insufficient to ground knowledge 70 JBI SUMARI The meta analysis of the results on quantitative interventional studies is well established process by which data from a number of empirical studies is combined and analyzed afresh to provide evidence for clinical decision making Meta analysis is strictly limited to quantitative data and is supported by advanced statistical techniques furthermore the Cochrane Collaboration has developed a widely recognized approach to Suri asserts however that some form of synthesis is essential to enhance the practical value of qualitative research in policy making p 1 Sandelowski Docherty and Emden describe qualitative meta aggregation as cross case generalizations created from the generalizations made from and about individual cases p 367 They go on to comment that the most complex problem synthesists face is developing and communicating the techniques used to compare the findings of ea
192. in the preceding section this section will address what this means in terms of meta analysis Deeks and Altman 2001 6 suggest three important criteria for choosing a summary statistic for meta analysis i consistency of effect across studies ii mathematical properties and iii ease of interpretation i Consistency of effect is important because the aim of meta analysis is to bring together the results of several studies into a single result The available evidence suggests that relative measures of effect such as the OR RR are more consistent than absolute measures 6 absolute measures of effect include the risk difference and the number needed to treat these are not currently included as analytical options in JBI CReMS MASTtARI and thus will not be discussed further There is little difference between the RR and OR in terms of consistency between studies i main mathematical property required by summary statistics is the availability of a reliable variance estimate a feature of both OR and RR Consensus about the other two mathematical properties reliance on which of the two outcome states e g mortality survival is coded as the event and the OR being the only statistic which is unbounded has not yet been reached 242 JBI SUMARI iii Ease of interpretation does vary between OR RR As previously mentioned most clinicians and lay readers can intuitively grasp the concept of being at risk
193. included if the review is a JBI review but be included at the reviewers discretion in reviews for generation of new theory rather than to guide practice 186 JBI SUMARI 471 Viewing meta aggregation To view the NOTARI View table click lt Synthesis gt on the top menu bar Note that only those syntheses that have had valid categories allocated to them will be shown here For insertion into systematic review reports NOTARI users who are also using JBI CReMS will be able to automatically export these tables into the Final Report in CReMS Qe NOTARI Norrative Opinion and Text Assessment ond Review In lt trument mogor Synth Synthesis This is the NOTARI view displaying the synthesos for the Review A comprehensive literature review on emergency surgery Note that only those syntheses that have had valid categories allocated to them are shown here 47 2 Saving and exporting a synthesis Click on Export for instructions on how to save the synthesis flow diagram as an image to insert into other programs or to save as a png file Past sation SUMARI JBI 187 48 JBI NOTARI Reporting When writing the final systematic review report there are numerous ways to present the information 481 Reporting by category To report information related to the categories select the lt Categories gt button in the top menu bar and click on lt Conclusions gt in the left hand menu The i
194. included or excluded and that assessment has been finalized The Status column describes whether the paper is new included or excluded When the data extraction process for included studies is completed Extraction will appear in the Status column Author Title Journal Year Status Assessment Pearson A Lived experiences of working for Intemational Journal of Evidence 2012 Included Complete Edit emergency unit Based Healthcare Relete Pearson amp 2013 Extraction Compl te m Pearson Sinergency surgery parca l gidince 2011 Excluded Complete m 1 2 10 v records per page 88 JBI SUMARI 20 2 critical appraisal criteria The reviewer must assess the quality of the paper against the ten listed statements on the JBI QARI Critical Appraisal Checklist QARI Qualitative Assessment and Review Instrument stegories Assessment for Pearson Ann Surg 2011 Type Primary User ayeaye Not Criteria Yes No Unclear Applicable Comment There ts congruity between the stated philosophical perspective and the research methodology There is congruity between the research methodology and the research question or abjectrves There is congruity between the research methodology and the methods 7 used to collect data There is congruity between the research methodology and the representation and analyzs of data There i
195. incomplete and there are Findings already associated with it those Findings will be made inactive until the Extraction is marked as completed 22 JBI QARI Findings A reviewer can add Findings to a study but only after an Extraction is completed on that study If the status of a study is changed to excluded then the related Findings will also be excluded but not deleted To identify findings reviewers need to read through the paper carefully to draw out the findings to be entered into JBI QARI Findings are conclusions reached by the researcher after examining the results of data analysis often in the form of themes or metaphors For example a finding might be While many descriptions could be interpreted as craving and nicotine withdrawal patients perceived symptoms as signs of illness relapse An illustration of that finding might be in this case a quote from a participant You have to keep a level up Like it s something your brain and body s doing automatically to let you know that your nicotine level is dropping It s a physical thing of actually needing it p 129 224 Adding findings When extraction has been completed selecting a study from the Studies page will automatically take the reviewer to the Findings page To insert findings click on the lt Add gt button in the Findings page Qu QARI Qualitative Assessment and Review Instrument e study Findings for Pearson Internationa
196. inha R Brus C P Shavers V L Fisher E L Curtain J Lynch C F Lung Cancer 2001 Comparable Cohort Case Control Studies Review Outcome Intervention Intervention B Version 5 0 Copyright Joanna Briggs Institute 2011 GESE If you have previously conducted data extraction on your outcome of interest you can simple select the appropriate outcome from the lt Existing titles gt drop down box You will then be taken back to the results page At this stage you can either add another outcome via the lt Add New Outcome gt button or you can extract the relevant data for the outcome you have just defined The following example will demonstrate the latter 34 5 Deleting outcomes Click Delete Outcome at the right hand side of the screen next to Results to remove this Study from contributing data to this review outcome When you do so you will be asked for confirmation SUMARI JBI 129 coy Pe The page at http www jbiconnect org says Are you sure you wish to remove this study from the outcome If this is the first and only Study assigned to this outcome and as such represented the creation of a New Outcome for the review in question removal of this first study will delete the outcome from the review Users please note once an Outcome is created for a review MAStARI numerical data should be entered for the outcome If values a
197. inion amd Text Assessment and Review Instrument dimus Cunbcation Publications in Meaningfulness of assisted bathing for older adults with dementia and their caregivers Thu page i used to manage the retrieved Publications from this page Publicavons can be selected to perform assessment and extraction and to develop Conclusions The drop down box can be used to fiter studes as naw included excluded extracbon or fenshed Skemes 3 M Journal of 1997 Extraction Complete Bathing It s tough job Gerontological 9 Nursing Coher W M Canadan Nureng 1998 Extracton Complete Edt Simerteid etal The need for uniform bathing policy Home Deiere b 3 Developing a approach to resident bathing Nursing 1998 Extracton Complete af Miler RI Joumal of 1994 Extraction Complete Managng disruptive responses to bathing by elderty 4 residents Strategies for the cognitwely impared tes 12 10 records per page A publication goes through a process of being Assessed Extracted then has Conclusions extracted from it Assessment of a publication determines whether that publication is to be Included or Excluded The Publications page also shows the status of each study in the Status and Assessment columns A publication must have a Primary Secondary and Final Assessment done before you can perform data extraction To aid in navigating amongst the publications the list can be so
198. ion The extraction form in NOTARI v 5 0 serves two purposes 1 to be an online saved record of the details abstracted from the included publication and 2 to rapidly 174 JBI SUMARI generate the appendices included any final review report Users will notice an asterix 9 has been included alongside certain field labels on the extraction form For further ease of use denotes which of the fields in the extraction form will be transferred to the table of included studies automatically generated for inclusion in the final review report in CReMS v 5 0 NOTARI Narrative Opinion and Text Assessment amd Review Instrument Mei Pilbiiscstion Categorie Extraction Details Pearson International Journal of Evidence Based Healthcare 2012 denotes field which wil appear in report append Type of Text Discussion paper Those Represented Heath care professionats worinng in ED Stated Allegiance Posibon Managemect of EO should be based on the best endence Setting ED in metrogoltan area e Australia Cultural Multicultural Logic of Argument Clear and conclusions supported Data Analysis Analytical and logical Authors Conclusion There should be varous educational oppertunbes for managers Reviewers Comments High quality paper Complete Yes v 43 1 Extraction fields 43 1 1 Types of text The type of opinion being reported e g an expert opinion a guideline a newsp
199. ion Ambulance Edit Tags Delete 46 1 Creating synthesized findings To create a synthesized finding click on Synthesis on the top menu bar and then click on Add Synthesis Alternatively in the Category Details page click on the link Add Synthesis Each will take the user to the Synthesis Details page NOTARI Opinion and Text Assessment and Review Instrument Lr publicatis D s E C This page allows the addition of a synthesis A Reccomensation ducation and Rumen resource management provision of consistent care delivery will be achieved Summary if clinical protocols end robust handover systems are utilised Sufficient resources and time are required to Enter the name of the synthesized finding as well as details into the Summary field and click on lt Update gt to save Clicking lt Cancel gt will return you to the previous page without adding the synthesis 46 2 Allocating categories to a synthesized finding To allocate a category to a synthesized finding click on lt Categories gt on the top menu bar then click on lt Categories gt on the left hand menu Use the drop down box to assign the appropriate synthesized finding Press lt Update gt to save Pressing the lt Cancel gt button will discard any changes SUMARI JBI 185 NOTAR Narrative Opinion and Text Assessment and Review Instninent Category Details This page allows the editing of a Categ
200. ion and Text Assessment and Review Instrument The analytical module designed for JBI systematic reviews of text and opinion evidence 224 SUMARI JBI QARI is the Joanna Briggs Institute Qualitative Assessment and Review Instrument The analytical module designed for JBI systematic reviews of qualitative evidence JBI SUMARI is the Joanna Briggs Institute System for the Unified Management Assessment and Review of Information JBI computer software package Levels of Credibility are used in meta synthesis to determine the validity of findings in the JBI QARI qualitative research and JBI NOTARI text and opinion analytical modules Unequivocal evidence which is beyond reasonable doubt Credible evidence that while subject to interpretation is plausible e Unsupported such evidence may be noted in review but is not included in a JBI meta synthesis of findings and categories in synthesized findings Mean is the standard measure of central tendency for normally distributed continuous data the average Meta aggregation is the term used to describe the JBI model for the synthesis of qualitative evidence It seeks to move beyond an outcome of implicit suggestions in order to produce declamatory or directive statements in order to guide practitioners and policy makers Meta analysis Meta analysis a statistical combination of data from similar studies used to give an overview of the included studies OR is the odds ratio
201. irrespective of Internet connection once a local version of any review project has been saved the option to Work Offline is presented every time JBI CReMS is opened 62 SUMARI XCReMs Login LO Enter username and password to login to Crems Username Password wo If a local version of a review has not been created the Work Offline button will appear unavailable to select 12 Appendices in Report Appendices are automatically generated at the end of the protocol and the final report taken from the information entered in JBI CReMS and the analytical module s used Protocol Appendix Appraisal Instruments Appendix Il Data Extraction Instruments Final Report Appendix Search Strategy Appendix Il Search Results Appendix Ill Studies Selected for retrieval Appendix IV Studies not selected for retrieval Appendix V Appraisal Instruments Appendix VI Data Extraction Instruments Appendix VII Included Studies Appendix VIII Excluded Studies Appendix IX List of Study Findings Conclusions SUMARI JBI 63 13 Configuring Proxy Server Settings in JBI CReMS 1 Once the application is installed go to the application folder and open the file CReMSConfiguration xml 2 Edit the fields in the following way useProxy true if the application will use a proxy false if not proxyIP Proxy IP or url without http for instance 192 168 0 1
202. is in the Assessment column NOTARI Narrotivc Opinion and ext Assessment ond Rewew Instrument Publication EA Synthesis Publications in comprehensive literature review on emergency surgery This page is used to manage the retneved Publications From Mma lg ring a pease geal develop Conclusions The drop down box can be used to filter studies new included excluded extraction or 1 Delete Interventional Procedures recovery after surgery Surgicat ARSERNIP S ERAS programs Poggetn Rer a WSES SM World Society World J Emerg Surg 2009 New Awaiting of Emergency Final Summer Meebng ahichts emeroency NOTARI Narrative Opinion and Text Assessment and Review Inctriiment Cat emirie B 5 Logani Avow Assessment for Pearson A International Journal of Evidence Based Healthcare 2012 Type Primary User Criteria Yes Unclear applicable Comment 1 Is the source of the opinion clearly identified B e 2 Does the source of the opinion have standing in the field of expertise o 5 3 Are the interests of pabants clients the central focus of the opinion D a m 4 16 the opinion s basis in logic experience clearly argued c E 5 Is the argument developed analytical c o Mei tec re ea 5 7 1s the opinion supported by peers LI 5 Include Yes Reason Thus a go
203. is review will consider studies that evaluate insert text phenomena of interest Type of outcome if any This review will consider studies that include insert text4 Type of Study This review will consider cost effectiveness cost benefit cost minimisation cost utility modify text as appropriate studies 7 6 2 Search Strategy Assessment of Methodological Quality Data Collection and Data Synthesis Selecting Set text will also generate standardized text options in the remainder of the protocol dialogue boxes Read the text carefully throughout Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash 8 characters SUMARI JBI 43 Review Summary Protocol Studies Report Builder Report View Review title inserted here Search Strategy The search strategy aims to find both published and unpublished studies A three step search strategy will be utilised in this review An initial limited search of MEDLINE and CINAHL will be undertaken followed by analysis of the text words contained in the title and abstract and of the index terms used to describe article A second search using all identified keywords and index terms will then be undertaken across all included databases Thirdly the reference list of all identified reports and articles will be searched for additional studies Studies published in insert language s amp
204. ister as a user of the free SUMARI software package This is essential to use CReMS v5 0 lt is recommended users uninstall any previous version of CReMS prior to installing the new version 5 0 Please download the SUMARI v5 0 User Guide supplement here Available Installers For users working in offline mode or with locally saved versions of their projects they wish to retain please click here for instructions Platform Release Date Windows 7 Vista XP Download 30 4M 29 Aug 2011 MAC OS X 10 6 Download 15 3M 29 Aug 2011 Mac OS X 10 6 Download 19 8M 29 Aug 2011 Mac OS X is a registered trademark of Apple Compuler Inc Solaris and Java are trademarks of Microsystems Inc Windows is a registered trademark of Microsoft Corporation Al other marks are properties of their respective owners CReMS v5 0 To open JBI CReMS double click on the JBI CReMS icon 4 1 Connecting via a proxy server Once installed if you experience difficulties in getting JBI CReMS to connect to the JBI server and you are using JBI CReMS from within your organization s network you may need to seek assistance from your organization s IT staff to establish if your institution accesses the internet via a proxy server configuration Details on how to perform this are in Section 13 Please note if you configure JBI CReMS to work via a proxy server in your normal workplace and you move your laptop for example to a new locale where t
205. ith the JBI standardized text As the standardized text serves as a useful aid to help reviewers enter appropriate and relevant information in each of the protocol fields it is recommended that users do this at the start of protocol development although the standardized text can be added at any stage of the protocol development The set text will insert at the beginning of each text box Any text already entered in any of the text boxes will still be available after the standardized text entry Users may then modify the text box as they prefer using the keyboard controls lt ctrl c gt to copy and lt ctrl v gt to paste lt command gt rather than lt ctrl gt for Apple Mac users 32 JBI SUMARI Once JBI CReMS Set text has been inserted it can only deleted from each of the fields manually Please note that if the lt Set gt button is pressed repeatedly text will be inserted repeatedly and will have to be deleted manually from the text fields again 7 3 Protocol development using the JBI QARI module If the review focuses on evidence generated through qualitative research and you wish to conduct the review using JBI QAHI click on the tick box in between Qualitative QARI to append the appropriate appraisal and extraction tools to your protocol and report then select the Set text tick box and click Set if you wish to use the JBI Set Text see Section 7 1 and 7 2 above Opting to insert the JBI standardized t
206. ity 17 3 194 2 1 m 3 a 46432 Hildebrand 2006 Harm resulti Journal 19 5 437 42 3 L tj 46417 Hoffmann 2008 Every error Quality 17 4 307 3 3 E3 EJ 46418 Jacobson L 2003 Errorandsa Family 20 3 237 2 Ti EJ E Ej 46769 Kaushal R 2007 Adverse dru Ambula 7 5 383 9 4 1 H 46405 Kendig S 2006 Primary care AWHON 10 6 831 8 3 E O E B 46984 Killip S Ir 2007 Patient safet Family 39 6 404 9 T 5 E 46406 Kohn L T 1999 Err is Hu Report 4 T m E arasa Vad aka Ae A S a Each paper selected will be automatically accessible in the analytical module it is allocated to when you save the current Review in JBI CReMS This is done by selecting lt Save gt from the File menu 54 JBI SUMARI 91 Accessing the JBI analytical modules from JBI CReMS The analytical modules mentioned above can be accessed through JBI CReMS In order to access these modules select ACTUARI MAStARI QARI or NOTARI from the drop down menu under Modules on the menu bar eoo Crems Version 5 1 File Studies Modules Export Help Current Worki Actuari Mastari Notari n F of Citations 54 ros inae lie e e n TE 46430 Gandhi T 2006 Missed and If your browser does not automatically open within JBI CReMS you will need to open your browser and navigate to the analytical module
207. ive Assessment and Review Instrument Study Categorias Studies in A comprehensive literature review on emergency surgery This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Fmdngs The drop down box can be used to filter studies as new included excluded extraction or finished Pearson A Lived expenences of workeg for Intemabenal Journal of Evidence 2012 New Secondary Eds emergency unit Based Healthcare Completed Delete Pearson A International Journal of Nursing 2013 New Primary Completed ee Emergency Surgery Practice Pearson A amp Emergency part 2 International Journal 2011 New Awaiting Final Edu 12 10 records per page QARI Qualitative Assessment and Review Instrument Reviews Assessment for Pearson Ann Surg 2011 Type Primary User ayeaye Not Criteria Yes No Unclear Applicable Comment There is congruity between the stated philosophical perspective and the e research methodology There ts congruity between the research methodology and the research quezbon or abjectwes There is congruity between the research methodology and the methods e used to collect data There is congruity between the research methodology and the e represantaton and analyzs of data There is congruity between the research methodology and the a interpretabon of results 6 There is a statement
208. l Journal of Evidence Based Healthcare 2012 All Findings SUMARI JBI 97 Findings explicitly stated the paper by the authors should be extracted and textual data that illustrates or supports each finding also extracted including relevant page numbers and inserted in the Illustration from Study field QARI Qualitative Assessment and Review Instrument Findings for Pearson A International Journal of Evidence Based Healthcare 2012 Staff were able to recognise abnormal vital sigas Feng mur bieod pressure has gune down from 130 te 26 Enka Wuetrauon Study 2 noure must do something about 15 Include Page Reference Evidence Hone E Unequrvocal Creditiie A credibility level see Section 14 6 can be assigned to each finding using the Evidence drop down box The Include menu allows a reviewer to either include Yes or exclude No a finding based mainly on the credibility of the finding This defaults to Yes The Category drop down menu allows the allocation of each finding to a category this process will be dealt with in the next section Pressing the Insert button will save the Findings view Pressing the Cancel button will take you back to the previous screen without saving any of the changes made 222 Viewing findings Within the Study page select a study and press the Findings button in the left hand column T
209. le in the diagnosis therapeutic management and surveillance of illness Diagnostic imaging may referto a range of medical procedures including radiographic and nuclear medicine procedures Magnetic Resonance Imaging MRI Computed Tomography CT Positron Emission Tomography PET Ultrasound US and Single Photon Emission Computed Tomography SPECT along with many other imaging investigations CT produces cross sectional images via the use of x rays and computer processing PET and SPECT are nuclear medicine procedures where radioactive tracers are used to produce an image and the machines themselves detect the radiation given off from the radioactive tracer rather than create it MRI uses a combination of magnetic fields and radio signals to produce images and does not use ionising radiation as required by CT PET X rays and 5 2 Medical imaging is an ever changing field and there have been significant advancements in imaging techniques and technologies overthe years The amount of imaging and the subsequent costs associated with it have been rising rapidly in many parts of the world forthe last 30 years leading to a larger percentage of people being exposed to these different imaging modalities Right Arrow Move forward through the document Left Arrow Move back through the document Right Arrow with Line Move to the end of the document Left Arrow with Line Move to the start of the document Zoom Zoom in or out of the
210. less of where which computer you access the review from It is recommended you do this regularly whilst working on a review project SUMARI JBI 29 6 5 1 Save Locally From the File menu click Save Locally to save the review project to the local hard drive of the computer Users are prompted to enter a file name This feature has been included for users primarily for users to save backup versions of their work If the filename entered is not modified the previous saved version will be overwritten without a prompt appearing The file extension is a cre file The location for saving the file has deliberately been made unmodifiable and it is recommended that users do not use saved cre files for example to email to other reviewers These files will sync information with the last version saved on the JBI Server and modification by more than one user on different copies of the file may result in loss of work if the correct file is not reconnected with the server JBI CReMS has the ability to export rtf files see Section 7 9 1 that allows for easy and rapid edit of documents in any text editor or word processor This feature allows input from others such as associate reviewers File Name Files of Type CRE CReMS Review File 30 JBI SUMARI 7 Defining the Protocol Once the logistical details have been completed in the Review Summary tab to begin to define th
211. lick lt Insert gt to create the new review project When the review is added the Review Summary will appear on screen see Section 6 4 below Please note once you have created a new review and enter the JBI CReMS working pages it is recommended you immediately select File from the menu items and Save the review before spending any significant time working on the review project Doing so will immediately create an ID number for the review on the JBI Server where it is saved which is essential for data stability For this reason Adding or creating a new review project can only be completed when JBI CReMS is in Online Mode see Section 11 below Once created users can work in Offline Mode at any stage 6 1 Assigning the Primary and Secondary Reviewers The JBI SUMARI software system interface is designed for two users the primary and secondary reviewers to access the system and undertake various analytical stages of the review namely appraisal extraction and synthesis of data via the JBI SUMARI analytical modules JBI QARI JBI NOTARI JBI MAStARI and JBI ACTUARI SUMARI JBI 21 Despite this requirement for a minimum of two people to be involved the systematic review process to limit bias and maximise validity of the results obtained through the review project only the primary reviewer is able to access any review via JBI CReMS e Primary Reviewer The primary reviewer will be automatically set as
212. low only reviews in which the user is the Primary Reviewer and which are currently being conducted open will be displayed To access reviews as the Secondary Reviewer click on the Secondary radio button on the left of screen To access completed reviews click on the Closed radio button ACTHARIE Analysis of Cost Lechnology and Utilisation Assessment and Review Instrument Reviews Filter Reviews Reviews Primary This page lists the Reviews that are in the system To add a review click on the Add button below To edit or delete a Review click the appropnate link Secondary Under the Actions column of Reviews B L1 This i3 a systematic review of cost mmmizabon stubes of mtrecerncal prostaglandin for cercel npering an outpatient versus inpabent 2010 cataint catai2 Edit Delete CostElfectnDenesi systemat review of cost effectveness 3tudws of effectiveness of gf nhaled mhaled corbcosterodis in asthma corticosteroids in 2010 cataint Edit Delete pachtaxel and 2010 cataint Ed Delete SUMARI JBI 195 52 1 Adding new review There are two ways to add a new review to JBI ACTUARI via the JBI ACTUARI software itself and via the JBI CReMS Joanna Briggs Institute Comprehensive Review Management Software 52 1 1 Adding a new review via JBI ACTUARI Within the Reviews page pressing the Add button will add a new review and open the review details
213. luded extrac Publication AORN A dialogue box will open asking for confirmation by the user prior to completion of the operation Once confirmed the publication record and any assessment extraction results associated with the publication within the analytical module will be erased Once erased this operation cannot be undone If there is information included in the synthesis that has been extracted from the publication being deleted you will be advised in a warning message 166 JBI SUMARI ications A Windows Internet Explorer 2 v s age is used to ations can be selected to perform pag p lop Conclusions There are outcomes related to this publication included excluded extraction you sure you want to delete this publication Citations 73 artmant nf Unalth Maw Canth Emarannes Annta and Cavarnmoan t Danart 42 JBI NOTARI Assessment Publications to be used in a JBI Review must be assessed using the standardized JBI critical appraisal tools The assessment process requires the following three steps 1 The primary and secondary reviewers critically appraise the publication independently 2 The primary reviewer performs the final assessment 3 If both the assessors agree the publication is either included or excluded The primary reviewer needs to resolve any conflicts between assessments 42 1 Conducting an assessment
214. lysis references The following citations are provided for further information about meta analysis 1 10 11 12 Baujat Mahe Pignon J P Hill graphical method for exploring heterogeneity in meta analyses application to a meta analysis of 65 trials Statistics in Medicine 2002 Sep 30 21 18 2641 52 Borenstein M Hedges LV Higgins JPT Rothstein HR Introduction to Meta Analysis Chichester John Wiley amp Sons Ltd 2009 Deeks J Altman DG Bradburn MJ Statistical methods for examining heterogeneity and combining results from several studies in meta analysis Egger M Davey Smith G Altman DG editors Systematic reviews in health care Meta analysis in context London BMJ Publication Group 2001 Deeks JJ Higgins JPT Altman DG Analysing and presenting results Section 8 In Higgins JPT Green S editors Cochrane handbook for systematic reviews of interventions 426 updated September 2006 Chichester John Wiley amp Sons Ltd 2006 DerSimonian R Laird N Meta analysis in clinical trials Controlled Clinical Trials 1986 Sep 7 3 177 88 Egger M Davey Smith G Altman DG Systematic reviews in health care Meta analysis in context London BMJ Publication Group 2001 Hardy RJ Thompson SG Detecting and describing heterogeneity in meta analysis Statistics in Medicine 1998 Apr 30 17 8 841 56 Higgins J Thompson S Deeks J Altman D Statistical heterogeneity in systematic revie
215. mation Selecting lt Yes gt here will effectively allow users to skip the subsequent critical appraisal step using the JBI appraisal instruments in the review process As a user intending to submit a systematic review to the JBI Library you should only select this if you have had a different appraisal tool approved by the Synthesis Science Unit SSU with the approval of your protocol for your review This step will otherwise generally only be selected by reviewers who are using the free JBI SUMARI software but who do not have the intention of submitting a systematic review to the JBI Library The result of this selection at the lt Assessment gt phase of the review is described later see Section 42 4 SUMARI JBI 163 41 JBI NOTARI Publications A publication is the basic unit of the review in general each review will assess many publications You may also hear the term paper used to refer to a publication The Publications page allows users to view add edit and delete publications To access this page either click on the title of the systematic review on the Reviews page or select Publication from the top toolbar The column on the right describes the stage reached for specific studies in the review To remove an included study open JBI CReMS and de select the checkbox for that study in the JBI NOTARI column see CReMS chapter of this user guide for further information on JBI CReMS NOTARI Narrative Op
216. mation entered in this field should be related to the inclusion and exclusion criteria of the research and include but not be limited to descriptions of age gender number of included participants ethnicity level of functionality and cultural background Included in this section should be definitions of terms used to group people that may be ambiguous or unclear for example if the paper includes role definitions 21 1 8 Data analysis The techniques used to analyze the data are stated in the Data Analysis field a list of examples though not exhaustive is provided below e Named software programs Contextual analysis e Comparative analysis e Thematic analysis Discourse analysis Content analysis 21 2 Viewing an extraction Within the Study page select the Study and press the Extraction button This opens the Extraction page Select Detail Assessment Extraction Findings 21 3 Saving an extraction After an extraction is edited pressing the lt Update gt button will save the Extraction and return the user to the Studies page 96 SUMARI 21 4 Cancelling changes to an extraction Pressing the lt Cancel gt button will return the user to the Studies page without saving any changes made 21 5 Completing extractions Within the Extraction page selecting the Complete drop down box marks the Extraction as being complete allowing Findings to be added to that study If an Extraction is
217. medical teams dont t know each other and the people you do doni t know how to abonormal vital signs may organaed respond senior nurse p21 contribute to eterioration incidents 100 JBI SUMARI By clicking on lt Categories gt the menu on the LEFT of your screen the page where categories can be added will open Categories for Comprehensive literature review Recognising and Responding to the Deteriorating Patient in Acute Hospitals This page allows categones to be managed Lack of clear roles and respensipiities of the statt nvotwad in canng for the patents may Contribute to the Team and social factors Team and social factors Delete Team and social Edit factors Delete hs ID whch obseryahon charta and pabsot cass notes ace designad and used may contribute to poor Organisational Eds tecarding of observations and to interpret them correctiy factors Delete There n no evene an anial frecuency of nated fiios revealed that vital Oraanisational Fer Click on Add at the bottom of the screen to add a category Category Details This page allows the editing of a Category Lack of clear roles and responsibilities of staff may Name contribute to the problem of deterioration nct being recognised Team and social factors Summary Synthesis O Vamsational factore Role descnption and stafing gt Add new synthesis Assign a
218. mmary of the strengths and weaknesses of the paper 43 2 Viewing an extraction Within the Publications page select the publication and press the lt Extraction gt button This opens the Extraction page 176 JBI SUMARI 43 3 Saving an extraction After an extraction is finished pressing the lt Update gt button will save the Extraction and return the user to the Conclusions page 43 4 Cancelling changes to an extraction Clicking the lt Cancel gt button will return the user to the Publications page without saving any changes made 43 5 Completing extractions Within the Extraction page selecting the Complete drop down box marks the Extraction as being complete allowing Conclusions to be added to that publication If an Extraction is incomplete and there are publications already associated with it those publications will be made inactive until the Extraction is marked as completed 44 JBI NOTARI Conclusions A reviewer can add Conclusions to a publication but only after an Extraction is completed on that publication If the status of a publication is changed to excluded then the related conclusions will also be excluded but not deleted Many text and opinion based reports only develop themes and do not report conclusions explicitly For this reason reviewers are required to read and re read each paper closely to identify the conclusions to be entered into JBI NOTAHI For example a conclusion might be
219. mpared the title of the screen has been changed to Intervention A description for to better reflect the process of identifying the label which data will be assigned to as opposed to entering New label descriptions c f MAStARI v 4 0 SUMARI JBI 131 MAStARI Meta Analysis of Statistics Assessment and Review Instrument Intervention A description for zac et al DNA 2010 Drop down menu will display existing Interventions for the currently selected review Upon selecting an existing intervention the abbreviation is automatically shown the box on the right New intervention and abbreviation can be inserted using the fields below Existing descriptions CREMS m CREMS New description New Abbreviation lt Back EME 34 8 Adding results The results entry page will differ according to whether the data are continuous or dichotomous In the example below the mean and standard deviation SD of continuous data have been entered the sample size n for each group has previously been entered in the extraction details page 34 9 Numerical data entry into MAStARI v5 0 The final section tailored for numerical data extraction has been enhanced to allow whole number data up to 6 digits and data with up to 2 decimal places 999999 99 Dichotomous Data For dichotomous data the required data are n and N where n is the number of participants having the outcome of interest for example t
220. mpted in the text where modification of the set text may be necessary This is indicated by instructions between hash characters 34 JBI SUMARI text words contained in the title and abstract and of describe article A second search using all identified terms will then be undertaken across all included dati reference list of all identified reports and articles will additional studies Studies published in insert langu considered for inclusion in this review Studies publis be considered for inclusion in this review The databases to be searched include insert text4 The search for unpublished studies will include insert text Initial keywords to be used will be insert text Assessment of Methodological Quality Papers selected for retrieval will be assessed by two for methodological validity prior to inclusion in the re standardised critical appraisal instruments from the Qualitative Assessment and Review Instrument JBI Q disagreements that arise between the reviewers will b discussion or with a third reviewer Data Collection Data will be extracted from papers included in the rev standardised data extraction tool from JBI QARI Appt extracted will include specific details about the phenc populations study methods and outcomes of signific question and specific objectives Data Synthesis Qualitative research findings will where possible be This will involve the aggregation or synthesis of findi o
221. n be found under the Appraise evidence tab on the right hand side of the webpage http www joannabriggs edu au Appraise 20Evidence JBI 20SUMARI 20 systematic 20review 20software 20FREE Cochrane Handbook http www cochrane handbook org version 5 1 0 updated March 2011 Additionally potential reviewers should undergo training in how to conduct systematic reviews the JBI provides a five day training course and other systematic review modules at venues around the world More details are available from www joannabriggs edu au There are a vast number of meta analytical options available to systematic reviewers those included in JBI MAStARI represent the most commonly conducted The examples included throughout this user guide are structured towards a concise systematic review question for example what is the effectiveness of treatment A compared to the standard or control treatment in changing outcome B in patients with condition C However the processes embedded in this simple example can be adapted to more complicated analyses such as those involving sub group analysis for broader questions that also suit sub group exploration 28 Accessing JBI MAStARI As JBI MAStARI is web based software browser compatibility has been extensively tested JBI MAStAHI will run on all common web browsers including Microsoft Internet explorer Firefox Safari and Google Chrome This range of platforms and browsers is designed to ensure that
222. n all outcome measurements are made using the same scale It then calculates an overall difference in mean for all studies this is equivalent to the effect size based on a weighted average of all studies which is in turn related to the SD JBI MAStAHI uses the inverse variance method of calculating WMD for fixed effects models and the DerSimonian and Laird method for random effects models see 58 3 16 for a discussion of fixed effects models and random effects models Alternatively different studies may measure the same outcome using different scales For example pain can be measured on a range of different scales including nonverbal scales e g visual analog scale and verbal scales e g 5 point categorical Scale These studies can be combined in a meta analysis that incorporates SMD If the measurement scales operate in the same direction e g an increase in pain is measured as an increase in on both scales then using SMD is straightforward 244 SUMARI However if two measurement scales operate in different direction for example a Score of 10 is the worst pain imaginable on one scale but a score of 1 is the worst pain imaginable on another scale then data from one scale need to be reversed This is relatively simply achieved by multiplying the mean data from one scale for both treatment and control groups by 1 Standard deviations do not need to be modified JBI MAStARI provides two options for calculation of
223. n entered will appear in the table of excluded studies in CReMS v 5 0 Click on Undo to remove any text entered in the Reason text field SUMARI JBI 213 55 JBI ACTUARI Data extraction and Synthesis The data for a systematic review are made up of the results from the included studies Data extraction is the process of taking the results from included studies in a systematic and repeatable way and preparing them in such a way that similar results can be grouped together 55 1 Extraction details The extraction form serves two purposes as an online saved record of the details abstracted from the included paper and also to rapidly generate the appendices included any final review report Users will notice an asterix has been included alongside certain field labels on the extraction form For further ease of use denotes which of the fields in the extraction form will be transferred to the automatically generated tables of included studies in CReMS v 5 0 To commence data extraction click on the authors hyperlink of a study that shows Included in the Status column and Complete in the Assessment column This will take you to the extraction details page ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Extraction Details Farmer et al Clinical Therapeutics 1996 denotes field which will appear in report appendix Economic Evaluation Method Cost Minimisation kl
224. nalysis do they each show a similar effect say a better outcome for patients in the treatment group or do the different studies show different patterns While some variation between the results of studies will always occur due to chance alone heterogeneity is said to occur if there are significant differences between studies and under these circumstances meta analysis is not valid and should not be undertaken But how does one tell whether or not differences are significant Visual inspection of the meta analysis is the first stage of assessing heterogeneity JBI MASTARI plots the results of individual studies and thus indicates the magnitude of any effect between the treatment and control groups Do the individual studies show a similar direction and magnitude of effect i e are the rectangular symbols at similar positions on the X axis SUMARI JBI 245 A formal statistical test of the similarity of studies is provided by the test of homogeneity This test calculates a probability P value from a chi square statistic calculated using estimates of the individual study s weight effect size and the overall effect size However note that this test suffers from a lack of power and will often fail to detect a significant difference when a difference actually exists especially when there are relatively few studies included in the meta analysis Because of this low power some review authors use a significance level of P lt 0 10 rather th
225. nalysis tool in MAStAHI v5 0 has been described in Section 35 2 The remainder of this description is for the user who has created started the review in the version 5 0 SUMARI software 35 7 Sensitivity analysis using MAStARI Users who have created a review and entered data using solely v 5 0 of the MAStARI software will notice under the Filter Results section of the meta analysis tool now they have an option to Filter by Studies Select this drop down list and unselect a tick box alongside the name of each study to remove one or more studies from the meta analysis this can be done before or after overall analysis select Analyse Results MAStARI Meta Analysis of Statistics Assessment and Review Inst Filter Results Statistics Software functionality Suman vi ve SUMARI alan Zac Craig ea 20 ed Zac Alan Craig 2011 Alan Zac Craig ed 2011 Melania B Daniel F 2011 Jordan B Melanie B Daniel F 2010 Yifan X Moola S 2010 Study Mantel Haenszel Relative Risk Risk Ratio Weight CI 95 Fixed Filter by outcome Effect Filter by comparison Meta analytical method Filter by studies Confidence Interval Preferred meta view NNNM RCT Once a study is unselected click Generate Graph and the graphical presentation will modify accordingly Apple Mac users will see this selection of citatio
226. nction to view groups of studies based on what stage of assessment or extraction they are at this function includes the capacity to filter for included or excluded papers Studies in Comprehensive literature review on Recognising and Responding to the Deteriorating Patient in Acute Hospitals This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Findings The drop down box can be used to filter studies as new included excluded extraction or finshed New n r Cioffi 2 Salter e E Clinicians responses to abnormal vital signs in 2905 Exuactin Complete Il Wilkes L vonu Delete an emergency department Hogan 3 Respiratory assessment why don t nurses British Journal of 2006 Extraction Complete Edt monitor the respiratory rates of patients Nursing Delete From the Studies screen select New from the drop down list This will filter the view so only studies not yet assessed are displayed The Assessment column indicates what is required to complete the assessment All All studies in the review New No assessment has been done either by primary reviewer or secondary reviewer Included The final assessment has been completed and the study is included The data have been extracted 92 SUMARI 20 4 Assessment Non JBI Review If you have chosen to do a Non JBI Review you will not use the J
227. nd click on Update to save Clicking Cancel will return you to the previous page without adding the synthesis 24 2 Allocating categories to a synthesized finding To allocate a category to a synthesized finding click on Categories on the top menu bar then click on Categories on the left hand menu Use the drop down box to assign the appropriate synthesized finding Press Update to save Pressing the Cancel button will discard any changes SUMARI JBI 103 Category Details This page allows the editing of a Category ear roles and responsibilities of staff may ti Name the problem of deterioration not being Team and social factors Summary Organisational factors Role description and staffing z add new None Poor communication stolis between juror doctors and nurses particularly in handover stuation conbibute to detenoration incidents Organisational factors Communication and leaemork opas Team and social factors Factors relating to clinical process Otservation charts Organisation factors Factors relating to clinical process Patient factors Nurses appreciation of the MET Nurses valued access to the MET system Organisational factors Educabon and training Organisational tectors Organisational supports Syntheses 24 3 Editing a synthesized finding To edit a synthesized finding click on lt Synthesis gt in the top menu This will list all syntheses that are present in
228. nect org tools services sumari_reg php and for existing users at http www jbiconnect org tools services update profile php Click the Update button to save Pressing Cancel returns the user to the Reviews page and does not save the information Note that only subscribers or nominated reviewers can directly participate in data entry as reviewers SUMARI JBI 161 40 4 Editing a review Within the Reviews page click the Edit button to edit the Review Modify the relevant information in the edit area Pressing Update saves the information and returns the user to the Reviews page Pressing Cancel returns the user to the Reviews page and does not save changes that have been made Pressing the Close button will change the status of the review to Closed this means it will no longer appear amongst your Opened review titles in the Reviews page NOTARI Narrative Opinion and Text Assessment ond Review Instrument Publication comprehensive literature review on emergency wargery What ere the common meanings and shared experiences the physicians encounter in relation te emergency surgery Year commenced 2009 Primary Reviewer ayeaye Secondary Reviewer ne Search Review Status Non JBI Review KA A ci Version 5 0 Copyright Joanna Briggs Institute 2011 40 5 Deleting a review Within the Reviews page click on lt Delete gt from within the Action column to delete
229. nformation displayed includes the conclusion with the supporting illustration from the publication as well as the category assigned to it NOTARI allows filtering of the conclusions of a particular review by category such that all of the conclusions relating to a particular category can be viewed together To view filtered conclusions click the Conclusions button on the left hand menu to bring up the list of categories Select the desired filter from the drop down menu next to Filter then click the Filter button to filter the conclusions by the category This assists the reviewer to write the section of their review report which describes the relationship of a group of conclusions to a particular category This information should be included in the final report in order to support the final synthesis and recommendations and ensure that the review process is transparent 48 2 Reporting by synthesis To report information related to the syntheses in the systematic review report select Synthesis from the top toolbar NOTARI View tables will be displayed These tables can be printed for use in systematic review reports by clicking on the Print button Bibliographic References 1 Henry F Tator C Discourses of domination Toronto University of Toronto Press 2002 2 Luke A Theory and practice in critical science discourse In Saha L editor International encyclopedia of the sociology of education Oxford Elsevier Science
230. ns used in the meta analysis with tick boxes alongside appear in a new dialogue box rather than as a dropdown menu as displayed here for PC MS Windows users SUMARI JBI 139 MAStARI Meta Analysis of Statistics Assessment and Review Inst Reviews Stud Filter Results Statistics Filter by outcome Software functionality v Effect Filter by comparison SUMARI v5 0 vs SUMARI M Filter by studies Alan Zac Craig ed 20 Confidence Interval Preferred meta view Meta analytical method RCT Study Mantel Haenszel Relative Risk Risk Ratio Weight 95 Fixed ed Zac Alan Craig 2011 21 08 1 36 0 83 2 21 Alan Zac Craig ed 2011 29 37 0 97 0 62 1 52 35 8 Subgroup analysis using MAStARI If a subgroup s has been assigned to a review outcome see Section 35 4 users can select the name of the review outcome from the Filter by Outcome dropdown menu Click on the name of the outcome which has a subgroup included On screen you will see the option to select whether you wish to present the subgroup in the analysis at all This can be done by unselecting the tick box alongside the name of the subgroup tuens D B CX EE wire 15 eC Ln olconmect org umani na ER creat eB Information for University JI Dictionary com 24 Google Scholar las O webmail BJ Adem intemet Adelaide Forecast MB ugue Simi Weignt CH 95 Fixed
231. nt and Review Instrument Studies in Cost Effectiveness of inhaled corticosteroids in asthma a systematic review This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Findings The drop down box can be used to filter studies as new included excluded extracted or finished E of Citations 4 Ss Author Title Journal 2011 Extraction Complete Edit Delete Edetal Cost Effectiveness of inhaled corticosteroids in asthma adult patients JAMA 2009 Extraction Complete Edit Delete Buxtonetal Cost Effectiveness of inhaled corticosteroids in adult asthma patients 2009 Extraction Complete Edit Delete Mumus et al Cost Effectiveness Health Policy 2009 None Edit Delete 1 50 v records per page Version 5 0 Copyright Joanna Briggs Institute 2011 SUMARI JBI 201 53 JBI ACTUARI Studies A study is the basic unit of a review in general each review will assess many studies You may also hear the term paper or publication used to refer to a study To access the studies page either click on the title of the systematic review on the reviews page or select Study from the main menu The studies page is a list of the publications that have so far been added to the review including the author title journal year of publication status stage of as
232. ntervention B pages after you have first defined an outcome or intervention 35 JBI MASIARI Meta analysis Meta analysis using data extracted from studies into JBI MAStARI is conducted in JBI CReMS A detailed description of meta analysis using JBI CReMS is provided here more information about JBI CReMS is included the CReMS Section of the user guide 351 Starting JBI CReMS Double click on the JBI CReMS icon and log in to JBI CReMS with your username and password details Select your review from the Welcome to CReMS page This will open the review summary window in JBI CReMS Click on MAStARI in the top menu bar next to the Report View button This will open the meta analysis module of JBI CReMS 35 2 Meta Analysis in MAStARI The meta analysis module is made up of a number of drop down menus that allow the user to specify the comparison required i e which intervention group is to be compared to which control group the outcome to be included and the statistical tests to be used The user must specify the correct data type continuous dichotomous the required effects model to be used random fixed the statistical method of meta analysis required and the size of confidence limits to be included in the calculations The method to be used will depend on the data type For continuous data under a fixed effects model there are three options for meta analysis included in JBI CReMS Hedge s adjusted standardised mean d
233. ntific Basis of Health Services amp Fifth Annual Cochrane Colloquium Oct 8 12 1997 Amsterdam The Netherlands 1997 p 291 Jones A Improving the reliability of data extraction abstract XI Cochrane Colloquium Evidence Health Care and Culture Oct 26 31 2003 Barcelona Spain 2003 p 46 Jones Remmington T Williamson PR Ashby D Smyth RL High prevalence but low impact of data extraction and reporting errors were found in Cochrane Systematic reviews Journal of Clinical Epidemiology 2005 58 7 741 2 Strang WN Boissel P Uberla K Inter reader variation Second International Conference Scientific Basis of Health Services amp Fifth Annual Cochrane Colloquium Oct 8 12 1997 Amsterdam The Netherlands 1997 p 278 von Elm E Poglia G Walder B Tramer MR Different patterns of duplicate publication an analysis of articles used in systematic reviews JAMA 2004 291 8 974 80 SUMARI JBI 239 58 3 AppendixV Meta analysis In meta analysis the results of similar individual studies are combined to determine the overall effect of a particular form of healthcare intervention the treatment compared to another standard or control intervention for a specified patient population and outcome In meta analysis the effect size and weight of each study are calculated The effect size indicates the direction and magnitude of the results of a particular study ie do the results favour the treatment or control and if so
234. ntion Once intervention B is complete the Results link in the far right column will become active clicking this link will take you to the results entry page where the original data from the study is to be entered Alternatively if the outcomes and interventions are already defined for a study the Results page can be accessed directly by selecting a study and clicking on the Results link on the left hand menu 34 7 Results screen NB existing reviews created using SUMARI v 4 0 or earlier only have access to the some of the meta analysis features described here as indicated dio MAStARI Meta Analysis of Statistics Assessment and Review Instrument Select Detail Assessmant Extraction Results Meta Analysis Outcome title for zac et al DNA 2010 Drop down menu will display existing Titles from studies of the currently selected review Select an existing title to maintain consistency A new title can be inserted using the field below Existing titles Select existing title Sa New Title Crems functionality hypertension Data Type Dichotomous T Continuous O Description Measure Scale Save Details f Reset EIL Version 5 0 Copyright Joanna Briggs Institute 2011 Click lt Reset gt to clear all of the new information entered or selection of existing titles descriptions for the entry screen Similarly when defining labels for the Interventions to be co
235. o note here that JBI NOTARI does not involve a reconsideration and analysis of the conclusions from included publications as if they were primary data JBI NOTARI focuses only on the combination of conclusions 36 5 Levels of evidence Current approaches to evaluating evidence utilize a hierarchy of evidence designed to assess the validity of recommendations for clinical guidelines focusing on the effectiveness of treatment and ranking only quantitative evidence according to the rigor of the research design used to limit bias Drawing from the literature an approach to categorizing the validity of narrative opinion and text was developed for JBI NOTARI This is based on three levels of credibility Degrees of credibility Unequivocal evidence beyond reasonable doubt which may include conclusions that are matter of fact directly reported observed and not open to challenge Credible conclusions that have been logically inferred from the data They are plausible in light of the data and theoretical framework but are open to challenge Unsupported when neither of the other level descriptors apply and when most notably conclusions are not supported by the data These three levels of credibility are incorporated into the NOTARI software 156 SUMARI 37 Accessing JBI NOTARI As JBI NOTARI is web based software browser compatibility has been extensively tested JBI NOTARI will run on all common web browsers including Micr
236. o rendent batheng Canadian Nursing 1999 Extraction Completa Edi Miter BI Journal of 1994 Extraction Complete Edt Managing disruptive responses to by a y Gerontological Delete 3 10 records per page 160 SUMARI 40 2 Adding anew review Within the Reviews page pressing the lt Add gt button opens the details page where a new review can be added The data fields for a new review are all mandatory If you are using JBI CReMS in conjunction with JBI NOTARI whenever a protocol is logged into JBI CReMS and is allocated to JBI NOTARI it will automatically create a new review in JBI NOTARI If you are not using JBI CReMS you will need to manually add a new review NOTARI Narrative Opinion and Text Assessment and Review Instrument Title of review a description of the reveiw Review Question Year commenced 2011 Primary Reviewer Secondary Reviewer Search Non Review No rer memi 40 3 Assigning reviewers The name of the person who has logged in will automatically be entered as primary reviewer The process to select the secondary reviewer from within NOTARI is the same as that described in the CReMS chapter of this user guide see Section 6 1 search for find and select your secondary reviewer you will need to enter both their username and email address registered via the SUMARI registration page for new users at http www jbicon
237. od publication KA LL ey Use the radio buttons to answer Yes No Unclear Not Applicable to each of the 168 JBI SUMARI questions This process is mandatory for all questions before being able to progress If the question asked in the JBI tool is clearly not applicable to the paper being appraised the option of selecting Not Applicable is now available in NOTARI v 5 0 Often an appraisal question will be not applicable to all of the papers of a particular study design which meet the inclusion criteria for a particular review The assessment of a publication can result in a publication being either included or excluded from the review Use the Include drop down menu to select whether the study is to be included or excluded If a publication is excluded the rationale for exclusion should be documented at the bottom of the Assessment screen Alongside each appraisal question a Comment text field has been introduced for users to insert a comment of up to 200 characters If this field is populated with text it is maintained here in the online module for user reference This text will not appear in any part of the final review report in CReMS v 5 0 Once the form is saved click Update upon re entering the assessment all of the text entered in the Comment field will appear for easy reference when the mouse is hovered over the text box Click Undo to clear all of the information entered on the screen This will
238. of users will have access to the system You will need a network or Internet connection to access the JBI QARI server JBI QARI can be accessed through a firewall as it uses standard web protocols i e HTTP on port 80 JBI QARI has been designed to operate on low bandwidth connections such as a dial up modem 74 JBI SUMARI 16 JBI QARI Getting started 16 1 Logging on Direct access to JBI QARI is available at the following URL address http www jbiconnect org sumari qari index cfm Alternatively access is available through the JBI web site at http www joannabriggs edu au Click on the JBI SUMARI systematic review software FREE under the Appraise Evidence link on the menu bar on the left of the front page This will take you to the JBI SUMARI home page http www joannabriggs edu au Appraise 20Evidence JBI 20SUMARI 20 systematic 20review 2O0software 20FREE Click on the link Qualitative Assessment and Review Instrument JBI QARI adjacent to the JBI QARI logo You will be presented with the JBI QARI log on screen This screen prompts you to enter your username and password Enter your username and password and click lt Logon gt to connect gol Qualitative Appraisal and Review nnw Instrument hstrenant Change Language Users of SUMARI v5 0 online modules should download CReMS v5 0 to complete the software package Username Password Logon Reset If you experience any difficulty please
239. of Naw Surgery and enhanced Surgeons Doleto Interventional Procedures recovery after surgery Surgical ARSERNIP S ERAS programs Poggetn Ber al WSES SM World Society World J Emerg Surg 2009 New awaiting of Emergency Surgery Final Delete Summer Meebng hiahikchts emeroency 42 2 The critical appraisal criteria The reviewer must assess the quality of the paper against the seven listed statements on the JBI NOTARI Critical Appraisal Checklist SUMARI JBI 171 NOTARI Narrative Opinion and Text Assessment and Review Instrument Categories Synthesis Assessment for Australian Health Workforce Advisory Committee Report from AHWAC 2006 Type Secondary User ne Criteria Yes No Unclear QUSE pia Comment 1 15 the source of the opinion clearty identified 2 Does the source of the opinion have standing in the field of expertise 3 Are the interests of patients clients the central focus of the opinion 4 Te the openon s bams in logec expenence clearly argued 5 1s the argument developed analytical 15 there reference to the extant literature evidence and any incongruency 9 with it logically defended 7 15 the opinion supported by peers Include Undetned 42 2 1 Is the source of the opinion clearly identified To assess an opinion it is important to locate its source Are the authors clearly identified 42 2 2 Does the source of the opinion have standing in the field of expertise Are the qual
240. of an outcome more easily than the odds of an outcome occurring Mis interpretation of an OR as an RR will usually result in an overestimation of the effect size suggesting that the treatment is better or worse than it actually is 2 6 For this reason RR are preferred however meta analysis of OR is still valid When meta analysis of OR is conducted reviewers should be careful to explain how odds ratios should be interpreted and differences between OR and RR when outcomes are common In summary both OR and RR can be included in meta analysis If possible consider using RR When this is not possible be careful when interpreting and explaining meta analysis of OR 58 3 8 Converting OR to RR Meta analysis should only be conducted on the same summary statistic In cases where there is a mixture of OR and RR measurements to combine into a meta analysis where possible the OR should be converted to a RR The two most common circumstances where this is possible are a cohort studies that have reported their results as OR and b case control studies in which the outcome is uncommon with an overall prevalence of less than 20 In circumstance a if all data total number of participants and total number of participants experience the outcome are known for both exposed and unexposed cohorts the RR can be calculated relatively simply In circumstance b the OR can be used as a good estimate of the RR If it is not possible to convert all
241. ofessionals and consumers evidence transfer facilitating the effective implementation of evidence and the evaluation of its impact on healthcare practice ad health outcomes evidence utilization JBI SUMAHI System for the Unified Management Assessment and Review of Information the Joanna Briggs Institutes premier software for the systematic review of literature It is designed to assist researchers and practitioners in fields such as health social sciences and humanities to appraise and synthesise evidence of feasibility appropriateness meaningfulness and effectiveness and to conduct economic evaluations of activities and interventions SUMARI JBI 11 JBI SUMARI Version 5 0 includes the Joanna Briggs Institute Comprehensive Review Management System JBI CReMS This module assists reviewers to manage and document a review and incorporates the review protocol search results and findings JBI CReMS links to the four analytical modules of JBI SUMARI e Joanna Briggs Institute Qualitative Assessment and Review Instrument JBI QARI This module accessible through CReMS is designed to facilitate critical appraisal data extraction and meta aggregation of the findings of qualitative studies Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument JBI MAStARI This module accessible through CReMS is designed to conduct the meta analysis of the results of comparable cohort time series and descriptive
242. ol page be edited here up to the point where the protocol is approved by the JBI Synthesis Science Unit and transferred to the report section of JBI CReMS It is important to check the text and edit it appropriately as once the protocol is transferred to the report it cannot be edited any further Search Strategy Assessment of Methodological Quality Data Collection and Data Synthesis Selecting Set text will also generate standardised text options in the remainder of the protocol dialogue boxes Read the text carefully throughout Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash characters Review Summary Protocol Studies Report Builder Report View Review title inserted here Search Strategy The search strategy aims to find both published and unpublished studies three step search strategy will be utilised in this review An initial limited search of MEDLINE and CINAHL will be undertaken followed by analysis of the text words contained in the title and abstract and of the index terms used ta describe article A second search using all identified keywords and index terms will then be undertaken across all included databases Thirdly the reference list of all identified reports and articles will be searched for additional studies Studies published in insert language s will be considered for inclusion in this review St
243. ome New Tite Software funcbonaity Data Type Dichotomous Continuous Description jasability scale Measure Scale 152 poor and 3 4 good New Subgroup Existing Subgroup ACT 2 Deere EXE Once subgroup is deleted studies which were assigned to that subgroup will revert back to being part of the original review outcome the study contributed data to 35 6 Meta Analysis screen new reviews only created using SUMARI v 5 0 This new menu item has been added to MAStARI v 5 0 to reflect the inclusion of the feature to do statistical meta analysis of data users previously performed in CReMS v 4 0 Please note that the statistical package runs within a java based Applet and this will require some time to load The first time it is opened warning messages may appear on the screen Tick the box to Always trust content from this publisher and then click Run Two such warnings may appear see Section 35 2 138 JBI SUMARI MASIARI Meta Analysis of Statistics Assessment and UM application s digital signature cannot be verified Do you want to run the application Publisher From http connector 2 Amaye trust content from tes piitan Th nes Ah cocer ch p Sevens Po v the cube The standard functioning of the meta a
244. omized Most reputable databases have a thesaurus or controlled vocabulary that is a list of headings used to standardize the indexing in the database it is important to use this when conducting Searches It is also useful if you want to narrow or broaden your search to use an aid called Boolean operators This aid is used by inserting near or not between search terms amp 57 1 5 Hand Searching Not all journals are referenced in the electronic databases and many other sources of evidence such as conference papers and unpublished work will be lost to the review if it is limited to only electronic searches A comprehensive review therefore also includes manual searching of journals and the reference lists of articles and abstracts retrieved 57 1 6 The Logistics of a Search In developing a search strategy and then following that strategy the logistics need to be well thought through It is useful to be clear about What databases resources can be searched Not all databases are accessible to reviewers and only those that can reasonably be utilised should be included Who will do the search Doing a comprehensive search is time consuming laborious and requires a degree of commitment Someone who has the time skill and commitment needs to be identified to do this and second reviewer with similar characteristics is also required What help will be available from librarians Although librarian
245. on 18 6 Creating a Non JBI Review QARI You will notice on the review edit screen there is also reference to the Non JBI Review The default setting here is No Qu QARI Qualitative Assessment and Review Instrument Review Study Categorie Comprehensive literature review on Reosgnising and Responding the Deteriorating Review Tithe Patient in Acute Hospitals The objeative s of this review is are to determine the experiences and issues on Review Question 260010715120 and responding the deteriorating patients acute care settings Year commenced 2010 Primary Reviewer ayeaye Secondary Reviewer no Review Status Non Review Yos E unto conl cione 80 SUMARI If you select Yes from the drop down menu you will see the following warning message appear on your screen pew Question 72 emergency surgery Weoo intrenet Explorer sar commenced 2009 Reviewer ayeaye icondary Reviewer ne Search wiew Status Y you to skip the appraisal step and not use the II appraisal onsidered for publsation in the IBI Liseary of JBI Review Yes zUpdete Undo Cancel Contact the Synthesis Science Unt at JB for further mfoemation Selecting Yes here will effectively allow users to skip the subsequent critical appraisal step using the JBI appraisal instruments in the review process As a user intending to submit a systema
246. on It is necessary to extract data from the primary research regarding the participants the intervention phenomena of interest the outcome measures and the results The analytical modules of JBI SUMAHI incorporate on line standardised data extraction instruments Data synthesis It is important to combine the literature in an appropriate manner when producing a report Statistical analysis meta analysis or textual analysis meta aggregation may or may not be appropriate and will depend on the nature and quality of the studies included in the review While it may not be possible to state exactly what analysis will be undertaken the general approach should be included in the protocol JBI CReMS presents editable standardized text describing the approach to meta analysis or meta aggregation for the analytical modules selected by the reviewer 57 2 Example protocol This is an example JBI review protocol that illustrates the outline of a comprehensive systematic review Note this is only an example and is an abridged version of an actual protocol and is available from the JBI Library of Systematic reviews http www joannabriggs edu au SUMARI JBI 231 Protocol Title The effectiveness of debriefing in simulation based learning for health professionals A systematic review Reviewers Prof Tracy Levett Jones RN PhD MEd amp Work BN DipAppSc Nursing Samuel Lapkin PhD Candidate RN BN Hons Email for correspondence
247. ontrol in reducing the numbers of patients reporting extreme pain following minor surgery The results from the three studies are summarized in Table 2 Table 2 Summary of three randomized controlled trials comparing Panadol to a placebo The table includes the number n of patients reporting pain after minor surgery and the total N included in each group SUMARI JBI 145 Study Panadol 35 17 Results from individual studies The results for the three individual studies are presented in the forest plot below The RR calculated for the three studies were 0 28 0 43 and 0 60 indicating that the Panadol is protective against pain and that the likelihood of experiencing pain after surgery for patients on Panadol are much less than that of patients on the placebo In comparison to the forest plot presented in the continuous example 35 12 the default setting in JBI CReMS of the left hand side of the forest plot representing a better outcome for patients and favoring the treatment accurately represents this finding This is because in this case a better patient outcome is associated with a reduction in the number of patients experiencing the outcome The overall meta analysis incorporating a fixed effects model Mantel Haenszel RR is included below for the three studies Whilst it would be possible to calculate OR from this data RR were selected as they are somewhat easier to interpret In this case the meta analysis indicates that patien
248. options for you to select from Once selected click Print 8 3 Deleting Studies in JBI CReMS Selecting the Delete tick box at the end of each row will allow you to delete a study from within JBI CReMS If this tick box is selected when the review is saved File menu select Save the review will update and the study records selected for deletion will be erased permanently from the JBI server fie Studies Modules Export Help Current Working Mode Online Rewew Summary Protocol Studies Report Bungor Report View of Citations 5 1 Autors Yes Twe Jouma Volume issue 1 Qan notan mastan acuan iReference Detetes 433 Zac 2011 Another a Journal of 99 99 1 L 43577 Melania 2011 SUMARI f Journal of 23 99 1108 435279 Mitan X 2010 SUMARI a Journal of 34 12 50 13508 ed Zac A 2011 Ana anaty Journal of 78 112 3445 Crems 2 Are you sure you want to delete tho elected recordray SUMARI JBI 53 If this study is linked to one of the analytical modules see Section 9 below a warning message will appear asking you to confirm the delete process as information linked to the paper in the analytical module will also be erased Once completed this operation cannot be undone SEE suma T Voma tjs Panel Mgr Mawpr T Adige Raa e _ nente ensure this
249. ord Enter your username and password and click Logon to connect Once you are logged on you will be taken to the main JBI MAStARI page This page consists of three parts the main menu reviews radio buttons and a summary of all reviews in the system These parts will be described in more detail later Meta Analysis of Statistics Assessment and Review Instrument Change Language Users of SUMARI v5 0 online modules should download CReMS v5 0 to complete the software package Username Password Egon Rese If you experience any difficulty please report problem to JBI Note You need to download CReMS v5 0 to work with this MASTARi version Version 5 0 Copyright Joanna Briggs Institute 2011 SUMARI JBI 111 29 2 Logging off Clicking on the lt Logout gt button on the main menu logs the user out after a quick confirmation and ends the session 30 Main menu The main menu Reviews Studies Logout About is located across the top of all JBI MAStARI pages As mentioned above the lt Logout gt tab is used to exit a review The lt About gt tab provides some background information on MAStARI and the functions of lt Reviews gt and lt Studies gt are explained in the following sections dm MAStARI Meta Analysis of Statistics Assessment and Review Instrument atout Filter Reviews Reviews This page lits the Reviews that are the system add a review dick the A
250. ory Introgection ef consultant ied model highly reccemances Name introdsction of consultant lead model is effective Summary therefore nigniy recommended synthesis Recommendation Ute of consultantied model 46 3 Editing a synthesized finding To edit a synthesized finding click on Synthesis in the top menu This will list all syntheses that are present in the system that have had categories allocated to them A synthesis will not appear here if it has not had valid categories allocated to it Select the synthesized finding to be edited by clicking on its name under the Synthesis column Edit the synthesis as required To save changes click Update To cancel changes and return to the previous screen without saving click Cancel 46 4 Deleting a synthesized finding Selecting the hyper link of the final aggregative synthesis will open the screen detailing Synthesis details Click Delete if you wish to erase the synthesis Deleting the synthesis will not alter the categories assigned to it 47 NOTARI View JBI NOTARI sorts the data into meta aggregation table or NOTARI View NOTARI View tables are automatically generated and include the categories and conclusions from which the synthesized findings were derived Conclusions within the NOTARI View table will have their level of credibility shown with a U for Unequivocal or a C for Credible Those findings that are Unsupported US should not be
251. osoft Internet explorer Firefox Safari and Google Chrome This range of platforms and browsers is designed to ensure that the majority of users will have access to the system You will need a network or Internet connection to access the JBI NOTARI server JBI NOTARI can be accessed through a firewall as it uses standard web protocols i e HTTP on port 80 JBI NOTARI has been designed to operate on low bandwidth connections such as a dial up modem 38 Getting started 38 1 Logging on Direct access to JBI NOTARI is available at the following URL address http www jbiconnect org sumari notari index cfm Alternatively access is available through the JBI web site at http www joannabriggs edu au Click on the JBI SUMARI systematic review software FREE under the Appraise Evidence link on the menu bar on the left of the front page This will take you to the JBI SUMARI home page http www joannabriggs edu au Appraise 20Evidence JBI 20SUMARI 20 systematic9620review9620software 9620FREE Click on the link Narrative Opinion and Text Assessment and Review Instrument JBI NOTARI adjacent to the JBI NOTARI logo You will be presented with the JBI NOTARI log on screen This screen prompts you to enter your username and password Enter your username and password and click Logon to connect SUMARI JBI 157 Narrative Opinion and Text Assessment and Review Instrument Change Language X Users o
252. ost s p 76 Przasnsky 1986 A strong leadership This requires motivated personnel and teamwork in every step of the patient care sunnart svstem can nrocess Tf all nrofessionals wnrkina in the OR remain interested in develonina their Categorization is the first step in aggregating study conclusions and moves from a focus on individual publications to consideration of all conclusions from all publications included in the review 45 1 Creating categories Categories need to be created before they can be assigned to conclusions In order to create new categories you must first click Categories in the top toolbar This page displays a list of all the conclusions and illustrations from publications for the review If categories have previously been added these will be listed in the far right column CESS Uimstration bine Pohlizntas Catequry ee Once the decison to transfer patent has been confirmed the of the local 9 yii apea ished transfer process should be actioned These include the completion of the transfer checklist notification of the patent flow units or bed managers NSW DoH Gudelme 2009 pi the commit n a Eae E theoretical success can be demonstrated but this involves overcoming the inertia that The need for research based aehedulesg n lack uf overhead evidence is highhghted opposes
253. owledgements Reviewers are required to enter a detailed outline of the search strategy for each analytical module s used This is entered in the text box headed Appendix Search Strategy This information is presented in Appendix Search Strategy Appendix Search Strategy Qari Appendix Search Strategy Notari Search Strategy Mastari Appendix Search Strategy Actuarl 58 JBI SUMARI 10 2 Systematic Review Report View The Report View tab at the far right of screen enables users to preview how the report will appear in pdf format At any given stage of the review reviewers can access report builder and monitor the progress of the review The screen displays one page at a time and you can navigate through the document using the icons at the bottom of the screen The effectiveness ofinterventions to reduce fear anxiety and claustrophobia of patients undergoing imaging with high technology modalities a systematic review Zachary Munn BMedRad GradDip HithSc Zoe Jordan BA Flin MA UnisA PhD Joanna Briggs Institute Faculty of Health Sciences The University of Adelaide Adelaide South Australia 5005 Executive summary Background in modem healthcare medical imaging plays an irreplaceable role in the patient s journey through illness and disease For many conditions and ailments medical imaging whether it is asimple chest X ray ora complex scan plays an essential ro
254. own box can be used to fiter studies as new included excluded extraction or finished E ome of Citations 9 Actions Dawson Paterson Brown 5 Emergency general surgery and the Surgeon 2004 Extraction Complete Edt for specialsabon Delete Eariey AS Pryor JP Ken Px Ann Surg 2006 Included Complete Edt An acute care surgary modal Jti Kunchi 000098 proves outcomes in patents with Delete 55 Rey appendicites Amenzan Collge of Report from the 2006 Extraction Complete tes of an College of Detete growing crisis in patient access to amp urdeone Div of emergency surgical Advocacy and Health Policy Royal Australasian College of Standards for safe working hours and RACS guidelines 2007 included Complete Edi Surgeons conditions for fellows surgical 0 trainees and intemational medical graduates A study goes through a process of being Assessed and Extracted Assessment of a study determines whether that study is to be Included or Excluded To aid in navigating amongst the studies the list can be sorted in ascending or descending alphabetical order by clicking on the heading of either the Author or Title column At the bottom of the page you will see you are able to select the number of studies to display on each page Click on the records per page drop down box to indicate how many studies you would like
255. page ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Review Title Review Question Year commenced Primary Reviewer catalint X Secondary Reviewer Search Is Non JBI Review iz Version 5 0 Copyright Joanna Briggs Institute 2011 Enter the relevant information review title review question and the year the review commenced Your name will automatically be entered as Primary Reviewer Click lt Search gt for the Secondary Reviewer Users will be prompted to search amongst all registered SUMARI users by searching with entry of a valid username and email address registered with that user name Users are no longer constrained to select secondary review authors from amongst those registered to the same organization or amongst those individuals directly registered by the primary reviewer as was the case SUMARI v 4 0 196 JBI SUMARI Search Secondary Reviewer User Name _ Email 52 1 2 Adding a new review via JBI CReMS All studies included in a review must be assigned to one of the four analytical modules of the SUMARI software JBI QARI JBI NOTARI JBI ACTUARI and JBI MASTtARI via the Studies page in JBI CReMS Assigning a study to an analytical module will facilitate the assessment appraisal and extraction of the study in that analytical module A new review viewable JBI ACTUARI
256. phic citation software from database sources will also 52 JBI SUMARI impact on the import of study citations into JBI CReMS All fields must be populated individually e g Journal Volume Issue page numbers etc for the same separation to be duplicated in JBI CReMS fields in the Studies list Open Endnote and select all the citations you wish to export and use the file dropdown menu to select export Make sure the output style selected is author date and the file type selected is xml Most citation management software is able to export this file type Endnote will ask you to select a file to save the export data to Place this file in a location you can easily find as you will need to open this file using JBI CReMS Once you have exported your bibliography from Endnote return to JBI CReMS to import this data In JBI CReMS select Studies on the menu bar and click Import Studies Browse through the window opened and select the xml file previously exported from Endnote JBI CReMS will support accurate import of up to 250 citations in the one import file Please note the larger the file imported the longer the import process will take 82 3 Printing the Selected Studies The full list of studies that appear in a review project in JBI CReMS can be printed at any stage by selecting File and then print from the menu bar and the clicking Selected Studies This will open a dialogue box with print
257. points include the community or society viewpoint and those of patients and third party payers Other viewpoints may also be relevant depending upon the particular analysis e Were there capital costs as well as operating costs included Has clinical effectiveness been established e Was this done through a randomized controlled clinical trial If so did the trial protocol reflect what would happen in regular practice e Was effectiveness established through an overview of clinical studies e Were observational data or assumptions used to establish effectiveness If so what are the potential biases in results Are costs and outcomes measured accurately e Were any of the identified items omitted from measurement If so does this mean that they carried no weight in the subsequent analysis Were there any special circumstances e g joint use of resources that made measurement difficult Were these circumstances handled appropriately Are costs and outcomes measured credibly e Were the sources of all values clearly identified Possible sources include market values patient or client preferences and views policy makers views and health professionals judgments e Were market values employed for changes involving resources gained or depleted e Where market values were absent e g volunteer labor or market values did not reflect actual values Such as clinic space donated at a reduced rate were adjustments ma
258. ported from JBI CReMS into JBI MAStARI will now be classed as New in the Status column on the studies page unassigned exported studies will be blank in this field Manually entered studies will already be classed as New 32 4 Editing a study Click on lt Edit gt to modify any of the study details This will bring you through to the same screen accessible via selecting the lt study gt button and then clicking lt Detail gt from the left hand box menu You may edit citation details and assign the appropriate study design from this screen If you wish to edit the details of a study at any time click on the study authors hyperlink the authors hyperlink is simply the names of the authors of the study which appear in blue on the screen on the studies page and then clicking on the lt Details gt button on the left hand side menu will open the study details page e Pressing the lt Update gt button after making any necessary changes will save the information and return the user to the studies page e Pressing lt Cancel gt does not save the information and returns the user to the studies page e Pressing lt Delete gt will delete the selected study SUMARI JBI 119 325 Filtering studies The filter function on the studies page allows studies to be sorted For example you can filter studies so that you only view new studies included or excluded studies studies that have been extracted or that have finished
259. possible be pooled using JBI NOTARI This will 0 Conflicts of Interest n Standardized text is automatically inserted in these fields when JBI NOTARI is chosen This text can be edited from here up to the point where the protocol is approved by the JBI Synthesis Science Unit and transferred to the report section of JBI CReMS see Section 7 9 2 It is important to check the text and edit it appropriately as once the protocol is transferred it cannot be edited any further SUMARI JBI 37 7 5 Protocol development using the JBI MAStARI module If the review focuses on evidence arising out of experimental studies you may wish to conduct the review using JBI MAStARI Due to the variety of study designs and corresponding range of appraisal tools some extra decision and selection is required by reviewers when conducting a review of quantitative evidence using JBI CReMS and JBI MAStARI 75 1 Selection of JBI MAStARI and Quantitative Evidence Selecting the tick box in between Quantitative MASTARI unlike any of the other three 3 selections available will not automatically append all of the JBI appraisal and extraction tools associated with quantitative evidence If users scroll down the page just above the field where procedures for Assessment of Methodological Quality are entered a new selection of tick boxes has now appeared prompting users to select which appraisal tools are appropriate for their review question This
260. r ideal conditions It is the maximum benefit or utility under ideal conditions Efficiency is defined either as minimising the opportunity cost of attaining a given output or as maximizing the output for a given opportunity cost Findings is a term used in qualitative research to describe conclusions reached by a researcher after examining the results of the data analysis in their primary research often presented in the form of themes or metaphors A fixed cost is a cost of production that does not vary with the level of output Fixed costs are those incurred whether patients are treated or not A forest plot is a diagrammatic representation of the effect sizes of individual studies in meta analysis Full economic evaluation considers both the costs and consequences for two or more interventions being compared within the analysis SUMARI JBI 223 Grey or gray literature is a term used to describe publications such as theses papers and reports produced by agencies such as government academic non profit organizations business and industry that are not published by commercial publishers Heterogeneity is a measure of how different or incompatible studies are within a systematic review Can have several dimensions such as clinical e g the studies are Clinically different methodological i e different study designs or statistical e g the studies have different effect sizes Homogeneity a measure of how similar studies are within
261. rated in this process The first step aims to generate a set of statements that represent the aggregated data through assembling the findings rated according to their quality The second step involves categorizing these findings on the basis of similarity in meaning These categories are then subjected to a meta aggregation in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence based practice Figure 1 SUMARI JBI 69 Identification of practice issues Search for appropriate research reports Critical appraisal and selection of studies to include Step 1 FINDINGS 32 findings 41 findings from 7 38 findings from 15 ethnographies from 11 phenomenological discourse tudi analyses Sidi Aggregate of 111 well founded and Step 2 explicit findings CATEGORIES from 33 studies into 19 categories Step 3 SYNTHESIZED FINDINGS Synthesis of 19 categories into 9 synthesised findings Recommendations for Practice Figure 1 Meta aggregation Of Qualitative Research Studies 142 role of qualitative evidence in systematic reviews Whilst the RCT is probably the best approach to generating evidence of effectiveness nurses medical practitioners allied health professionals and those in the social sciences are equally concerned with more than cause and effect questions and this is reflected in the wide range of research approaches ut
262. rature within an agreed time frame Critically appraising the studies retrieved oO a DN Extracting data from the primary research regarding the participants the intervention the outcome measures and the results 7 Pooling the results Statistical analysis meta analysis may or may not be used and will depend on the nature and quality of studies included in the review When statistical analysis is not possible current practice is to develop a narrative summary This current approach to systematic reviews thus consigns any evidence of a qualitative nature to a non systematic marginal process of writing up a narrative summary Because of this the relative status of evidence other than that generated using quantitative approaches is reduced The Synthesis of Qualitative Research Findings The synthesis or pooling ofthe findings of qualitative research studies is controversial It is contested by quantitative researchers because of the subjective nature of qualitative evidence and by qualitative researchers because of the ideological philosophical and methodological differences that characterize the flexibility of the qualitative research tradition Some qualitative researchers argue that the synthesis of qualitative studies is impossible and meaningless Others support the notion of qualitative synthesis but there is no emerging consensus on appropriate guidance for the systematic review of qualitative eviden
263. re not entered for one outcome the java applet which performs the meta analysis will not recognize any subsequent outcomes which do have numerical data associated with them In this event the outcome can easily be deleted from the review and any outcomes that do have data associated with them will appear for meta analysis MASIARL Mets Analysis of Statistics Assessment und Review Instrument stud IT Rv herw Outcome title for Alavanja M C Fleld R W Sinha R Brus C Shavers V L Fisher Ly Curtain J Lynch C F Lung Cancer 2001 Drop down manu wil display existing Titles from studies of the currently selected review Mene aure new 600 can be inserted using th field below Easting New Select new bitie if you want to add a new outcome New E Data Dichotomous Continuous 9 Desenpton A E 130 JBI SUMARI 34 6 Adding interventions Under the Intervention A column click on the Add link to open the new intervention A page Any pre existing interventions will be viewable from the lt Existing interventions gt drop down menu otherwise add an intervention from the study Add in a description of the intervention and an abbreviation and note these for future reference Save this information using the lt Save Details gt button and repeat the process for intervention B in this case the Control interve
264. riginal or primary research studies that will be included in the systematic review and preparing them for inclusion in a meta analysis It is important that a standard extraction tool be used by both reviewers that both reviewers have practiced using the extraction tool and can apply the tool consistently and that the data can be accurately and reliably entered into JBI MAStARI 58 2 1 Data extraction tools The JBI has developed standard data extraction tools suitable for each of the three main study types that can be analysed using JBI MAStARI 58 2 2 Deriving the required data from continuous data The data required for meta analysis of continuous studies includes the sample size the mean response and the standard deviation SD If the standard error SE only is reported the SD can be calculated from the SE as long as the sample size n is known The equation for converting from SE to SD is simply SD SE x y n 58 2 3 Other issues In some cases it may not be possible to extract all of the raw data required for a Systematic review from the results section of a publication Perhaps only aggregated data are reported in the publication or perhaps data from two different patient 238 JBI SUMARI populations have been combined in the data analysis and your review is focused on only one of the patient populations In these circumstances the standard approach is to make contact with the authors of the publication and seek their assist
265. ritical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument JBI MAStARI Appendix 234 JBI SUMARI Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer Data collection Quantitative data will be extracted from papers included in the review using the standardised data extraction tool from JBI MAStARI Appendix Il The data extracted will include specific details about the interventions populations study methods and outcomes of significance to the review question and specific objectives Data synthesis Quantitative papers will where possible be pooled in statistical meta analysis using JBI MAStAHI All results will be subject to double data entry Effect sizes expressed as odds ratio for categorical data and weighted mean differences for continuous data and their 9596 confidence intervals will be calculated for analysis Heterogeneity will be assessed statistically using the standard Chi square and also explored using subgroup analyses based on the different quantitative study designs included in this review Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate Conflicts of interest Nil NB Acknowledgements References and Appendices have been left out of this user guide SUMARI
266. rld Wide Web When selected users will be prompted to save a copy of the review locally on the hard drive of the computer See Section 6 5 1 Whilst working in Offline Mode users may open a previous saved version of the review by selecting lt Open gt from the File menu Users will see the name of the review project and alongside this in parentheses the file name entered usually to reflect the version of the review with the date and time the file was created 60 SUMARI Select from your existing local reviews The effectiveness of SUMARI v5 0 File local save cre Last update 13 05 11 06 27 Once file is selected click on Open to open the file or Delete to delete the file Please note that the current open review cannot be deleted from this window 11 1 Functionality in Offline mode Please be aware that as the current working review will not be connected to the World Wide Web any new work performed in the JBI SUMARI analytical modules on individual studies such as extracted information and results of meta synthesis or analysis for example maybe by your secondary reviewer will not appear in the Report View of JBI CReMS until the review project is reconnected to the JBI server where this information is stored JBI CReMS can be used normally in Offline Mode and retains all of its functionality except the feature to be able to Delete studies or modi
267. rmation Pressing the Yes button returns the user to the Publications Page pressing the No button cancels the action to leave the Conclusions page 45 JBI NOTARI Categorizing Once all information on a publication is collected in the form of extractions and individual conclusions with illustrations from publications the conclusions can be allocated to user defined Categories To do this the reviewer needs to read all of the conclusions and identify similarities that can then be used to create categories Categories are groups of conclusions that reflect similar relationships between similar phenomena variables or circumstances that may inform practice 180 JBI SUMARI Concusions Conclusions for A comprehensive literature review on emergency surgery Categuries Filter by category All gt Uu roniciors A clear logistics for local 101 Once the decision to transfer a patient has been confirmed the logistics of the local transfer process should be actioned These include the completion of the transfer checklist notification of the patient flow units or bed managers NSW DoH Guideline 2009 p 27 T t of OI No progress will be made toward an effective solution until practical i e non theoretical VULP iss es tack oF success can be demonstrated but this involves overcoming the inertia that opposes feck ot significant changes and involves a substantial initial commitment and overhead c
268. rocess 76 JBI SUMARI 18 JBI QARI Reviews Reviews are the projects that Studies Extractions and Findings are related to The Review page lists the Reviews that are in the system This page is used to add new to edit existing or to cancel Reviews An Action column has been introduced in QARI v 5 0 which replaces the Edit column that was in SUMARI v 4 0 The number 4 of reviews is also displayed At the bottom of the page you will also see you are able to select the number of reviews to display on each page The Status column that appeared on the Reviews page SUMARI v 4 0 has been removed in SUMARI v 5 0 Qu QARI Qualitative Assessment and Review Instrument eviews study Categories Fiter Reviews Reviews Primary This page ksta the Revws that ars in the eystum To add a review click on tha Add button below To adit or delete a Review chek the appropriate brik Secondary under the Actions column Fop of Reviews Closed A comprshensive What are the common meanings and shared experiences the physicians reer 9n encounter in retabon to emergency surgery 200 ayeave ne Surgery sxpenence of What are the common meanings and shared axpenences the patients paben encounter at the time of receiving unfavorable aaa sas jung cancer The objective of thie systematic review is to identify and synthesize all ahaa hing cancer reesarch Hefe avninnnn natian
269. ropriate for the included studies 6 Exclude studies In general it is difficult to justify the exclusion of a study that would otherwise have been included solely on the basis that it adds heterogeneity to the data set Rather it is preferable to conduct a sub group analysis which excludes suspect studies and compare these results to the entire analysis Note that Deeks Higgins and Altman also discuss the implications of ignoring the heterogeneity and conducting a fixed meta analysis but this is not a recommended approach to dealing with heterogeneity 248 SUMARI
270. rted in ascending or descending alphabetical order by clicking on the heading of either the Author or Title column At the bottom of the page you will see you are able to select the number of publications to display on each page Click on the records per page drop down box to indicate how many publications you would like to appear on each page This value can be increased from 10 to 20 50 or 100 prior to any re pagination Whilst assessing or extracting publications in the system the module will now return to the page displaying the last paper assessed extracted rather than returning to the first study as was the case in SUMAHI v 4 0 164 JBI SUMARI 41 1 Importing a publication from CReMS Publications can be imported into JBI CReMS from EndNote bibliographic software and allocated to JBI NOTARI via the check box in JBI CReMS see CReMS chapter of this user guide for further information on JBI CReMS Once these publications have been assigned to JBI NOTARI they will be automatically exported into JBI e Note that references from EndNote must be journal articles with all fields completed for the import function to be successful 41 2 Manually adding a new publication to JBI CReMS or JBI NOTARI Publications can be manually entered into JBI NOTARI using the lt Add gt button at the bottom of the Publications page Fill out the standard bibliographic details of the publication Author s Title Journal Year Volume
271. s Version 5 0 The relations File Modules Export Help Curr Import Studies pline Add Study Review Summary of Citations 54 System ID Author s Year Title Journal Volume 46407 Agency 2006 Seven St London 46408 Becher E 2001 Improvi Health 20 46767 Bhasale 1998 Analysi Medical 169 46402 Brennan 1991 Incidenc 324 Pannas annn Tha Tu nollie 821 Add a single study Click on Studies in the menu bar and the click lt Add study gt Enter the following data e Author s Enter the name or names of the author s e Title Enter the name of the Study e Journal Enter the name of the Journal e Year Enter the year of the Study Volume Enter the volume in relation to the Issue of the Study Issue Enter the Issue in relation to the Volume of the Study Page s Enter the numbers of the pages relevant to the study SUMARI JBI 51 File Studies Modules Export Help Current Working Mode Online Review Summary Protocol Studies _ Report Builder Report View 7003 Fenn P 2004 The Title 46980 Fernald 2004 Eve 46429 Fischer 1997 Pi System ID Authoris Vem journal Velume issue Pagers Qari Notarii Reference Deleted 46407 Agency 2006 Seven 1 London LT T it 17 L 46408 2001 improvi Health 20 3 63 81 a 46767 1998 Analy
272. s congruity between the research methodology and the interpretation of resuits 6 There is a statement locating the researcher culturally or theoretically E The infiuence of the researcher on the research and vice versa is addressed B Participants and ther voices are adequately represented The research is ethical according to current criteria or for recent studies there is evidence of ethical approval by an appropriate body Conclusions drawn in the research report do appear to flow from the anz yas or interpretation of tha data Include Yes 7 Reason The study is of adequate quality to include Undo 10 20 2 1 Congruity between the stated philosophical perspective and the research methodology Does the report clearly state the philosophical or theoretical premises on which the study is based Does the report clearly state the methodological approach adopted in the study Is there congruence between the two For example A report may state that the study adopted a critical perspective and that a participatory action research methodology was followed There is congruence between a critical view focusing on knowledge arising out of critique action and reflection and action research an approach that focuses on working with groups to reflect on issues or practices to consider how they could be different acting to change and identifying new knowledge arising out of the
273. s may not be well versed in the substantive area of the review question they are highly skilled in electronic searching and in the retrieval of papers 230 SUMARI 57 1 7 Selecting Studies for Retrieval Once an exhaustive search is conducted the resulting titles and abstracts if available are assessed to establish whether they meet the eligibility criteria set out in the protocol Those articles that do meet the inclusion criteria are rejected but bibliographical details are recorded in a table of excluded studies for inclusion in the systematic review report Some reviewers do not include this in the report for example Cochrane Reviews do not do so whereas others do for example Joanna Briggs Institute reviews do include them in an appendix If there is uncertainty about the degree to which an article meets the inclusion criteria or if the criteria are clearly met then the full text of the article is retrieved 57 1 8 Critical Appraisal Extraction and Meta analysis Meta synthesis Critical appraisal It is important to assess the quality of the research to minimize the risk of an inconclusive review resulting from excessive variation in the quality of the studies The protocol must therefore describe how the validity of primary studies will be assessed and any exclusion criteria based on quality considerations The analytical modules of JBI SUMARI incorporate on line standardised critical appraisal instruments Data extracti
274. sessment and actions edit or delete The studies page allows users to view add edit and delete studies Analysis of Cost Fechnology and Uldisati ssessment and Review Instrument 22222 EL lect Studies A systematic review of cost effectiveness of paclitaxel and cisplatin versus cyclophosphamide and cisplatin Deals This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Findings The drop down bax can be used to filter studies as new mouded excluded extracted or finehed Poraction Al fs of Citations 2 Se gergeret Cost effectiveness analysis of palitaxel and cisplatin versus cyclophosphamide and 1998 Extraction Complete Edit osplabn Cancer 9 Cost effectiveness of pacitaxel Caacer 296 ant 1 50 v records per page E Version 5 0 Copyright Joanna Briggs Institute 2011 53 1 Importing a study into JBI CReMS Studies can be imported into JBI CReMS from EndNote Thomson bibliographic Software Once these studies have been assigned to JBI ACTUARI they will be automatically exported into JBI ACTUARI 53 2 Manually adding a new study Alternatively studies can be manually entered into JBI CReMS Again once the studies are assigned to JBI ACTUARI studies will be automatically exported into JBI ACTUARI Additionally studies can be m
275. si Medical 169 2 73 6 a Y 46402 Brennan 1991 incidenc 324 370 376 46401 Cooper 2009 The Han 2nd edit 46758 Devine 2010 The imp journal 17 1 78 84 464044 Doggett J 2007 Anew a Centre 1 46409 Donalds 2000 Add study to current review 16413 DoveyS 2002 Ag 46414 ElderC 2002 46415 Elder N 2004 7 4 Authors 46424 Elder N 2006 Y DODOL WDD 46430 Candhi 2006 Mis Year 46982 Candhi 2000 Dri Volume 46983 Candhi 2003 Ady 46425 Garfield 2009 996 46431 2008 Pagels 45990 Gurwitz 2003 46410 2003 46418 Jacobso 2003 46769 Kaushal 2007 Mr p ggg Q 46405 KendigS 2006 Primary lt ia B a 46984 Kilip S 2007 Patient Family 39 404 9 I e v m 46406 Koha L 1999 To Err i Report o n 5 46770 2007 Confide Quality 16 2 95 100 A z m 46419 Kripalan 2007 Deficits 297 gs T z 5 46771 2008 Mediat Quality 17 4 285 290 T z 46991 Kuzel A 2004 Patient r Annals 2 4 333400 T 2 46426 Ludwick 2009 Adoptin Internat 78 1 22 31 a m m 8 46420 2002 An inter Medical 177 68 72 4 46433 McKay 2009 Artview BMCFa 10 lip a n x 45978 Miller C 2006 Adverse Medical 184 7
276. sing the Update button will save the changes and return the reviewer to the Categories page Pressing the Cancel button discards any changes to the category and returns the reviewer to the Categories page 45 5 Deleting a category Under the Action column click on Delete to delete a category A prompt asking for confirmation will be displayed Pressing the OK button will delete the category and return you to the Categories page If conclusions are already allocated to a category then the allocation changes back to Undefined These conclusions can now be assigned to another existing category or to a newly created one 184 SUMARI 46 JBI NOTARI Synthesizing Categories To synthesize the categories the reviewer needs to consider the full list of categories and identify categories of sufficient similarity in meaning to generate synthesized findings A synthesis is defined as a group of categorised conclusions that allows for the generation of recommendations for practice To view all listed categories click on lt Categories gt on the top toolbar and then Categories on the left hand menu NOIA Narratve Opinion and Trot Assessment and Hewew Instrument Cateqorios RAF Categories for A comprehensive literature review on emergency surgery Thee page allows categones to be managed Recommendation Models Edit simata Delete Recommendation Standard care Edit Delete Recommendat
277. sion to include or exclude is based on pre determined requirements for example all included studies must have adequate randomization and blinding of participants allocators and assessors or all included studies must have a minimum number of yes scores The reviewer then Selects Yes No or Undefined from the Include drop down box JBI MAStARI offers critical appraisal tools for randomized pseudo randomized controlled trials comparable cohort case control studies and descriptive case Series studies 122 JBI SUMARI 33 3 Critical appraisal criteria for a randomized controlled trial pseudo randomized trial For a randomized controlled trial oseudo randomized trial there are ten criteria that need to be answered during critical appraisal the example given below the reviewer made the decision to include the study in the review because there were more than five yes scores out of the ten criteria Assessment for Fripp 2003 Perat Type Primary m ork cien us Design Randomsed Control Trial Pseudo randomised Trial Melo Analysis Criteria Yes No Undear Fa Comment 1 Was the assignment to treatment groups truly random 2 Were parbopants binded to treatment adiocabon 3 Was allocation to treatment groups concealed from the allocator 4 Were the outcomes of people who withdrew described and included in the analysis 5 Were those assessing outcomes blind to the treatment
278. sis Science Unit SSU for use with your protocol for your review This step will otherwise generally only be selected by reviewers who are using the free JBI SUMARI software but who don t have the intention of submitting a systematic review to the JBI Library The result of this selection at the Assessment phase of the review is described in Section 33 116 JBI SUMARI 32 JBI MAStARI Studies Accessed by clicking on the Studies tab on the main menu A study is the basic unit of a review in general each review will assess many studies You may also hear the term paper or publication used to refer to a study To access the studies page either click on the title of the systematic review on the reviews page or select Studies from the main menu The studies page is a list of the first ten publications that have so far been added to the review including the author title journal year of publication status and stage of assessment If there are more than ten studies these can be viewed by clicking on the Next 10 rows hyperlink at the bottom of the screen To aid in navigating amongst the studies the list can be sorted in ascending or descending alphabetical order by clicking the heading of either the Author or Title column The studies page allows users to view add edit and delete studies ee MAStARI Meta Analysis of Statistics Assessment and Review Instrument Reviews D ES per Studies in DNA
279. sment column ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument Reviews Study Studies in Cost Effectiveness of inhaled corticosteroids in asthma a systematic review This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Findings The drop down box can be used to filter studies as new included excluded extracted or finished Hn of Citations 4 mM Edetal Cost Effectiveness of inhaled corticosteroids in asthma adult patients 2009 Extraction Complete Edit Delete Buxton etal Cost Effectiveness of inhaled corticosteroids in adult asthma patients 2009 Extraction Complete Edit Delete Mumus et al Cost Effectiveness Health Policy 2009 New Secondary Completed Edit Delete lohnetal Cost effectiveness BMJ 2008 New Primary Completed Edit Delete 1 50 records per page Version 5 0 Copyright Joanna Briggs Institute 2011 SUMARI JBI 207 54 2 ACTUARI critical appraisal criteria Users will notice that the appraisal tools have changed to add functionality ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument mm Assessment for Mumus et al Health Policy 2009 Type Primary user Catractan Criteria Yes Undear applicable Comment 1 15 there Wel defined queston 2 Is there
280. sment extraction results associated with the study within the analytical module will be erased Once erased this operation cannot be undone If there is information included in the synthesis that has been extracted from the study being deleted you will be advised in a warning message Qualitative Assessment and Review Instrument QARI Windows Internet Explorer ing to the Deteriorating Patient in Acute Hospitals There are outcomes related to this study Are you sure you want to delete thes study be selected to perform assessment and extraction and to develop This page is used to extraction or finished Findings The drop down bo Cioffi 1 Salter a ians responses to vital signs in Aust Cnt Care 2006 Extraction Complete fbi an emergency department 59 Bonceany O Scott J Hogan Respiratory assessment why don t nurses British Journal of 2006 Extraction Complete eat 84 SUMARI 20 JBI QARI Assessment Studies to be used in a JBI Review must be assessed using the standardized JBI critical appraisal tools The assessment process requires the following three steps 1 The primary and secondary reviewers critically appraise the study independently 2 The primary reviewer performs the final assessment 3 If both the assessors agree the study is either included or excluded The primary reviewer needs to resolve any conflicts between assessments 20 1
281. stem whether via the analytical module or via CReMS it will appear as the first record in the list of reviews rather than the last as was the case across the SUMARI v 4 0 analytical modules Information about a review including 112 JBI SUMARI its a description of the review the year the review was commenced the names of primary and secondary reviewers and the current status of progress in the review are all presented Only a reviewer can view the information on this page and only reviews that correspond to the selected lt Reviews gt buttons will be displayed In the example above only reviews in which the user is the primary reviewer and which are currently being conducted i e are open will be displayed To access reviews as the secondary reviewer click on the lt Secondary gt button on the left of screen To access completed reviews click on the lt Closed gt button Besides the new look to the screen on the entry page an Action column has been introduced which replaces the edit column that was in the SUMARI v 4 0 modules The number of reviews is now also displayed At the bottom of the page you will also see you are able to select the number of reviews to display on each page The status column of the review v 4 0 has been removed from the reviews page 311 Adding a new review There are two ways to add a new review to JBI MASTARI via the JBI MAStARI software itself and via the JBI C
282. steroids in 2010 catalint catalin2 Edit Delete Systematic review A systematic review systematic review of cost effectiveness of cost effectiveness of paclitaxel and 2010 catalini catalin2 Edit Delete if cisplatin versus cyclophosphamide and cisplatin 50 2 Logging off Clicking on the lt Logout gt button on the main menu logs the user out after a quick confirmation and ends the session 50 3 Switching users There may be a situation arising whereby you need to change your login ID For example you may be logged in as User A but need to work as User B If this is the case you should log out from any current JBI ACTUARI use by employing the lt Logout gt button confirm that you wish to logout and then log back in as the new user It is important that you do not use your browser s Back button SUMARI JBI 193 51 JBI ACTUARI Main menu The main menu Reviews Study Logout About is located across the top of all JBI ACTUARI pages ACTUARI Analysis of Cost Technology and Utilisation Assessment and Review Instrument 52 JBI ACTUARI Reviews Each review has a Primary and Secondary reviewer A Primary reviewer leads the review and has rights to add edit or delete reviews a Secondary reviewer assesses every paper selected for critical appraisal and assists the primary reviewer in conducting the review The Reviews page lists all reviews that are in the system This pag
283. summary statistics to either RR or OR the reviewer should consider whether meta analysis of this dataset is warranted For example a dataset consisting of a mix of RR and OR is suggestive of a mix in study designs including for example RCTs cohort studies and case control studies The reviewer must be satisfied that the studies are sufficiently similar to include in meta analysis and this may not be the case with such a wide range of study designs Alternatively the reviewer could consider conducting a sensitivity analysis and compare the results of including only one of the set of summary statistics e g RR with a meta analysis of both RR and If there is no difference in the results of this sensitivity analysis then it is likely reasonable to assume that the findings of the combined meta analysis are valid These findings and assumptions should be clearly stated in the review 58 3 9 Dichotomous data different methods of meta analysis There are several different methods available to pool results of dichotomous data depending on the data type and whether a random or fixed effects model is required Mantel Haenszel Peto s and DerSimonian and Laird See section 58 3 16 for a discussion about the differences between fixed and random effects models SUMARI JBI 243 58 3 10 Mantel Haenszel Mantel Haenszel is the default meta analytical method for dichotomous data using a fixed effects model Both OR and RR can be pooled using M
284. systematic and repeatable way and preparing them in such a way that similar results can be grouped together for meta analysis 34 4 Extraction Screen The extraction form in the analytical Modules of SUMARI v 5 0 serves two purposes as an online saved record of the details abstracted from the included paper and also to rapidly generate the appendices included in any final review report Users will notice an asterix has been included alongside certain field labels on the extraction form and denotes which of the fields in the extraction form will be transferred to the automatically generated tables of included studies in CReMS 5 0 MASTARI Meta Analysis of Statistics Assessment and Review Instrument Revie Extraction Details Ed et al The journal of international studies 2011 Study Information denotes field which will appear in report appendix Method Setting Participants Participants Group A Group B Interventions Interventions A Interventions B Authors Conclusion Reviewers Comments Complete No Es SUMARI JBI 127 34 2 Extraction details To begin extracting data click on the authors name hyperlink for a study that shows Included in the Status column and Complete in the Assessment column This will take you to the extraction details page The extraction details page lists a range of fields which
285. t aenerioncee nf havinn a zoos ye aint Nalot Each entered review has a primary and secondary reviewer To view reviews where you are the primary reviewer click on the radio button Primary To view reviews where you are the secondary reviewer click on the radio button Secondary A primary reviewer leads the review and has rights to add edit or delete their own reviews Before a secondary reviewer can work on a project they must be assigned to the review either when the review is first created or later by editing the review A secondary reviewer assesses every paper selected for critical appraisal and assists the primary reviewer in conducting the review Associate reviewers may also be added to each review there is no limit on the number of associate reviewers SUMARI JBI 77 181 Opening an existing review To open an existing review click on the review title By opening the review in this manner you are automatically selecting it and are able to see the studies listed by citation that have been allocated to the review QARI Qualitative Assessment and Review Instrument EM Fitter Reviews Reviews Primary This page kits the Revers that in the systam add a review click on the Add button below or delete a Review click the appropriate brik Secondary under the Actions column of Reviews Closed A compcehensive What are the common meanings and shared experiences
286. t where the protocol is approved by the JBI Synthesis Science Unit and transferred to the report section of JBI CReMS see Section 7 9 2 It is important to check the text and edit it appropriately as once the protocol is transferred to the report it cannot be edited any further 77 Protocol development using multiple modules If the review project focuses on a range of different types of evidence and you wish to use a combination of the analytical modules select the lt QARI gt lt NOTARI gt lt MASTARI gt and or lt ACTUARI gt tick boxes to append appraisal and extraction instruments for more than one type of evidence If you wish to use JBI Set text Select the Set text tick box for each of the selected modules and click Set This will automatically generate text in some of the Protocol fields as it is for each individual module The text inserted will be appropriate to reflect to the reader that more than one type of evidence is being addressed 44 SUMARI Read the text carefully throughout Users prompted the text where modification of the set text may be necessary This is indicated by instructions between hash characters Specific details related to study design for JBI MAStARI will need to be addressed as detailed in Section 7 5 above This text can be edited from the protocol page up to the point where the protocol is approved by the JBI Synthesis Science Unit and transferred to the report s
287. tails to both the protocol and review documents when exported see Section 7 9 1 r Author Information Primary Reviewer trainee30 Details Secondary Reviewer trainee29 Details Associate Reviewers Search Details Delete e To add and associate reviewer click on lt Search gt to search all registered JBI SUMARI users using both known user name and registered email address See Section 6 1 above Click Select to insert the associate reviewers details into the project To edit an associate reviewers details select the name of the user you wish to include and click Details Their name and registered contact details will appear in the text box and is editable here All Associate Reviewers will have a default Author Sequence number of 3 however the default order of appearance of the authors on both the protocol and review will be in order of entry This can be changed at any stage by simply changing the value in the Author Sequence box whilst modifying the author s details Any changes made in the Review Summary tab to the Sequence of authors see above will appear in any exported version of the protocol and once the protocol is transferred to the report in your review The changes to sequence will not appear updated here Click on Update once complete As mentioned once Associate reviewers have been added their details can be edited at anytime from
288. tation the body of the text itself as it will not be recognised in the final protocol or report The text between the double square brackets e g author date is a special marker that JBI CReMS uses to locate places where you have placed a citation 7 9 Completing the protocol To complete the protocol enter all of the information required in the text fields and edit the protocol data carefully The completed protocol can be exported in either either the rtf or pdf for printing and circulation Once exported you will then need to choose where to save either the rtf or pdf protocol on your computer Do not click on Transfer to report until the protocol has been finalised and the JBI Synthesis Science Unit have provided their feedback and the protocol has been approved 791 Exporting the Protocol or Review Report in JBI CReMS Select Export from the menu items available Current Working Mode Protocol Review Summary BR Report Builder Report View Selected studies 5s of SUMARI v5 0 versus v4 0 for producing a systeme systematic review Authors Information Primary Reviewer Edoardo Aromataris Secondary Reviewer Zachary Munn Associate Reviewers Briggs Joe DNA Evolution Select one or more of the SUMARI Analytical Module s you will use dependent on the type of evidence Evidence Module Quantitative 71 MASTARI Qualitative C QARI When you select to export ei
289. tention to treat analysis and the results of the clinical outcome Note that both the study date and the sample size fields require numbers non numerical data will not be saved to the database Economic effectiveness results There are several fields in the economic effectiveness results section The first relates to the date year when the economic data were collected Note that only numerical data can be entered here For multiple studies option the next field relates to economic modeling used The third field requires a list of the measurements of benefits that were used in the economic evaluation The fourth fifth and sixth fields relate to costs examined in the study direct costs of the intervention program being evaluated indirect costs and the currency used to measure the costs Another field requires information on statistical analysis of costs data Another field relates to the results of any sensitivity analysis conducted as part of the study One field relates to listing the estimated benefits to using the intervention instead of the comparator Another field requires a summary of the cost results findings and a final field is a summary of the synthesis of the costs and results Outcome category The outcome category section is a three by three matrix of all possible outcomes of an economic evaluation The ultimate decision about the clinical and cost effectiveness of the intervention under examination is entered here
290. ter then click the Filter button to filter the findings by the category This assists the reviewer to write the section of their review report which describes the relationship of a group of findings to a particular category This information Should be included in the final report in order to support the final synthesis and recommendations and ensure that the review process is transparent 26 2 Reporting by synthesis To report information related to the syntheses in the systematic review report select Synthesis from the top toolbar QARI View tables will be displayed These tables can be printed for use in systematic review reports by clicking on the Print button Bibliographic References 1 Pearson A Balancing the evidence incorporating the synthesis of qualitative data into systematic reviews JBI Reports 2003 2 45 64 2 Sherwood GD Meta synthesis merging qualitative studies to develop nursing knowledge International Journal for Human Caring 1999 3 37 42 8 Oxford English Dictionary Oxford Oxford University Press 1995 p 487 4 Wolf FM Meta analysis Quantitative Methods for Research Synthesis Beverly Hills CA Sage 1986 5 Cochrane Collaboration RevMan 5 0 March 2011 6 Suri H The process of synthesizing qualitative research Paper presented at the Annual Conference of the Association for Qualitative Research 1999 6 10 July Melbourne 1999 8pp unnumbered Available from URL htto Awww latrobe e
291. tered and edited Read the text carefully throughout Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash 4 characters Dependent on your selection of options 1 2 or 3 above this will automatically insert different text in the Types of Studies field that details the types of studies you plan to include in the review Type of Study This review will consider studies that focus on qualitative data including butnot limited to designs such as phenomenology grounded theory ethnography action research and feminist research In the absence of research studies other text such as opinion papers and reports will be considered If you wish to include opinion papers and reports select Textual Evidence and the NOTARI analytical Module and then select to insert set text now Any of the text on the protocol page can be edited here up to the point where the protocol is approved by the JBI Synthesis Science Unit and transferred to the report section of JBI CReMS It is important to check the text and edit it appropriately as once the protocol is transferred to the report it cannot be edited any further Search Strategy Assessment of Methodological Quality Data Collection and Data Synthesis Selecting Set text will also generate standardised text options in the remainder of the protocol dialogue boxes Read the text carefully throughout Users are pro
292. terms to be used are Debriefing Simulation e Health professional The second stage will involve searching electronic databases using several combinations and permutations of key words and index terms identified by the initial literature scoping Using a defined search and retrieval method the databases to be searched are AMED CINAHL Dissertation and Theses EMBASE ERIC Journals Ovid MEDLINE ProQuest Nursing Journals 10 PsycINFO OOO Cochrane Central Register of Controlled Trials CENTRAL The following sources will be hand searched for any additional articles Mednar e Directory of open access journals Conference Proceedings Lastly reference lists of all included literature will be searched for any additional relevant studies The bibliographical software package Endnote will be utilized to manage all references as it facilitates the importation of references from electronic databases as well as the linkage of references into the Joanna Briggs Institute JBI Comprehensive Review Management System CReMS for assessment of methodological quality using the JBI critical appraisal tools These guidelines have been developed to minimize bias and establish validity of the findings Assessment of methodological quality Quantitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardised c
293. the Review Summary page by selecting their name and clicking on Details 28 JBI SUMARI File Studies Modules Export Help Current Working Mode Online Review Summary Protocol Studies Report Builder Report View Title Review title inserted here Question Year 2612 Author Information Primary Reviewer trainee30 Details Secondary Reviewer trainee29 Details Associate Reviewers Search Details Delete Summary of Studies Number of studies found 0 Refresh As you proceed through the systematic review process this Review Summary Screen will automatically record the number of studies or papers found in the search the number of papers included after appraisal in the analytical module the number of studies excluded after appraisal in an online analytical module and the number of studies awaiting appraisal 65 Savingareview It is important to save your work often It is recommended that you save your work periodically whilst working on a review project and also when you have finished working with JBI CReMS To aid the later you will be prompted to Save your current review every time you exit JBI CReMS To save the current review select Save from the File menu bar This will upload any information you have entered into JBI CReMS to the JBI SUMARI database making it available the next time you work with a review regard
294. the person who has logged onto JBI CReMS and is creating the New Review To change to a different primary reviewer select the name from the drop down list The primary reviewer can only be selected from any registered JBI SUMARI users within the same organization Secondary Reviewer Click here to select your secondary reviewer Users will be prompted to search amongst all registered JBI SUMARI users by searching with entry of a valid username and email address registered with that user name It is essential that all registered users new or existing update these details accurately to allow secure assignment of a secondary review author to the review project This can be done by new users at http Awww jbiconnect org tools services JBI SUMARI_reg php and by existing users of the JBI SUMARI software package at http www jbiconnect org tools services update_profile php All registered SUMARI users will have also registered an email address e n the text field User name insert the user id of the registered user you would like to assign as your secondary n the text field email insert the registered email address of the registered user you would like to assign as your secondary Search User UserName train5 Email tranQibi Search No records found Select Cancel Click Search 22 JBI SUMARI Email train ibi Hi
295. the physicians kerature revere gn encounter m relation to emergency surgery 2009 ayouye om emergency surgery Life expenence of What are the and shared expenences the patients patents melts hel Unfavorable news about lung ness objective ity ahat hinn concert research chia arininn narant nf haying a Naom QARI Qualitative Assessment and Review Instrument Studies in A comprehensive literature review on emergency surgery This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Findings The drop down box can be used to filter studies as new included excluded extraction or finished 2 of Citations 9 Dawson Paterson Broan 5 Emergency general surgery and the Surgeon 2004 Extraction Complete Edit implicabons for specialization Easy AS Pryor 2 Kim PK Ah acute c i Ann Surg 2006 inckided Complete Edit tmd Qu tanus gue improves outcomes in patents with a hab Cu appendicitis Amsrican colige of Report from tha 2006 Extraction Complete Edit Surgeons Amencan Colige of At if growing cnsis in patentaccess to Smear a Ostate emergency mages cun Advocacy and Haalth Policy BovalAustralaman Colege of Standards for safe working s and RACS guidelines 2007 Inchided Complete Edit Surgeons
296. the system that have had categories allocated to them A synthesis will not appear here if it has not had valid categories allocated to it Select the synthesized finding to be edited by clicking on its name under the Synthesis column Edit the synthesis as required To save changes click lt Update gt To cancel changes and return to the previous screen without saving click lt Cancel gt 244 Deleting a synthesized finding Selecting the hyper link of the final aggregative synthesis will open the screen detailing Synthesis details Click lt Delete gt if you wish to erase the synthesis Deleting the synthesis will not alter the categories assigned to it 25 QARI View JBI QARI sorts the data into a meta aggregation table or QARI View QARI View tables are automatically generated and include the categories and findings from which the synthesized findings were derived Findings within the QARI view table will have their level of credibility shown with a U for Unequivocal or a C for Credible Those findings that are Unsupported US should not be included if the review is a JBI review but may be included at the reviewers discretion in reviews for generation of new theory rather than to guide practice 104 JBI SUMARI 251 Viewing meta aggregation To view the QARI View table click lt Synthesis gt on the top menu bar Note that only those syntheses that have had valid categories allocated to them will be shown her
297. ther lt Protocol gt lt Report gt or lt Selected Studies gt you will open a dialogue box where you can define the location for the exported file to be saved the name of the file and also the file format SUMARI JBI 47 Save In 5 Documents SAARE Intervideo FileName Files of Type RTF Rich Text Format JBI CReMS supports pdf and also rtf format for export Files in rtf format can be opened and are editable in even the most simple basic text editor software Appropriate assessment and extraction tools are automatically appended to the protocol dependent on selection of SUMARI module type of evidence made in the Protocol tab see Section 7 1 Please note that although rtf files be viewed and modified in any text editor the software used must have the capability to present pictures if users wish to see images embedded in the file including the appraisal and extraction instruments or any images of meta synthesis or analysis created in the online analytical modules Most simple text editors are unable to display these images All exported documents irrespective of file type are preformatted to match the submission requirements of the JBI Online Library of Systematic Reviews and Protocols Exported protocols should be emailed directly to the Synthesis Science Unit Choosing to export lt Selected Studies gt presents a list of the full study
298. tic review to the JBI Library you should only select this if you have had a different appraisal tool approved by the Synthesis Science Unit SSU with the approval of your protocol for your review This step will otherwise generally only be selected by reviewers who are using the free JBI SUMARI software but who do not have the intention of submitting a systematic review to the JBI Library The result of this selection at the Assessment phase of the review is described later see Section 20 4 SUMARI JBI 81 19 JBI QARI Studies A study is the basic unit of a review in general each review will assess many studies You may also hear the term paper or publication used to refer to a study The Study page allows users to view add and edit studies To access this page either click on the title of the systematic review on the Reviews page or select Study from the top toolbar The column on the right describes the stage reached for specific studies in the review To remove an included study open JBI CReMS and de select the checkbox for that study in the JBI QARI column see CReMS chapter of this user guide for further information on JBI CReMS QARI Qualitative and Review Instr Studies in A comprehensive literature review on emergency surgery This paga s used to manage the retneved Studies From this page Studies can ba selected to perform assessment and extraction and to davelop Findings The drop d
299. tions within the interpretive and critical paradigm Meta aggregation in JBI QARI does not distinguish between methodologies or theoretical standpoints and adopts a pluralist position that values viewing phenomena from different perspectives Qualitative meta aggregation evaluates and aggregates qualitative research findings on the basis of them being the result of rigorous research processes 14 3 Critical appraisal The major aim in critically appraising experimental or quantifiable data is to limit bias and thus establish the validity of a study From a quantitative perspective sources SUMARI JBI 71 of bias include selection bias performance bias and attrition bias and validity is assessed by establishing the extent to which a particular study design addresses potential bias This focus on limiting bias to establish validity is antithetical to the philosophical foundations of qualitative approaches to inquiry Qualitative approaches are located in diverse understandings of knowledge they do not claim to be able to distance the researcher from that which is researched and the data analysis is legitimately influenced by the researcher when they interpret the data Critical appraisal therefore focuses on 1 Congruity between philosophical position adopted in the study study methodology study methods representation of the data and the interpretation of the results 2 The degree to which the biases of the researcher are made expl
300. to appear on each page This value can be increased from 10 to 20 50 or 100 prior to any re pagination Whilst assessing or extracting studies in the system the module will now return to the page displaying the last paper assessed extracted rather than returning to the first study as was the case in SUMARI v 4 0 82 SUMARI 191 Importing study from CReMS Studies can be imported into JBI CReMS from EndNote bibliographic software and allocated to via the check box in JBI CReMS see CReMS chapter of this user guide for further information on JBI CReMS Once these studies have been assigned to JBI QARI they will be automatically exported into JBI QARI e Note that references from EndNote must be journal articles with all fields completed for the import function to be successful 19 2 Manually adding a new study to JBI CReMS or JBI QARI Studies can be manually entered into JBI QARI using the Add button at the bottom of the Studies page Fill out the standard bibliographic details of the publication Author s Title Journal Year Volume Issue if relevant and Page number The key can be used to move to the next field holding down the Shift and keys together will move backwards between fields Pressing Insert adds and saves the information and returns the user to the Studies page Studies manually entered into JBI QARI will be automatically uploaded into the JBI CReMS fiel
301. ts of participants exposure to a particular risk factor are evaluated through comparison with a group that is not exposed or with an historical control group The two most common observational study types are case control and cohort studies Many of the biases that affect experimental studies also can affect observational studies For example selection bias could occur in a case control study if the controls are not representative of the cases The issue of how confounders have been addressed in observational studies is another important consideration when determining study quality The review author must consider what design and analytical tools have been implemented to account for known confounders and what is the likely impact of any unknown confounders 236 JBI SUMARI 58 1 3 Critical appraisal tools There are a variety of checklists and tools available to assess the validity of studies Most of these use a series of criteria that can be scored as being met not met or unclear The decision as to whether or not to include a study can be made based on meeting a pre determined proportion of all criteria or on certain criteria being met It is also possible to weight the different criteria differently for example blinding of assessors to prevent detection bias may be considered to be twice as important as blinding the caregivers to prevent performance bias These decisions about the scoring system and the cut off for inclusion should
302. ts taking Panadol are 0 38 times less likely to experience pain following minor surgery than patients taking a placebo equivalent to a 62 reduction in risk Filter Results Statistics Filter by outcome Pain Effect Filter by comparison Panadol vs Placebo jv Meta analytical method Filter by studies Zar 2001 Fripp 2003 Confidence Interval Generate Graph Preferred meta view Pain Analyse Results Study Mantel Haenszel Relative Risk Risk Ratio Weight 95 Fixed Zar 2001 Fripp 2003 Hill 2002 L 20 62 0 43 0 27 0 70 Favours Treatment0 0 1 0 10 0Favours Control 19 80 0 60 0 42 0 86 59 57 0 28 0 21 0 39 A n Save to Report Save graph to disk 146 SUMARI 35 18 Study weight For dichotomous data the determination of study weight is slightly more complex than for continuous data For calculations of both OR and RR studies with larger numbers of controls that experience the outcome will have greater weighting Additionally studies with larger numbers in the intervention group not experiencing the outcome will have greater weighting but the calculations are subtly different for OR and RR In the example above the Fripp 2003 study exerts most influence on the overall effect this study has the greatest sample size and has the highest numbers of controls that experience the outcome 138 and the highest numbers of patients in t
303. ts the comparison of interest the score from the three by three matrix for each study the dominance rating and the study citation Bibliographic References 1 Drummond M Jefferson T Guidelines for authors and peer reviewers of economic submissions to the BMJ BMJ 1996 313 275 83 2 Drummond Aguiar lbanez R Nixon J Economic evaluation Singapore Med J 2006 47 6 456 61 3 Drummond MF O Brien B Stoddart GL Torrance GW Methods for the economic evaluation of health care programmes Oxford Oxford University Press 1997 4 Nixon J Khan KS Kleijnen J Summarising economic evaluations in systematic reviews a new approach BMJ 2001 322 1596 8 SUMARI JBI 221 56 Appendix Glossary of terms Benefit Cost Ratio is a ratio commonly used to describe the conclusion of a Cost Benefit study It is the ratio of the present value of benefits to the present value of costs Capital costs are incurred when major capital assets such as buildings or equipment are purchased Capital costs include the cost of equipment vehicles buildings and one time training programs Category categories are used to describe a group of findings that can be grouped together on the basis of similarity of meaning This is the first step in aggregating study findings in the JBI meta aggregation approach of meta synthesis Acomprehensive systematic review is a JBI comprehensive review is asystematic review that incorporates more than one typ
304. ttenton to AVS was Tt is unikely that most staff would take wital sign for something that s been abnormal and Credible far expected practica just anto the naxt patient and ignore it MO 4 Delete Difference n education Ths is AVS and you must do something about it The is really dolled into nursing s taft Credibie between nurses and Mos Night throughout the hospital It spread ence the MET thing came in You can t just Edt contributed to identifying document it and walk sway Whereas the doctors just say 1 have been told about that and Delete ANS as important just walk away and stil feel comfortable to do that RN 2 p68 Iti likely to missout the seen it happen a few times where someone has come in for something on ther leg and Credible identification when a patient they incidentally had pulse of 170 and they were in AF atrial fbnillation verres d Edt presented with condibon weak later with haart fadure and you sort of look Dack It all got missed although Delete associated with were sean by the specialst these ws ay m thay congas ted symptoms related to AVS pos insxpansnce of staff to had a couple of those grads you know patient s alert nothing realy wrong Credible recognise the sigrficance of with them but their blood pressure was BO 40 and they didn t think to say anything Edt a measurement they had and whan I went to them and said do you re
305. tting a predetermined plan to ensure scientific rigor and minimize potential bias e Stating review question s or hypotheses e Establishing the criteria that will be used to select the literature e Detailing a strategy to identify all relevant literature from an agreed time frame Critical appraisal of the studies retrieved e Extracting data from the primary research regarding the participants the intervention the outcome measures and the results e Pooling or generating a summary estimate of the results Statistical analysis meta analysis may or may not be used and will depend on the nature and quality of studies included in the review When statistical analysis is not possible current practice is to develop a narrative summary of the results JBI MASTARI is designed to assist with critical appraisal data extraction and data synthesis steps of the systematic review process and these steps are explained in greater detail in the following sections Steps 1 4 are addressed in the CREMS Section of this user manual These sections are targeted at explaining how rather than why JBI MAStARI conducts meta analysis Interested readers are encouraged to seek out both the JBI Reviewers Manual and the Cochrane Handbook for Systematic Reviews of Interventions Both are freely available from the respective websites SUMARI JBI 109 JBI Reviewers Manual 2011 http www joannabriggs edu au Updated July 2011 The Reviewers Manual ca
306. u 19 diuo nn der et hy agii a arr rir excluded extracted or finished tw ELLE of Citations 3 ex Zac Alan Craig Ana analysis of Journat of 2011 Included Complete Edit Ociete CREMS functionality Computing Studies Alan Zac Craig ed Another analysis of Journal of computer 2011 New Primary Edit Delete CREMS for good stucies Completed measure Craig ed Alan Zac CREMS 5 0 journal Advanced 2011 Secondary Edit Delete userguide computing Competed 1 records per page Version 5 0 Copyright Joanna Briggs Inetitute 7013 33 2 critical appraisal criteria As previously mentioned see 32 3 the critical appraisal criteria used in JBI MAStARI vary with different study designs Each of the criteria must be addressed using the Yes No Unclear Not Applicable buttons next to each checklist item Select this option if the question asked in the JBI tool is clearly not applicable to the paper being appraised Often an appraisal question will be lt Not Applicable gt to all of the papers of a particular study design which meet the inclusion criteria for a particular review SUMARI JBI 121 Alongside each appraisal question a text field lt Comment gt has also been introduced for users to insert a comment of up to 200 characters If this field is populated with text it is maintained here in the online module for user reference This text will not appear in any part of the review report in CReMS v 5
307. u do opt to use the standardized text this will automatically generate text in some of the Protocol fields At this point the review question s objective s can be revised In the Background field enter your initial literature review also detailing the rationale for the review and its relevance to health care The specific criteria related to the participants phenomena of interest and context outcome of the review also be entered and edited Read the text carefully throughout Users are prompted in the text where modification of the set text may be necessary This is indicated by instructions between hash characters Review Summary Protocol Studies Report Builder Report View Review title inserted here Qualitative QARI Set Text Textual NOTARI Set Text Economic 71 ACTUARI Set Text A Review Question The objective s of this review is are to identify the findings of describe 4 Background Inclusion Criteria Types of Participants This review will consider publications that include describe participants Types of Intervention s p s This review will consider publications that describe insert text phenomena of interest Type of outcome if any Type of Study This review will consider expert opinion discussion papers position papers and 1 other text 36 JBI SUMARI Any of the text on the protoc
308. udies published insert dates will be considered for inclusion in this review The databases to be searched include insert text The search for unpublished studies will include insert text Initial keywords to be used will be insert text for authenticity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute Narrative Opinion Assessment of Methodological Quality Papers selected for retrieval will be assessed by two independent reviewers and Text Assessment and Review Instrument JBI NOTARI Appendix V Any disagreements that arise between the reviewers will be resolved n through discussion or with a third reviewer Data Collection Data will be extracted from papers included in the review using the standardised data extraction tool from JBI NOTARI Appendix The data extracted will include specific details about the phenomena of interest populations study methods and outcomes of significance to the review question and specific objectives involve the aggregation or synthesis of conclusions to generate a set of statements that represent that aggregation through assembling and categorising these conclusions on the basis of similarity in meaning These categories are then subjected to meta synthesls in order to produce L single comprehensive set of synthesised findings that can be used as a Data Synthesis Textual data will where
309. udy is collected in the form of extractions and individual findings with illustrations from studies the findings can be allocated to user defined categories To do this the reviewer needs to read all of the findings and identify similarities that can then be used to create categories of one or more findings Findings for Abbott Burns Gleadell Gunnell British Journal of Community Nursing 2007 All Findings fw Some patients prefer not sure how ethical it is But it gave her peace of mind Abott et ai 2007 p 10 There Credible use unne testing tp few patients that 1 have been to who have unne sticks But that is very much their own business and 1 don t get involved Abort at al 2007 p 10 Edit Delete 1 10 records per page Categorization is the first step in aggregating study findings and moves from a focus on individual studies to consideration of all findings for all studies included in the review 23 1 Creating categories On the top menu bar select Categories to open the Categories page which lists all the findings and illustrations for the review If categories have previously been added these will be listed in the far right column QARI Qualitative Assessment and Review Instrument Study Findings for Comprehensive literature review on Recognising and Responding to the Deteriorating Patient in Acute Hospitals Fiter by category Al Miar A faslin
310. uity between the research methodology and the methods used to collect data Are the data collection methods appropriate to the methodology For example A report may state that the study pursued a phenomenological approach and data was collected through phenomenological interviews There is congruence between the methodology and data collection A report may state that the study pursued a phenomenological approach and data was collected through a postal questionnaire There is incongruence between the methodology and data collection method here as phenomenology seeks to elicit rich descriptions of the experience of a phenomena that cannot be achieved through seeking written responses to standardized questions 20 2 4 Congruity between the research methodology and the representation and analysis of data Are the data analyzed and represented in a way that is congruent with the stated methodological position For example Areport may state that the study pursued a phenomenological approach to explore people s experience of grief by asking participants to describe their experiences of grief If the text generated from asking these questions is searched to establish the meaning of grief to participants and the meanings of all participants are included in the report findings then this represents congruity 90 SUMARI e The same report however focus only on those meanings that were common to all participants and discar
311. ule for user reference This text will not appear in any part of the final review report in CReMS v 5 0 Once the form is saved click lt Update gt upon re entering the assessment all of the text entered in the Comment field will appear for easy reference when the mouse is hovered over the text box Click lt Undo gt to clear all of the information entered on the screen N B This will clear the entire appraisal form also including the details added to the lt Comment gt field Click on the lt Update gt button to save the assessment or lt Cancel gt Both buttons will return the user to the Assessment screen Following assessment by each reviewer the lt Add Primary gt and lt Add Secondary gt buttons will become lt Edit Primary gt and lt Edit Secondary gt respectively allowing the reviewer to make alterations to their assessment After the primary and secondary reviewers have completed their assessment the primary reviewer is required to complete a final assessment At this stage the Assessment column on the list of studies page will state Awaiting Final to show that the primary reviewer can now perform their final assessment QARL Qualitative Assessment and Review Instrument Studies in A comprehensive literature review on emergency surgery This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Findings
312. ussion is aimed at facilitating learning to enhance future performance and ultimately improving patient outcomes This is achieved in part by providing an opportunity to clarify the learner s knowledge and rationale for actions during the simulation experience Debriefing is considered critical to experiential learning as it encourages the learner to reflect on their performance and construct meaning from that experience with a view to clinical improvement 27 In a recent systematic review of high fidelity simulation literature Issenberg et al reported that 51 studies listed educational feedback during debriefing as the single most important feature of simulation based medical education However the effectiveness of the debriefing process may potentially be compromised by behaviors such as the use of ridicule focusing on errors and non constructive criticism 8 232 JBI SUMARI issues highlighted here along with the limited number of empirical studies illustrate the gaps that currently exist in relation to the effectiveness of debriefing in simulation based learning in the healthcare setting A search Cochrane Database of Systematic Reviews and Joanna Briggs Library of Systematic Reviews did not identify any systematic reviews focusing on simulation debriefing This presents an opportunity for systematically searching synthesizing and summarizing the best available evidence on the effectiveness of debriefing in simulation based le
313. usually covers the theoretical underpinnings of the research A list though not exhaustive of commonly used qualitative methodologies has been provided below In a review it is useful to add further detail such as the particular perspective or approach of the author s Such as Critical or Feminist ethnography Action Description Subjectivity Structures of Analytical Consciousness Ethnography Phenomenology Conceptual Analytical Grounded Theory Ethnomethodology Action Research Discourse Analysis Case Studies Phenomenography Biographical Textual Narrative Descriptive NENNEN Cultural Media Analysis Program Evaluation NENNEN Deconstructive Analysis 94 SUMARI 21 1 2 Method The Method is the way in which the data was collected Multiple methods of data collection may be used in a single paper these should all be stated By way of example a list of methods though not exhaustive is provided below Individual Interview Focus Group Interview Field Notes e Journal e Participatory Observation e Non Participatory Observation Be sure to specify if for example you choose individual interview what type of interview open ended semi structured face to face telephone etc 21 1 3 Phenomena of interest Intervention Phenomena of interest are more likely to be the focus in a QARI review A phenomenon of interest is the experience event or process occurring that is under study such as response to pain
314. veness Health Policy 2009 New None Edit Delete 1 5 E records per page Studies in Cost minimization analysis of intracervical prostaglandin for cervical ripening in an outpatient versus inpatient setting A systematic review This page is used to manage the retrieved Studies From this page Studies can be selected to perform assessment and extraction and to develop Findings The drop down box can be used to filter studies as new included excluded extracted or finished E of Citations 2 CIEN ee actions Farmer cost minimization analysis of intracervical prostaglandine for cervical ripening Clinical Therapeutics 1996 Extraction Complete Edit etal in an outpatient versus inpatient setting Basskin Cost minimization of intracervical prostaglandin for cervical ripening epu GRE is 1 50 v records per page Amongst the changes on this screen an Actions column has been added with SUMARI JBI 203 functions alongside each study At the bottom of the page you will also see you are able to select the number of studies to display on each page Click on the lt 10 gt value box to indicate how many studies you would like to appear on each page This value can be increased to 20 50 or 100 prior to any re pagination Whilst assessing or extracting studies in the system the module will now return to the page displaying the last paper assessed extracted rather than returning to the
315. volve our infection control personnel One of the Edi great successes of this project was the tremendous response of our environmental services people p 515 of the principles we stated at the beginning of the project i that we would add Credible personnal order to make this work We did not add any nurses or other personnel tat throughout our entire project P515 1 i i i process rides may bs associated with moroed patent sabalacbon and statt aanatacnan oordnated multidisciplinary required in Ueducing NOT in OF process Indesign te introduces OS process rodezgn without Organisdbons need Lo provide a reward syatem for the staff ho are dedicated in implementation of OR a dea ma ac ae 0 misma amia ca nd ccetianct Gane Click Delete to erase a conclusion previously entered for a publication A prompt asking you to confirm the operation will appear prior to deletion SUMARI JBI 179 Heviews Publication Categories have more proving on tir as better sa 445 Returning to the Publications page Within the Conclusions page pressing the Return button closes the Conclusions page and returns the user to the Publications page If there is unsaved information in the edit area of the Conclusions page a prompt will open asking whether the user wants to discard the unsaved info
316. will be automatically created when a JBI CReMS review has at least one of the studies included in the review assigned to JBI ACTUARI More information about creating new reviews and assigning studies to analytical modules in JBI CReMS is available in the JBI CReMS user manual When a new Review is entered into the system whether via the ACTUARI analytical module or via CReMS it will appear as the first record in the list of reviews rather than the last as was the case across the SUMARI v 4 0 analytical modules This page lists the Reviews that are in the system To add a review click on the Add button below To edit or delete a Review click the appropriate link under the Actions column of Reviews 9 Descri Year Primary Secondary ferente foes een tee New Economic What is the cost effectiveness of X compared with Y for Z patients Systematic m 2011 catalini catalin2 Edit Delete Cost minimization This is a systematic review of cost minimization studies of intracervical analysis of prostaglandin for cervical ripening in an outpatient versus inpatient intracervical setting prostaglandin for d D EET 2010 catalini catalin2 Edit Delete cervical ripening in an outpatient versus inpatient setting A systematic review 52 2 Deleting a Review from the ACTUARI Analytical Module Click lt Delete gt from within the Actions column to delete the entire review project SUMARI JBI 197 from the JBI database When
317. will give similar overall results When heterogeneity is present the random effects estimate provides a more conservative estimate of the overall effect size and is less likely to detect significant differences For this reason random effects models are sometimes employed when heterogeneity is not severe however the random effects model does not actually analyze the heterogeneity away and should not be considered as a substitute for a thorough investigation into the reasons for the heterogeneity Additionally random effects models give relatively more weight to the results of smaller studies this may not be desirable because smaller studies are typically more prone to bias and of lower quality than larger studies 246 SUMARI 58 3 17 What to do when heterogeneity is indicated Statistical heterogeneity as designated by significance either P lt 0 05 or 0 10 depending on the level that you are comfortable with in the test of homogeneity suggests that there is not one single treatment effect rather a range of treatment effects and thus it is not appropriate to attempt to calculate a single treatment effect Deeks Higgins and Altman 2006 provide six alternatives to conducting meta analysis when heterogeneity is indicated 1 Double check the data entered into JBI MAStARI and extracted from included studies Possible errors could include using the incorrect units or not standardizing units of measurement between your studies
318. with all of the citations available to be inserted as references in the document These citations available must be selected as a reference To do this click on the Reference tick box in the studies screen see Section 8 thereby identifying it as available to be inserted as a reference in the text of the protocol or report To insert the reference select the citation to highlight it and click Insert Multiple citations can be inserted simultaneously by holding down the lt gt key whilst selecting SUMARI JBI 45 n Review Question The qualitative objective is to identify and describe the patient experience perception imaging Bolejko A C Sarvik et al Meeting patient information needs before magneti Brand KP How well is your patient prepared for an MRI 1994 Cooke R E Peel etal The neuroimaging research process from the particip Davies C and Channon Deaf patients in the medical imaging depart Laidlaw A Henwood S Patients with multiple sclerosis their experiences and Leithner K 5 Pornbacher et al Prenatal magnetic resonance imaging Towa Murphy F Lay beliefs and knowledge of medical imaging procedures 2001 25 Murphy F Understanding the humanistic interaction with medical imaging tech Murphy F Act scene agency The drama of medical imaging 2009 Ollivier L Apiou F Leclere J Sevellec M Asselain Bredart A Neu
319. within a java based Applet This will require some time to load The first time it is opened warning messages may appear on the screen Tick the box to Always trust content from this publisher and then click lt Run gt An example is below Two such warnings may appear MASUR Meta Analysis of Statistics Assessment and Review Instrument The application s digital signature cannot be verified wy Do you want to run the application eiua i ree th ener nh may fad ut panana rah Rim th appe Frm See tet Users will see a meta view graph displayed when the applet displays on screen This entry graph does not display statistical meta analysis as you will notice it is without the overall summary estimate of effect You will also notice a title label appears above the figure which corresponds to the Review Outcome Title see Section 34 3 This figure can be Saved to the report or Saved to disk see below without performing the actual meta analysis of the data For example users may prefer to present such a figure if studies are too heterogeneous to warrant statistical combination SUMARI JBI 135 MASTARI Meta Analysis of Statistics Assessment and Review Instrument Reviews me rores z Anaoa Ronne Study Mantel Relative Risk Risk Ratio Weight CI 95 Fixed Lapidus et ai 2007 43 89 0 78 0461
320. ws of clinical trials a critical appraisal of guidelines and practice Journal of Health Services amp Research Policy 2002 Jan 7 1 51 61 Higgins JPT Thompson SG Deeks JJ Altman DG Measuring inconsistency in meta analyses BMJ 2003 Sep 6 327 7414 557 60 Moher D Pham B Jones A Cook DJ Jadad AR Moher M et al Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta analyses Lancet 1998 352 609 13 Song F Sheldon TA Sutton AJ Abrams KR Jones DR Methods for exploring heterogeneity in meta analysis Evaluation amp the Health Professions 2001 Jun 24 2 126 51 Thompson SG Sharp SJ Explaining heterogeneity in meta analysis a comparison of methods Statistics in Medicine 1999 Oct 30 18 20 2693 708 SUMARI JBI 149 NOTARI 36 Introduction to JBI NOTARI 36 1 JBI NOTARI and its use in the systematic review of evidence The Joanna Briggs Institute Narrative Opinion and Text Assessment and Review Instrument JBI NOTARI approach to reviewing text derived from sources other than research is a simplified adaptation of content and modified discourse analytical procedures to establish a process that enables reviewers to synthesize the conclusions drawn on a particular health care intervention or activity in narrative opinion or other textual form The JBI NOTARI approach to reviewing non research text requires reviewers to consider its validity as a source of guidance for practi
321. y are at this function includes the capacity to filter for included or excluded papers NOTARI Narrative Opinion and Text Assessment and Review Instrument Publications in A comprehensive literature review on emergency surgery This page is used to manage the retrieved Publications From this page Publications can be selected to perform assessment and extraction and to develop Conclusions Tine irap dei Dora bu 00 Bir uode haw included excluded extraction or finished a New Excluded vae di EB pm ee a Actoni Austraben Safety and Bref review l ast track Review from the Royal Australaman College of 2009 Extraction Complete Regater of New Delete Interventenal Procedures recovery after Surgical ARSCRNIP 2 ERAS programs Poggath Ret al WSES SM World Society World 3 Emerg Surg 2009 New Awaiting of Emergency Final Delete Summer Meeting ts surgery around the world From the Publications screen select New from the drop down list This will filter the view so only publications not yet assessed are displayed The Assessment column indicates what is required to complete the assessment All publications the review SUMARI JBI 173 assessment has been done either by primary reviewer or secondary reviewer The final assessment has been completed and the publication is included Extraction The data have been extracted 42 4 Assessment in a Non JBI
322. y be less specific Asking answerable clinical questions is not as easy as it sounds but it is a skill that can be learned Generally speaking although health professionals often want to answer very broad questions the narrower a question is the easier it may be to address in a review If the reviewers are interested in finding out the most effective appropriate and feasible way of improving the quality of life of people with emphysema it is desirable to conduct a series of reviews based on specific focused questions rather than a broad all encompassing review that includes different populations interventions and outcomes 57 1 3 Inclusion Criteria The protocol must describe the criteria that will be used to select the literature It is important to be precise in defining the inclusion criteria as the reader of the review report needs to know the focus and limitations of the review Specifically in developing inclusion criteria it is important to address The types of studies to be included for example randomised controlled trials pseudo randomised controlled trials or interpretive studies The intervention activity or phenomena for example the nasal inhalation of steam The comparator for effectiveness reviews e The context for qualitativereviews e The outcome for example measurement of nasal secretions or patient experiences e The specific study populations for example adult males aged 18 years
323. ynthesis once a review has been selected and the prior steps in data extraction undertaken see Section 46 lt Logout gt will take users to a confirmation screen before exiting the NOTARI program lt About gt links to a summary of the review process 40 JBI NOTARI Reviews Reviews are the projects that Publications Extractions and Conclusions are related to The Reviews page lists the reviews that are in the system This page is used to add new to edit existing or to cancel reviews An Actions column has been introduced in NOTARI v 5 0 which replaces the Edit column that was in SUMARI v 4 0 The number of reviews is also displayed At the bottom of the page you will also see you are able to select the number of reviews to display on each page The status column that appeared on the Reviews page in SUMARI v4 0 has been removed in SUMARI v 5 0 NOTARI Narrative Opinion and Text Assessment anid Review Instrument SR of seit What is the best available evidence of the appropnatensss menitenng blood mearingfuiness and effectiveness of self monstonng of blood in patents craig tan Glucose in patents with type 2 diabetes 2008 ne ockwood Delete with type Il diabetes Meanigfuness of What are the meaningfulnes of assisted bathing for older adults with assisted bathng for dementia and thee caregvers emt cider adults with 2010 ne Stem dementia and their Dieta caregwers What are the issues in relation to

User Manual: Version 5.0 - Joanna Briggs Institute

Contents

Download Pdf Manuals

Related Search

Related Contents