I'm performing a systematic review of cosmetic gynecology procedures. There is very little if any Level I evidence in this area. The majority of literature is based on single provider experiences and case reports. As such the goal of this systematic review is to raise awareness an publish the current literature that is available on this topic.
After running a search with my current criteria:
This study population includes all patients who underwent a cosmetic gynecology procedure.
Inclusion Criteria:
1) A Cosmetic Gynecology Procedure (as defined above) where a technique is described and either outcome (cosmetic/functional) or adverse event data is reported.
2) Must have data on at 3 or more subjects (not a case report).
3) Written in English language (or have translation readily available)
Exclusion Criteria:
1) Any studies that do not meet the above criteria
2) Technique or descriptive review paper that does not contain any patient data.
I have somewhere on the order of 60 documents for review.
My question is can this all feasibly be reviewed in one systematic review paper?
And in the paper would it be best to have a table that describes overview and results of each study?
Bobby - 60 would be hard to manage and make for a 'bulky' publication. I'm wondering if there is such a 'plethora' of studies available - has a systematic review not already been done before and, if so, how recent? Yes - tabulated information is usually required for reviews i.e. PRISMA, CASP etc. Many readers just want the summary information. If a recent review hasn't been conducted - my advice would be to adjust the inclusion criteria and filters so that you end up with a more manageable corpus.
Alternatively, do a scoping review rather than a systematic review. By the sound of it, the type of documents you have found are not suited to a systematic review.
60 sounds like a high number to include in the paper. Can you further eliminate for bias, years, etc?
Dean Whitehead Adrian Esterman Lance Michael Mabry
Thank you very much for your input. The goal of this project is to bring awareness to the variable outcomes assessed and complication profile of these procedures. I will adjust inclusion criteria to obtained a more tailored product.
I do not think the number in itself is an issue. I have seen reviews with larger number of studies included. It appears your literature is heterogenous and may require a narrative summary.
I would be reluctant to change the inclusion criteria post hoc.
Consider reporting heterogeneity and reasons for it as your main findings to inform better planning for future studies.
Usually, we refine the inclusion and exclusion criteria, not based on personal views. There is a lot of work that should be considered by the researchers to improve their inclusion and exclusion criteria. These include: (1) what other studies in this area have considered as inclusion and exclusion criteria and how your study should not aim at repeating what was done unless there are obvious reasons, (2) types of studies available in the literature, for example, if only 2-3 randomised control studies were found, you might here want to add control studies as well. But maybe not all control studies are suitable, and you need to add an item to define which control studies to be used, (3) sharpening the focus of the systematic review. If there is no focus from what you are including, go to your research question and redefine it and modify or add new item in the excursion criteria, (4) look again into the meaning of the research question, the studies to be included and the meaning of the systematic review and whether more adjustment is needed. The process requires a lot of skills, and I advice working with an expert in systematic reviews. This stage must be correctly completed. Good luck, Prof Samy Azer
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