Kumarkrishna - given the context that you present, it shouldn't be that difficult to develop a PICO/T-related question. Perhaps the example offered on page 63 of this attached chapter might assist?

Hello Dean,

Thank you for providing the relevant literature..

However, being a systematic review on the psychotic adverse events induced by cycloserine I am not very sure how to formulate the C.. I could mostly fetch case stories about the patients who were subjected to cycloserine as part of their treatment for MDR-TB.. It becomes difficult to use a comparator for the PICO/T question.. So, what can be done in this case.. I understand here the P is the population that was administered cycloserine, I is the intervention cycloserine and O outcome is adverse events.. But, what about C?

Firstly see what type of sys rev you are going to conduct:

Article What kind of systematic review should I conduct? A proposed ...

It is tricky to do a systematic review of case reports. I advise you to read the recent discussion here:

1) https://www.jiscmail.ac.uk/cgi-bin/webadmin?A1=ind1801&L=evidence-based-health#29

2) https://www.jiscmail.ac.uk/cgi-bin/webadmin?A1=ind1801&L=evidence-based-health#30

3) https://www.jiscmail.ac.uk/cgi-bin/webadmin?A1=ind1802&L=evidence-based-health#26

From this discussion I am quoting from Mohammed T Ansari: "Clinical trials are not usually designed to analyze long-term rare adverse events . Such adverse event data is often reported spontaneously as journal/grey lit published case reports. Post Market phamarcovigilance programs of regulatory agencies analyze this data. Case reports indeed are invaluable in this regard. In such instances, causality assessment is patient level, not group level. One relevant too for casualty assessment of case reports is this:

https://www.who-umc.org/media/2768/standardised-case-causality-assessment.pdf

Another is the "Naranjo algorithm"...and there are others."

Thing to consider:

1) Methodological quality of case reports

1a) http://ebm.bmj.com/content/early/2018/02/02/bmjebm-2017-110853

1b) http://www.equator-network.org/reporting-guidelines/care/

1c) https://reviewersmanual.joannabriggs.org/display/MANUAL/Appendix+4+Critical+appraisal+checklist+for+case+reports

2) You could perform IPD meta-analysis in certain situations

http://www.bmj.com/content/340/bmj.c221

3) Haw a look at similar literature

Here is a meta-analysis of case reports:

https://link.springer.com/content/pdf/10.1186/1752-1947-2-317.pdf

Here are more similar case report SRs:

https://www.google.co.uk/search?q=%22systematic+review+of+case+reports%22