Conducting a systematic review is a time and effort-consuming project (Borah, R. et al., 2017, BMJ Open, 7(2), e012545).  A 2011 Institute of Medicine (IoM) report identifies eight standards necessary to produce high quality, rigorous and objective systematic review.  As this report states, "the initial steps in the systematic review process define the focus of the complete review and influence its ultimate use in clinical decision making" (IoM (US), 2011, Committee on Standards for Systematic Review of Comparative Effectiveness Research).

The summary below details steps, prescribed and in some cases required by publishers and organizations, such as Cochrane Collaboration, Joanna Briggs Institute, and IoM:

Step 1:  Preliminary topic investigation

Conduct a preliminary topic investigation to determine how many studies are available on the topic.  This step includes investigating whether any other systematic reviews on the topic are registered, or have been published already.

There are different strategies and tactics to consider if an existing review requires an update.  Studies and reviews, resulted from the preliminary literature review need to be carefully recorded and analyzed.  A summary of these findings needs to be transcribed, and will contribute to the background portion of the future publication.  These findings will be essential to the formulation and focus of the research topic and question(s).

Step 2:  Research question development

Finalize formulation of the research topic and question(s), following confirmation of the need for a review, or an update for an existing review. 

Question development frameworks are used to craft well-built research questions by defining the concepts that make up the question. PICO (Population, Intervention, Comparison, Outcome) is a common framework used in systematic reviews. Although, there are alternative question structures for different type of systematic reviews that should be considered. 

Step 3:  Build a team

Establish a team with appropriate demonstrated expertise to conduct a systematic review.  While the size of the team and distribution of responsibilities may vary, all of the established systematic review standards emphasize the importance of a well-balanced and experienced review team.  The essential skills and competencies for a systematic review team must include knowledge of topic/subject area, expertise in systematic review methods, expertise in searching for evidence, expertise in quantitative and qualitative analyses, and writing skills.

Note for Step 3: The IoM report specifically addresses the importance of including management of the Conflict of Interest (COI) into the process of creating a team.  It includes full disclosure of potential COI and professional or intellectual bias, followed by the exclusion of members with identified COI.

Step 4:  Be cognizant of standards

Explore and consider existing systematic review standards.  The PRISMA and PRISMA-P are currently the most endorsed standards for documenting and reporting systematic reviews.  Other guidance from organizations such as Cochrane, AHRQ, IoM, or relevant to subject area associations may need to be considered as well.  It is also important to investigate submission guidelines and requirements for protocol registration and publication.

Step 5: Identify tools  

Identify the tools and resources necessary to conduct a systematic review, as well as the availability of and access to technology and content.  You may also identify existing or needed expertise in using these tools and resources by the team members.

Step 6: Develop a protocol

 Develop a systematic review protocol.  Make the final copy of the protocol publicly available, preferably in designated register such as PROSPERO, the International Prospective Register of Systematic Reviews.

For systematic review manuals, knowledge base articles, tools and resources, follow the 'systematic review' link below, look at resources linked to this article, or search this website.