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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #233769

Title: Application of systematic review methodology to the field of nutrition

Author
item Lichtenstein, Alice
item Yetley, Elizabeth
item Lau, Joseph

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/18/2008
Publication Date: 12/1/2008
Citation: Lichtenstein, A.H., Yetley, E.A., Lau, J. 2008. Application of systematic review methodology to the field of nutrition. Journal of Nutrition. 138(12):2297-2306.

Interpretive Summary: Systematic reviews can be a useful tool for the nutrition community. By summarizing a large amount of data in an unbiased way, they offer a rigorous and clear option for reviewing and potentially updating rapidly changing topics. They can be useful for developing clinical and public health guidelines, setting research agendas, formulating scientific consensus statements, identifying the state of science including knowledge gaps and associated research needs, supporting development of science-based recommendations, and serving as the foundation for updates as new data emerge. The use of the systematic reviews approach for nutrition related topics has lagged behind their use in clinical medicine. The advantages of systematic reviews are that they provide independently-conducted comprehensive and objective assessments of available information. The disadvantage is that their use is limited to addressing precise, rather than general, questions. The objective of this work was to describe the steps for performing systematic reviews and highlight areas unique to the discipline of nutrition important to consider in data assessment. The steps addressed in this document include identifying staffing and planning for outside expert input, forming a research team, developing an analytic framework, developing and refining research questions, defining eligibility criteria, identifying search terms, screening abstracts according to eligibility criteria, retrieving articles for evaluation, constructing evidence and summary tables, assessing methodological quality and applicability, and synthesizing results including performing meta-analysis, if appropriate. With respect to the field of nutrition, researchers and policy makers are faced with factoring in such variables as baseline nutrient exposure, nutrient status, bioequivalence of bioactive compounds, bioavailability, multiple and interrelated biological functions, undefined nature of some interventions, and uncertainties in intake assessment. In summary, systematic reviews are valuable and independent components to decision making processes by groups responsible for developing science-based recommendations and policies.

Technical Abstract: Systematic reviews represent a rigorous and transparent approach of synthesizing scientific evidence that minimizes bias. They evolved within the medical community to support development of clinical and public health practice guidelines, set research agendas and formulate scientific consensus statements. The use of systematic reviews for nutrition related topics is more recent. Systematic reviews provide independently-conducted comprehensive and objective assessments of available information addressing precise questions. This approach to summarizing available data is a useful tool for identifying the state of science including knowledge gaps and associated research needs, supporting development of science-based recommendations and guidelines, and serving as the foundation for updates as new data emerge. Our objective is to describe the steps for performing systematic reviews and highlight areas unique to the discipline of nutrition important to consider in data assessment. Steps involved in generating systematic reviews include identifying staffing and planning for outside expert input, forming a research team, developing an analytic framework, developing and refining research questions, defining eligibility criteria, identifying search terms, screening abstracts according to eligibility criteria, retrieving articles for evaluation, constructing evidence and summary tables, assessing methodological quality and applicability, and synthesizing results including performing meta-analysis, if appropriate. Unique and at times challenging, nutrition related considerations include baseline nutrient exposure, nutrient status, bioequivalence of bioactive compounds, bioavailability, multiple and interrelated biological functions, undefined nature of some interventions, and uncertainties in intake assessment. Systematic reviews are a valuable and independent component to decision making processes by groups responsible for developing science-based recommendations and policies.