Conducting systematic reviews of association (etiology): The Joanna Briggs Institute's approach
Abstract
The systematic review of evidence is the research method which underpins the traditional approach to evidence-based healthcare. There is currently no uniform methodology for conducting a systematic review of association (etiology). This study outlines and describes the Joanna Briggs Institute's approach and guidance for synthesizing evidence related to association with a predominant focus on etiology and contributes to the emerging field of systematic review methodologies. It should be noted that questions of association typically address etiological or prognostic issues.The systematic review of studies to answer questions of etiology follows the same basic principles of systematic review of other types of data. An a priori protocol must inform the conduct of the systematic review, comprehensive searching must be performed and critical appraisal of retrieved studies must be carried out.The overarching objective of systematic reviews of etiology is to identify and synthesize the best available evidence on the factors of interest that are associated with a particular disease or outcome. The traditional PICO (population, interventions, comparators and outcomes) format for systematic reviews of effects does not align with questions relating to etiology. A systematic review of etiology should include the following aspects: population, exposure of interest (independent variable) and outcome (dependent variable).Studies of etiology are predominantly explanatory or predictive. The objective of reviews of explanatory or predictive studies is to contribute to, and improve our understanding of, the relationship of health-related events or outcomes by examining the association between variables. When interpreting possible associations between variables based on observational study data, caution must be exercised due to the likely presence of confounding variables or moderators that may impact on the results.As with all systematic reviews, there are various approaches to present the results, including a narrative, graphical or tabular summary, or meta-analysis. When meta-analysis is not possible, a set of alternative methods for synthesizing research is available. On the basis of the research question and objectives, narrative, tabular and/or visual approaches can be used for data synthesis. There are some special considerations when conducting meta-analysis for questions related to risk and correlation. These include, but are not limited to, causal inference.Systematic review and meta-analysis of studies related to etiology is an emerging methodology in the field of evidence synthesis. These reviews can provide useful information for healthcare professionals and policymakers on the burden of disease. The standardized Joanna Briggs Institute approach offers a rigorous and transparent method to conduct reviews of etiology.
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Twenty articles (22%) gave recommendations on the key item "research question", with publication dates between 1997 and 2015 (median year 2009).
“Twenty articles (22%) gave recommendations on the key item “research question” [29, 30, 35, 36, 38–43, 45–54], with publication dates between 1997 and 2015 (median year of publication 2009).”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [41]
Aspects frequently mentioned as important to address in the research question were the population, exposures or interventions, and outcomes.
“Aspects that were frequently mentioned as important to address were the population, exposures or interventions, and outcomes [38–41, 43, 47, 48, 50, 54].”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [41]
The articles recommended that the protocol should state the objectives, hypotheses to be tested and the rationale of the review, describe eligibility criteria, define the type of studies to be included, and give the reason when including observational studies in the review.
“The articles recommended that the protocol should state the objectives, hypotheses to be tested and the rationale of the review, [29] and that it should describe eligibility criteria [29, 33, 35, 36, 38, 39, 41], define the type of studies to be included [35, 37, 42, 44], and give the reason when including observational studies in the review [35, 37, 40].”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [41]
It was recommended that the protocol should define the methods to be used for risk of bias assessment, meta-analysis and exploration of heterogeneity.
“Additionally, it was recommended that the protocol should define the methods to be used for risk of bias assessment, meta-analysis and exploration of heterogeneity [41, 42, 44].”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [41]
Twenty-two articles (24%) provided recommendations on the key item "study eligibility", with publication dates between 1995 and 2016 (median year 2009).
“Twenty-two articles (24%) provided recommendations on the key item “study eligibility”, [12, 29, 30, 33, 34, 37–39, 41–43, 46–48, 54, 55, 61, 65, 70–73] with publication dates between 1995 and 2016 (median year of publication 2009).”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [41]
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- Authors
- Moola, S., Munn, Z., Sears, K., Sfetcu, R., Currie, M., Lisy, K., Tufanaru, C., Qureshi, R., Mattis, P., & Mu, P.
- Affiliations
- Australian National University (AU)
- The University of Adelaide (AU)
- Queen's University (CA)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Moola, Sandeep
- Venue
- International Journal of Evidence-Based Healthcare
- Published
- 2015-09
- Volume
- 13
- Issue
- 3
- Pages
- 163-169
- ISSN
- 1744-1595 (ISSN-L)
- 1744-1609
- OpenAlex
- W2402421755
- Cited by
- 849
- References
- 6
- Citations by year
- 2026: 164 · 2025: 181 · 2024: 166 · 2023: 107 · 2022: 89 · 2021: 72 · 2020: 30 · 2019: 18 · 2018: 12 · 2017: 7 · 2016: 3
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Evidence-Based Healthcare (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Health Professions › Health Information Management › Methodologies in Health Research and Practice
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- etiology, risk factors, PICO, exposure-outcome association, confounding, causal inference, evidence synthesis, Joanna Briggs Institute, disease burden, prognostic factors
- MeSH terms
- Humans, Research Design, Review Literature as Topic, Bias, Causality, Guidelines as Topic, Evidence-Based Medicine, Empirical Research
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