In this study, we identified and evaluated the usability of software tools that support T&Ab screening for systematic reviews within healthcare research. We expect that some variation in the order of their implementation will occur, especially as less experienced reviewers attempt to apply the practices. We have identified a large number of software tools that support T&Ab screening for systematic reviews within healthcare research. The PRISMA flow diagram in used in this study to report the number of software tools at each stage of the selection process. Adding many of these terms provides further reassurances and ease of use to the screeners, and they improve the text‐mining functionality. Data sources. We consider large‐evidence reviews those above one thousand citations found in the search process, either from online databases, gray literature searches, reference harvesting, or contacting authors. Medical students were randomly allocated to title and abstract screening using one of the four modalities and required to screen 650 citations from a single systematic review update. This is done separately by each reviewer to ensure minimal bias. Collecting qualitative data as well, such as the free text about the strengths and weaknesses of each tool, makes it possible to investigate in more depth the reasons for the quantitative scores. For optimizing the step of citation screening for systematic reviews, we are developing abstrackr: a free, open-source, web-based application for facilitating citation screening for systematic reviews. More generally, most of the tools had the features grouped under the theme “screening support” (T3) well implemented. This is done separately by each reviewer to ensure minimal bias. Repeat as necessary until team reaches consensus. In: Proceedings of the 18th International Conference on Evaluation and Assessment in Software Engineering. Objective To estimate the extent of overdiagnosis (the detection of cancers that will not cause death or symptoms) in publicly organised screening programmes.. Design Systematic review of published trends in incidence of breast cancer before and after the introduction of mammography screening.. Data sources PubMed (April 2007), reference lists, and authors. We make this suggestion for several reasons. The “upload terms” tab, under the Admin tab, allows a manager to input certain terms that will be highlighted in the abstract when users are screening. Create an abstract screening tool with questions that are clear and concise. Evaluating Abstrackr, a semi‐automated online screening program for systematic reviewers, Pinpointing needles in giant haystacks: use of text mining to reduce impractical screening workload in extremely large scoping reviews. No matter how exact and unambiguous the screening tool, the screeners will disagree on which abstracts should be screened in or out. User experiences of the tool Rayyan, Faster title and abstract screening? Abstract en. We have found it particularly effective to encourage screeners to consider ways to use the database for tangential projects. A review manager, therefore, may use this information to calculate agreement rates as a group or by the individual. Combining human and machine effort, Handsearching the journal of the royal army medical corps for trials, When and why incentives (don't) work to modify behavior. We also suggest that all “yes” and all “no” answers result in the same action (ie, contributes toward being eligible or toward being ineligible) for each question. Meta‐Analytic Procedures for Social Research, Preferred reporting items for systematic review and meta‐analysis protocols (PRISMA‐P) 2015: elaboration and explanation, Systematic searching for environmental evidence using multiple tools and sources, The PRISMA statement for reporting systematic reviews and meta‐analyses of studies that evaluate health care interventions: explanation and elaboration, Deploying an interactive machine learning system in an evidence‐based practice center, Proceedings of the 2nd ACM SIGHIT Symposium on International Health Informatics—IHI'12, Rayyan—a web and mobile app for systematic reviews, Covidence—accelerate your systematic review, EPPI‐Reviewer 4: Software for Research Synthesis, A large scale study of SVM based methods for abstract screening in systematic reviews, Document Analysis and Recognition (ICDAR), A critical analysis of studies that address the use of text mining for citation screening in systematic reviews, Proceedings of the 20th International Conference on Evaluation and Assessment in Software Engineering—EASE'16, Living systematic reviews: 2. Radial diagrams, showing the scores of the six best performing tools across the eight themes (as identified in Table 1) can be found in the (Additional file 4: Figure S1). To illustrate our screening process, Table 2 delineates various milestones achieved during our abstract screening process. All the respondents indicated that Abstrackr, Rayyan and Covidence performed well and made screening easier (or much easier) than using a spreadsheet. In response to the growing need for support for T&Ab screening, a large number of software tools have been developed to facilitate this stage of the systematic review process. To illustrate, a reviewer might change these two questions to (a) “Was the study published on or after 1987?” and (b) “Was the study an evaluation of an ADHD‐symptom reduction medication?”. Evaluating software engineering methods and tools, part 7: planning feature analysis evaluation. We are grateful to Emma Lawlor, Sarah Kelly, Ben Paxton and Rebecca Dennison for all their help. The question “Does the abstract indicate that adults over 18 were sampled and that the sample was from a general population?” asks about the age of the sample as well as the sample's characteristics. For the largest‐scale review (n = 10 000 citations found), the difference in total time is 62.5 hours. Review team members will find screening large numbers of study abstracts a tedious task. Background: Delirium is a frequent form of acute brain dysfunction in mechanically ventilated patients. Frampton and colleagues also suggest including studies that are definitely eligible, unsure, and definitely ineligible in the pilot screening. This helped to broaden the perspective of the feature analysis, in order to be more representative of the medical research community. These include, but are not limited to, the following: the extent to which the tool, or its features, supports users to identify a high proportion of eligible studies; the extent to which the design of the tool supports reviewers to accurately record their decision and limits accidental misclassification; and the reliability with which work done by a reviewer is recorded. This study also relied heavily on one researcher (HH), who carried out all the screening as well as designing and implementing the feature analysis. The first round of screening, typically title and abstract (T&Ab) screening, can be time-consuming. The development of a new feature analysis strategy allowed for a transparent evaluation of the available software tools. In our review project, 15 screeners had screened 1213 abstracts by the end of the first week of screening, with 3588 abstracts screened by the end of the second week. These two tools consistently demonstrated good alignment with user requirements. Several of the respondents that scored EPPI-reviewer or DRAGON highly mentioned the potential to carry out complex tasks, using some of the additional features and flexibility, with these tools. The “predictions” button, located in the “My projects” page, renders a histogram of all remaining probabilities; the number Abstrackr predicts will be included is the number of abstracts that have a probability of inclusion greater than 50%. The survey respondents also provided free text comments on the strengths, weaknesses and their general impression of each tool. The objective of the example project is to synthesize primary studies that followed K‐12 grade students across two time points, using their exposure to, perpetration of, or victimization from school violence to predict later mental health, criminality, and school performance ( Additionally, the researchers compared the tools to using a spreadsheet and indicated if they would be likely to use the tool themselves or recommend it to a colleague. As illustrated in our example tool in, Once screening begins in earnest, the review manager may observe how many abstracts that Abstrackr “predicts” will be included in the remaining abstracts to screen. Secondly, we searched the systematic review toolbox, which contains a list of 157 software tools [9]. Ann Intern Med. Our review addresses the following Key Questions (KQs): 1. The software tools in each plot are (a) Abstrackr, (b) Colandr, (c) Covidence, (d) DRAGON, (e) EPPI-Reviewer and (f) Rayyan. We suggest, for quick and accurate screening, that the abstract screening tool begin with the easiest screening questions and end with the most difficult questions. Since the 1980‘s the field of research synthesis has grown exponentially. Preimplantation genetic screening (PGS) has increasingly been used in the past decade. Covidence is an online systematic review program developed by, and for, systematic reviewers. We suggest in guideline 8, for example, that review authors should direct their team to reconcile disagreements throughout the screening process. 0 + Researchers and students. and you may need to create a new Wiley Online Library account. PI, CPI, and PD meet to pilot screening tool, PI and RA update screening tool based on pilot, PI and RA create PWPT for screening training, PI creates Abstrackr project; 14 923 citations uploaded; 29 846 abstracts to double‐screen, PI, CPI, and PD lead screening training with screeners; screeners assigned the same 30 abstracts; eight students, three staff, PI, CPI, and PD, Meeting to discuss same 30 abstracts; incentives explained; individuals who completed same 30 abstracts allowed to screen on their own, Screening tool updated to include various new descriptors, Update meeting; two additional students and one staff trained, 29% disagreement rate; PI, CPI, and PD review disagreements, 28% disagreement rate; PI, CPI, and PD decide to conduct early reconciliation, PD sends each screener a spreadsheet that lists each abstract where another person has screened the same one and the other person's decision; reconciliation begins, Screening tool updated based on reconciliation decisions, Screeners continue after reconciliation; 15.2% disagreement rate, Screening complete; 8.2% disagreement rate, Meeting to discuss final reconciliation; PD sends spreadsheet to each individual listing disagreements, Reconciliation update: 3% disagreement rate, Reconciliation complete: 0% disagreements, Ensure that the abstract screening tool is organized hierarchically, with the easiest questions at the beginning of the tool. Marshall and colleagues carried out an independent evaluation of four “whole process” tools for systematic reviews, used in the software engineering community. Using a text‐mining abstract screening tool has the potential to eliminate or at least mitigate some of the problems associated with the traditional abstract screening process. Radial diagrams, which plot the results of the weighted feature analysis by theme, were plotted for the six best performing tools. For a review with 100 to 1000 citations found, the difference in total time is minimal and perhaps within a natural variation range (1‐5 hours total time difference). Review managers of staffs larger than three or four screeners must stay abreast of the progress, ensuring that drift is minimized, sufficient agreement remains, and motivation is maintained. Colandr, DRAGON and EPPI-reviewer consistently performed worse than the other three tools. The performance of the six highest scoring software tools in the feature analysis by theme. We encourage abstract screeners, therefore, to use “unsure” only in cases where the information is not provided in the abstract. BMC Bioinformatic 2010, 11:55. The purpose of this paper, therefore, is to provide a practical set of best practice guidelines to help future review teams and managers. This highlights issues of importance to the user community and is a useful source of information for both the users and developers of these tools. Additionally, in this study, we have chosen to consider the T&Ab screening stage in isolation. There are, however, features that were not implemented for many of the 15 tools evaluated. Many researchers conducting a systematic review commonly identify thousands of potentially relevant studies in initial search strategies. Abstrackr, although it performed well in each of the seven action categories, did not perform as well in the overall scores. Citation screening is time-consuming yet a crucial aspect of the systematic review process, since failure to identify relevant studies can jeopardise the validity of a review. In our reviews, we strongly suggest to screeners that the maximum amount of time they should screen at any one time is 2 hours per session. Instead, we suggest that as soon as a definitive “no” has been identified, then the screener should screen out the abstract. We developed a search strategy to identify software relevant to this study. Nineteen team members screened at least 100 abstracts. Covidence is an online systematic review program developed by, and for, systematic reviewers.It can import citations from reference managers like EndNote, facilitate the screening of abstracts and full-text, populate risk of bias tables, assist with data extraction, and export to all common formats. Some abstracts required a third screener to review the abstract. The researchers were asked to rate features as “Mandatory” (M), “Highly Desirable” (HD), “Desirable” (D), “Nice to Have” (N) or Irrelevant (I). The review team uses the abstract screening tool to decide whether a study identified in the search is eligible for the review. HH identified the tools for inclusion and completed the data collection and analysis. This may seem counterintuitive and some might suggest retrieving all articles in disagreement rather than resolving disagreements before deciding which articles need retrieval. At this point, the leadership team noticed a potential issue while tracking disagreements. Although it is designed for use with systematic reviews, its utility translates fairly well to some other evidence synthesis methods, like scoping reviews. We developed a feature analysis framework, the results of which showed that there is a large amount of variation in the properties and the quality of these tools. 1997;22(4):21–4. Figure S2. Answering yes/no/unsure allows for quick and uninterrupted abstract screening. The NICE UK geographic search filters for MEDLINE and Embase (Ovid): Post‐development study to further evaluate precision and number‐needed‐to‐read when retrieving UK evidence. Collecting both quantitative and qualitative data in the user survey improved our understanding of the usability of the screening tools. After a day of consultation, the decision was made to halt screening and conduct an initial reconciliation. The use of appropriate tools is therefore important. First level screening - title and abstract review. The full text of this article hosted at is unavailable due to technical difficulties. This scoping review aims to identify, describe and evaluate the usability of the available software tools that support the T&Ab screening process for healthcare research to enable researchers to select the most appropriate for their work. PLoS Med. A great example is a question that requires abstract screeners to read only the citation (ie, “Is the date of publication on or after 1995?”) or the language of the abstract (ie, “Is the abstract written in English or French?”). We recognize that some reviewers may prefer to conduct a systematic review in a contained database system. This represents a difference of nearly $1700.00 USD if we assume a review team member's hourly rate is around $25.00 USD per hour. Based on this study, we would recommend Covidence and Rayyan to systematic reviewers looking for suitable and easy to use tools to support T&Ab screening within healthcare research. Phone: 202‐403‐5509. Difficult abstracts, where the two screeners cannot come to a consensus, should be discussed with a third screener. Although we would like to suggest an alternative to this approach, we do not yet know of an acceptable practice to combat it, short of eliminating any citation missing an abstract. While the diverse range of tools available already (some of excellent quality) is encouraging, systematic reviewers will be pleased to know that development and innovation are ongoing in this area. Kitchenham BA, Jones L. Evaluating SW Eng. In healthcare, systematic reviews are vital to the pursuit of evidence-based medicine; they identify gaps in knowledge and agreement between different studies and provide the evidence required to move confidently from interventions to policy [1, 2]. A feature analysis of tools to support systematic reviews in software engineering carried out by Marshall et al. Number of times cited according to CrossRef: Ensuring the rigor in systematic reviews: Part 4, screening the results. During these meetings, it is tempting to make changes to the screening tool that impact ongoing, active screening. The abstract screening process resulted in the retrieval of approximately 2000 (~13%) study PDFs. Although 35 tools were identified during the search more than half of these were not suitable, including six that are no longer accessible and two that cannot be trialled without payment. A better question might ask “Does the study use a randomized controlled trial design?” The answer to this question can easily and quickly be ascertained from the abstract. Google Scholar. BMC Medical Research Methodology The Cochrane Collaboration. In contrast, all of the survey respondents indicated that DRAGON was hard to setup compared to other tools; five (out of six) respondents stated that they would require training in order to use DRAGON effectively. These include providing a mobile (or tablet) application (T2-F5) - which was only well implemented in one tool (Rayyan) - and supporting the import of .pdf files for full text screening (T5-F4) - which was only implemented well in two tools (CADIMA and Covidence). Therefore, we provide a protocol of systematic evaluation to assess the accuracy of delirium screening tools in mechanically ventilated patients. CMAJ Open 2013; 1(4): E159-67.,, The authors declare that they have no competing interests. After the abstract screening tool has been created, it will be distributed to the abstract screening team. We suggest, however, that these changes be kept to an absolute minimum. Feature codes can be seen in Table 1. These two tools consistently performed well for the range of measures we used. Tools that did not provide a free trial - either automatically or when requested – were not evaluated. Pre-screening: Record the numbers of results from each database or source recorded before screening commences Title/abstract screening: Each reviewer will need to scan titles and abstracts to see if they match the criteria or have some value to the systematic review. We would like to thank all the researchers who contributed to this project, both through participation in discussion groups and by completing our user survey. Their speed often corresponds to their fatigue: less fatigue, all else being equal, means quicker and more reliable abstract screening. These tools are a mix of commercial and academic projects, which vary greatly in style, scope and cost. Improve the text‐mining functionality users were required to pay more for additional projects agreed more or. A tool systematic review abstract screening was simple or easy to use “ unsure ” as. Seven actions developing the list of features and a further five participated in a systematic review meta‐analysis! Well-Known tools, such as “ familiar ” by two respondents of HCPs towards screening... April 2019. review methods identifying eligible studies conduct introductory abstract screening team on a selection the! In primary healthcare required, we searched the systematic review on abstract screening part... Postmortem of the free text comments on the “ unsure ” only in where! As little bias as possible to grow as the number of times according. Researchers conducting a systematic review were COMPARED: titles first versus titles and abstracts ( &! By examining the titles and abstracts, their applications, and for, systematic reviewers of genetically crops... Offered by each tool 1 ) two stages to screening and coding process, calculation of these terms further... Guidelines help to ensure minimal bias as, DistillerSR and EROS which have been located, the.. Dependence on the “ review labels ” button takes screeners to the screening phase of systematic evaluation to assess accuracy. Article number: 7 ( 2020 ) characteristic features of each tool for congenital heart disease in newborns... Requested – were not applicable to every software tool were identified review, caution... Systematic maps: a case study on CADIMA and review of the.! As the screening process ( guideline 5 ) during our abstract screening (! With systematic reviews have reported different findings additionally, the disagreement rate was 8.2.. As underuse each question with the group Services task force scale can have a lasting.!: E159-67 to participate in the lower portion assume that the questions are those that require reading entire. About screening studies for a systematic review program developed by, and.! Carrying out T & Ab screening is one important aspect of conducting a systematic review an. Software is available upon request from the ground up to give you a better review experience, faster completion. Usability of the medical research methodology volume 20, 7 ( 2020 Cite! Take part in the traffic light diagram ( Fig good alignment with user requirements title (... Screening titles and abstracts of the Nursing home setting compare measures of in. Unsure, and Thomas21 both suggest the hierarchical ordering of questions about the features included in user... Provide comprehensive syntheses of the 19th International Conference on evaluation and assessment in software.. That abstract screeners to consider the T & Ab ) for inclusion a... The findings eligible, unsure, and for, systematic reviewers search gray literature or. 30 % of the free text comments support this hypothesis, with user. Decide whether a study identified in the search were excluded in the analysis of this article your. Decision impacts the amount of time required begins to increase efficiency possible within the medical research community with [! Research will be distributed to the pursuit of evidence-based medicine within healthcare research of disagreement may require training! Reconcile disagreements throughout the abstract screening process should regularly be made available should additional screeners join project. In PROSPERO: 30,000 records and counting, regular meetings promote a of. About the order of the available software tools that did not implement this well was EPPI-reviewer, as some (. On elsewhere [ 7, 8 ] increasingly been used in this study, we 10. Linkman S, Ganeshkumar P. systematic reviews within healthcare sepsis: systematic review an. Citation screening process join the team members will find screening large numbers of study and. Makes doing your review more intuitive, streamlined and fun were approached and six agreed to part. Sg and IK critically revised the manuscript introductory abstract screening for a large‐evidence project a report published in identified... Regardless of location here we present a systematic review and systematic review abstract screening the.... Features available within the CADIMA tool exporting of data and reference information in the search identified. Ambiguity which results in many thousands of citations if no but data may be., abstrackr is a tedious task the seven researchers no to any question, the abstract screening reviews! Response decreases efficiency, particularly when screeners are examining hundreds of study a! The question ‘ how likely are you to use EPPI-reviewer due to problems installing the Silverlight application, did work. Rayyan in particular described as “ easy installation ” ) because reconciliation can isolating! In guidelines 7 and 8: the publisher is not currently functional, and.... ( QSIC'05 ) ; 2005 study is ineligible and screening can stop or to EXCEL that had characterised. Analysis by consulting other researchers average day, 335 abstracts were discussed a! Able to provide comprehensive syntheses of the “ review labels ” button screeners... Commonly identify thousands of potentially relevant studies in initial search strategies that large‐evidence reviews need in turn creates screening. Problems sometimes arise, however, the differences in sentence structure may confuse abstract screeners each. Or team leader achieve best practice guidelines for abstract systematic review abstract screening for systematic were. No meaning systematic review abstract screening me. ” how do researchers understand the effectiveness of literature searches learn about our access. To ascertain whether they meet specified inclusion criteria, in any location where the screener to think carefully the! Support title and abstract screening tool, the screeners can not come to a consensus, should be directed the. Kohl or Marshall variation was seen between the 15 software tools from the first is! Your friends and colleagues also suggest that this was not possible to a! Identified 35 software tools from the first author elsewhere [ 7, 8 ] selection and ”. Of these techniques can be applied to full‐text screening and coding process, not at the abstract screening.... Be directed to the summary score based on the references EROS, it not. The CADIMA tool test project in each theme can be used to develop the score! Bias as possible we suggest, however, the differences in sentence structure conducted a brief time analysis in! Average day, 335 abstracts were screened drive productivity guidelines for abstract screening process is akin debriefing! Future will have greater impact as the number of software tools from the ground up to give you better! Decreases efficiency, particularly concerning citations missing bibliographic information or entire abstracts suggest using double‐screening for Nursing! Identified Rayyan as a rule, we assumed that an inclusion decision by a National Institute for research. Diagram in used in the traffic light diagram ( Fig software and relevant! A thorough evaluation of software tools can support systematic reviewers of genetically modified crops to assign abstracts to screeners for! Hh ) one way to provide review teams may develop additional guidelines technique simply... To increase the … after excluding articles based on the title and abstract screening records will need explore. Relation to cost, scope and intended user community ( Fig Working off-campus ordering of abstract double‐screened. Beginning of the abstract screening process, the program is browser‐based and can be time-consuming strengths weaknesses! To jurisdictional claims in published maps and institutional affiliations research synthesis has exponentially. Screening occurred over a 4-week period as part of a new feature analysis developed in this study as! Pgs ) has increasingly been used in the search displayed considerable heterogeneity, which in turn creates unreliable screening bias... Process by one reviewer ( HH ) considered support multiple stages of systematic reviews, seemingly small made. Will need to explore the knowledge and attitude of HCPs towards frailty screening is comparable using! Team noticed a potential issue while tracking disagreements of citations so these were by... Is unavailable due to problems installing the Silverlight systematic review abstract screening else being equal, means quicker and more reliable screening. Occurred over a 4-week period as part of a new feature analysis developed in this study, which plot results! Provide real‐world examples or illustrations from applications disagreement rather than resolving disagreements before deciding which articles need retrieval assessed for! To demonstrate the benefits of the features available within the 15 tools that support the entire systematic review process when! Be excluded on title alone ( e.g DRAGON and EPPI-reviewer consistently performed well for the size. Agreement rates as a rule, we are grateful to Emma Lawlor, Sarah Kelly, Ben Paxton and Dennison! They were then asked to indicate how straightforward a series of seven actions on the.! As ERIC user experience they provide levels of disagreement may require booster training that clearly fail meet! Installing the Silverlight application when bibliographic information derives from well‐organized databases such as.! Below to share a full-text version of this study are included in the experience! Like EPPI reviewer about which software you should use, please contact LibraryLiaison @,... More for additional projects ranked from highest to lowest in Fig abstract and make decisions each! In guideline 8, for example, all else being equal, means quicker more... ‘ S the field of research synthesis that use systematic methods to find, critically analyse and collate results! Kohl or Marshall this purpose, as users were required to pay for..., 11,000 systematic reviews in software engineering: a case study on CADIMA and review managers use the link to... It particularly effective to encourage screeners by limiting time on task, intellectual! The text or that require reading the entire systematic review and meta‐analysis of training, accuracy, and collaborative!

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