How to Write a Systematic Review: A Narrative Review

Ali Hasanpour Dehkordi, Elaheh Mazaheri, Hanan A. Ibrahim, Sahar Dalvand, Reza Ghanei Gheshlagh


In recent years, published systematic reviews in the world and in Iran have been increasing. These studies are an important resource to answer evidence‑based clinical questions and assist health policy‑makers and students who want to identify evidence gaps in published research. Systematic review studies, with or without meta‑analysis, synthesize all available evidence from studies focused on the same research question. In this study, the steps for a systematic review such as research question design and identification, the search for qualified published studies, the extraction and synthesis of information that pertain to the research question, and interpretation of the results are presented in details. This will be helpful to all interested researchers.


Narrative review; review; systematic review

Full Text:



Pati D, Lorusso LN. How to write a systematic review of the

literature. HERD 2018;11:15‑30.

Strech D, Sofaer N. How to write a systematic review of reasons.

J Med Ethics 2012;38:121‑6.

Klassen TP, Jadad AR, Moher D. Guides for reading and

interpreting systematic reviews: I. Getting started. Arch Pediatr

Adolesc Med 1998;152:700‑4.

Higgins JPT GS, editors. Cochrane Handbook for Systematic

Reviews of Interventions Version 5.1.0 [updated March 2011].

The Cochrane Collaboration; 2011. Available from: www.

cochrane‑ [Last accessed on 2015 Mar 07].

Jadad AR, Cook DJ, Browman GP. A guide to interpreting

discordant systematic reviews. CMAJ 1997;156:1411‑6.

Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF.

Improving the quality of reports of meta‑analyses of randomised

controlled trials: The QUOROM statement. Oncol Res Treat


Whiting P, Rutjes A, Dinnes J, Reitsma J, Bossuyt P, Kleijnen J.

Development and validation of methods for assessing the quality

of diagnostic accuracy studies. Health Technol Assess 2004;8:iii,


Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD,

Rennie D, et al. Meta‑analysis of observational studies

in epidemiology: A proposal for reporting. JAMA


Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche

PC, Vandenbroucke JP. The strengthening the reporting of

observational studies in epidemiology (STROBE) statement:

Guidelines for reporting observational studies. Ann Intern Med


Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred

reporting items for systematic reviews and meta‑analyses: The

PRISMA statement. PLoS Med 2009;6:e1000097.

Asar S JS, Ayoubi F, Rahmani M, Rezaeian M. PRISMA; Preferred

Reporting Items for Systematic Reviews and Meta‑Analyses.

Rafsanjan Univ Med Sci Health Serv 2016;15:68‑80.

PRISMA. Available from:

Mallett R, Hagen‑Zanker J, Slater R, Duvendack M. The benefits

and challenges of using systematic reviews in international

development research. J Dev Effect 2012;4:445‑55.

Jahan N, Naveed S, Zeshan M, Tahir MA. How to conduct

a systematic review: A narrative literature review. Cureus


Lichtenstein AH. Systematic Reviews in the Field of Nutrition.

Handbook of Clinical Nutrition and Aging: Springer; 2015.

p. 21‑34.

Harris JD, Quatman CE, Manring M, Siston RA, Flanigan DC.

How to write a systematic review. Am J Sports Med


Saffari M, Sanaeinasab H, Pakpour AH. How to do a systematic

review regard to health: A narrative review. Iran J Health Educ

Health Promot 2013;1:51‑61.

MacLure K, Paudyal V, Stewart D. Reviewing the literature, how

systematic is systematic? Int J Clin Pharm 2016;38:685‑94.

Godfrey C, Harrison M. Systematic Review Resource Package.

The Joanna Briggs Institute Method for Systematic Review

Research Quick Reference Guide. Kingston, ON: Queen’s Joanna

Briggs Collaboration; 2010.

Denison HJ, Dodds RM, Ntani G, Cooper R, Cooper C,

Sayer AA, et al. How to get started with a systematic review in

epidemiology: An introductory guide for early career researchers.

Arch Public Health 2013;71:21.

Phan K, Tian DH, Cao C, Black D, Yan TD. Systematic review

and meta‑analysis: Techniques and a guide for the academic

surgeon. Ann Cardiothorac Surg 2015;4:112.

Ely JW, Osheroff JA, Ebell MH, Chambliss ML, Vinson DC,

Stevermer JJ, et al. Obstacles to answering doctors’ questions

about patient care with evidence: Qualitative study. BMJ


Rathbone J, Carter M, Hoffmann T, Glasziou P. A comparison

of the performance of seven key bibliographic databases in

identifying all relevant systematic reviews of interventions for

hypertension. Syst Rev 2016;5:27.

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J,

et al. AMSTAR 2: A critical appraisal tool for systematic reviews

that include randomised or non‑randomised studies of healthcare

interventions, or both. BMJ 2017;358:j4008.

Tawfik GM, Dila KAS, Mohamed MYF, Tam DNH, Kien ND,

Ahmed AM, et al. A step by step guide for conducting a

systematic review and meta‑analysis with simulation data. Trop

Med Health 2019;47:46.

Singh S. How to conduct and interpret systematic reviews and

meta‑analyses. Clin Transl Gastroenterol 2017;8:e93.

Umscheid CA. A primer on performing systematic reviews and

meta‑analyses. Clin Infect Dis 2013;57:725‑34.

Wright RW, Brand RA, Dunn W, Spindler KP. How to write a

systematic review. Clin Orthop Relat Res 2007;455:23‑9.

Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM,

Gavaghan DJ, et al. Assessing the quality of reports of

randomized clinical trials: Is blinding necessary? Control Clin

Trials 1996;17:1‑12.

Natto ZS, AlGhamdi DS. Quality assessment of systematic

reviews and meta‑analyses published in Saudi journals from

to 2017. Saudi Med J 2019;40:426.

Oxman AD, Guyatt GH. Validation of an index of the quality of

review articles. J Clin Epidemiol 1991;44:1271‑8.

Public Health Resource Unit CASPCmsoeqthmsorhwc‑un.

Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E,

Grimshaw J, et al. AMSTAR is a reliable and valid measurement

tool to assess the methodological quality of systematic reviews.

J Clin Epidemiol 2009;62:1013‑20.

CASP Qualitative Checklist. Available from: www.casp-uk.

net/#!casp-tools-checklists/c18f8. [Last cited on 2018].

National Institute for Health and Clinical Excellence. The

guidelines manual. London (UK): National Institute for Health

and Clinical Excellence. Available from: https://www.nice.orguk/process/pmg6/chapter/introduction. [Last updated on 2012

Nov; Last cited on 2012].

Munn Z. Software to support the systematic review process: The

Joanna Briggs Institute System for the Unified Management,

Assessment and Review of Information (JBI‑SUMARI). LWW;

Elamin MB, Flynn DN, Bassler D, Briel M, Alonso‑Coello P,

Karanicolas PJ, et al. Choice of data extraction tools for

systematic reviews depends on resources and review complexity.

J Clin Epidemiol 2009;62:506‑10.

ten Ham‑Baloyi W, Jordan P. Systematic review as a research

method in post‑graduate nursing education. Health Sa

Gesondheid 2016;21:120‑8.

Whiting P, Savovic J, Higgins J, Caldwell D, Reeves B,

Shea B. ROBIS: Tool to assess risk of bias in systematic

reviews‑Guidance on how to use ROBIS. 2016.

González IF, Urrútia G, Alonso‑Coello P. Systematic reviews and

meta‑analysis: Scientific rationale and interpretation. Rev Esp

Cardiol 2011;64:688‑96.

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring

inconsistency in meta‑analyses. BMJ 2003;327:557‑60.

Higgins J, Thompson SG. Quantifying heterogeneity in a

meta‑analysis. Stat Med 2002;21:1539‑58.

Mueller KF, Meerpohl JJ, Briel M, Antes G, von Elm E, Lang B,

et al. Detecting, quantifying and adjusting for publication bias in

meta‑analyses: Protocol of a systematic review on methods. Syst

Rev 2013;2:60.

Song F, Eastwood A, Gilbody S, Duley L, Sutton A.

Publication and related biases: A review. Health Technol Assess


Easterbrook PJ GR, Berlin JA, Matthews DR. Publication bias in

clinical research. Lancet 1991;337:867‑72.

Egger M, Smith GD, Schneider M, Minder C. Bias in

meta‑analysis detected by a simple, graphical test. BMJ


Lee YH. Meta‑analysis of genetic association studies. Ann Lab

Med 2015;35:283‑7.

Lyman GH, Kuderer NM. The strengths and limitations of

meta‑analyses based on aggregate data. BMC Med Res Methodol


Hagen‑Zanker J, McCord A, Holmes R. The impact of

employment guarantee schemes and cash transfers on the poor.

Available from:

Neyeloff JL, Fuchs SC, Moreira LB. Meta‑analyses and Forest

plots using a microsoft excel spreadsheet: Step‑by‑step guide

focusing on descriptive data analysis. BMC Res Notes 2012;5:52