We were approached by a client to conduct a systematic literature review and meta-analysis on the risk of adverse health outcomes associated with substance misuse, in order to support the value communication of a novel pharmacological therapy in this disease area.
Throughout the project, we provided strategic leadership to ensure that the review was conducted to the highest academic standards as well as being targeted to the client’s needs. For example, the thorough scoping we conducted at the proposal stage identified that the evidence base for the topic planned was extremely large. In order to maximise the ability of the review to identify all relevant studies within the client’s required timelines, we recommended focusing the topic area of the review on a single adverse health outcome of particular importance. This recommendation was approved by the client and allowed the development of highly sensitive search terms for the review.
The review was conducted using the most stringent methodology recommended in the Cochrane Handbook for Systematic Reviews of Interventions and by the University of York’s Centre for Reviews and Dissemination. Two reviewers independently screened the articles at both the abstract and full-text review stages, and resolved any disagreements regarding the eligibility of an article by discussion until a consensus was met. Comprehensive hand searches of the bibliographies of included articles were also conducted in order to identify further potentially relevant studies for inclusion in the review. As we strongly believe that assessing the quality of studies included in a systematic review is essential, we identified a relevant, detailed and recently published quality assessment form and tailored it to align with the objectives of our systematic review. We then applied the quality assessment to each included study in order to remove any studies that were not credible from the meta-analysis.
As well as involving a large number of articles, the review was highly complex as it included observational studies published over a period of more than fifty years. The terminology, understanding and reporting of the disease area have evolved considerably over this time period leading to high heterogeneity between studies. We were able to use our expertise and insight into the disease area to make informed decisions on which studies met our eligibility criteria, and to produce an insightful written analysis of the results. The client was delighted with our clear and thorough report.
We subsequently collaborated with the client, an external author, and Costello Medical’s Publications Division to prepare the results for publication, in line with the PRISMA and MOOSE reporting guidelines for systematic review and meta-analyses.