How to write a systematic review.
BACKGROUND
The role of evidence-based medicine in sports medicine and orthopaedic surgery is rapidly growing. Systematic reviews and meta-analyses are also proliferating in the medical literature.


OBJECTIVE
To provide the outline necessary for a practitioner to properly understand and/or conduct a systematic review for publication in a sports medicine journal.


METHODS
Review.


METHODS
The steps of a successful systematic review include the following: identification of an unanswered answerable question; explicit definitions of the investigation's participant(s), intervention(s), comparison(s), and outcome(s); utilization of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and PROSPERO registration; thorough systematic data extraction; and appropriate grading of the evidence and strength of the recommendations.


RESULTS
An outline to understand and conduct a systematic review is provided, and the difference between meta-analyses and systematic reviews is described. The steps necessary to perform a systematic review are fully explained, including the study purpose, search methodology, data extraction, reporting of results, identification of bias, and reporting of the study's main findings.


CONCLUSIONS
Systematic reviews or meta-analyses critically appraise and formally synthesize the best existing evidence to provide a statement of conclusion that answers specific clinical questions. Readers and reviewers, however, must recognize that the quality and strength of recommendations in a review are only as strong as the quality of studies that it analyzes. Thus, great care must be used in the interpretation of bias and extrapolation of the review's findings to translation to clinical practice. Without advanced education on the topic, the reader may follow the steps discussed herein to perform a systematic review.
The Methodist Orthopedics and Sports Medicine Center, Houston, Texas joshuaharrismd@gmail.com.
Joshua D
JD
Harris
Sports Medicine Center, The Ohio State University, Columbus, Ohio Department of Orthopaedic Surgery, The Ohio State University, Columbus, Ohio.
Carmen E
CE
Quatman
Department of Orthopaedic Surgery, The Ohio State University, Columbus, Ohio.
M M
MM
Manring
Sports Medicine Center, The Ohio State University, Columbus, Ohio Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio.
Robert A
RA
Siston
Sports Medicine Center, The Ohio State University, Columbus, Ohio Department of Orthopaedic Surgery, The Ohio State University, Columbus, Ohio.
David C
DC
Flanigan
D019317:Evidence-Based Medicine; D006801:Humans; D066209:Medical Writing / Q000592:standards*; D015201:Meta-Analysis as Topic; D009985:Orthopedics; D011643:Publishing / Q000592:standards*; D012196:Review Literature as Topic; D013178:Sports Medicine
PRISMA; PROSPERO; evidence-based medicine; meta-analysis; systematic review