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Systematic reviews vs meta-analysis: what’s the difference?

Posted on 24th July 2023 by Verónica Tanco Tellechea

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You may hear the terms ‘systematic review’ and ‘meta-analysis being used interchangeably’. Although they are related, they are distinctly different. Learn more in this blog for beginners.

What is a systematic review?

According to Cochrane (1), a systematic review attempts to identify, appraise and synthesize all the empirical evidence to answer a specific research question. Thus, a systematic review is where you might find the most relevant, adequate, and current information regarding a specific topic. In the levels of evidence pyramid , systematic reviews are only surpassed by meta-analyses. 

To conduct a systematic review, you will need, among other things: 

  • A specific research question, usually in the form of a PICO question.
  • Pre-specified eligibility criteria, to decide which articles will be included or discarded from the review. 
  • To follow a systematic method that will minimize bias.

You can find protocols that will guide you from both Cochrane and the Equator Network , among other places, and if you are a beginner to the topic then have a read of an overview about systematic reviews.

What is a meta-analysis?

A meta-analysis is a quantitative, epidemiological study design used to systematically assess the results of previous research (2) . Usually, they are based on randomized controlled trials, though not always. This means that a meta-analysis is a mathematical tool that allows researchers to mathematically combine outcomes from multiple studies.

When can a meta-analysis be implemented?

There is always the possibility of conducting a meta-analysis, yet, for it to throw the best possible results it should be performed when the studies included in the systematic review are of good quality, similar designs, and have similar outcome measures.

Why are meta-analyses important?

Outcomes from a meta-analysis may provide more precise information regarding the estimate of the effect of what is being studied because it merges outcomes from multiple studies. In a meta-analysis, data from various trials are combined and generate an average result (1), which is portrayed in a forest plot diagram. Moreover, meta-analysis also include a funnel plot diagram to visually detect publication bias.

Conclusions

A systematic review is an article that synthesizes available evidence on a certain topic utilizing a specific research question, pre-specified eligibility criteria for including articles, and a systematic method for its production. Whereas a meta-analysis is a quantitative, epidemiological study design used to assess the results of articles included in a systematic-review. 

Remember: All meta-analyses involve a systematic review, but not all systematic reviews involve a meta-analysis.

If you would like some further reading on this topic, we suggest the following:

The systematic review – a S4BE blog article

Meta-analysis: what, why, and how – a S4BE blog article

The difference between a systematic review and a meta-analysis – a blog article via Covidence

Systematic review vs meta-analysis: what’s the difference? A 5-minute video from Research Masterminds:

  • About Cochrane reviews [Internet]. Cochranelibrary.com. [cited 2023 Apr 30]. Available from: https://www.cochranelibrary.com/about/about-cochrane-reviews
  • Haidich AB. Meta-analysis in medical research. Hippokratia. 2010;14(Suppl 1):29–37.

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Understanding the Differences Between a Systematic Review vs Meta Analysis

systematic literature review vs meta analysis

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The advent of evidence-based medicine has increased the demand for systematic methods to analyze and synthesize clinical evidence. When it comes to the search for the best available clinical evidence, randomized control trials, systematic reviews, and meta-analysis are considered the “gold standard” [1].

Since both systematic reviews and meta-analyses are secondary research approaches (research of research), sometimes the terms are used interchangeably, but there are vast differences between them.

A systematic review is a review that collects, critically appraises, and synthesizes all the available evidence to answer a specifically formulated research question.

A meta-analysis, on the other hand, is a statistical method that is used to pool results from various independent studies, to generate an overall estimate of the studied phenomenon.

Systematic reviews can sometimes use meta-analysis to synthesize their results, but they are two very distinct techniques. In this article, we will look at the definition of a systematic review , and understand how it is different from a meta-analysis.

What Is A Systematic Review?

In section 1.2.2 of the Cochrane Handbook, titled What is a systematic review?, the following definition can be found, “A systematic review attempts to collate all empirical evidence that fits the pre-specified eligibility criteria in order to answer a specific research question. It uses explicit, systematic methods that are selected with a view to minimizing bias, thus providing more reliable findings from which conclusions can be drawn and decisions made (Antman 1992, Oxman 1993). The key characteristics of a systematic review are: a clearly stated set of objectives with pre-defined eligibility criteria for the studies; an explicit, reproducible methodology; a systematic search that attempts to identify all the studies that would meet the eligibility criteria; an assessment of the validity of the findings of the included studies, for example through the assessment of the risk of bias; and a systematic presentation, and synthesis, of the characteristics and findings of the included studies”[2].

The evidence collected in a systematic review can be analyzed and synthesized, quantitatively, or qualitatively. The quantitative analysis of empirical evidence can use a meta-analysis as the statistical approach. To know more about how to write a systematic review , you can read our article; previously linked.

What Is Meta-Analysis?

Meta-analysis is a statistical method used to combine the results of individual studies. It uses a quantitative, formal, and epidemiological study design to systematically assess the results of previous studies to derive conclusions about a specific research parameter [3]. It is therefore an approach for systematically combining pertinent qualitative and quantitative study data from several included studies to establish a single conclusion that has significant statistical power.

Typically, the primary studies included in a meta-analysis are randomized controlled trials (RCTs). In a meta-analysis, the main objective is to provide more precise estimates of the effects of a treatment or of a risk factor for a disease, than any of the individual studies included in the pooled analysis. The data is also analyzed for heterogeneity (variation within outcomes), and generalizability (similarities between outcomes) within the individual studies, which facilitates more effective clinical decision making. Examining the heterogeneity of effect estimates within the primary studies is perhaps the most important task in a meta-analysis.

Meta-analyses of observational studies such as cohort studies are frequently performed, but no widely accepted guidance is available at the moment. While these meta-analyses are frequently published in literature, they are considered suboptimal to those involving RCTs.  The main reason is that the observational studies may entail an increased risk of biases and high levels of heterogeneity. Researchers who have to conduct meta-analyses on observational studies ought to carefully consider whether all included studies are able to answer the same clinical question.

Although meta-analysis is a subset of systematic reviews, a systematic review may or may not include a meta-analysis. An advantage of meta-analysis is that it has the ability to be completely objective in evaluating the research parameter. However, not all research areas have enough evidence to allow a meta-analysis. The inclusion of meta-analysis in a systematic review depends on the research question, the intervention to be studied, and the desired outcomes.

  • Sur RL, Dahm P. History of evidence-based medicine. Indian journal of urology: IJU: journal of the Urological Society of India. 2011;27(4):487–9.
  • Clarke M, Chalmers I. Discussion sections in reports of controlled trials published in general medical journals: islands in search of continents? Jama. 1998;280(3):280–2.
  • Haidich AB. Meta-analysis in medical research. Hippokratia. 2010;14(Suppl 1):29-37.

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The difference between a systematic review and a meta-analysis

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Home | Blog | Best Practice | The difference between a systematic review and a meta-analysis

Covidence explains the difference between systematic review & meta-analysis.

Systematic review and meta-analysis are two terms that you might see used interchangeably. Each term refers to research about research, but there are important differences!

A systematic review is a piece of work that asks a research question and then answers it by summarising the evidence that meets a set of pre-specified criteria. Some systematic reviews present their results using meta-analysis, a statistical method that combines the results of several trials to generate an average result. Meta-analysis adds value because it can produce a more precise estimate of the effect of a treatment than considering each study individually 🎯.

Let’s take a look at a few related questions that you might have about systematic reviews and meta-analysis.

🙋🏽‍♂️ What are the stages of a systematic review?

A systematic review starts with a research question and a protocol or research plan. A review team searches for studies to answer the question using a highly sensitive search strategy. The retrieved studies are then screened for eligibility using the inclusion and exclusion criteria (this is done by at least two people working independently). Next, the reviewers extract the relevant data and assess the quality of the included studies. Finally, the review team synthesises the extracted study data (perhaps using meta-analysis) and presents the results. The process is shown in figure 1.

systematic literature review vs meta analysis

Covidence helps researchers complete systematic review quickly and easily! It supports reviewers with study selection, data extraction and quality assessment. Data exported from Covidence can be saved in Excel for reliable transfer to your choice of data analysis software or, if you’re writing a Cochrane Review, to RevMan 5.

🙋🏻‍♀️ What does 'systematic' actually mean?

In this context, systematic means that the methods used to search for and analyse the data are

transparent, reproducible and defined before searching begins. This is what differentiates a systematic review from a descriptive review that might be based on, for example, a subset of the literature that the author is familiar with at the time of writing. Systematic reviews strive to be as thorough and rigorous as possible to minimise the bias that would result from cherry-picking studies in a non-systematic way. Systematic reviews sit at the top of the evidence hierarchy because it is widely agreed that studies with rigorous methods are those best able to minimise the risk of bias on the results of the study. This is what makes systematic reviews the most reliable form of evidence (see figure 2). 

systematic literature review vs meta analysis

🙋🏾‍♂️ Why don't all systematic reviews use meta-analysis?

Meta-analysis can improve the precision of an effect estimate. But it can also be misleading if it is performed with data that are not sufficiently similar, or with data whose methodological quality is poor (for example, because the study participants were not properly randomized). So it’s not always appropriate to use meta-analysis and many systematic reviews do not include them. Reviews that do not contain meta-analysis can still synthesise study data to produce something that has greater value than the sum of its parts.

🙋🏾‍♀️ What does meta-analysis do?

Meta-analysis produces a more precise estimate of treatment effect. There are several types of effect size and the most suitable type is chosen by the review team based on the type of outcomes and interventions under investigation. Typical effect sizes in systematic reviews are the odds ratio, the risk ratio, the weighted mean difference and the standardized mean difference. The results of a meta-analysis are displayed using a forest plot like the one in figure 3.

systematic literature review vs meta analysis

Some meta-analyses also include subgroup analysis or meta-regression. These techniques are used to explore a factor (for example, the age of the study participant) that might influence the relationship between the treatment and the intervention. Plans to analyse the data using these techniques should be described and justified before looking at the data, ideally at the research plan or protocol stage, to avoid introducing bias. Like meta-analysis, subgroup analysis and meta-regression are advisable only in certain circumstances.

Systematic reviewer pro-tip

  Think carefully before you plan subgroup analysis or meta-regression and always ask a methodologist for advice

🙋🏼‍♀️ What are the other ways to synthesise evidence?

Systematic reviews combine study data in a number of ways to reach an overall understanding of the evidence. Meta-analysis is a type of statistical synthesis. Narrative synthesis combines the findings of multiple studies using words. All systematic reviews, including those that use meta-analysis, are likely to contain an element of narrative synthesis by summarising in words the evidence included in the review. But narrative synthesis doesn’t just describe the included studies: it also seeks to explain the gathered evidence, for example by looking at similarities and differences between the study findings and by exploring possible reasons for those similarities and differences in a systematic way. Narrative synthesis should not be confused with narrative review, which is a term sometimes used for a non-systematic review of the literature (for example in a textbook chapter) where there is no systematic attempt to address issues of bias.

There are many types of systematic review . What they all have in common is the use of transparent and reproducible methods that are defined before the search begins. There is no ‘best’ way to synthesise systematic review evidence, and the most suitable approach will depend on factors such as the nature of the review question, the type of intervention and the outcomes of interest.

Covidence is a web-based tool that saves you time at the screening, selection, data extraction and quality assessment stages of your review. It provides easy collaboration across teams and a clear overview of task status, helping you to efficiently complete your review. Sign up for a free trial today! 😀

1 Effectiveness of psychosocial interventions for reducing parental substance misuse – McGovern, R – 2021 | Cochrane Library https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012823.pub2/full .  Accessed 25 March 2021

Laura Mellor. Portsmouth, UK

Laura Mellor. Portsmouth, UK

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Reproduced from Grant, M. J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26: 91–108. doi:10.1111/j.1471-1842.2009.00848.x

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  • Systematic Review | Definition, Example, & Guide

Systematic Review | Definition, Example & Guide

Published on June 15, 2022 by Shaun Turney . Revised on November 20, 2023.

A systematic review is a type of review that uses repeatable methods to find, select, and synthesize all available evidence. It answers a clearly formulated research question and explicitly states the methods used to arrive at the answer.

They answered the question “What is the effectiveness of probiotics in reducing eczema symptoms and improving quality of life in patients with eczema?”

In this context, a probiotic is a health product that contains live microorganisms and is taken by mouth. Eczema is a common skin condition that causes red, itchy skin.

Table of contents

What is a systematic review, systematic review vs. meta-analysis, systematic review vs. literature review, systematic review vs. scoping review, when to conduct a systematic review, pros and cons of systematic reviews, step-by-step example of a systematic review, other interesting articles, frequently asked questions about systematic reviews.

A review is an overview of the research that’s already been completed on a topic.

What makes a systematic review different from other types of reviews is that the research methods are designed to reduce bias . The methods are repeatable, and the approach is formal and systematic:

  • Formulate a research question
  • Develop a protocol
  • Search for all relevant studies
  • Apply the selection criteria
  • Extract the data
  • Synthesize the data
  • Write and publish a report

Although multiple sets of guidelines exist, the Cochrane Handbook for Systematic Reviews is among the most widely used. It provides detailed guidelines on how to complete each step of the systematic review process.

Systematic reviews are most commonly used in medical and public health research, but they can also be found in other disciplines.

Systematic reviews typically answer their research question by synthesizing all available evidence and evaluating the quality of the evidence. Synthesizing means bringing together different information to tell a single, cohesive story. The synthesis can be narrative ( qualitative ), quantitative , or both.

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Systematic reviews often quantitatively synthesize the evidence using a meta-analysis . A meta-analysis is a statistical analysis, not a type of review.

A meta-analysis is a technique to synthesize results from multiple studies. It’s a statistical analysis that combines the results of two or more studies, usually to estimate an effect size .

A literature review is a type of review that uses a less systematic and formal approach than a systematic review. Typically, an expert in a topic will qualitatively summarize and evaluate previous work, without using a formal, explicit method.

Although literature reviews are often less time-consuming and can be insightful or helpful, they have a higher risk of bias and are less transparent than systematic reviews.

Similar to a systematic review, a scoping review is a type of review that tries to minimize bias by using transparent and repeatable methods.

However, a scoping review isn’t a type of systematic review. The most important difference is the goal: rather than answering a specific question, a scoping review explores a topic. The researcher tries to identify the main concepts, theories, and evidence, as well as gaps in the current research.

Sometimes scoping reviews are an exploratory preparation step for a systematic review, and sometimes they are a standalone project.

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A systematic review is a good choice of review if you want to answer a question about the effectiveness of an intervention , such as a medical treatment.

To conduct a systematic review, you’ll need the following:

  • A precise question , usually about the effectiveness of an intervention. The question needs to be about a topic that’s previously been studied by multiple researchers. If there’s no previous research, there’s nothing to review.
  • If you’re doing a systematic review on your own (e.g., for a research paper or thesis ), you should take appropriate measures to ensure the validity and reliability of your research.
  • Access to databases and journal archives. Often, your educational institution provides you with access.
  • Time. A professional systematic review is a time-consuming process: it will take the lead author about six months of full-time work. If you’re a student, you should narrow the scope of your systematic review and stick to a tight schedule.
  • Bibliographic, word-processing, spreadsheet, and statistical software . For example, you could use EndNote, Microsoft Word, Excel, and SPSS.

A systematic review has many pros .

  • They minimize research bias by considering all available evidence and evaluating each study for bias.
  • Their methods are transparent , so they can be scrutinized by others.
  • They’re thorough : they summarize all available evidence.
  • They can be replicated and updated by others.

Systematic reviews also have a few cons .

  • They’re time-consuming .
  • They’re narrow in scope : they only answer the precise research question.

The 7 steps for conducting a systematic review are explained with an example.

Step 1: Formulate a research question

Formulating the research question is probably the most important step of a systematic review. A clear research question will:

  • Allow you to more effectively communicate your research to other researchers and practitioners
  • Guide your decisions as you plan and conduct your systematic review

A good research question for a systematic review has four components, which you can remember with the acronym PICO :

  • Population(s) or problem(s)
  • Intervention(s)
  • Comparison(s)

You can rearrange these four components to write your research question:

  • What is the effectiveness of I versus C for O in P ?

Sometimes, you may want to include a fifth component, the type of study design . In this case, the acronym is PICOT .

  • Type of study design(s)
  • The population of patients with eczema
  • The intervention of probiotics
  • In comparison to no treatment, placebo , or non-probiotic treatment
  • The outcome of changes in participant-, parent-, and doctor-rated symptoms of eczema and quality of life
  • Randomized control trials, a type of study design

Their research question was:

  • What is the effectiveness of probiotics versus no treatment, a placebo, or a non-probiotic treatment for reducing eczema symptoms and improving quality of life in patients with eczema?

Step 2: Develop a protocol

A protocol is a document that contains your research plan for the systematic review. This is an important step because having a plan allows you to work more efficiently and reduces bias.

Your protocol should include the following components:

  • Background information : Provide the context of the research question, including why it’s important.
  • Research objective (s) : Rephrase your research question as an objective.
  • Selection criteria: State how you’ll decide which studies to include or exclude from your review.
  • Search strategy: Discuss your plan for finding studies.
  • Analysis: Explain what information you’ll collect from the studies and how you’ll synthesize the data.

If you’re a professional seeking to publish your review, it’s a good idea to bring together an advisory committee . This is a group of about six people who have experience in the topic you’re researching. They can help you make decisions about your protocol.

It’s highly recommended to register your protocol. Registering your protocol means submitting it to a database such as PROSPERO or ClinicalTrials.gov .

Step 3: Search for all relevant studies

Searching for relevant studies is the most time-consuming step of a systematic review.

To reduce bias, it’s important to search for relevant studies very thoroughly. Your strategy will depend on your field and your research question, but sources generally fall into these four categories:

  • Databases: Search multiple databases of peer-reviewed literature, such as PubMed or Scopus . Think carefully about how to phrase your search terms and include multiple synonyms of each word. Use Boolean operators if relevant.
  • Handsearching: In addition to searching the primary sources using databases, you’ll also need to search manually. One strategy is to scan relevant journals or conference proceedings. Another strategy is to scan the reference lists of relevant studies.
  • Gray literature: Gray literature includes documents produced by governments, universities, and other institutions that aren’t published by traditional publishers. Graduate student theses are an important type of gray literature, which you can search using the Networked Digital Library of Theses and Dissertations (NDLTD) . In medicine, clinical trial registries are another important type of gray literature.
  • Experts: Contact experts in the field to ask if they have unpublished studies that should be included in your review.

At this stage of your review, you won’t read the articles yet. Simply save any potentially relevant citations using bibliographic software, such as Scribbr’s APA or MLA Generator .

  • Databases: EMBASE, PsycINFO, AMED, LILACS, and ISI Web of Science
  • Handsearch: Conference proceedings and reference lists of articles
  • Gray literature: The Cochrane Library, the metaRegister of Controlled Trials, and the Ongoing Skin Trials Register
  • Experts: Authors of unpublished registered trials, pharmaceutical companies, and manufacturers of probiotics

Step 4: Apply the selection criteria

Applying the selection criteria is a three-person job. Two of you will independently read the studies and decide which to include in your review based on the selection criteria you established in your protocol . The third person’s job is to break any ties.

To increase inter-rater reliability , ensure that everyone thoroughly understands the selection criteria before you begin.

If you’re writing a systematic review as a student for an assignment, you might not have a team. In this case, you’ll have to apply the selection criteria on your own; you can mention this as a limitation in your paper’s discussion.

You should apply the selection criteria in two phases:

  • Based on the titles and abstracts : Decide whether each article potentially meets the selection criteria based on the information provided in the abstracts.
  • Based on the full texts: Download the articles that weren’t excluded during the first phase. If an article isn’t available online or through your library, you may need to contact the authors to ask for a copy. Read the articles and decide which articles meet the selection criteria.

It’s very important to keep a meticulous record of why you included or excluded each article. When the selection process is complete, you can summarize what you did using a PRISMA flow diagram .

Next, Boyle and colleagues found the full texts for each of the remaining studies. Boyle and Tang read through the articles to decide if any more studies needed to be excluded based on the selection criteria.

When Boyle and Tang disagreed about whether a study should be excluded, they discussed it with Varigos until the three researchers came to an agreement.

Step 5: Extract the data

Extracting the data means collecting information from the selected studies in a systematic way. There are two types of information you need to collect from each study:

  • Information about the study’s methods and results . The exact information will depend on your research question, but it might include the year, study design , sample size, context, research findings , and conclusions. If any data are missing, you’ll need to contact the study’s authors.
  • Your judgment of the quality of the evidence, including risk of bias .

You should collect this information using forms. You can find sample forms in The Registry of Methods and Tools for Evidence-Informed Decision Making and the Grading of Recommendations, Assessment, Development and Evaluations Working Group .

Extracting the data is also a three-person job. Two people should do this step independently, and the third person will resolve any disagreements.

They also collected data about possible sources of bias, such as how the study participants were randomized into the control and treatment groups.

Step 6: Synthesize the data

Synthesizing the data means bringing together the information you collected into a single, cohesive story. There are two main approaches to synthesizing the data:

  • Narrative ( qualitative ): Summarize the information in words. You’ll need to discuss the studies and assess their overall quality.
  • Quantitative : Use statistical methods to summarize and compare data from different studies. The most common quantitative approach is a meta-analysis , which allows you to combine results from multiple studies into a summary result.

Generally, you should use both approaches together whenever possible. If you don’t have enough data, or the data from different studies aren’t comparable, then you can take just a narrative approach. However, you should justify why a quantitative approach wasn’t possible.

Boyle and colleagues also divided the studies into subgroups, such as studies about babies, children, and adults, and analyzed the effect sizes within each group.

Step 7: Write and publish a report

The purpose of writing a systematic review article is to share the answer to your research question and explain how you arrived at this answer.

Your article should include the following sections:

  • Abstract : A summary of the review
  • Introduction : Including the rationale and objectives
  • Methods : Including the selection criteria, search method, data extraction method, and synthesis method
  • Results : Including results of the search and selection process, study characteristics, risk of bias in the studies, and synthesis results
  • Discussion : Including interpretation of the results and limitations of the review
  • Conclusion : The answer to your research question and implications for practice, policy, or research

To verify that your report includes everything it needs, you can use the PRISMA checklist .

Once your report is written, you can publish it in a systematic review database, such as the Cochrane Database of Systematic Reviews , and/or in a peer-reviewed journal.

In their report, Boyle and colleagues concluded that probiotics cannot be recommended for reducing eczema symptoms or improving quality of life in patients with eczema. Note Generative AI tools like ChatGPT can be useful at various stages of the writing and research process and can help you to write your systematic review. However, we strongly advise against trying to pass AI-generated text off as your own work.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

  • Student’s  t -distribution
  • Normal distribution
  • Null and Alternative Hypotheses
  • Chi square tests
  • Confidence interval
  • Quartiles & Quantiles
  • Cluster sampling
  • Stratified sampling
  • Data cleansing
  • Reproducibility vs Replicability
  • Peer review
  • Prospective cohort study

Research bias

  • Implicit bias
  • Cognitive bias
  • Placebo effect
  • Hawthorne effect
  • Hindsight bias
  • Affect heuristic
  • Social desirability bias

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

A systematic review is secondary research because it uses existing research. You don’t collect new data yourself.

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Literature Review, Systematic Review and Meta-analysis

Literature reviews can be a good way to narrow down theoretical interests; refine a research question; understand contemporary debates; and orientate a particular research project. It is very common for PhD theses to contain some element of reviewing the literature around a particular topic. It’s typical to have an entire chapter devoted to reporting the result of this task, identifying gaps in the literature and framing the collection of additional data.

Systematic review is a type of literature review that uses systematic methods to collect secondary data, critically appraise research studies, and synthesise findings. Systematic reviews are designed to provide a comprehensive, exhaustive summary of current theories and/or evidence and published research (Siddaway, Wood & Hedges, 2019) and may be qualitative or qualitative. Relevant studies and literature are identified through a research question, summarised and synthesized into a discrete set of findings or a description of the state-of-the-art. This might result in a ‘literature review’ chapter in a doctoral thesis, but can also be the basis of an entire research project.

Meta-analysis is a specialised type of systematic review which is quantitative and rigorous, often comparing data and results across multiple similar studies. This is a common approach in medical research where several papers might report the results of trials of a particular treatment, for instance. The meta-analysis then statistical techniques to synthesize these into one summary. This can have a high statistical power but care must be taken not to introduce bias in the selection and filtering of evidence.

Whichever type of review is employed, the process is similarly linear. The first step is to frame a question which can guide the review. This is used to identify relevant literature, often through searching subject-specific scientific databases. From these results the most relevant will be identified. Filtering is important here as there will be time constraints that prevent the researcher considering every possible piece of evidence or theoretical viewpoint. Once a concrete evidence base has been identified, the researcher extracts relevant data before reporting the synthesized results in an extended piece of writing.

Literature Review: GO-GN Insights

Sarah Lambert used a systematic review of literature with both qualitative and quantitative phases to investigate the question “How can open education programs be reconceptualised as acts of social justice to improve the access, participation and success of those who are traditionally excluded from higher education knowledge and skills?”

“My PhD research used systematic review, qualitative synthesis, case study and discourse analysis techniques, each was underpinned and made coherent by a consistent critical inquiry methodology and an overarching research question. “Systematic reviews are becoming increasingly popular as a way to collect evidence of what works across multiple contexts and can be said to address some of the weaknesses of case study designs which provide detail about a particular context – but which is often not replicable in other socio-cultural contexts (such as other countries or states.) Publication of systematic reviews that are done according to well defined methods are quite likely to be published in high-ranking journals – my PhD supervisors were keen on this from the outset and I was encouraged along this path. “Previously I had explored social realist authors and a social realist approach to systematic reviews (Pawson on realist reviews) but they did not sufficiently embrace social relations, issues of power, inclusion/exclusion. My supervisors had pushed me to explain what kind of realist review I intended to undertake, and I found out there was a branch of critical realism which was briefly of interest. By getting deeply into theory and trying out ways of combining theory I also feel that I have developed a deeper understanding of conceptual working and the different ways theories can be used at all stagesof research and even how to come up with novel conceptual frameworks.”

Useful references for Systematic Review & Meta-Analysis: Finfgeld-Connett (2014); Lambert (2020); Siddaway, Wood & Hedges (2019)

Research Methods Handbook Copyright © 2020 by Rob Farrow; Francisco Iniesto; Martin Weller; and Rebecca Pitt is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Systematic reviews.

  • Getting Started with Systematic Reviews

What is a Systematic Review and Meta-Analysis

Differences between systematic and literature reviews.

  • Finding and Evaluating Existing Systematic Reviews
  • Steps in a Systematic Review
  • Step 1: Developing a Question
  • Step 2: Selecting Databases
  • Step 3: Grey Literature
  • Step 4: Registering a Systematic Review Protocol
  • Step 5: Translate Search Strategies
  • Step 6: Citation Management Tools
  • Step 7: Article Screening
  • Other Resources
  • Interlibrary Loan (ILL)

A systematic review collects and analyzes all evidence that answers a specific research question. In a systematic review, a question needs to be clearly defined and have inclusion and exclusion criteria. In general, specific and systematic methods selected are intended to minimize bias. This is followed by an extensive search of the literature and a critical analysis of the search results. The reason why a systematic review is conducted is to provide a current evidence-based answer to a specific question that in turn helps to inform decision making. Check out the Centers for Disease Control and Prevention and Cochrane Reviews links to learn more about Systematic Reviews.

A systematic review can be combined with a meta-analysis. A meta-analysis is the use of statistical methods to summarize the results of a systematic review. Not every systematic review contains a meta-analysis. A meta-analysis may not be appropriate if the designs of the studies are too different, if there are concerns about the quality of studies, if the outcomes measured are not sufficiently similar for the result across the studies to be meaningful.

Centers for Disease Control and Prevention. (n.d.).  Systematic Reviews . Retrieved from  https://www.cdc.gov/library/researchguides/sytemsaticreviews.html

Cochrane Library. (n.d.).  About Cochrane Reviews . Retrieved from  https://www.cochranelibrary.com/about/about-cochrane-reviews

systematic literature review vs meta analysis

Source: Kysh, Lynn (2013): Difference between a systematic review and a literature review. [figshare]. Available at:  https://figshare.com/articles/Difference_between_a_systematic_review_and_a_literature_review/766364

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  • Next: Finding and Evaluating Existing Systematic Reviews >>
  • Last Updated: Feb 15, 2024 2:53 PM
  • URL: https://guides.library.ucmo.edu/systematicreviews

Systematic Reviews and Meta Analysis

  • Getting Started
  • Guides and Standards
  • Review Protocols
  • Databases and Sources
  • Randomized Controlled Trials
  • Controlled Clinical Trials
  • Observational Designs
  • Tests of Diagnostic Accuracy
  • Software and Tools
  • Where do I get all those articles?
  • Collaborations
  • EPI 233/528
  • Countway Mediated Search
  • Risk of Bias (RoB)

Cochrane Handbook

The Cochrane Handbook isn't set down to be a standard, but it has become the de facto standard for planning and carrying out a systematic review. Chapter 6, Searching for Studies, is most helpful in planning your review.

Scoping Reviews, JBI Manual for Evidence Synthesis

The Joanna Briggs Institute provides extensive guidance for their authors in producing both systematic and scoping reviews. Their chapter on scoping reviews provides a succinct overview of the scoping review process. JBI maintains a page with other materials for scoping reviewers.

Methods Guide for Effectiveness and Comparative Effectiveness Reviews

Very good chapters on conducting a review, most of which were published as articles in the Journal of Clincal Epidemiology.

Institutes of Medicine Standards for Systematic Reviews

The IOM standards promote objective, transparent, and scientifically valid systematic reviews. They address the entire systematic review process, from locating, screening, and selecting studies for the review, to synthesizing the findings (including meta-analysis) and assessing the overall quality of the body of evidence, to producing the final review report.

Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care

Provides a succinct outline for carrying out systematic reviews and well as details about constructing a protocol, testing for bias, and other aspects of the review process. Includes examples.

Systematic reviews to support evidence-based medicine how to review and apply findings of healthcare research

Khan, K., & Royal Society of Medicine. 2nd ed,  2013. London [England]: Hodder Annold. [Harvard ID required]

Systematic reviews to answer health care questions

Nelson, H. (2014). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. [Harvard ID required]

Systematic Review Toolbox

Not a guide or standard but a clearinghouse for all things systematic review. Check here for templates, reporting standards, screening tools, risk of bias assessment, etc.

Reporting Standards: PRISMA and MOOSE

You will improve the quality of your review by adhering to the standards below. Using the approriate standard can reassure editors and reviewers that you have conscienciously carried out your review.

http://www.prisma-statement.org/ The Preferred Reporting Items for Systematic Reviews and Meta-Analyses is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses. A 27-item checklist,  PRISMA  focuses on randomized trials but can also be used as a basis for reporting systematic reviews of other types of research, particularly evaluations of interventions. PRISMA may also be useful for critical appraisal of published systematic reviews, although it is not a quality assessment instrument to gauge the quality of a systematic review.

Consider using PRISMA-P when completing your protocol. PRISMA-P is a 17-item checklist for elements considered essential in protocol for a systematic review or meta-analysis. The documentation contains an excellent rationale for completing a protocol, too.

Use PRISMA-ScR, a 20-item checklist, for reporting scoping reviews. The documentation provides a clear overview of scoping reviews.

Further Reading:

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. Epub 2009 Jul 21. PubMed PMID: 19621072 .  

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting  systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009 Jul 21;6(7):e1000100. Epub 2009 Jul 21. PubMed PMID: 19621070 . 

Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA; PRISMA-P Group. Preferred reporting items for systematic review andmeta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015 Jan 2;349:g7647. doi: 10.1136/bmj.g7647. PubMed PMID: 25555855 .

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA; PRISMA-P Group. Preferred reporting items for systematic review andmeta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015 Jan 1;4:1. doi: 10.1186/2046-4053-4-1. PubMed PMID: 25554246 .

Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033 .

Also published in the Annals of Internal Medicine, BMJ, and the Journal of Clinical Epidemiology.

MOOSE Guidelines

http://www.consort-statement.org/Media/Default/Downloads/Other%20Instruments/MOOSE%20Statement%202000.pdf Meta-analysis of Observational Studies in Epidemiology checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology. Editors will expect you to follow and cite this checklist.  It refers to the  Newcastle-Ottawa Scale for assessing the quality of non-randomized studies, a method of rating each observational study in your meta-analysis.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000 Apr 19;283(15):2008-12. PubMed PMID:  10789670 .

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  • Last Updated: Feb 14, 2024 2:47 PM
  • URL: https://guides.library.harvard.edu/meta-analysis

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  • Research Process

Systematic Literature Review or Literature Review?

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Table of Contents

As a researcher, you may be required to conduct a literature review. But what kind of review do you need to complete? Is it a systematic literature review or a standard literature review? In this article, we’ll outline the purpose of a systematic literature review, the difference between literature review and systematic review, and other important aspects of systematic literature reviews.

What is a Systematic Literature Review?

The purpose of systematic literature reviews is simple. Essentially, it is to provide a high-level of a particular research question. This question, in and of itself, is highly focused to match the review of the literature related to the topic at hand. For example, a focused question related to medical or clinical outcomes.

The components of a systematic literature review are quite different from the standard literature review research theses that most of us are used to (more on this below). And because of the specificity of the research question, typically a systematic literature review involves more than one primary author. There’s more work related to a systematic literature review, so it makes sense to divide the work among two or three (or even more) researchers.

Your systematic literature review will follow very clear and defined protocols that are decided on prior to any review. This involves extensive planning, and a deliberately designed search strategy that is in tune with the specific research question. Every aspect of a systematic literature review, including the research protocols, which databases are used, and dates of each search, must be transparent so that other researchers can be assured that the systematic literature review is comprehensive and focused.

Most systematic literature reviews originated in the world of medicine science. Now, they also include any evidence-based research questions. In addition to the focus and transparency of these types of reviews, additional aspects of a quality systematic literature review includes:

  • Clear and concise review and summary
  • Comprehensive coverage of the topic
  • Accessibility and equality of the research reviewed

Systematic Review vs Literature Review

The difference between literature review and systematic review comes back to the initial research question. Whereas the systematic review is very specific and focused, the standard literature review is much more general. The components of a literature review, for example, are similar to any other research paper. That is, it includes an introduction, description of the methods used, a discussion and conclusion, as well as a reference list or bibliography.

A systematic review, however, includes entirely different components that reflect the specificity of its research question, and the requirement for transparency and inclusion. For instance, the systematic review will include:

  • Eligibility criteria for included research
  • A description of the systematic research search strategy
  • An assessment of the validity of reviewed research
  • Interpretations of the results of research included in the review

As you can see, contrary to the general overview or summary of a topic, the systematic literature review includes much more detail and work to compile than a standard literature review. Indeed, it can take years to conduct and write a systematic literature review. But the information that practitioners and other researchers can glean from a systematic literature review is, by its very nature, exceptionally valuable.

This is not to diminish the value of the standard literature review. The importance of literature reviews in research writing is discussed in this article . It’s just that the two types of research reviews answer different questions, and, therefore, have different purposes and roles in the world of research and evidence-based writing.

Systematic Literature Review vs Meta Analysis

It would be understandable to think that a systematic literature review is similar to a meta analysis. But, whereas a systematic review can include several research studies to answer a specific question, typically a meta analysis includes a comparison of different studies to suss out any inconsistencies or discrepancies. For more about this topic, check out Systematic Review VS Meta-Analysis article.

Language Editing Plus

With Elsevier’s Language Editing Plus services , you can relax with our complete language review of your systematic literature review or literature review, or any other type of manuscript or scientific presentation. Our editors are PhD or PhD candidates, who are native-English speakers. Language Editing Plus includes checking the logic and flow of your manuscript, reference checks, formatting in accordance to your chosen journal and even a custom cover letter. Our most comprehensive editing package, Language Editing Plus also includes any English-editing needs for up to 180 days.

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Book cover

Orthopaedic Sports Medicine pp 1–11 Cite as

Systematic Review and Meta-Analysis

  • Yousif Eliya 5 ,
  • Alexander Zakharia 6 ,
  • Aaron Gazendam 7 &
  • Darren de SA 8  
  • Living reference work entry
  • First Online: 30 September 2023

Within the paradigm of evidence-based orthopedics, systematic reviews and meta-analyses top the hierarchy of evidence. A systematic review summarizes available literature of a specific research question, and meta-analysis applies statistical methods to combine results from two or more studies. Systematic reviews are increasingly published in orthopedic surgery, many answering the same clinical questions with different conclusions. A well-performed systematic review includes a clinical question that is comprehensively searched over multiple databases by at least two reviewers. Findings from systematic reviews should include outcomes most meaningful to patients and discuss results based on clinical and statistical significance. This chapter highlights characteristics of a well-conduced systematic review and meta-analysis and offers nine tips on the best methods to design, synthesize, and appraise this research methodology.

  • Systematic Reviews
  • Meta-analysis
  • Research Methodology
  • Evidence-Based Orthopedics
  • Evidence-Based Medicine

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Ardern CL, Büttner F, Andrade R, Weir A, Ashe MC, Holden S, et al. Implementing the 27 PRISMA 2020 statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance. Br J Sports Med. 2022;56:175–95.

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Authors and affiliations.

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada

Yousif Eliya

MacSports Research Program, McMaster University, Hamilton, ON, Canada

Alexander Zakharia

Department of Surgery, Division of Orthopaedic Surgery, Center for Evidence Based Orthopaedics, McMaster University, Hamilton, ON, Canada

Aaron Gazendam

Department of Surgery, Division of Pediatric Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada

Darren de SA

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Correspondence to Darren de SA .

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FIFA Medical Centre of Excellence, Clínica Espregueira, Porto, Portugal

João Espregueira-Mendes

Dept. Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden

Jón Karlsson

UPMC Freddie Fu SportsMed Ctr, Orth Surg, University of Pittsburgh, Pittsburgh, PA, USA

Volker Musahl

McMaster University, Hamilton, ON, Canada

Olufemi R. Ayeni

Section Editor information

UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

Volker Musahl MD

Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada

Mohit Bhandari

Mark R. Neaman Family Chair of Orthopaedic Surgery and Director, Orthopaedic & Spine Institute, NorthShore University HealthSystem, Skokie IL, Skokie, IL, USA

Jason L. Koh

Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg – Clinique d’Eich, Luxembourg, Grand Duchy of Luxembourg

Caroline Mouton

Sports Medicine and Science, Luxembourg Institute of Research in Orthopaedics, Luxembourg city, Luxembourg

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Eliya, Y., Zakharia, A., Gazendam, A., de SA, D. (2024). Systematic Review and Meta-Analysis. In: Espregueira-Mendes, J., Karlsson, J., Musahl, V., Ayeni, O.R. (eds) Orthopaedic Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-65430-6_80-1

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DOI : https://doi.org/10.1007/978-3-030-65430-6_80-1

Received : 03 September 2023

Accepted : 04 September 2023

Published : 30 September 2023

Publisher Name : Springer, Cham

Print ISBN : 978-3-030-65430-6

Online ISBN : 978-3-030-65430-6

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Systematic Reviews

  • Introduction to Systematic Reviews

Traditional Systematic Reviews

Meta-analyses, scoping reviews, rapid reviews, umbrella reviews, selecting a review type.

  • Reading Systematic Reviews
  • Resources for Conducting Systematic Reviews
  • Getting Help with Systematic Reviews from the Library
  • History of Systematic Reviews
  • Acknowledgements

Systematic Reviews are a family of review types that include:

This page provides information about the most common types of systematic reviews, important resources and references for conducting them, and some tools for choosing the best type for your research question .

Additional Information

  • A typology of reviews: an analysis of 14 review types and associated methodologies This classic article is a valuable reference point for those commissioning, conducting, supporting or interpreting reviews.
  • Traditional Systematic Reviews follow a rigorous and well-defined methodology to identify, select, and critically appraise relevant research articles on a specific topic and within a specified population of subjects
  • The primary goal of this type of study is to comprehensively find the empirical data available on a topic, identify relevant articles, synthesize their findings and draw evidence-based conclusions to answer a clinical question
  • Cochrane Handbook for Systematic Reviews of Interventions The Cochrane Handbook for Systematic Reviews of Interventions provides direction on the standard methods involved in conducting a systematic review. It is the official guide to the process involved in preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
  • JBI Manual for Evidence Synthesis The JBI Manual for Evidence Synthesis is designed to provide authors with a comprehensive guide to conducting JBI systematic reviews. It describes in detail the process of planning, undertaking and writing up a systematic review using JBI methods. The JBI Manual for Evidence Synthesis should be used in conjunction with the support and tutorials offered at the JBI SUMARI Knowledge Base.

These are some places where protocols for systematic reviews might be published.

  • PROSPERO: International prospective register of systematic reviews PROSPERO is an international database of prospectively registered systematic reviews in health and social care, welfare, public health, education, crime, justice, and international development, where there is a health related outcome. Key features from the review protocol are recorded and maintained as a permanent record. PROSPERO aims to provide a comprehensive listing of systematic reviews registered at inception to help avoid duplication and reduce opportunity for reporting bias by enabling comparison of the completed review with what was planned in the protocol.
  • Guidance Notes for Registering A Systematic Review Protocol with PROSPERO
  • OSF Registries Open Science Framework (OSF) Registries is an open network of study registgrations and pre-registrations. It can be used to pre-register a systematic review protocol. Note that OSF pre-registrations are not reviewed.
  • OSF Preregistration Initiative This page explains the motivation behind preregistrations and best practices for doing so.
  • Protocols.io A secure platform for developing and sharing reproducible methods, including protocols for systematic reviews.
  • PRISMA 2020 Statement The PRISMA 2020 Statement was published in 2021. It consists of a checklist and a flow diagram, and is intended to be accompanied by the PRISMA 2020 Explanation and Elaboration document.
  • Meta-analysis is a statistical method that can be applied during a systematic review to extract and combine the results from multiple studies
  • This pooling of data from compatible studies increases the statistical power and precision of the conclusions made by the systematic review
  • Systematic reviews can be done without doing a meta-analysis, but a meta-analysis must be done in connection with a systematic review
  • Scoping reviews identify the existing literature available on a topic to help identify key concepts, the type and amount of evidence available on a subject, and what research gaps exist in a specific area of study
  • They are particularly useful when a research question is broad and the goal is to provide an understanding of the available evidence on a topic rather than providing a focused synthesis on a narrow question
  • JBI Manual Chapter 11: Scoping Reviews
  • Updated methodological guidance for the conduct of scoping reviews The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR).
  • Steps for Conducting a Scoping Review This article in the Journal of Graduate Medical Education provides a comprehensive yet brief overview of the scoping review process.

Note: Protocols for scoping reviews can be published in all the same places as traditional systematic reviews except PROSPERO.

  • Best practice guidance and reporting items for the development of scoping review protocols The purpose of this article is to clearly describe how to develop a robust and detailed scoping review protocol, which is the first stage of the scoping review process. This paper provides detailed guidance and a checklist for prospective authors to ensure that their protocols adequately inform both the conduct of the ensuing review and their readership.
  • PRISMA for Scoping Reviews (PRISMA-ScR) The PRISMA extension for scoping reviews was published in 2018. The checklist contains 20 essential reporting items and 2 optional items to include when completing a scoping review. Scoping reviews serve to synthesize evidence and assess the scope of literature on a topic. Among other objectives, scoping reviews help determine whether a systematic review of the literature is warranted.
  • Touro College: What is a Scoping Review? This page describes scoping reviews, including their limitations, alternate names, and how they differ from traditional systematic reviews.
  • What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis This article from JBI Evidence Synthesis provides a thorough definition of what scoping reviews are and what they are for.
  • The role of scoping reviews in reducing research waste This article from the Journal of Clinical Epidemiology looks at how scoping reviews can reduce research waste.
  • Rapid reviews streamline the systematic review process by omitting certain steps or accelerating the timeline
  • They are useful when there is a need for timely evidence synthesis, such as in response to questions concerning an urgent policy or clinical situation such as the COVID-19 pandemic
  • Rapid Review Guidebook This document provides guidance on the process of conducting rapid reviews to use evidence to inform policy and program decision making.
  • Rapid reviews to strengthen health policy and systems: a practical guide This guide from the World Health Organization offers guidance on how to plan, conduct, and promote the use of rapid reviews to strengthen health policy and systems decisions. The Guide explores different approaches and methods for expedited synthesis of health policy and systems research, and highlights key challenges for this emerging field, including its application in low- and middle-income countries. It touches on the utility of rapid reviews of health systems evidence, and gives insights into applied methods to swiftly conduct knowledge syntheses and foster their use in policy and practice.
  • Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews The Cochrane Rapid Reviews Methods Group offers new, interim guidance to support the conduct of Rapid Reviews.
  • Touro College: What is a Rapid Review? This page describes rapid reviews, including their limitations, alternate names, and how they differ from traditional systematic reviews.
  • Umbrella reviews synthesize evidence from multiple systematic reviews and meta-analyses on a specific topic
  • They provide a next-generation level of evidence synthesis, analyzing evidence taken from multiple systematic reviews to offer a broader perspective on a given subject
  • JBI Manual Chapter 10: Umbrella reviews
  • Preferred Reporting Items for Overviews of Reviews (PRIOR) Overviews of reviews (i.e., overviews) compile information from multiple systematic reviews to provide a single synthesis of relevant evidence for healthcare decision-making. Despite their increasing popularity, there are currently no systematically developed reporting guidelines for overviews. This is problematic because the reporting of published overviews varies considerably and is often substandard. Our objective is to use explicit, systematic, and transparent methods to develop an evidence-based and agreement-based reporting guideline for overviews of reviews of healthcare interventions (PRIOR, Preferred Reporting Items for Overviews of Reviews).
  • Touro College: What is an Overview of Reviews? This page describes umbrella reviews, including their limitations, alternate names, and how they differ from traditional systematic reviews.
  • Cornell University Systematic Review Decision Tree This decision tree is designed to assist researchers in choosing a review type.
  • Right Review This tool is designed to provide guidance and supporting material to reviewers on methods for the conduct and reporting of knowledge synthesis.
  • << Previous: Introduction to Systematic Reviews
  • Next: Reading Systematic Reviews >>
  • Last Updated: Feb 12, 2024 5:59 PM
  • URL: https://libguides.ohsu.edu/systematic-reviews

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Literature Reviews

  • Types of reviews
  • Getting started

Types of reviews and examples

Choosing a review type.

  • 1. Define your research question
  • 2. Plan your search
  • 3. Search the literature
  • 4. Organize your results
  • 5. Synthesize your findings
  • 6. Write the review
  • Thompson Writing Studio This link opens in a new window
  • Need to write a systematic review? This link opens in a new window

systematic literature review vs meta analysis

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Overview of types of literature reviews

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  • Literature (narrative)
  • Scoping / Evidence map
  • Meta-analysis

Characteristics:

  • Provides examination of recent or current literature on a wide range of subjects
  • Varying levels of completeness / comprehensiveness, non-standardized methodology
  • May or may not include comprehensive searching, quality assessment or critical appraisal

Mitchell, L. E., & Zajchowski, C. A. (2022). The history of air quality in Utah: A narrative review.  Sustainability ,  14 (15), 9653.  doi.org/10.3390/su14159653

  • Assessment of what is already known about an issue
  • Similar to a systematic review but within a time-constrained setting
  • Typically employs methodological shortcuts, increasing risk of introducing bias, includes basic level of quality assessment
  • Best suited for issues needing quick decisions and solutions (i.e., policy recommendations)

Learn more about the method:

Khangura, S., Konnyu, K., Cushman, R., Grimshaw, J., & Moher, D. (2012). Evidence summaries: the evolution of a rapid review approach.  Systematic reviews, 1 (1), 1-9.  https://doi.org/10.1186/2046-4053-1-10

Virginia Commonwealth University Libraries. (2021). Rapid Review Protocol .

Quarmby, S., Santos, G., & Mathias, M. (2019). Air quality strategies and technologies: A rapid review of the international evidence.  Sustainability, 11 (10), 2757.  https://doi.org/10.3390/su11102757

  • Compiles evidence from multiple reviews into one document
  • Often defines a broader question than is typical of a traditional systematic review.

Choi, G. J., & Kang, H. (2022). The umbrella review: a useful strategy in the rain of evidence.  The Korean Journal of Pain ,  35 (2), 127–128.  https://doi.org/10.3344/kjp.2022.35.2.127

Aromataris, E., Fernandez, R., Godfrey, C. M., Holly, C., Khalil, H., & Tungpunkom, P. (2015). Summarizing systematic reviews: Methodological development, conduct and reporting of an umbrella review approach. International Journal of Evidence-Based Healthcare , 13(3), 132–140. https://doi.org/10.1097/XEB.0000000000000055

Rojas-Rueda, D., Morales-Zamora, E., Alsufyani, W. A., Herbst, C. H., Al Balawi, S. M., Alsukait, R., & Alomran, M. (2021). Environmental risk factors and health: An umbrella review of meta-analyses.  International Journal of Environmental Research and Public Dealth ,  18 (2), 704.  https://doi.org/10.3390/ijerph18020704

  • Main purpose is to map out and categorize existing literature, identify gaps in literature
  • Search comprehensiveness determined by time/scope constraints, could take longer than a systematic review
  • No formal quality assessment or critical appraisal

Learn more about the methods :

Arksey, H., & O'Malley, L. (2005) Scoping studies: towards a methodological framework.  International Journal of Social Research Methodology ,  8 (1), 19-32.  https://doi.org/10.1080/1364557032000119616

Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science: IS, 5, 69. https://doi.org/10.1186/1748-5908-5-69

Miake-Lye, I. M., Hempel, S., Shanman, R., & Shekelle, P. G. (2016). What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products.  Systematic reviews, 5 (1), 1-21.  https://doi.org/10.1186/s13643-016-0204-x

Example : 

Rahman, A., Sarkar, A., Yadav, O. P., Achari, G., & Slobodnik, J. (2021). Potential human health risks due to environmental exposure to nano-and microplastics and knowledge gaps: A scoping review.  Science of the Total Environment, 757 , 143872.  https://doi.org/10.1016/j.scitotenv.2020.143872

  • Seeks to systematically search for, appraise, and synthesize research evidence
  • Adheres to strict guidelines, protocols, and frameworks
  • Time-intensive and often take months to a year or more to complete. 
  • The most commonly referred to type of evidence synthesis. Sometimes confused as a blanket term for other types of reviews.

Gascon, M., Triguero-Mas, M., Martínez, D., Dadvand, P., Forns, J., Plasència, A., & Nieuwenhuijsen, M. J. (2015). Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review.  International Journal of Environmental Research and Public Health ,  12 (4), 4354–4379.  https://doi.org/10.3390/ijerph120404354

  • Statistical technique for combining results of quantitative studies to provide more precise effect of results
  • Aims for exhaustive, comprehensive searching
  • Quality assessment may determine inclusion/exclusion criteria
  • May be conducted independently or as part of a systematic review

Berman, N. G., & Parker, R. A. (2002). Meta-analysis: Neither quick nor easy. BMC Medical Research Methodology , 2(1), 10. https://doi.org/10.1186/1471-2288-2-10

Hites R. A. (2004). Polybrominated diphenyl ethers in the environment and in people: a meta-analysis of concentrations.  Environmental Science & Technology ,  38 (4), 945–956.  https://doi.org/10.1021/es035082g

Flowchart of review types

  • Review Decision Tree - Cornell University For more information, check out Cornell's review methodology decision tree.
  • LitR-Ex.com - Eight literature review methodologies Learn more about 8 different review types (incl. Systematic Reviews and Scoping Reviews) with practical tips about strengths and weaknesses of different methods.
  • << Previous: Getting started
  • Next: 1. Define your research question >>
  • Last Updated: Feb 15, 2024 1:45 PM
  • URL: https://guides.library.duke.edu/lit-reviews

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Efficacy of sotrovimab on omicron BA.2, BA.4 and BA.5 subvariants of sars-cov-2 vs. other early therapies: a systematic review and meta-analysis of literature data

Affiliation.

  • 1 Department of Mental Health and Public Medicine - Infectious Disease Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
  • PMID: 38352882
  • PMCID: PMC10861778
  • DOI: 10.3389/fimmu.2024.1295029

Background: The aim of this meta-analysis was to ascertain whether sotrovimab was effective in reducing COVID-19 related hospitalization and mortality also in Omicron BA.2, BA.4 and BA.5 subvariants compared to other antivirals effective in index period.

Methods: A systematic review and meta-analysis of Randomized Controlled Trials (RCTs) and observational studies comparing the efficacy of early treatment with sotrovimab compared to other early treatment effective in index period, antivirals or monoclonal antibodies (mAbs), in patients with COVID-19 during BA.2, BA.4, BA.5 waves, conducted in accordance with PRISMA guidelines. We searched MEDLINE, Google Scholar and the Cochrane Library. Mortality and hospitalization were defined as outcomes.

Results: Four studies were included, allowing a meta-analysis of 8,041 patients. Meta-analysis showed no statistical difference between groups in hospitalization and mortality. Precisely, the RR of mortality showed no difference in the sotrovimab group compared to treatment with other drugs (OR 0.38, 95% CI 0.10-1.49, p<0.166). As regards the rate of hospitalization, no significant difference resulted between the patients treated with sotrovimab and those with other drugs (OR 1.66, 95% CI 0.41-6.66, p=0.477).

Interpretation: In conclusion, this meta-analysis showed no significant difference between sotrovimab or other antivirals in reducing COVID-19 evolution in patients with a high risk of progression, considering both hospitalization and mortality.

Keywords: COVID-19; early treatment; hospitalization; monoclonal antibodies; mortality.

Copyright © 2024 Russo, Grimaldi, Pisaturo, Onorato and Coppola.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Antibodies, Monoclonal, Humanized*
  • Antibodies, Neutralizing*
  • Antiviral Agents / therapeutic use
  • SARS-CoV-2*
  • Secondary Prevention
  • Antiviral Agents
  • Antibodies, Neutralizing
  • Antibodies, Monoclonal, Humanized

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  • v.2(1); Jan-Mar 2013

Systematic Reviews and Meta-analysis: Understanding the Best Evidence in Primary Healthcare

S. gopalakrishnan.

Department of Community Medicine, SRM Medical College, Hospital and Research Centre, Kattankulathur, Tamil Nadu, India

P. Ganeshkumar

Healthcare decisions for individual patients and for public health policies should be informed by the best available research evidence. The practice of evidence-based medicine is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient's values and expectations. Primary care physicians need evidence for both clinical practice and for public health decision making. The evidence comes from good reviews which is a state-of-the-art synthesis of current evidence on a given research question. Given the explosion of medical literature, and the fact that time is always scarce, review articles play a vital role in decision making in evidence-based medical practice. Given that most clinicians and public health professionals do not have the time to track down all the original articles, critically read them, and obtain the evidence they need for their questions, systematic reviews and clinical practice guidelines may be their best source of evidence. Systematic reviews aim to identify, evaluate, and summarize the findings of all relevant individual studies over a health-related issue, thereby making the available evidence more accessible to decision makers. The objective of this article is to introduce the primary care physicians about the concept of systematic reviews and meta-analysis, outlining why they are important, describing their methods and terminologies used, and thereby helping them with the skills to recognize and understand a reliable review which will be helpful for their day-to-day clinical practice and research activities.

Introduction

Evidence-based healthcare is the integration of best research evidence with clinical expertise and patient values. Green denotes, “Using evidence from reliable research, to inform healthcare decisions, has the potential to ensure best practice and reduce variations in healthcare delivery.” However, incorporating research into practice is time consuming, and so we need methods of facilitating easy access to evidence for busy clinicians.[ 1 ] Ganeshkumar et al . mentioned that nearly half of the private practitioners in India were consulting more than 4 h per day in a locality,[ 2 ] which explains the difficulty of them in spending time in searching evidence during consultation. Ideally, clinical decision making ought to be based on the latest evidence available. However, to keep abreast with the continuously increasing number of publications in health research, a primary healthcare professional would need to read an insurmountable number of articles every day, covered in more than 13 million references and over 4800 biomedical and health journals in Medline alone. With the view to address this challenge, the systematic review method was developed. Systematic reviews aim to inform and facilitate this process through research synthesis of multiple studies, enabling increased and efficient access to evidence.[ 1 , 3 , 4 ]

Systematic reviews and meta-analyses have become increasingly important in healthcare settings. Clinicians read them to keep up-to-date with their field and they are often used as a starting point for developing clinical practice guidelines. Granting agencies may require a systematic review to ensure there is justification for further research and some healthcare journals are moving in this direction.[ 5 ]

This article is intended to provide an easy guide to understand the concept of systematic reviews and meta-analysis, which has been prepared with the aim of capacity building for general practitioners and other primary healthcare professionals in research methodology and day-to-day clinical practice.

The purpose of this article is to introduce readers to:

  • The two approaches of evaluating all the available evidence on an issue i.e., systematic reviews and meta-analysis,
  • Discuss the steps in doing a systematic review,
  • Introduce the terms used in systematic reviews and meta-analysis,
  • Interpret results of a meta-analysis, and
  • The advantages and disadvantages of systematic review and meta-analysis.

Application

What is the effect of antiviral treatment in dengue fever? Most often a primary care physician needs to know convincing answers to questions like this in a primary care setting.

To find out the solutions or answers to a clinical question like this, one has to refer textbooks, ask a colleague, or search electronic database for reports of clinical trials. Doctors need reliable information on such problems and on the effectiveness of large number of therapeutic interventions, but the information sources are too many, i.e., nearly 20,000 journals publishing 2 million articles per year with unclear or confusing results. Because no study, regardless of its type, should be interpreted in isolation, a systematic review is generally the best form of evidence.[ 6 ] So, the preferred method is a good summary of research reports, i.e., systematic reviews and meta-analysis, which will give evidence-based answers to clinical situations.

There are two fundamental categories of research: Primary research and secondary research. Primary research is collecting data directly from patients or population, while secondary research is the analysis of data already collected through primary research. A review is an article that summarizes a number of primary studies and may draw conclusions on the topic of interest which can be traditional (unsystematic) or systematic.

Terminologies

Systematic review.

A systematic review is a summary of the medical literature that uses explicit and reproducible methods to systematically search, critically appraise, and synthesize on a specific issue. It synthesizes the results of multiple primary studies related to each other by using strategies that reduce biases and random errors.[ 7 ] To this end, systematic reviews may or may not include a statistical synthesis called meta-analysis, depending on whether the studies are similar enough so that combining their results is meaningful.[ 8 ] Systematic reviews are often called overviews.

The evidence-based practitioner, David Sackett, defines the following terminologies.[ 3 ]

  • Review: The general term for all attempts to synthesize the results and conclusions of two or more publications on a given topic.
  • Overview: When a review strives to comprehensively identify and track down all the literature on a given topic (also called “systematic literature review”).
  • Meta-analysis: A specific statistical strategy for assembling the results of several studies into a single estimate.

Systematic reviews adhere to a strict scientific design based on explicit, pre-specified, and reproducible methods. Because of this, when carried out well, they provide reliable estimates about the effects of interventions so that conclusions are defensible. Systematic reviews can also demonstrate where knowledge is lacking. This can then be used to guide future research. Systematic reviews are usually carried out in the areas of clinical tests (diagnostic, screening, and prognostic), public health interventions, adverse (harm) effects, economic (cost) evaluations, and how and why interventions work.[ 9 ]

Cochrane reviews

Cochrane reviews are systematic reviews undertaken by members of the Cochrane Collaboration which is an international not-for-profit organization that aims to help people to make well-informed decisions about healthcare by preparing, maintaining, and promoting the accessibility of systematic reviews of the effects of healthcare interventions.

Cochrane Primary Health Care Field is a systematic review of primary healthcare research on prevention, treatment, rehabilitation, and diagnostic test accuracy. The overall aim and mission of the Primary Health Care Field is to promote the quality, quantity, dissemination, accessibility, applicability, and impact of Cochrane systematic reviews relevant to people who work in primary care and to ensure proper representation in the interests of primary care clinicians and consumers in Cochrane reviews and review groups, and in other entities. This field would serve to coordinate and promote the mission of the Cochrane Collaboration within the primary healthcare disciplines, as well as ensuring that primary care perspectives are adequately represented within the Collaboration.[ 10 ]

Meta-analysis

A meta-analysis is the combination of data from several independent primary studies that address the same question to produce a single estimate like the effect of treatment or risk factor. It is the statistical analysis of a large collection of analysis and results from individual studies for the purpose of integrating the findings.[ 11 ] The term meta-analysis has been used to denote the full range of quantitative methods for research reviews.[ 12 ] Meta-analyses are studies of studies.[ 13 ] Meta-analysis provides a logical framework to a research review where similar measures from comparable studies are listed systematically and the available effect measures are combined wherever possible.[ 14 ]

The fundamental rationale of meta-analysis is that it reduces the quantity of data by summarizing data from multiple resources and helps to plan research as well as to frame guidelines. It also helps to make efficient use of existing data, ensuring generalizability, helping to check consistency of relationships, explaining data inconsistency, and quantifies the data. It helps to improve the precision in estimating the risk by using explicit methods.

Therefore, “systematic review” will refer to the entire process of collecting, reviewing, and presenting all available evidence, while the term “meta-analysis” will refer to the statistical technique involved in extracting and combining data to produce a summary result.[ 15 ]

Steps in doing systematic reviews/meta-analysis

Following are the six fundamental essential steps while doing systematic review and meta-analysis.[ 16 ]

Define the question

This is the most important part of systematic reviews/meta-analysis. The research question for the systematic reviews may be related to a major public health problem or a controversial clinical situation which requires acceptable intervention as a possible solution to the present healthcare need of the community. This step is most important since the remaining steps will be based on this.

Reviewing the literature

This can be done by going through scientific resources such as electronic database, controlled clinical trials registers, other biomedical databases, non-English literatures, “gray literatures” (thesis, internal reports, non–peer-reviewed journals, pharmaceutical industry files), references listed in primary sources, raw data from published trials and other unpublished sources known to experts in the field. Among the available electronic scientific database, the popular ones are PUBMED, MEDLINE, and EMBASE.

Sift the studies to select relevant ones

To select the relevant studies from the searches, we need to sift through the studies thus identified. The first sift is pre-screening, i.e., to decide which studies to retrieve in full, and the second sift is selection which is to look again at these studies and decide which are to be included in the review. The next step is selecting the eligible studies based on similar study designs, year of publication, language, choice among multiple articles, sample size or follow-up issues, similarity of exposure, and or treatment and completeness of information.

It is necessary to ensure that the sifting includes all relevant studies like the unpublished studies (desk drawer problem), studies which came with negative conclusions or were published in non-English journals, and studies with small sample size.

Assess the quality of studies

The steps undertaken in evaluating the study quality are early definition of study quality and criteria, setting up a good scoring system, developing a standard form for assessment, calculating quality for each study, and finally using this for sensitivity analysis.

For example, the quality of a randomized controlled trial can be assessed by finding out the answers to the following questions:

  • Was the assignment to the treatment groups really random?
  • Was the treatment allocation concealed?
  • Were the groups similar at baseline in terms of prognostic factors?
  • Were the eligibility criteria specified?
  • Were the assessors, the care provider, and the patient blinded?
  • Were the point estimates and measure of variability presented for the primary outcome measure?
  • Did the analyses include intention-to-treat analysis?

Calculate the outcome measures of each study and combine them

We need a standard measure of outcome which can be applied to each study on the basis of its effect size. Based on their type of outcome, following are the measures of outcome: Studies with binary outcomes (cured/not cured) have odds ratio, risk ratio; studies with continuous outcomes (blood pressure) have means, difference in means, standardized difference in means (effect sizes); and survival or time-to-event data have hazard ratios.

Combining studies

Homogeneity of different studies can be estimated at a glance from a forest plot (explained below). For example, if the lower confidence interval of every trial is below the upper of all the others, i.e., the lines all overlap to some extent, then the trials are homogeneous. If some lines do not overlap at all, these trials may be said to be heterogeneous.

The definitive test for assessing the heterogeneity of studies is a variant of Chi-square test (Mantel–Haenszel test). The final step is calculating the common estimate and its confidence interval with the original data or with the summary statistics from all the studies. The best estimate of treatment effect can be derived from the weighted summary statistics of all studies which will be based on weighting to sample size, standard errors, and other summary statistics. Log scale is used to combine the data to estimate the weighting.

Interpret results: Graph

The results of a meta-analysis are usually presented as a graph called forest plot because the typical forest plots appear as forest of lines. It provides a simple visual presentation of individual studies that went into the meta-analysis at a glance. It shows the variation between the studies and an estimate of the overall result of all the studies together.

Forest plot

Meta-analysis graphs can principally be divided into six columns [ Figure 1 ]. Individual study results are displayed in rows. The first column (“study”) lists the individual study IDs included in the meta-analysis; usually the first author and year are displayed. The second column relates to the intervention groups and the third column to the control groups. The fourth column visually displays the study results. The line in the middle is called “the line of no effect.” The weight (in %) in the fifth column indicates the weighting or influence of the study on the overall results of the meta-analysis of all included studies. The higher the percentage weight, the bigger the box, the more influence the study has on the overall results. The sixth column gives the numerical results for each study (e.g., odds ratio or relative risk and 95% confidence interval), which are identical to the graphical display in the fourth column. The diamond in the last row of the graph illustrates the overall result of the meta-analysis.[ 4 ]

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Interpretation of meta-analysis[ 4 ]

Thus, the horizontal lines represent individual studies. Length of line is the confidence interval (usually 95%), squares on the line represent effect size (risk ratio) for the study, with area of the square being the study size (proportional to weight given) and position as point estimate (relative risk) of the study.[ 7 ]

For example, the forest plot of the effectiveness of dexamethasone compared with placebo in preventing the recurrence of acute severe migraine headache in adults is shown in Figure 2 .[ 17 ]

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Forest plot of the effectiveness of dexamethasone compared with placebo in preventing the recurrence of acute severe migraine headache in adults[ 17 ]

The overall effect is shown as diamond where the position toward the center represents pooled point estimate, the width represents estimated 95% confidence interval for all studies, and the black plain line vertically in the middle of plot is the “line of no effect” (e.g., relative risk = 1).

Therefore, when examining the results of a systematic reviews/meta-analysis, the following questions should be kept in mind:

  • Heterogeneity among studies may make any pooled estimate meaningless.
  • The quality of a meta-analysis cannot be any better than the quality of the studies it is summarizing.
  • An incomplete search of the literature can bias the findings of a meta-analysis.
  • Make sure that the meta-analysis quantifies the size of the effect in units that you can understand.

Subgroup analysis and sensitivity analysis

Subgroup analysis looks at the results of different subgroups of trials, e.g., by considering trials on adults and children separately. This should be planned at the protocol stage itself which is based on good scientific reasoning and is to be kept to a minimum.

Sensitivity analysis is used to determine how results of a systematic review/meta-analysis change by fiddling with data, for example, what is the implication if the exclusion criteria or excluded unpublished studies or weightings are assigned differently. Thus, after the analysis, if changing makes little or no difference to the overall results, the reviewer's conclusions are robust. If the key findings disappear, then the conclusions need to be expressed more cautiously.

Advantages of Systematic Reviews

Systematic reviews have specific advantages because of using explicit methods which limit bias, draw reliable and accurate conclusions, easily deliver required information to healthcare providers, researchers, and policymakers, help to reduce the time delay in the research discoveries to implementation, improve the generalizability and consistency of results, generation of new hypotheses about subgroups of the study population, and overall they increase precision of the results.[ 18 ]

Limitations in Systematic Reviews/Meta-analysis

As with all research, the value of a systematic review depends on what was done, what was found, and the clarity of reporting. As with other publications, the reporting quality of systematic reviews varies, limiting readers’ ability to assess the strengths and weaknesses of those reviews.[ 5 ]

Even though systematic review and meta-analysis are considered the best evidence for getting a definitive answer to a research question, there are certain inherent flaws associated with it, such as the location and selection of studies, heterogeneity, loss of information on important outcomes, inappropriate subgroup analyses, conflict with new experimental data, and duplication of publication.

Publication Bias

Publication bias results in it being easier to find studies with a “positive” result.[ 19 ] This occurs particularly due to inappropriate sifting of the studies where there is always a tendency towards the studies with positive (significant) outcomes. This effect occurs more commonly in systematic reviews/meta-analysis which need to be eliminated.

The quality of reporting of systematic reviews is still not optimal. In a recent review of 300 systematic reviews, few authors reported assessing possible publication bias even though there is overwhelming evidence both for its existence and its impact on the results of systematic reviews. Even when the possibility of publication bias is assessed, there is no guarantee that systematic reviewers have assessed or interpreted it appropriately.[ 20 ]

To overcome certain limitations mentioned above, the Cochrane reviews are currently reported in a format where at the end of every review, findings are summarized in the author's point of view and also give an overall picture of the outcome by means of plain language summary. This is found to be much helpful to understand the existing evidence about the topic more easily by the reader.

A systematic review is an overview of primary studies which contains an explicit statement of objectives, materials, and methods, and has been conducted according to explicit and reproducible methodology. A meta-analysis is a mathematical synthesis of the results of two or more primary studies that addressed the same hypothesis in the same way. Although meta-analysis can increase the precision of a result, it is important to ensure that the methods used for the reviews were valid and reliable.

High-quality systematic reviews and meta-analyses take great care to find all relevant studies, critically assess each study, synthesize the findings from individual studies in an unbiased manner, and present balanced important summary of findings with due consideration of any flaws in the evidence. Systematic review and meta-analysis is a way of summarizing research evidence, which is generally the best form of evidence, and hence positioned at the top of the hierarchy of evidence.

Systematic reviews can be very useful decision-making tools for primary care/family physicians. They objectively summarize large amounts of information, identifying gaps in medical research, and identifying beneficial or harmful interventions which will be useful for clinicians, researchers, and even for public and policymakers.

Source of Support: Nil

Conflict of Interest: None declared.

  • Open access
  • Published: 16 February 2024

The prevalence of hepatitis B in Chinese general population from 2018 to 2022: a systematic review and meta-analysis

  • Shuwen Bai 1 ,
  • Wen Dang 1 ,
  • Wenying Hong 1 ,
  • Wenyu Liao 1 &
  • Robert David Smith 1  

BMC Infectious Diseases volume  24 , Article number:  211 ( 2024 ) Cite this article

Metrics details

Within China, Hepatitis B virus (HBV) infection remains widely prevalent and one of the major public health problems. There have been only two previous estimates of its prevalence at the population level in China, with the latest survey conducted in 2006. A meta-analysis estimated the prevalence of HBV within China between 2013 and 2017 as 7%. This review provides an updated estimate of HBV prevalence in China from 2018 to 2022.

Systematic searches of literature from January 1, 2018 to December 25, 2022 were conducted in four international databases (Medline, Web of Science, Embase, Cochrane Database of Systematic Reviews) and three Chinese databases (CNKI, CBM, and WanFang data). Random-effects meta-analyses were conducted to calculate the pooled HBV prevalence with 95% confidence intervals in the overall population and subgroups. Publication bias, heterogeneity between studies, and study quality were assessed.

Twenty-five articles were included in the meta-analysis. The pooled prevalence of HBV infection in the Chinese general population from 2018 to 2022 was 3% (95%CI: 2–4%). The prevalence of HBV infection was similar between males and females (both 3%), while rural areas had a higher prevalence than urban areas (3% vs 2%). The highest prevalence of HBV was reported in the eastern provinces (4, 95%CI: 2–6%). The HBV prevalence of people aged ≥18 years old (6, 95%CI: 4–8%) was higher than people aged < 18 years old (0, 95%CI: 0–1%).

Compared to the previous meta-analysis prevalence in 2013–2017, the updated meta-analysis estimated prevalence of HBV infection (3%) from 2018 to 2020 showed a decreasing trend, suggesting China had moved into a lower intermediate epidemic area (2–5%). However, the prevalence of HBV in rural areas and eastern regions was still higher than the national average. People aged ≥18 years old showed a higher HBV prevalence. HBV prevention should be prioritized in the highest-prevalence areas and high-risk populations. Due to heterogeneity in data collection methods among studies, there remains a need for systematic surveillance of nationwide HBV prevalence.

Peer Review reports

Hepatitis B virus (HBV) is a leading cause of liver cancer, with an estimated 296 million people living with chronic HBV infection worldwide in 2019 and 1.5 million new infections occurring each year [ 1 ]. Due to the increased risks of morbidity after infection, HBV was predicted to be the tenth leading cause of death globally, accounting for 820,000 deaths in 2019 [ 2 ]. HBV infection is most prevalent in Africa, with a prevalence rate of 8.83%, followed by the Western Pacific at 5.26% [ 3 ]. Definitions of global prevalence rates for HBV are separated into four categories: high (> 8%), intermediate (5–7.99%), medium-low (2–4.99%), and low HBV endemic (< 2%) prevalence [ 4 , 5 , 6 ].

China has been reported to have a relatively high prevalence of HBV, although during the past 30 years, the prevalence of HBV infection showed a decreasing trend in China. Two population-level surveys of HBV infection rates in Chinese people aged 1–59 showed that the prevalence of HBV decreased between 1992 and 2006 from 9.75% in 1992 to 7.18%. Additionally, a downward trend was identified among people aged 1–29, from 10.1% in 1992 to 2.6% in 2014 [ 7 ]. Over this period, the HBV immunization programs were credited with the observed reductions in HBV prevalence [ 8 ]. Estimates on the HBV prevalence in China remains unclear, as previous meta-analyses have found high heterogeneity in reported prevalence across studies [ 9 ]. An explanation for the high variability in prevalence among studies could be different in population types. For example, in one survey, the prevalence of HBV among Chinese pregnant women was estimated to be 6.17% [ 10 ], compared to another survey was 3.3% [ 11 ]. Within China, there are still sub-groups exhibiting a higher risk of HBV infection. A previous meta-analysis estimated the HBV prevalence in China as 6.89% during the period between 2013 and 2017 [ 9 ]. Approximately 90% of those infected HBV cases were adults aged 20 years and over. The prevalence rate was higher in males compared to females, higher in rural areas than in urban areas, and higher in western regions than in central and eastern regions. The same meta-analysis investigated geographical differences within China and estimated the prevalence rates in western China were 8.9%, followed by eastern China (6.2%) and central China (5.2%) [ 9 ]. The last synthesis of data describing nationwide HBV prevalence was published in 2017. We performed an updated systematic review and meta-analysis to identify new studies published since 2018 and to describe trends in HBV prevalence in China.

Search strategy

This article was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines [ 12 ]. The protocol of this systematic review was registered in the International prospective register of systematic reviews (PROSPERO), National Institute for Health research (Number: CRD42023396671). This review provided an update on the findings of a previous systematic review [ 9 ]. Only articles published from January 1, 2018 to December 25, 2022 were retrieved . Databases searched included four international databases (Medline, Web of Science, Cochrane Database of Systematic Reviews, and Embase) and three national databases (China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), and WanFang Data). All included search terms used for each searched database were reported in the Additional file 1 .

Inclusion and exclusion criteria

All articles that reported cross-sectional studies on the general population tested for HBsAg in different regions of China were included. As this was an updated systematic review from a previous systematic review covering up to 2017 [ 9 ], only articles published and covering data from 2018 and 2022 were included. The inclusion criteria were restricted to original research articles written in English or Chinese. Studies were limited to those recruited using random sampling approaches to minimize the risk of section bias in the estimates of HBV prevalence rates. We only retained studies with sample sizes above 800 participants, as this was estimated by the review team to be a reasonable sample size for population-level studies and to minimize bias from smaller studies on the pooled HBV prevalence. To ensure the validity of our meta-analysis findings, the surveillance reports were excluded due to insufficient reporting of data sources and variations in data collection methods or statistical approaches across different reports. In this article, the proportion of participants with a positive HBsAg positive result was determined as the criteria for HBV cases. The exclusion criteria were the following: (1) conference abstracts, case reports, surveillance reports, and systematic reviews or meta-analyses; (2) study designs with non-random sampling; (3) studies that did not report the positive rate of HBsAg; (4) sample sizes of less than 800 people; (5) study populations co-infected with, Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV). While we excluded review articles, the citations of identified systematic reviews or meta-analyses were examined for additional eligible studies.

Screening, data extraction and quality assessment

Articles were screened independently by the primary reviewer and at least one secondary reviewer, with all conflicting decisions agreed up between reviewers. After the title and abstract were screened, the full text was screened, with the study characteristics of the included article extracted. Study characteristics included author, publication year, the number of HBV positive cases, sample size, geographical regions surveyed (provinces, autonomous regions, or municipalities), urban/rural status, sex, age groups, HBV testing method (e.g. Enzyme-Linked Immunosorbent Assay) of the included papers.

The Cross-Sectional/Prevalence Study Quality Assessment Forms which were recommended by the Agency for Healthcare Research and Quality (AHRQ) [ 13 ] were used to assess study methodological quality. The AHRQ (Additional file 2 : Table S1), consisted of 11 items, of which 10 questions related to cross-sectional studies. The 11th question designated for longitudinal data studies was not applicable in this review, so it was excluded. Items 1 to 10 were graded was scored using 3 options: Yes, No, and Unclear. If the answer was Yes, the item got 1 point, and if the answer was No or Unclear, the item got 0 points. The AHRQ was scored using a sum score of the first 10 items, with higher scores indicating higher levels of methodological quality.

Statistical analysis

All statistical analyses were conducted using R software version 4.2.3 [ 14 ]. The primary analysis estimated the pooled prevalence of HBsAg positive cases, reported as a percentage with the 95% confidence interval (95% CI) using a random-effects meta-analysis. In subgroups analyses, pooled prevalence rates were assessed within prespecified subgroups by sexes, different regions, urban/rural status, and age groups. Subgroup analyses were conducted in different regions. According to the National Bureau of Statistics [ 15 ], Mainland China was divided into four major regions based on economic development zones, namely the eastern, central, western, and northeast regions. For subgroup analysis of sexes were separated into males and females. For subgroup analysis of urban/rural status, we described this according to the rural/urban distinction of the original included literature. Rural and urban areas in the original included literature were divided according to the National Bureau of Statistics of China [ 16 ]. For subgroup analysis of age groups, we divided the age groups into two parts which are people aged < 18 years old and aged ≥18 years old. The division of the age groups mainly based on a nationwide HBV vaccination program 18 years ago in China in 2005, providing free HBV vaccine to all newborns [ 17 ]. This division allowed us to intuitively analyze the comparison between different age groups.

Magnitude of heterogeneity was estimated by I 2 . I 2 > 50% indicated high heterogeneity. Sources of heterogeneity were investigated within prespecified subgroup analysis of different regions, urban/rural status, sexes, and age groups, which were extracted from the included articles. Publication bias assessment was tested by Egger’s test and funnel plot. The Freeman-Tukey double arcsine transformation was applied in funnel plot analysis to stabilize variance and improve result accuracy [ 18 ]. Egger’s test, through linear regression analysis of the funnel plot, determined the presence of publication bias, with a P value greater than 0.05 indicating no significant bias [ 19 ].

Across the seven searched databases, a total of 1418 articles published in English and 1883 articles published in Chinese were retrieved. After removing duplicate articles (691 Chinese and 528 English respectively), there were 2082 articles remaining. Of retrieved articles, 2026 (61%) articles were removed after title and abstract screening, and further 31 articles were removed during the full text screening. Finally, a total of 25 (1%) articles were included in this review (Fig. 1 ). The characteristics of all the included articles [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ] were shown in Table 1 and the characteristics of age groups were shown in the Additional file 3 .

figure 1

PRISMA flow chart. Footnote: HBV, Hepatitis B virus; HCV, Hepatitis C Virus; HIV, Human Immunodeficiency Virus; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

All included studies accounted for a total sample size of 99,816 participants with a total number of HBsAg positive cases of 3016 (3%). The largest study sample size included in this review included 21,177 participants and the smallest included 836 participants. In terms of quality assessment, all the studies (100%) had a total quality of more than 4 points, 14 (56%) studies had a total quality of 5 points, and one article (4%) had a total quality of more than 5 points (Additional file 4 : Table S3).

Prevalence of HBV infection in the general population

The prevalence of HBsAg positive in China from 2018 to 2022 was 3% (95%CI, 2–4%) (Fig. 2 ). The highest prevalence was reported in Jiangxi Province (Central China), with a prevalence rate of 8% (95%CI, 7–9%) [ 41 ].

figure 2

Forest plot of HBV prevalence in the general population from 2018 to 2022

Heterogeneity of the meta-analysis was substantial above the I 2  = 50% cutoff ( I 2  = 99%, P  < 0.01). Based on the funnel plot displaying a moderately symmetrical distribution of studies across the funnel (Fig. 3 ) and Egger’s test (Fig. 4 ) for the prevalence of HBV infection ( P  = 0.35), there was little evidence of possible publication bias among all studies.

figure 3

Bias assessment funnel plot of studies reporting HBV prevalence in China from 2018 to 2022

figure 4

Egger’s test

Subgroup analysis of HBV infection according to sexes, regions, urban/rural status, and age groups

Table 2 displays the results of the subgroup analysis. In the subgroup analysis of sexes, HBsAg positive cases in males were reported in 16 articles and females was reported in 17 articles. The prevalence of female (3, 95%CI: 2, 4%) was similar to male (3, 95%CI: 2, 5%). The heterogeneity within both analyses of sexes remained substantial ( I 2  = 97 and 98%, respectively).

In the regional subgroup, HBsAg positive cases in eastern provinces were reported in 8 articles, western provinces were reported in 10 articles, and central provinces were reported in 6 articles. The eastern region (4, 95%CI: 2–6%) had the highest prevalence, followed by the central region (3, 95%CI:1–6%) and the western region (2, 95%CI: 1–4%). Heterogeneity within the analysis of the eastern, central, and western regions remained substantial ( I 2  = 99% in each region). None of the included articles in this meta-analysis reported on HBV prevalence within the northeast region (as shown in Fig. 5 ).

figure 5

The frequency of occurrences for each province, autonomous regions, and municipalities in the included literature in the meta-analysis

As for the subgroup of urban/rural status, HBsAg positive cases in urban status were reported in 5 articles and rural status were reported in 6 articles. The prevalence in urban (2, 95%CI: 0–5%) was lower than that in rural (3, 95%CI: 1–6%). The heterogeneity was substantial at I 2  = 97 and 98%, respectively.

As for the subgroup of age groups, HBsAg positive cases in people aged ≥18 years old were reported in 14 articles and people < 18 years old were reported in 17 articles. The prevalence of people aged ≥18 years old (6, 95%CI: 4–8%) was higher than people aged less < 18 years old (0, 95%CI: 0–1%). Heterogeneity in both age groups remained substantial at I 2  = 98 and 89%.

We systematically evaluated peer-reviewed studies published in English or Chinese describing HBV prevalence in China from 2018 to 2022 to provide an updated meta-analysis from a previous meta-analysis. Using data from 25 included studies, our meta-analysis found the pooled prevalence of HBV was 3%, suggesting that China now has gone from a higher-intermediate to a lower-intermediate prevalence country over the past decade [ 5 , 6 ]. In the subgroup analysis, we found that HBV prevalence was similar between males and females. The prevalence of HBV appeared to be higher in the eastern regions compared to other regions and higher in rural areas compared to urban areas. After comparison between the people aged < 18 years old and those aged ≥18 years old, people aged ≥18 years old had the higher HBV prevalence.

The previous 2017 meta-analysis describing HBV prevalence in China included a total sample size of 5,422,405 individuals across 27 studies, including four large nationwide studies with participants from all 31 provinces [ 9 ]. In contrast, our meta-analysis included 99,816 individuals across 25 studies, all of which were local or regional studies and none were conducted at the national level. The absence of nationwide studies in our meta-analysis may limit the generalizability of our findings to the entire country. In the earlier review, 16 studies included rural HBV prevalence and 10 reported urban prevalence [ 9 ]. In this presented review, there were 6 studies on rural prevalence and 5 studies on urban prevalence. This presented review had fewer studies on the prevalence of HBV in rural and urban areas, which would lead to a reduction in HBV prevalence in rural and urban areas. However, we found a comparable amount of studies reporting on both rural and urban areas, which enhanced the comparability of our findings for rural and urban areas in our meta-analysis. The previous review (16 studies) [ 9 ] had more studies conducted within the eastern region of China compared to the current review (8 studies). This may potentially restrict the generalizability of our findings regarding HBV prevalence in the eastern region. The previous 2017 meta-analysis divided the age groups into 9 groups but in our meta-analysis, we only had two age groups. However, we both found the prevalence of HBV increased with age.

Our meta-analysis and previous meta-analysis identified similar prevalence of HBV in both males and females. Compared to the previous meta-analysis, it appears the prevalence rates of HBV in both men and women have decreased. Since 2012, universal screening for HBsAg in pregnant women has been implemented per national policy in China, leading to improved detection and treatment rates for women [ 45 ]. Previously, it was shown that males had a higher risk of contracting HBV [ 46 ]. Other investigations on sex and risk of HBV attributed to males relatively greater exposure to sexually transmitted risk factors, such as men who have sex with men and persons with multiple sexual partners to increased prevalence of HBV compared to females [ 47 , 48 ]. However, in recent years, this higher prevalence compared to females appears to have decreased, likely due to increased awareness and access to preventative healthcare [ 49 , 50 ].

In our subgroup analysis, the prevalence of HBV was highest among studies in the eastern regions of China. However, the 2013–2017 data showed that the western region had the highest prevalence, while both studies indicated the central region had the lowest prevalence. There are several possible reasons why our analysis and the 2017 review identified different patterns in HBV prevalence by region. In recent years, large-scale population migration has occurred, with Chinese eastern coastal areas seeing increasing rates of migration to those regions [ 51 ]. According to the ‘National Survey Report on Migrant Workers in 2018’, there was a net inflow of 53.98 million rural migrant workers into the eastern region [ 51 ]. As a result of the large-scale migration, a substantial number of HBV carriers, infected individuals, and those without HBV antibodies could have migrated to those areas. A survey collecting data on the prevalence of HBV among rural males aged 21–49 in China from 2010 to 2012 revealed an HBsAg positive prevalence of 6% and a 26% prevalence rate of HBeAg (indicative of high susceptibility of infection) [ 52 ]. Inequalities in access to medical care in different regions may lead to poorer medical testing levels in underdeveloped areas, making HBV surveys challenging [ 53 ].

Both this meta-analysis and the previous meta-analysis reported a higher prevalence in rural areas compared to urban areas. Reduced health literacy about HBV, poorer access to HBV treatment and disparities in HBV vaccination coverage among rural residents may account for this observed increased prevalence. In 2015, the World Health Organization recommended that the management of HBV infection should involve connecting individuals to care through the process of detection and diagnosis [ 54 ]. However, in a survey of chronic hepatitis B (CHB) among rural Chinese women, nine out of 10 women with CHB were unaware of their infection status, within this survey 7.4% required antiviral treatment, only 0.22% received treatment, and 29% of women with CHB also tested positive for HBeAg (indicating high infectivity) [ 55 , 56 ]. Compared to urban population, there is generally a lack of widespread health education and awareness regarding HBV, leading to a higher prevalence of HBV among rural residents [ 57 ]. Furthermore, since HBV vaccines in China are not provided free of charge for adults, urban residents are typically more capable of affording vaccination compared to the rural people [ 58 , 59 ]. To address this, the Chinese government began providing free vaccination to newborns and children since 2005, resulting in a significant increase in vaccine coverage rates [ 60 ]. This increase was identified in both urban areas, where coverage reached 95%, and rural areas, where coverage rates climbed to between 84 and 97% [ 61 ].

The prevalence of HBV varied in different age groups. In our meta-analysis, the age group with higher prevalence was people aged ≥18 years old, while the age group with lower prevalence was those aged < 18 years old (6 and < 1% respectively). This result indicated that the prevalence of HBV may increase with age, which was concurrent with the results in the 2017 meta-analysis [ 9 ]. Possible reasons for this result include changes in vaccination policies for younger age groups and improvements in screening practice. The HBV vaccine has been available in China since 1982 [ 17 ], but there has been limited availability [ 62 ], with varying vaccination rates among different regions of China [ 60 ], partially due to vaccine pricing [ 63 ]. These reasons led to the vaccination rate of HBV in regions of China being limited since the vaccine was introduced. The Chinese government has implemented a nationwide HBV program, introduced in 2005, that provides vaccines free of charge to all neonates, leading to a rapid increase in HBV immunization coverage among young children [ 17 ]. Therefore, the changes in HBV vaccine policies over different years could account for the differences in prevalence that were observed in aging. Detection through screening has also increased over recent years, nucleic acid amplification testing (NAT) was included in routine donor screenings in 2010 [ 64 ] and this practice was expanded nationwide in 2014 [ 65 ]. Full coverage of NAT in all blood stations substantially improved blood safety and prevented transfusion-transmitted infections, including HBV [ 66 ].

Over the past 30 years, numerous strategies addressing HBV have been implemented within China and the prevalence of HBV has been declining during this period. The Chinese government allocated funds for newborn vaccination and procured national immunization vaccines and syringes between 1992 and 2005 [ 8 ]. A catch-up vaccination campaign for children under 15 years old vaccinated approximately 68 million children was conducted between 2009 and 2011 [ 67 ]. Pregnant women and patients undergoing medical procedures were required to be screened for HBV. A pre-pregnancy health screening program was launched in 2010, offering free HBV serological testing to couples of childbearing ages, and expanded nationwide in 2013 [ 68 ]. As a result, HBV three-dose vaccine and timely birth-dose coverage in China have achieved the targeted service coverage of 90% for elimination of HBV in 2015 [ 68 ]. China has made significant strides in reducing HBV prevalence, but internationally, the prevalence remains relatively high compared to other countries. In England [ 69 ] and Canada [ 53 ], the general population’s prevalence of HBV is low at 0.5–1.0%, and in Northern Europe, it is less than 0.1% [ 53 ]. Both current and previous analyses noted high prevalence in rural areas, which could be due to unequal distribution of medical resources, varying diagnostic capabilities, and lack of free adult HBV vaccination [ 53 ]. Further researchers can focus on reducing vaccination for hard-to-reach populations through improving medical service coverage and reducing health inequalities. Wider implementation of a more comprehensive HBV vaccination program for adults, especially those living in less economically developed areas, could also address the higher infection prevalence among older age groups. It is also important to improve diagnostic capacity and provide timely treatment for HBV patients in order to reduce the prevalence of HBV.

This systematic review had some limitations. First, the heterogeneity of meta-analysis was high. Subgroup analysis was used to identify potential sources of heterogeneity and provided data on HBV infection rates among sub-groups. However, heterogeneity in the subgroup analysis did not decrease substantially. Additionally, due to the lack of national-scale surveys, the results of the meta-analyses may not reflect the true prevalence of HBV in the general population in China. Moreover, only cross-sectional studies that reported HBV prevalence were analyzed in this meta-analysis. Therefore, this analysis does not report HBV incidence and cannot evaluate which public health programs may have contributed to observed decreases in HBV prevalence. Further research may consider other factors that may explain the source of high heterogeneity among studies on HBV prevalence in China. One way to address this is to use individual-level data from a large population across China. The provincial and city scale surveys of HBV prevalence in the general population in China could be expanded, where possible. Only the prevalence of HBV in the general population was studied in this study, and the prevalence of HBV in people within special disease groups or high/low-risk groups may be investigated in further studies.

This meta-analysis of currently available evidence from 2018 to 2022 indicates that China has experienced a decline in HBV prevalence, transitioning from a higher intermediate area to a medium-low epidemic level. However, in the subgroup analysis by different regions and age groups, the prevalence of HBV showed significant differences, especially among populations in rural areas and people aged ≥18 years old, where the prevalence of HBV was higher. This suggests that in the future, HBV prevention focus should be on the highest-prevalence areas and high-risk populations. No nationwide studies were identified in this meta-analysis from 2018 to 2022, there is a need for more systematic estimates of nationwide HBV prevalence.

Availability of data and materials

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Hepatitis B virus

Hepatitis C Virus

Hepatitis B surface antigen

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

China National Knowledge Infrastructure

Chinese Biomedical Database

Human Immunodeficiency Virus

Agency for Healthcare Research and Quality

Chronic Hepatitis B

Hepatitis B e-Antigen

Enzyme-Linked Immunosorbent Assay

CLIA-Chemiluminescence Immunoassay

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This work was supported by the internal grant of the Faculty of Health Sciences, University of Macau. The PhD scholarship of Wen Dang was supported by the internal grant of the Faculty of Health Sciences, University of Macau.

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Shuwen Bai conceived the content, extracted, and analyzed the data, conducted the quality assessment, and wrote the essay. Robert David Smith supervised the study design and provided advice, review, and content modification. Wen Dang supervised the study design and provided advice, review, and content modification. Wenying Hong conducted the data extraction and quality assessment. Wenyu Liao conducted the data extraction and quality assessment.

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Additional file 2: Table S1.

Cross-Sectional/Prevalence Study Quality Assessment Forms

Additional file 3: Table S2.

Characteristics of age groups of the studies included in the meta-analysis

Additional file 4: Table S3.

Quality assessment of eligible studies

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Bai, S., Dang, W., Hong, W. et al. The prevalence of hepatitis B in Chinese general population from 2018 to 2022: a systematic review and meta-analysis. BMC Infect Dis 24 , 211 (2024). https://doi.org/10.1186/s12879-024-09103-8

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    Covidence explains the difference between systematic review & meta-analysis. Systematic review and meta-analysis are two terms that you might see used interchangeably. Each term refers to research about research, but there are important differences!

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    A systematic review may include a meta-analysis. For details about carrying out systematic reviews, see the Guides and Standards section of this guide. Is my research topic appropriate for systematic review methods? A systematic review is best deployed to test a specific hypothesis about a healthcare or public health intervention or exposure.

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    What are systematic reviews and meta-analyses? Created: June 15, 2016; Last Update: September 8, 2016; Next update: 2020. Individual studies are often not big and powerful enough to provide reliable answers on their own. Or several studies on the effects of a treatment might come to different conclusions.

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    17 Citations Abstract Distinguishing between a systematic review and meta-analysis is essential to understand the role each plays in presenting and analysing data and estimates of treatment effects. Often, novice researchers mistakenly use these terms synonymously.

  10. Meta‐analysis and traditional systematic literature reviews—What, why

    Abstract Meta-analysis is a research method for systematically combining and synthesizing findings from multiple quantitative studies in a research domain. Despite its importance, most literature evaluating meta-analyses are based on data analysis and statistical discussions.

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    Thus, this article has two goals: (1) based on the findings of previous editorials and methodological articles, it defines methodological recommendations for meta-analyses submitted to Management Review Quarterly (MRQ); and (2) it serves as a practical guide for researchers who have little experience with meta-analysis as a method but plan to co...

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    A meta-analysis is the use of statistical methods to summarize the results of a systematic review. Not every systematic review contains a meta-analysis.

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    Meta-analysis is a statistical tool that provides pooled estimates of effect from the data extracted from individual studies in the systematic review. The graphical output of meta-analysis is a forest plot which provides information on individual studies and the pooled effect.

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    A systematic review is a summary of existing evidence that answers a specific clinical question, contains a thorough, unbiased search of the relevant literature, explicit criteria for assessing studies and structured presentation of the results. A systematic review that incorporates quantitative pooling of similar studies to produce an overall ...

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    PRISMA-P is a 17-item checklist for elements considered essential in protocol for a systematic review or meta-analysis. The documentation contains an excellent rationale for completing a protocol, too. Use PRISMA-ScR, a 20-item checklist, for reporting scoping reviews. The documentation provides a clear overview of scoping reviews.

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    Within the paradigm of evidence-based orthopedics, systematic reviews and meta-analyses top the hierarchy of evidence. A systematic review summarizes available literature of a specific research question, and meta-analysis applies statistical methods to combine results from two or more studies.

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    A meta-analysis goes beyond critique and integration and conducts secondary statistical analyses on the outcomes of similar studies.It is a systematic review that uses quantitative methods to synthesize and summarize the results. An advantage of a meta-analysis is the ability to be completely objective in evaluating research findings.

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    Meta-analysis is a statistical method that can be applied during a systematic review to extract and combine the results from multiple studies ... scoping reviews help determine whether a systematic review of the literature is warranted. Additional Information. Touro College: What is a Scoping Review? This page describes scoping reviews ...

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    Sacket et al 1, 2 defined evidence‐based practice as "the integration of best research evidence with clinical expertise and patient values". The "best evidence" can be gathered by reading randomized controlled trials (RCTs), systematic reviews, and meta‐analyses. 2 It should be noted that the "best evidence" (e.g. concerning ...

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    An overview of conducting literature reviews in the social sciences and STEM fields. ... Miake-Lye, I. M., Hempel, S., Shanman, R., & Shekelle, P. G. (2016). What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. ... Meta-analysis: Neither quick nor easy. BMC Medical Research ...

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    Background: The aim of this meta-analysis was to ascertain whether sotrovimab was effective in reducing COVID-19 related hospitalization and mortality also in Omicron BA.2, BA.4 and BA.5 subvariants compared to other antivirals effective in index period. Methods: A systematic review and meta-analysis of Randomized Controlled Trials (RCTs) and observational studies comparing the efficacy of ...

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