Systematic review automation technologies

Abstract

Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects.We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time.

Figure 1

Existing methods for systematic reviews follow these steps with some variations. Not all systematic reviews follow all steps. This process typically takes between 12 and 24 months. Adapted from the Cochrane [10] and CREBP [11] Manuals for systematic reviews. SR systematic review, SD standard deviation.

Figure 2

A screen capture of the Quick Clinical query screen from the smartphone app version. The Profile pull-down menu lets one select the class of question being asked (e.g. medication, diagnosis, patient education). The query fields are chosen to suit the question class. The four query fields shown (Disease, Drug, Symptom and Other) are taken from the Therapy question class.