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This paper is based on the work of a one-year project that was commissioned by the English National Board for Nursing, Midwifery and Health Visiting in the area of cancer nursing education. Following a critical and analytical discussion of the principles of systematic reviewing, the authors describe the processes involved in a literature review and outline the techniques of critically appraising all types of literature including evidence that is `opinion' based rather than research based
General Principles for Systematic reviews
Systematic reviews are widely accepted as providing a reliable source of information about the effectiveness of health care (Chalmers and Altman 1995) and are central to the drive for evidence-based health care' (Parahoo 1997). They aim to provide an overview of work in a specific area by finding, evaluating and synthesising evidence from research studies. A comprehensive summary of the available evidence is provided with minimal bias and error arising as a result of incomplete or inappropriate selection of literature. There are clear published guidelines that can be followed in order to carry out a full systematic review (NHS Centre for Reviews and Dissemination 1996) and the whole process of undertaking literature reviews is becoming increasingly rigorous with its own methodology and scientific activity (Mulrow 1994). Undertaking full `systematic reviews' as defined by the NHS Centre for Reviews and Dissemination (NHS Centre for Reviews and Dissemination 1996) requires good resources including reviewers who are skilled in all the necessary methodological processes.
A full `systematic review' is beyond the scope and resources of many, due to its laborious and time consuming nature (Parahoo 1997; NHS Centre for Reviews and Dissemination 1996) and its tendency to rely on randomised controlled trials. However the general principles and techniques can be used to good effect in providing a comprehensive and critical literature review. There is some useful guidance available for the task of reviewing (such as Booth 1996, Droogan and Song 1996, Mason 1993, Schira 1992 and de Vet et al 1997) which provides advice on the overall process of producing a comprehensive review. Others focus on different stages of literature reviewing such as searching (eg Barber 1995; Brazier and Begley 1996; Burnham and Shearer 1993; Hek 1994; Lefbvre 1994; Roberts 1992) critical evaluation and critical appraisal (eg...