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A Framework To Facilitate the Use of Systematic Reviews and Meta-Analyses in the Design of Primary Research Studies

Research White Papers

Investigators: , MBChB, MPH, DPhil, MRCGP, , MHS, , PhD, , PhD, MPH, and , MD, MPH.

Oregon Evidence-based Practice Center
Rockville (MD): Agency for Healthcare Research and Quality (US); .
Report No.: 12-EHC009-EF

Structured Abstract


Systematic reviews are currently used by only a minority of researchers to inform the design of research studies. This may lead to inefficient and potentially wasteful research. We aimed to develop a framework which clinical researchers can apply to existing systematic reviews in order to effectively inform the design of proposed new clinical research studies.

Data Sources:

Published frameworks or models designed to use results of systematic reviews or meta-analyses in new research study design.

Review Methods:

A multiphase iterative process was used to develop the framework. Phase 1 involved a focused literature search to identify existing frameworks and processes that have been proposed as methods to identify research gaps by systematic reviews. In phase 2, we convened a multidisciplinary group with varied expertise to develop a stepwise framework. In phase 3, we identified two systematic reviews and applied this framework to their results. Phase 4 invited external opinions from additional experts to further refine the framework.


We developed a four-step framework designed to be useable by primary researchers: Step 1 involves clearly laying out the crucial design elements of the proposed study using PICOTS (populations, interventions, comparators, outcomes, timing, and setting) elements. Step 2 provides a simple method to identify an existing systematic review which is current, valid, and relevant enough to the proposed research study to inform its design. In Step 3, the details of the systematic review are examined to determine the extent to which it has already addressed the questions proposed by the new study, and uses the PICOTS elements of the primary studies included in the systematic review to modify the design of the proposed study. Finally, Step 4 establishes the need (or otherwise) for the proposed study, and prioritizes modifications to the research design.


The four-step framework proposes a practical method which can be used by clinical researchers who are not experts in systematic reviews to determine whether further research studies are needed and suggest ways that the primary literature identified by the systematic review can be used to modify the design of further research studies. Further research needs to determine how useful and practical this proposed framework is for researchers, and attempt to measure its value in modifying research designs and optimizing research efficiency.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. 290-2007-10057-I. Prepared by: Oregon Evidence-based Practice Center, Portland, Oregon

Suggested citation:

Thompson M, Tiwari A, Fu R, Moe E, Buckley DI. A Framework to Facilitate the Use of Systematic Reviews and Meta-analyses in the Design of Primary Research Studies. (Prepared by the Oregon Evidence-based Practice Center under Contract HHSA 290-2007-10057-I.) AHRQ Publication No. 12-EHC009-EF. Rockville, MD: Agency for Healthcare Research and Quality. January 2012.

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290-2007-10057-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.

This report may be used, in whole or in part, as the basis for research design or funding opportunity announcements. AHRQ or the U.S. Department of Health and Human Services endorsement of such derivative products or actions may not be stated or implied.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.


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Bookshelf ID: NBK83621PMID: 22299187


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