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Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

Aim: This paper explores the processes of collaboration between a librarian and two academic physiotherapists working on a systematic review jointly funded by the University of the West of England (UWE), Bristol, and the Royal National Hospital for Rheumatic Diseases (RNHRD), Bath, UK. The aim of this paper is to describe and evaluate some of the processes of collaboration between the three authors in their work in progress on a funded systematic literature review on the topic of hydrotherapy and pain.

Methods: The vehicle for describing and analysing these processes is a joint (National Health Service Trust and University) funded systematic literature review currently in progress on the topic of hydrotherapy and pain.

Results: Systematic review methodology is becoming increasingly complex and is rapidly developing its own research base. Librarian input is a key element in a successful systematic review.

Conclusions: Systematic reviews play a critical role in informing healthcare delivery and research in the UK. The individual nature and inherent complexity of each review demands close collaboration between librarians, academics and clinicians. In addition to enhancing the reviews themselves, there are many other personal and institutional benefits of collaborative working. Consideration may need to be given to library staff structures and roles if these benefits are to be maximized and sustained.


Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

The last decade has seen a rapid rise in development of the methodology of systematic review and its use in clinical practice. Systematic review,1 a highly rigourous approach to researching the research, has become increasingly viewed as a research method in its own right, with a consequent growth in the development of the science of the method of review, spearheaded by organizations such as the Cochrane Collaboration2 and the Centre for Reviews and Dissemination.3 Currently, evidence obtained from systematic review of literature is ranked among the top levels in hierarchies of evidence.4−6 The findings of systematic reviews now play a pivotal role in influencing healthcare delivery in the UK by critically informing the clinical guidelines, clinical care pathways and other officially sanctioned recommendations which drive much of contemporary healthcare practice. In addition, for those undertaking primary research, systematic review of published evidence is seen both academically and ethically as the foundation from which to develop legitimate research questions.7

Many factors underpin the growing importance of systematic reviews. Current preoccupation with ‘evidence-based practice’ (EBP) stems from the early 1990s and has philosophical roots going back to the mid 19th century.8 At its heart lies the concept of clinical effectiveness; practice based on ‘current best evidence’ and, as we are increasingly being made aware, on cost-effectiveness.9 The exponential rise in the volume of published research10 has made it difficult for busy practitioners to meet individual and service requirements for effective practice based on the best available evidence (for example, Chartered Society of Physiotherapy, 200511). Traditional, ‘narrative’ reviews are now considered to play a limited role in providing this evidence.12

The drive towards evidence-based practice has, over the last decade, resulted in the rapid evolution of the librarian's role in systematic reviews.8,13,14 Prior to this, librarians typically played a more limited role in supporting literature reviews. However, as systematic reviews have increased in importance, the science of the method has become much more sophisticated, calling for greater collaboration between librarians and clinicians during the review process. Reviews are considered to be ‘more relevant to the end-user and of higher quality if they are informed by advice from people with a range of experiences.’2 However, although this need for collaboration is often stressed,13,15 details on the reality of this process are rarely published.16

The aim of this paper is to describe and evaluate some of the processes of collaboration between the three authors during work on a funded systematic literature review on the topic of hydrotherapy and pain.

Hydrotherapy

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

Hydrotherapy is a specialist area of physiotherapy. It is currently defined in the UK as: ‘A therapy programme utilizing the properties of water, designed by a suitably qualified physiotherapist specifically for an individual to improve function, carried out by appropriately trained personnel, ideally in a purpose-built, and suitably heated hydrotherapy pool.’17

Systematic reviews are underpinned by a research question, which typically incorporates the population of interest, an intervention and a primary outcome. Isolating and refining a clinically relevant research question in itself demands detailed scrutiny of the literature. Has a systematic review already been conducted on this research area? If so, does it cover the population and outcomes of interest? Our question, ‘Does hydrotherapy relieve pain in adults with neuromusculoskeletal disease?’, was formulated to address the broad question of whether hydrotherapy relieves pain in people with neuromusculoskeletal pathology.

Of the two clinicians working on the project, one had specialist knowledge of the subject area and was aware of a previous systematic review.18 This previous review, however, concerns the overall effectiveness of hydrotherapy and does not focus on the clinical outcome of pain or explore the raw data from the selected clinical trials. Our intention was to build on this earlier work by focusing on the outcome of sensory pain and to take the review forward to extraction and synthesis of pain data.

Selecting databases for the review

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

Systematic reviews ‘use explicit and rigourous methods to identify, critically appraise, and synthesize relevant studies.’19 Broadly, five main processes are involved: selecting relevant literature, quality assessment, data extraction, synthesis of results and grading of the overall body of evidence.2,3 Within these processes, attention to the control of bias has become as important in literature review as it is in randomized controlled trials. Bias, ‘systematic errors in the design and execution of a study which may lead to over or underestimation of the “true” effect of an intervention’,20 can arise during any and all of the processes of systematic review and may influence any stage of the review process. Inevitably, compromises have to be made and it is the description of these, exploration of their implications and transparent reporting of both21 which are most likely to provide the best basis for clinical decision making.

In developing a search strategy, bias may arise from a number of factors, including the predilection of journals to publish research with (statistically) significant findings; medline bias for excluding papers not indexed in medline and ‘language bias’ from exclusion of non-English publications.22 In our review, the selection of appropriate sources and the development of the search strategy was a dynamic, iterative process balancing the expertise and neutrality of the librarian with the knowledge and experience of the physiotherapists in the specialty of hydrotherapy. The key principle was to be as inclusive as possible within the resources and timescales for the project, whilst being open to the possibility of bias. In developing our search strategy we continually traded sensitivity (recall) against specificity (precision). We were aware that greater importance should be given to high recall2 and aspired to capturing all publications relevant to our question within resource constraints. We therefore initially considered 18 databases available via the University Library (Table 1). These databases were explored in a series of discussions which balanced the knowledge of the librarian on their characteristics (for example, accessibility, currency and potential relevance) and the physiotherapists’ knowledge of the subject area and of publications within the allied health professions. Potential search terms were applied across all these databases, enabling us to explore the suitability and functionality of their search interface and the significance of their output to our review. Through this process, databases were eliminated on a variety of grounds, for example, some did not contain any relevant papers [e.g. Latin American and Caribbean Health Sciences Literature (LILACS)] and duplicated the output from other databases [e.g. Turning Research Into Practice Database (TRIP)]. Other databases lacked sensitivity in their search interface, for example, by limiting the use of search terms to preset menus and controlled vocabulary (e.g. OTseeker). Eventually, these processes of exploration and negotiation led to the final inclusion of 14 databases in this review.

Table 1.  Eighteen databases considered for the review
DatabaseInterface/provider
  • *

    These four databases were not included in the final review.

Allied and Alternative Medicine Database (amed)Ovid
Applied Social Sciences Index and Abstracts (assia)CSA
British Nursing Index (bni)Ovid
Cochrane Central Register of Controlled Trials (central)Wiley
Cochrane Database of Systematic Reviews (cdsr)Wiley
Cumulative Index to Nursing and Allied Health Literature (cinahl)Ovid
Database of Abstracts of Reviews of Effects (dare)Wiley
embaseOvid
Health Technology Assessment Database (hta)Wiley
Index to Theses*Index to Theses
ISI ProceedingsMIMAS/Web of Knowledge
Latin American and Caribbean Health Sciences Literature (lilacs)*LILACS
medlineOvid
OTseeker*OTseeker
Physiotherapy Evidence Database (pedro)PEDro
psycinfoOvid
sportdiscusOvid
Turning Research Into Practice Database (trip)*TRIP

Having taken a sensitive approach to inclusion of relevant sources for this review, it is interesting to note that, of the 15 full papers currently under evaluation, 13 would have been retrieved through searching two databases, embase and medline. All 15 would have been retrieved through searching three databases; amed, embase and medline. However, we chose to take an inclusive approach, exploring the full range of sources available in order to be sure of capturing all relevant publications. The range of databases that might be relevant to include in a review will depend on a number of factors, including the topic area and the targeted study design. On the basis of this finding in future reviews of randomized controlled trials in hydrotherapy we would consider searching a more limited range of databases.

The iterative processes of balancing pragmatic considerations (such as funding and time), attempts at methodological rigour and specialist subject knowledge were a perennial feature of our review and these are typified by our decision to exclude non-English publications. The physiotherapists’ understanding was that hydrotherapy, as defined, is practiced mainly in predominantly English-speaking countries, the UK and North America. This decision was challenged by the librarian and then tested through sampling of the non-English language papers discarded when limiting the search results. Limiting the results of the final search strategy to English language resulted in the elimination of 314 papers. A random sample of 50 of these was then tested against our inclusion criteria for titles and keywords (Table 2). Forty-six of these were not using hydrotherapy as an intervention so would have been discarded. Two papers were single subject case studies and therefore did not meet the inclusion criteria. One paper was indecipherable because of the language of the title and the lack of an abstract. Finally, only one paper met our inclusion criteria and this study, having been published several times, was already in our English language results. Our decision to exclude non-English language papers was further validated by exploration of the LILACS database, which did not reveal any papers meeting the inclusion criteria. The clinicians’ expert decision was therefore corroborated by expert librarian input.

Table 2.  Inclusion/exclusion criteria stage 1: title and keywords
Criteria for acceptance:
 title/keywords suggest some aspect of hydrotherapy as officially defined17 in adults with neuromusculoskeletal pathology
Criteria for rejection:
 titles/keywords will be rejected for the following reasons:
 1 Non-human
 2 Population is less than 18 years old
 3 Refers to water or water-based activity/treatments not related to hydrotherapy definition (e.g. rowing, mud packs, colonic irrigation, water injections)
 4 Does not relate to neuromusculoskeletal pathology
 5 Hydrotherapy incidental to the study

Developing the search terms

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

In tandem with our exploration of databases, a cyclic, iterative approach to identifying appropriate search terms was undertaken through a series of half-day meetings. Search terms were developed using what were considered to be the richest sources of data for this review; amed, cinahl, embase, medline, sportdiscus, bni and psycinfo (‘core databases’ accessed on the Ovid interface). The search was built on two concepts; Hydrotherapy and Pain. Search terms which encapsulated hydrotherapy were initially derived from the researchers’ knowledge as given by the professional group representing this specialism.17 For pain, the sample list of frequently used terms published by the International Association for the Study of Pain23 (IASP) was used. Earlier descriptors, going back to 1979, were also incorporated into the search strategy.

Overall, a sensitive approach was taken to the development of the strategy, by searching for our terms using the default keyword search in the Ovid interface. This maps search terms to a range of fields (Table 3) including titles, subject headings, heading words and abstracts. Finding the appropriate balance between sensitivity (recall) and specificity (precision) was achieved through the iterative process of refining and testing the search terms and strategy across the seven ‘core databases’. This process involved randomly sampling 10% of the references retrieved.

Table 3.  Final search strategy
Core databases: amed, bni, cinahl, embase, medline, psycinfo, sportdiscus
Interface: Ovid
Search strategy:
All terms used as keywords mapped to default range of fields when cross searching databases in the Ovid interface.
Fields mapped to:
mp = ab, hw, ti, it, sh, tn, ot, dm, mf, nm, tc, id, da, fa, ce, fc, fd
1hydrother$
2balneo$
3aquarobic$
4aquatic rehab$
5aqua$
6water
75 or 6
8exercis$
9gymnast$
10aerobic$
118 or 9 or 10
127 and 11
131 or 2 or 3 or 4 or 12
14pain
15allodynia
16analges$
17anaesthes$
18anaesthes$
19causalg$
20dysesthes$
21dysaesthes$
22hyperesthes$
23hyperaesthes$
24hyperalges$
25hypoalges$
26hypoesthes$
27hypoaesthes$
28neuralgi$
29neuritis
30neuropath$
31nocicept$
32noxious stimulus
33paresthes$
34paraesthes$
35hyperpath$
3614 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35
3713 and 36
38Limit to English
39Limit to Human
40Limit 1980–

Thesauri for the ‘core databases’ were checked to identify any further potential search terms and to ensure that all relevant subject headings were extracted to be included in the list of search terms. Encapsulating all relevant subject headings as search terms negated the need to perform exploded subject heading searches alongside mapping keywords to titles, subject headings and abstracts. The standard keyword search in the Ovid interface was used when searching, mapping the search terms to a default range of fields which included titles, subject headings, heading words and abstracts (Table 3). This approach meant that it was unnecessary to develop separate search strategies for each of the ‘core databases’ built around their unique subject heading structure. A single all encompassing search strategy could be developed and applied across all of the databases in the Ovid interface. Pragmatically, this allowed for a single set of results to be generated from which duplicates could be removed by the Ovid ‘remove duplicates’ tool. Logistically having a single final search strategy that could be used across the ‘core databases’ was a real bonus for this review, reducing the complexity of having multiple strategies that would need to be run individually.

The final search strategy (Table 3) comprised a straightforward string of keywords for the pain concept and a search string for hydrotherapy which was slightly more complex to ensure sufficient sensitivity. It included as its basis the terms hydrother*, aquarobic*, aquatic rehab* and balneo*. In order to increase the sensitivity of this hydrotherapy search string, a further string was included which split the hydrotherapy concept into its two component concepts, water and therapy. A range of terms for both water and therapy were tested on the seven core databases on the Ovid interface and the resulting publications were then sampled to inform decision making about inclusion of each term in the final strategy. An initial very sensitive additional string for water and therapy of:

(Aqua* OR water OR pool OR immers* OR spa)

AND

(Therap* OR exercis* OR gymnast* OR training OR aerobic* OR rehab* OR running)

retrieved n = 3234 references (after removal of duplicates). This compared with n = 430 references when using a more specific approach for the hydrotherapy concept which simply used the two key terms hydrother* and balneo*. Of the 3234 references retrieved when using the very sensitive hydrotherapy string, over 2800 papers did not mention hydrotherapy or balneotherapy in their bibliographic records. Sampling of 100 of these papers revealed that only 8% were relevant to the research question. Examination of the terminology used in the relevant references led to the development of an additional water and therapy string as below:

(aqua* OR water)

AND

(exercis* OR gymnast* OR aerobic*)

Proximity operators were tested on this string and found that, with an adjacency of four words, they reduced the yield of this search string by a factor of four. Sampling of the records discarded through using the proximity operator identified over 50% of the first 20 discarded records were papers that we would want to review for inclusion and not discard. It was decided to maximize sensitivity to ensure that these relevant papers were included in the search results, proximity operators were therefore not used for this string.

A further sample of 100 papers, discarded in moving from the very sensitive hydrotherapy string to the final search strategy, was tested against the inclusion criteria for titles and keywords (Table 2) to ascertain whether anything of value had been lost in moving to a more specific strategy. No records in this sample met the inclusion criteria.

Limits, filters and ‘housekeeping’

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

In our quest to identify relevant literature, we were keen to capture all available publications irrespective of research design. We also had concerns that applying methodological filters could result in losing some randomized controlled trials and also useful papers from which we could carry out reference list checking. The search strategy was therefore designed to be sensitive to the full range of research methodologies used by the Allied Health Professions and methodological filters were therefore not applied. Limits to Human, English language and publication year from 1980 were applied (Table 3).

Procite reference management software was used to manage the references retrieved.

The Ovid ‘save searches’ function was used to save various iterations of the search strategy as it developed. This meant that the final search strategy was available to be re-run across the seven core databases through the life of the project to identify recently published material.

Principles of paper selection

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

A three-stage approach was taken in the final selection of papers to be included in our review. The first stage involved screening of the titles and keywords of the 682 papers which emerged from our search strategy. Criteria for acceptance/rejection were developed in a series of pilot exercises in which we all previewed the titles and keywords of the first 50 papers emerging from our search. Titles were accepted if they (and/or the keywords) implied some aspect of hydrotherapy17 in a sample of adults with neuromusculoskeletal pathology. In line with these criteria, we also developed some rules for rejection (Table 2). During this process we were mindful to stay focused on our research question and our agreed definitions of the intervention, population group and outcomes. The objectivity of the librarian combined with the subject expertise of the clinicians, enabled us to develop a core set of inclusion and exclusion criteria which balanced sensitivity and specificity at a level likely to capture those articles of relevance to our research question. Having achieved consensus on the inclusion/exclusion criteria for the initial set of 50 papers, the two physiotherapists proceeded to independently screen the remaining titles and titles/abstracts. In the absence of an abstract, if the title and keywords met our inclusion criteria, the full paper was reviewed. For this particular review, involvement of the librarian at this stage was not necessary because the physiotherapists had the appropriate mix of skills and experience to evaluate the hydrotherapy research literature.

Assessment of study quality

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

The choice of quality assessment instrument has been shown to have a significant effect on the quality rating of individual physiotherapy trials and therefore on the overall outcomes of systematic reviews in this field.22,24

The rapid development of systematic review methodology has led to a bewildering growth in the number and variety of systems to rate the quality of individual studies of various designs. Katrak et al. for example, recently identified 121 published appraisal tools.25 These range from checklists, examining key dimensions of quality without calculation of an overall score; to scales, which summate and score individual facets of quality; and guidance documents such as user guides. As instruments have become more elaborate and time consuming, debate on their advantages and disadvantages has grown.2 For our hydrotherapy literature review we found that sourcing quality assessment tools and the debates surrounding them was not simply a straightforward process of literature searching on medline or other bibliographic databases. Close collaboration between librarian and researchers was needed to seek out information from a range of sources, for example, the websites of key organizations [such as the Centre for Reviews and Dissemination (CRD)3 and the Cochrane Collaboration2] and recently published systematic reviews in the field of allied health. Among other processes, our literature review has involved a re-evaluation of the constructs of best evidence in hydrotherapy within the clinical context in which it is practised and, on the basis of this, a modification of an existing quality assessment tool.20

Discussion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

This paper describes the reality of collaboration on a work in progress. We are currently in the final stages of our review. The role of the librarian has so far focused on the development of a search strategy, the piloting of inclusion and exclusion criteria on samples of output, identification of quality assessment tools and preparation of public outputs. More recently, our collaborative work has extended to a rerun of our searches and international presentation of our preliminary findings.26 Working together has enabled us to fully appreciate the benefits of collaborative working between librarians, clinicians and academics. To enable librarians to be fully integrated with the research team their input needs to be fully costed.

This paper illustrates the value of searching with each other, and involved a series of intense and iterative decision-making processes in which the expertise of the librarian is integrated with the subject and clinical expertise of the academic staff. Any tendency to bias by the reviewers was mitigated by the collaborative iterative processes of checking out assumptions and seeking clarification at critical decision points.

The collaborative work on this review advocates the librarian being fully integrated with the research team. Concepts of interprofessional working in health and social care rarely incorporate professions with no history of direct involvement at the patient/client interface.27 Recently, however, encouraging attempts have been made to develop librarians as a new breed of health professional working with multidisciplinary teams to facilitate evidence-based practice at the bedside.28 In addition to improving the quality of the systematic review itself, we have found that working in an integrated, interprofessional research team has provided invaluable ‘spin-offs’ for each participant. For example, this project has provided a good working example of the processes of developing a search strategy which has been used by the librarian for dissertation preparation workshops for students. Also, from the perspective of the academic clinicians, this project has enabled them to supervise postgraduate students undertaking systematic reviews more effectively. The reciprocal benefits of collaborative working on projects such as ours are becoming increasingly obvious as we work together in the final stages of our review and in preparing public output. The challenge now is to develop models of collaborative working between librarians, clinicians and academics that are sustainable across the faculty. Our experiences on this review have contributed towards initiatives to change library staffing structure in order to facilitate librarian involvement in research activity. It is anticipated that this will lead to the new appointment of Research Librarian with a remit to develop collaborative working on research projects. This will enable the benefits that we have experienced through undertaking our review to be cascaded more widely across the faculty.

Conclusion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

Our experience has shown that the methodology of systematic reviews has rapidly evolved into a series of complex and sophisticated processes at all levels. Each systematic review is unique both in its research question, purpose and therefore in its execution. The individual nature and inherent complexity of each review demands close collaboration between librarians, academics and clinicians. Despite their apparent objectivity, systematic reviews are underpinned by an iterative complex of decisions based on expert reasoning in the areas of research, clinical practice and information management. Systematic reviews both require and provide an opportunity for collaborative working at its best. In addition to enhancing the reviews themselves, there are many other personal and institutional benefits of collaborative working. Consideration needs to be given to library staff structures and roles if these benefits are to be maximized and sustained.

Acknowledgements

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

The authors wish to thank the University of the West of England, Bristol, and the Royal National Hospital for Rheumatic Diseases, Bath for financial support of this project.

Key Messages

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References

Implications for Policy

  • • 
    The contribution of librarians to systematic literature reviews should be fully funded.

Implications for Practice

  • • 
    Librarians have a key role to play in systematic literature reviews.
  • • 
    There are significant individual and institutional benefits to collaborative working on systematic literature reviews.
  • • 
    In order for these benefits to be maximized and sustained, consideration may need to be given to library staff structures and roles.

References

  1. Top of page
  2. Abstract
  3. Introduction
  4. Hydrotherapy
  5. Selecting databases for the review
  6. Developing the search terms
  7. Limits, filters and ‘housekeeping’
  8. Principles of paper selection
  9. Assessment of study quality
  10. Discussion
  11. Conclusion
  12. Acknowledgements
  13. Key Messages
  14. References
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