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Guidance for Conducting Systematic Scoping Reviews

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Reviews of primary research are becoming increasingly popular as evidence-based practice gains recognition as the benchmark for healthcare. Systematic reviews are one of the most trusted sources used to inform healthcare decisions and policymaking. They employ a rigorous, reliable, and reproducible methodology to identify, critically appraise, and summarize all relevant literature to answer a focused research question. Due to its methodological rigor, the level of evidence of a systematic review is of very high quality. Since systematic reviews are considered the highest forms of evidence, conducting a thorough quality assessment of the study is required. A wide variety of quality assessment tools for systematic reviews are available. Different types of systematic reviews have now been developed to answer a variety of research questions. One of these review types is a systematic scoping review.

In this article, we will further explore what it is and how to conduct a systematic scoping review.

What Is A Systematic Scoping Review?

The first-ever framework for scoping reviews was published in 2005[1]. Yet, they are a relatively new methodology and do not possess a universal definition or definitive method [2,3]. Scoping reviews synthesize research evidence to map existing literature in a given field in terms of its nature, features, and volume [1]. Therefore, scoping reviews are also referred to as ‘mapping reviews’ [1,2,4]. Usually, scoping reviews are used for ‘reconnaissance’ – to clarify working definitions and conceptual boundaries of a topic. Compared to a typical systematic review which employs a rigid predetermined protocol to answer a specific research question such as the effectiveness of an intervention, a scoping review utilizes a more inclusive approach to answer broad research questions to the scope or map a body of literature.

Why Conduct A Systematic Scoping Review?

Despite the benefits of systematic reviews, there are certain limitations to the scope of literature that can be included in them due to their rigid methodology. This led to the emergence of scoping reviews. As their name suggests, scoping reviews are effective tools to determine the scope of coverage of a body of literature on a given topic.

Scoping reviews provide clear information about the volume and nature of studies available in a specific research area. Scoping reviews done before systematic reviews usually enable authors to identify the nature of a broad field of evidence [6]. Therefore, systematic reviews done after scoping reviews are assured of the effective location of adequate numbers of relevant studies for inclusion [6].

Some of the key indications for conducting a scoping review are;

Identify and map all the available evidence on a given topic [1].

  1. To clarify key concepts and definitions
  2. To examine how the research is being carried out in a certain field
  3. As a precursor to a systematic review
  4. To identify and inform knowledge gaps in research

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Systematic Scoping Review Methodology

As with all systematic reviews, the conduct of a systematic scoping review requires at least two reviewers. A priori scoping review protocol must be developed before undertaking the review. Just like a systematic review, this predetermined protocol defines the aims, objectives, inclusion/exclusion criteria for the selection of primary studies, and the methodology of the review. Following is the general protocol for conducting a scoping review.

Formulating the Research Question or Title

Since a scoping review attempts to answer questions with a broader “scope” with correspondingly more expansive inclusion criteria, it is recommended to use the PCC (Population, concept, and context) mnemonic to guide the question development [5]. The title, therefore, must be concise enough to reflect these three elements which are then used to establish a priori inclusion and exclusion criteria.

Background

The background information included in a scoping review should be comprehensive including the main elements of the topic, important definitions, and the existing knowledge in the field. This section serves as an introduction to the topic that is further explored or mapped in the scoping review.

Search For Primary Studies

The approach to searching for primary studies to be included in a scoping review follows the same three steps as in any systematic review. A comprehensive search strategy is developed to identify both published and unpublished (gray) literature. Each step of the search must be clearly defined in this section of the protocol.

Synthesis And Representation of Results

The number of studies selected must be reported along with a narrative description of the search decision process and a search decision flowchart [6]. The extraction of data from selected studies in a scoping review is referred to as ‘charting the results’ and is a logical, descriptive summary of the results that align with the research question and objective.

Discussion

Results presented in the charting stage are discussed in detail in the context of the current literature, practice, and policy, in this section.

Conclusions And Implications for Research And Practice

Overall conclusions drawn based on the results of the scoping review can be summarized in this section. The conclusion should match the review objective and question. Clear, specific recommendations for future research based on gaps in knowledge identified from the results of the review can be presented here.

Final Takeaway

Systematic scoping reviews have emerged more recently in the field of evidence synthesis. They are similar to systematic reviews in that they follow a structured process, however, there are key methodological differences between the two, and they are performed for different reasons. Scoping reviews are now seen as a valid approach in those circumstances where systematic reviews due to their methodological constraints are unable to meet the objectives of the researchers. While guidelines for the synthesis of evidence using systematic reviews are now relatively sophisticated, much refinement is still needed for the conduct of scoping reviews.

References

  1. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005; 8:19–32.
  2. Anderson S, Allen P, Peckham S, Goodwin N. Asking the right questions: scoping studies in the commissioning of research on the organization and delivery of health services. Health Res Policy Syst 2008; 6:12.
  3. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci 2010; 5:1–9.
  4. Ehrich K, Freeman GK, Richards SC, et al. How to do a scoping exercise: continuity of care. Res Pol Plan 2002; 20:25–29.
  5. Peters MD. In no uncertain terms: the importance of a defined objective in scoping reviews. JBI Database System Rev Implement Rep. 2016;14(2):1–4.
  6. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151:264–269.
  7. Munn, Zachary, et al. “Systematic Review or Scoping Review? Guidance for Authors When Choosing between a Systematic or Scoping Review Approach.” BMC Medical Research Methodology 2018; 18 (1)

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