I said that I’d do a Systematic Review… My Quick Guide to Getting Started (of sorts)


photo_27-4-14_easter_focusStarting at the beginning: I said that I’d do a Systematic Review… Easy right?! Hmm…

For the last two years it’s been my job to find and appraise published, peer-reviewed literature. Over that time I’ve seen my share of great reviews and then there were those that I needed a dictionary to wade my way through reading them. There were reviews that had the ‘insufficient research with robust methodology to support this practice’ statement. Actually there’s quite a few of those to be found on speechBITE, by merely typing ‘insufficient’ into the simple (keyword) search, 39 of them spring up at the time of writing this.

So, after reading and pondering over all these systematic reviews, surely conducting one myself would be a piece of cake (one that hopefully has really good icing)? Particularly when, let’s face it, there’s not a lot of research that has been published in the area of using social media (or specifically the use of Twitter) for enhancing communication after someone has had a traumatic brain injury. As someone wisely once said to me, “What could possibly go wrong?”. Well, the answer is HEAPS! Without a great deal of preparation and planning, conducting a systematic review has the potential to go pear shaped and end up in being a great deal of work for little outcome. By being ‘systematic’ in the approach, my aim is to conduct a robust search and critical review of the literature-to-date in the field and be able to report it in such a way that the search and review could be a) replicated and b) understood with ease (which for me, is just as important).

Working along and getting things started has led me to develop My Quick Guide to Getting Started (of sorts). Essentially, these are the tools that I would point out to anyone thinking about heading down the road to conducting a Systematic Review:

This article by Grant et al. (2009) provides a great outline of the differences between review types and can be used to determine which review type and associated methodology might best suit your purpose in conducting a review. For example, a literature review and a systematic review often differ significantly in the way literature is searched for.

In developing a systematic review the next logical step might be to see if there’s already a review being done in the topic area that you’re keen to investigate. By searching the current published literature you will know whether there are any completed reviews but what about those that are being conducted and yet to be published? Not all researchers publish their review protocol, so my tip – check PROSPERO as a starting point, as this is a prospective register of systematic reviews currently underway internationally.

Next, I like to know what to actually do! By looking through the Cochrane Handbook for Systematic Reviews of Interventions it’s easy to identify and prepare for the different stages of the systematic review process. The Cardiff University’s SysNet website also has some great information and links to resources. There’s even a best practice statement about what the minimum requirements are when reporting a systematic review. The PRISMA statement provides a checklist and flow chart that can help you navigate towards a publication that provides enough detail for the review to be replicated and will also allow readers to easily determine the methodological quality of your review. I know I love it when I get to read a paper that is logical and provides enough detail for me to know the process that has been followed. Having to re-read an article with a fine toothed comb is my least favourite thing to do, particularly if I’m then left frustrated with the lack of clear statements about the methods that have been employed.

A huge amount of my critical appraisal knowledge and skill comes from frequent practice and exposure to research methodology as part of my role in speechBITE. Although speechBITE is not currently able to provide critical appraisal of systematic reviews, if it were able to, the AMSTAR rating scale has been discussed as the tool that it would use. Certainly, alongside the PRISMA checklist, the AMSTAR rating scale is widely used to critically evaluate systematic reviews. Where PRISMA is utilised to evaluate reporting quality, the AMSTAR checklist is a validated and reliable tool that is used to evaluate methodological quality. To this end, in order to comprehensively know what constitutes a ‘good quality’ systematic review, I’m aiming to annotate my ever growing EndNote references by evaluating the systematic reviews using the AMSTAR checklist as well. There are several systematic reviews in the broad arena of investigating social networking sites in health related topics and I was keen to find out what was currently being done and the ‘level of quality’ they would be considered to have using this rating tool. Doing a little more background reading, I also came across this paper by Sharif et al. (2013) which gives a very easy-to-read overview of the AMSTAR rating scale.

So, I’m off to keep rating reviews but the next tip I have would be to look at the search strategies employed by other researchers in the field that you’re investigating. This can be extremely helpful in fine-tuning your own search strategy and double-checking that you haven’t left a crucial term out (or indeed terms)! I’m reading this recent article today that looked at testing search strategies for systematic reviews for some more tips!

I’m hoping to post more about reporting and methodological quality of systematic reviews. In keeping with best practice, I’ll be asking a second, independent rater to review the systematic reviews that I’m reading and evaluating, with the aim of being able to provide some further critical appraisal in upcoming posts. In the meantime, happy reviewing and let me know your tried and true tips on how to survive and shine during the systematic review process 🙂


PhD ponderings in the realms of Traumatic Brain Injury and Twitter



Getting started in the world of PhD candidature this year has been invigorating, this blog aims to catalogue and share the discoveries along my path towards learning more about the research world. Currently refining research methodology, seeking ethical approval and continuously searching the literature.

PhD Research Topic

Twitter use by people with communication disabilities post traumatic brain injury (TBI).


Bronwyn Hemsley, The University of Newcastle (primary supervisor)
Leanne Togher, The University of Sydney
Stephen Dann, Australian National University
Stuart Palmer, Deakin University



It is proposed that this project will align itself with the funded DECRA research ‘TweetReach’ being conducted by Dr Bronwyn Hemsley at the University of Newcastle (commencing 2014-17). The ‘TweetReach’ research aims to examine the impact of training adults with communication disabilities (specifically targeting populations of adults with communication difficulties as a result of lifelong disabilities of Cerebral Palsy; aphasia post stroke; and neurodegenerative ALS) to use Twitter, and barriers and facilitators to successful use to increase information exchange in this vulnerable group.

In addition to these identified populations, teenagers and adults with communication disabilities resulting from traumatic brain injury (TBI) face similar challenges in accessing information independently and engaging effectively in social networks1. There is an ever growing mass of literature examining the use of social media in health care, there is however limited knowledge of its use, benefits and limitations within the realm of communication disabilities. Whilst there is emerging literature for TBI in social media specifically relating to concussion2, 3, 4, there is currently no known research focussing on the use of social media for teenagers and adults with communication difficulties post TBI, nor studies evaluating the provision of training in social media and its effect on participant abilities to effectively access information and engage socially.


The aims of this project are to:

a)      Investigate young people with TBI’s and their parents/partners/spouses’ views and experiences on the use, benefits and limitations of Twitter, and barriers and facilitators to its successful use

b)      Evaluate the efficacy of providing an online training module on using Twitter for the target population – teenagers and young adults with TBI. The PhD candidate will teach teenagers and young adults with communication difficulties post TBI to use Twitter for information and engagement via the development of:

  1. An online training module for the target population and their significant others (e.g. spouse, parent, friend)
  2. Policies and clinical practice guidelines to assist clinicians working with target population

c)       Evaluate the use of Twitter by the target population following online training intervention.

Expected outcomes, significance or rationale

To date, there is no published speech pathology evidence of social media Twitter use for consumers or professionals in the TBI population with communication difficulties. This project is therefore unique as it aims to establish a baseline for current use of Twitter as a social media within this population and evaluate the implementation of a training program on use of Twitter for information exchange and engaging within social networks in this population. It is anticipated that publications arising from this research will also inform future investigations into the use of Twitter and potentially other social media within the TBI population and how best to incorporate functional, everyday aspects of communication (such as social networking) into rehabilitation programs to improve outcomes for teenagers and adults post TBI, as well as reducing dependence and burden on their significant others.


  1. McDonald S, Togher L, & Code C (Eds.). (2013). Social and Communication Disorders Following Traumatic Brain Injury. Psychology Press.
  2. Ahmed OH, Sullivan SJ, Schneiders AG, & Mccrory P (2010). iSupport: do social networking sites have a role to play in concussion awareness?. Disability & Rehabilitation32(22), 1877-1883.
  3. Sullivan SJ, Schneiders AG, Cheang CW, Kitto E, Lee H, Redhead J, Ward S, Ahmed OH, & McCrory PR (2012). ‘What’s happening?’A content analysis of concussion-related traffic on Twitter. British journal of sports medicine46(4), 258-263.
  4. Ahmed OH, Sullivan SJ, Schneiders AG, & McCrory PR (2012). Concussion information online: evaluation of information quality, content and readability of concussion-related websites. British journal of sports medicine, 46(9), 675-683.