The Nordic Nutrition Recommendations 2022 – handbook for qualified systematic reviews
Abstract
Background: Systematic reviews (SRs) constitute a major part of the Nordic Nutrition Recommendations (NNRs). The step-by-step procedure used to develop SRs has evolved considerably over time and is often tailored to fit the exposure and outcomes in focus.
Objective: To describe a detailed procedure for developing qualified SRs commissioned by the NNR2022 project.
Design: Scrutinizing procedures of recent SRs commissioned by leading national food and health authorities or international food and health organizations.
Results: The following eight steps must be included when developing qualified SRs for the NNR2022 project: 1) define research question, 2) protocol development, 3) literature search, 4) screening and selection of studies, 5) data extraction, 6) assessing risk of bias, 7) synthesis and grading of total strength of evidence, and 8) reporting according to certain standards.
Discussion: This guide is based on the guidelines developed for the fifth edition of NNR but includes some important new domains in order to adhere to more recent, authoritative standards.
Conclusion: All qualified SRs in the NNR2022 project will follow the protocol described here.
Downloads
References
- Christensen JJ, Arnesen EK, Andersen R, Eneroth H, Erkkola M, Høyer A, et al. The Nordic Nutrition Recommendations 2022 – principles and methodologies. Food Nutr Res 2020. doi: 10.29219/fnr.v64.4402
- Arnesen EK, Christensen JJ, Andersen R, Eneroth H, Erkkola M, Høyer A, et al. The Nordic Nutrition Recommendations 2022 – structure and rationale of qualified systematic reviews. Food Nutr Res 2020; 64:4403. doi: 10.29219/fnr.v64.4403
- Nordic Council of Ministers. A guide for conducting SLR for NNR5. How to undertake a systematic review of nutrition recommendations. Copenhagen: Nordic Council of Ministers; 2014.
- Lichtenstein AH, Yetley EA, Lau J. Application of systematic review methodology to the field of nutrition: nutritional research series, Vol 1. AHRQ Technical Reviews. Rockville, MD: AHRQ; 2009.
- Fogelholm M, Anderssen S, Gunnarsdottir I, Lahti-Koski M. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review. Food Nutr Res 2012; 56. doi: 10.3402/fnr.v56i0.19103
- Higgins JPT, Lasserson T, Chandler J, Tovey D, Churchill R. Methodological Expectations of Cochrane Intervention Reviews (MECIR): Cochrane Community; 2018. Available from: https://community.cochrane.org/mecir-manual [cited 25 July 2019].
- Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283(15): 2008–12. doi: 10.1001/jama.283.15.2008
- Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4: 1. doi: 10.1186/2046-4053-4-1
- Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2015; 350: g7647. doi: 10.1136/bmj.g7647
- Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; 358: j4008. doi: 10.1136/bmj.j4008
- Dekkers OM, Vandenbroucke JP, Cevallos M, Renehan AG, Altman DG, Egger M. COSMOS-E: guidance on conducting systematic reviews and meta-analyses of observational studies of etiology. PLoS Med 2019; 16(2): e1002742. doi: 10.1371/journal.pmed.1002742
- Relevo R, Balshem H. Finding evidence for comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2011; 64(11): 1168–77. doi: 10.1016/j.jclinepi.2010.11.022
- Reeves BC, Deeks JJ, Higgins JPT, Wells GA. Including non-randomized studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration; 2011.
- Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 2007; 18(6): 805–35. doi: 10.1097/EDE.0b013e3181577511
- Scottish Intercollegiate Guidelines Network (SIGN). Search Filters. Available from: http://sign.ac.uk/search-filters.html [cited 24 November 2019].
- Higgins JPT, Deeks JJ. Selecting studies and collecting data. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions, version 5.1.0. The Cochrane Collaboration; 2011.
- Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016; 5(1): 210. doi: 10.1186/s13643-016-0384-4
- Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6(7): e1000097. doi: 10.1371/journal.pmed.1000097
- PRISMA. PRISMA flow diagram generator. Available from: http://prisma.thetacollaborative.ca/ [cited 24 November 2019].
- Higgins JPT, Altman DG, Sterne JA. Assessing risk of bias in included studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration; 2011.
- Sterne JA, Hernan MA, Reeves BC, Savovic J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919. doi: 10.1136/bmj.i4919
- Wang Z, Taylor K, Allman-Farinelli M, Armstrong B, Askie L, Ghersi D, et al. A systematic review: tools for assessing methodological quality of human observational studies [Draft]. Canberra: NHMRC; 2019.
- Viswanathan M, Patnode CD, Berkman ND, Bass EB, Chang S, Hartling L, et al. Recommendations for assessing the risk of bias in systematic reviews of health-care interventions. J Clin Epidemiol 2018; 97: 26–34. doi: 10.1016/j.jclinepi.2017.12.004
- Norris SL, Atkins D, Bruening W, Fox S, Johnson E, Kane R, et al. Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2011; 64(11): 1178–86.
- Lachat C, Hawwash D, Ocke MC, Berg C, Forsum E, Hornell A, et al. Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut): an extension of the STROBE statement. PLoS Med 2016; 13(6): e1002036. doi: 10.1371/journal.pmed.1002036
- Yetley EA, MacFarlane AJ, Greene-Finestone LS, Garza C, Ard JD, Atkinson SA, et al. Options for basing Dietary Reference Intakes (DRIs) on chronic disease endpoints: report from a joint US-/Canadian-sponsored working group. Am J Clin Nutr 2017; 105(1): 249S–85S. doi: 10.3945/ajcn.116.139097
- Myers EF, Parrott JS, Splett P, Chung M, Handu D. Using risk of bias domains to identify opportunities for improvement in food- and nutrition-related research: an evaluation of research type and design, year of publication, and source of funding. PLoS One 2018; 13(7): e0197425. doi: 10.1371/journal.pone.0197425
- Nutrition Evidence Systematic Review. Risk of Bias for Nutrition Observational Studies (RoB-NObs) Tool 2019. Available from: https://nesr.usda.gov/sites/default/files/2019-07/RiskOfBiasForNutritionObservationalStudies-RoB-NObs.pdf [cited 06 February 2020].
- Greenland S, O’Rourke K. Meta-analysis. In: Rothman KJ, Greenland S, Lash TL, editors. Modern epidemiology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkin; 2008, pp. 652–82.
- DeeksJJ, Higgins JPT, Altman DG. Analysing data and undertaking meta-analyses. In: Higgins JPT, Altman DG, editors. Cochrane handbook for systematic reviews of interventions, version 5.1.0. The Cochrane Collaboration; 2011.
- Morton SC, Murad MH, O’Connor E, Lee CS, Booth M, Vandermeer BW, et al. Quantitative synthesis – an update. 2018. In: Methods guide for comparative effectiveness reviews [Internet]. Rockville, MD: Agency for Healthcare Research and Quality. doi: 10.23970/AHRQEPCMETHGUIDE3
- Hill AB. The environment and disease: association or causation? Proc R Soc Med 1965; 58: 295–300.
- World Cancer Research Fund, American Institute for Cancer Research. Continuous Update Project Report. Judging the evidence. London: World Cancer Research Fund; 2018.
- Berkman ND, Lohr KN, Ansari MT, Balk EM, Kane R, McDonagh M, et al. Grading the strength of a body of evidence when assessing health care interventions: an EPC update. J Clin Epidemiol 2015; 68(11): 1312–24. doi: 10.1016/j.jclinepi.2014.11.023
Authors retain copyright of their work, with first publication rights granted to SNF Swedish Nutrition Foundation. Read the full Copyright- and Licensing Statement.