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Physical Therapy - Dallas

Physical therapy research guide for TWU Dallas students, faculty, and staff.

Inclusion Criteria

Before you begin reviewing resources, your team should create a list of inclusion criteria that describes your ideal studies for your review. Typical criteria would include language, publication date, and type of study, along with specifics related to your research question (population, interventions, comparisons, outcomes).

Example

Research question: Does the use of mirror therapy in lower limb stroke rehabilitation improve motor function, muscle tone, balance characteristics, functional ambulation, walking velocity, PROM and gait characteristics?

Inclusion criteria:

  • English language
  • Randomized-controlled trial (RCT) or cross-over RCTs
  • Study compared mirror therapy to any other type of therapy
  • Participants were older than 18 and had been diagnosed of a stroke, with physiological changes in the lower extremities afterward
  • The mirror therapy used matched the authors' definition of such therapy

Exclusion criteria:

  • Mirror therapy was not clearly defined in the study
  • Full-text article could not be accessed
  • Study assessed other conditions besides stroke

Example based on Broderick P., Horgan F., Blake C., Ehrensberger M., Simpson D., & Monaghan K. (2018). Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. Gait & Posture 63, 208-220. https://doi.org/10.1016/j.gaitpost.2018.05.017

Excluding Citations

With the broad searches required to capture all possible titles related to your review, search results may have lots of extraneous articles that are not pertinent to the topic and which will end up being eliminated. In addition, searching across multiple databases will bring back duplicate titles that will need to be eliminated from your total number.

PRISMA guidelines for scoping and systematic reviews have three rounds of elimination.

Duplicate Articles

This step can be undertaken by an individual. It simply requires going through all found titles to remove duplicates.

Title/Abstract

Eliminate articles based on their title and abstract using your inclusion/exclusion criteria. 

  • This step must be undertaken by a team of at least two (preferably three) people.
  • Reviewer (A) and reviewer (B) go to their separate corners and independently select which articles to include and exclude.
  • The results are compared. 
  • Per Arksey and O'Malley, disagreements in selections can be resolved via conversation. However, this can lead to bias, e.g. if one member of the team has a higher status such as being the lead researcher then he/she may get her way more often than not. A better way to resolve disagreements in selections is to add a third member of the team and have him/her come in and cast a deciding vote on those articles that are in dispute.

Full Text

Eliminate articles based on the full text using your inclusion/exclusion criteria.

  • This step must be undertaken by a team of at least two (preferably three) people.
  • Reviewer (A) and reviewer (B) go to their separate corners and independently select which articles to include and exclude.
  • The results are compared. 
  • Per Arksey and O'Malley, disagreements in selections can be resolved via conversation. However, this can lead to bias, e.g. if one member of the team has a higher status such as being the lead researcher then he/she may get her way more often than not. A better way to resolve disagreements in selections is to add a third member of the team and have him/her come in and cast a deciding vote on those articles that are in dispute.

To reduce bias in the exclusion process, using a systematic review software like Rayyan can allow for blind judging of inclusion/exclusion.

Learn From Your Golden Standard Articles

After the above exclusion rounds, what you have left is commonly referred to as the "golden standard"  -- those articles or book chapters that are a perfect fit for your review’s topic. Use these resources to make sure you've included every pertinent study on your topic.

Review References

Inspect the citation pages of all the sources in your golden standard. If the article is perfect for your needs, then it stands to reason that some of the articles the author used in their research might also be a perfect fit.

  • Record the number of citations to the existing number under "Articles from Other Sources’ in the table where you are tracking the articles included in your review.
  • Subject these new sources to the same inclusion/exclusion elimination criteria.
  • If you find any that will be added to your golden standard, then these, in turn, must have their citation pages investigated.

This process continues until the citations fall outside your specified date range.

Review Articles That Have Cited Your Articles

If the article is great for your review, others may have also cited it, and their articles may also fit your review.

  • Use Google Scholar or Web of Science to find articles that have cited your golden standard articles.
  • Add the number of such articles to the existing number under "Articles from Other Sources’ in the table where you are tracking the articles included in your review.
  • Subject these new sources to the same inclusion/exclusion elimination criteria.
  • If you find any that will be added to your golden standard, then these, in turn, must have their citation pages investigated.

This process continues until no more "cited by" articles are added to your golden standard.