Advanced Search
Welcome to the Systematic
Review Data Repository
Welcome to the Systematic Review Data Repository
The Systematic Review Data Repository (SRDR) is a powerful and easy-to-use tool for the extraction and management of data for systematic review or meta-analysis. It is also an open and searchable archive of systematic reviews and their data.
To contribute data or comment on deposited projects, simply Register for an account.


Registered users, log in below:
Forgot Password?

Recently Completed and Deposited Reports Data

SRDR Project Indexing


Public Report Complete
Statistics: 152 Studies, 1 Key Question, 1 Extraction Form,
Date Created: May 20, 2018 11:24PM
Description: This is a Methods Research project that catalogs the various projects with publicly available data on the SRDR Webpage.

Systematic reviews on interventions for corneal disease: What is the reliability of the evidence?


Public Report Complete
Statistics: 254 Studies, 1 Key Question, 1 Extraction Form,
Date Created: May 24, 2018 08:29PM
Description: Although a number of systematic reviews on corneal disease have been published, the reliability of these reviews remains unclear. We will characterize and appraise the methodological reliability of systematic reviews on interventions for corneal disease. The purpose of our study is to evaluate the current available evidence on interventions for corneal disease, state the strengths and limitations and formulate recommendations for improving future review conduct.

Dry Eye SRs


Public Report Complete
Statistics: 40 Studies, 1 Key Question, 1 Extraction Form,
Date Created: Feb 21, 2017 02:00AM
Description: Although a number of systematic reviews on dry eye have been published, the quality of these reviews remains unclear. We will characterize and appraise the methodological quality of systematic reviews on interventions for dry eye. The purpose of our study is to evaluate the current available evidence on interventions for dry eye, state the strengths and limitations and formulate recommendations for improving future review conduct.

Screening for Hepatitis B Virus Infection in Pregnant Women: An Updated Systematic Review for the U.S. Preventive Services Task Force [Entered Retrospectively]


Public Report Complete
Statistics: 2 Studies, 4 Key Questions, 1 Extraction Form,
Date Created: Sep 04, 2019 08:09PM
Description: Objective: To update the 2009 U.S. Preventive Services Task Force (USPSTF) “A” recommendation on screening for hepatitis B virus (HBV) infection in pregnancy, we systematically reviewed evidence on the benefits (Key Question [KQ] 1) and harms (KQ 2) of universal screening programs for HBV infection in pregnant women, and the benefits (KQ 3) and harms (KQ 4) of case management programs to prevent perinatal transmission. Data Sources: We conducted a literature search of MEDLINE, PubMed Publisher-Supplied Records, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, the Cumulative Index for Nursing and Allied Health Literature, Embase, and PsycInfo from January 1, 1986 to May 3, 2018. Study Selection: We screened 5,688 titles and abstracts and 499 full-text articles to identify eligible studies based on a priori inclusion and exclusion criteria. Data Analysis: Two investigators independently appraised any article that met inclusion criteria using design-specific criteria. We abstracted and narratively synthesized included study data. Results: No studies were identified for KQs 1 or 2 that addressed either the effects of screening programs on perinatal HBV transmission or the potential harms of screening. Two fair-quality observational studies that compared perinatal transmission rates over time were included for KQ 3. One study reported outcomes of case management for infants with data reported to the national Perinatal Hepatitis B Prevention Program (PHBPP), administered by the Centers for Disease Control and Prevention (CDC). In the PHBPP, 155,081 infants born to HBV-positive women were identified for case management from 1994 to 2008; perinatal transmission outcomes were available for infants born from 1999 to 2008 who received serologic testing (N=55,362). A statistically significant decline in the perinatal transmission rate was observed; perinatal transmission was reported for 1.9 percent of case-managed infants in 1999 and 0.8 percent in 2008 (p<0.001). Over the study period, the number of infants born to HBV-positive women increased in the United States, and an increasing proportion of infants born to HBV-positive women were enrolled in the PHBPP for case management (p<0.001). Serologic testing within 24 months of birth also increased across the time period (p=0.001). The second study reported outcomes of case management for infants born to HBV-positive women in a large regional health care organization in the United States. The health system case management program reported on 4,446 infants born to HBV-positive women from 1997 to 2010. Over this period, 85 percent of infants were tested for HBV, and a decreasing trend in perinatal transmission was reported (incident rate ratio, 0.90 [95% confidence interval, 0.82 to 1.00]). Overall rates of perinatal transmission were very low (25 of 3,353 of infants tested [0.75%]). More than 97 percent of case-managed infants received HBV vaccination and hepatitis B immune globulin within 12 hours of birth. No studies were identified for KQ 4 to assess potential harms of case management. Limitations: Our review was narrowly focused on evidence of the effectiveness of screening or case management on prevention of perinatal transmission in contexts where prenatal screening and universal vaccination for HBV at birth are established practice. The included observational studies’ findings on declining perinatal transmission trends could be influenced by secular changes in other public health activities (e.g., universal HBV vaccination) or by improvements within case management program implementation and interventions (e.g., antiviral medication). Changes in data collection and reporting methods used in the studies could also introduce bias. Conclusions: Perinatal transmission would be observed in more than one third of infants born to HBV-positive mothers in the absence of prophylaxis. Very low and declining rates of perinatal transmission have been documented for infants in case management programs that track and coordinate the delivery of preventive interventions. Screening for HBV infection in pregnancy is standard prenatal care practice in the United States and identifies women and infants eligible for effective case management for effective interventions to prevent perinatal transmission.

Medication Use for the Risk Reduction of Primary Breast Cancer in Women: A Systematic Review for the U.S. Preventive Services Task Force [Entered Retrospectively]


Public Report Complete
Statistics: 82 Studies, 4 Key Questions, 1 Extraction Form,
Date Created: Aug 26, 2019 05:25PM
Description: Background: Medications to reduce breast cancer risk are an effective prevention intervention for women at increased risk, although medications also cause adverse effects. Purpose: To update the 2013 U.S. Preventive Services Task Force (USPSTF) systematic review on the use of medications to reduce the risk of primary breast cancer. Data Sources: Searches included the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, EMBASE, and MEDLINE (January 1, 2013 to February 1, 2019); and manual review of reference lists. Studies published before 2013 were identified from prior systematic reviews for the USPSTF. Study Selection: Discriminatory accuracy studies of breast cancer risk assessment methods; double-blind, placebo-controlled or head-to-head randomized controlled trials (RCT) of tamoxifen, raloxifene, and aromatase inhibitors for primary prevention of breast cancer that enrolled women without preexisting breast cancer; and RCTs and observational studies of harms of medications. Data Extraction: One investigator abstracted data on study methods; setting; population characteristics; eligibility criteria; interventions; numbers enrolled and lost to followup; method of outcome ascertainment; and results for each outcome and a second investigator checked abstractions for accuracy. Two investigators independently assessed study quality using methods developed by the USPSTF. Data Synthesis (Results): Eighteen risk models evaluated in 25 studies had generally low discriminatory accuracy in predicting the probability of breast cancer in an individual (c-statistics 0.55 to 0.65). Most models performed only slightly better than age alone as a risk predictor. No studies evaluated optimal ages or frequencies of risk assessment. In placebo-controlled trials, tamoxifen (risk ratio [RR] 0.69; 95% confidence interval [CI], 0.59 to 0.84; 7 fewer cases per 1000 women over 5 years of use [95% CI, 4 to 12]; 4 trials), raloxifene (RR 0.44; 95% CI, 0.24 to 0.80; 9 fewer cases [95% CI, 3 to 15]; 2 trials), and the aromatase inhibitors exemestane and anastrozole (RR 0.45; 95% CI, 0.26 to 0.70; 16 fewer cases [95% CI, 8 to 24]; 2 trials) reduced invasive breast cancer. Risk for invasive breast cancer was higher for raloxifene than tamoxifen in the Study of Tamoxifen And Raloxifene (STAR) head-to-head trial (RR, 1.24; 95% CI, 1.05 to 1.47) after long-term followup. Effects did not differ by age of initiation or duration of use (3 to 5 years), although these effects were not directly compared. Risk reduction persisted at least 8 years after discontinuation in tamoxifen trials with long-term followup. All medications reduced estrogen receptor positive, but not estrogen receptor negative invasive breast cancer; tamoxifen reduced noninvasive cancer in two trials; and breast-cancer specific and all-cause mortality were not reduced. In placebo-controlled trials, raloxifene (RR 0.61; 95% CI, 0.53 to 0.73; 2 trials) reduced vertebral fractures; tamoxifen reduced nonvertebral fractures in the National Surgical Adjuvant Breast and Bowel Project (NSABP P-1) trial (RR 0.66; 95% CI, 0.45 to 0.98); while the aromatase inhibitors had no effect on fractures. Tamoxifen and raloxifene had similar effects on reducing fractures at multiple vertebral and nonvertebral sites in the STAR head-to-head trial. In placebo-controlled trials, tamoxifen (RR 1.93; 95% CI, 1.33 to 2.68; 4 trials) and raloxifene (RR 1.56; 95% CI, 1.11 to 2.60; 2 trials) increased thromboembolic events, while aromatase inhibitors did not. Raloxifene caused fewer thromboembolic events (RR 0.75; 95% CI, 0.60 to 0.93) than tamoxifen in the STAR head-to-head trial. Tamoxifen, raloxifene, and aromatase inhibitors did not increase coronary heart disease events or strokes. In placebo-controlled trials, tamoxifen increased endometrial cancer (RR 2.25; 95% CI, 1.17 to 4.41; 3 trials), while raloxifene and aromatase inhibitors did not. In the STAR head-to-head trial, raloxifene caused fewer cases of endometrial cancer (RR 0.55; 95% CI, 0.36 to 0.83) and endometrial hyperplasia (RR 0.19; 95% CI, 0.12 to 0.29), and fewer hysterectomies (RR 0.45; 95% CI, 0.37 to 0.54) than tamoxifen. Tamoxifen increased cataracts (RR 1.22; 95% CI, 1.08 to 1.48; 3 trials) and cataract surgery compared with placebo, while raloxifene and aromatase inhibitors did not. Risks for thromboembolic events and endometrial cancer with tamoxifen were higher for older compared with younger women and returned to normal after discontinuation. All medications caused adverse effects, such as vasomotor or musculoskeletal symptoms, that varied by medication. Risks for invasive cancer were generally reduced in all population subgroups evaluated based on menopausal status (pre and postmenopausal); family history of breast cancer; body mass index categories; modified Gail model risk categories; and age at menarche, parity, or age at first live birth, although results varied. Tamoxifen and anastrozole had larger effects in reducing invasive breast cancer in women with previous breast lesions (lobular carcinoma in situ, atypical ductal hyperplasia, or atypical lobular hyperplasia). Limitations: Trials were limited by clinical heterogeneity related to different medications, exposure durations, eligibility criteria, adherence, and ascertainment of outcomes. No trials compared timing and duration directly. Long-term followup data were lacking from most trials, and followup was particularly short for the aromatase inhibitors. Trials were not designed for subgroup comparisons and analysis of differences may be underpowered. Conclusions: Tamoxifen, raloxifene, and the aromatase inhibitors exemestane and anastrozole reduce invasive breast cancer in women without preexisting breast cancer, but also cause adverse effects that vary by medication. Tamoxifen and raloxifene increase thromboembolic events and tamoxifen increases endometrial cancer and cataracts. Identifying candidates for therapy is complicated by risk stratification methods that demonstrate low accuracy.

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA1/2-Related Cancer in Women: A Systematic Review for the U.S. Preventive Services Task Force [Entered Retrospectively]


Public Report Complete
Statistics: 110 Studies, 5 Key Questions, 1 Extraction Form,
Date Created: Aug 26, 2019 04:31PM
Description: Background: Pathogenic mutations in breast cancer susceptibility genes BRCA1 and BRCA2 increase risks for breast, ovarian, fallopian tube, and peritoneal cancer in women; interventions reduce risk in mutation carriers. Purpose: To update the 2013 U.S. Preventive Services Task Force review on benefits and harms of risk assessment, genetic counseling, and genetic testing for BRCA1/2-related cancer in women. Data Sources: Cochrane libraries; MEDLINE, PsycINFO, EMBASE (January 1, 2013 to March 6, 2019 for updates; January 1, 1994 to March 6, 2019 for new key questions and populations); reference lists. Study Selection: Discriminatory accuracy studies, randomized controlled trials (RCTs), and observational studies of women without recently diagnosed BRCA1/2-related cancer. Data Extraction: Data on study methods; setting; population characteristics; eligibility criteria; interventions; numbers enrolled and lost to followup; outcome ascertainment; and results were abstracted. Two reviewers independently assessed study quality. Data Synthesis (Results): 103 studies (110 articles) were included. No studies evaluated the effectiveness of risk assessment, genetic counseling, and genetic testing in reducing incidence and mortality of BRCA1/2-related cancer. Fourteen studies of 10 risk assessment tools to guide referrals to genetic counseling demonstrated moderate to high accuracy (area under the receiver operating characteristic curve 0.68 to 0.96). No studies determined optimal ages, frequencies, or harms of risk assessment. Twenty-eight studies indicated genetic counseling is associated with reduced breast cancer worry, anxiety, and depression; increased understanding of risk; and decreased intention for testing. A RCT showed that population-based testing of Ashkenazi Jews detected more BRCA1/2 mutations than family-history based testing, while measures of anxiety, depression, distress, uncertainty, and quality of life were similar between groups; clinical outcomes were not evaluated. Twenty studies indicated breast cancer worry and anxiety were higher after testing for women with positive results and lower for others, and understanding of risk was higher. No RCTs evaluated the effectiveness of intensive screening for breast or ovarian cancer in mutation carriers. In observational studies, false-positive rates, additional imaging, and benign biopsies were higher with magnetic resonance imaging than mammography. In eight RCTs, tamoxifen (risk ratio [RR], 0.69; 95% confidence interval [CI], 0.59 to 0.84; 4 trials), raloxifene (RR, 0.44 95% CI, 0.24 to 0.80; 2 trials), and aromatase inhibitors (RR, 0.45 95% CI, 0.26 to 0.70; 2 trials) were associated with lower risks of invasive breast cancer compared with placebo; results were not specific to mutation carriers. Adverse effects included venous thromboembolic events for tamoxifen and raloxifene; endometrial cancer and cataracts for tamoxifen; and vasomotor, musculoskeletal, and other symptoms for all medications. In observational studies, mastectomy was associated with 90 to 100 percent reduction in breast cancer incidence and 81 to 100 percent reduction in breast cancer mortality; oophorectomy or salpingo-oophorectomy was associated with 69 to 100 percent reduction in ovarian cancer; complications were common with mastectomy. Limitations: Including only English-language articles and studies applicable to the United States; varying number, quality, and applicability of studies; and few studies of untested women previously treated for BRCA1/2-related cancer. Conclusions: Risk assessment, genetic counseling, and genetic testing to reduce BRCA1/2-cancer incidence and mortality as a prevention service has not been directly evaluated by current research. Risk assessment with familial risk tools accurately identifies high-risk women for genetic counseling. Genetic counseling reduces breast cancer worry, anxiety, and depression; increases understanding of risk; and decreases intention for mutation testing, while testing improves accuracy of understanding of risk. The effectiveness of intensive screening is not known, but it increases false-positive results and procedures. Risk-reducing medications and surgery are associated with reduced breast and ovarian cancer, but also have adverse effects. Evidence gaps relevant to prevention remain and additional studies are needed to better inform clinical practice.



Creative Commons LicenseThis graphic notice indicates that you are leaving this Federal Government Web site and entering a non-Federal Web site. Creative Commons  
The data contained in this project are distributed under the terms of the Creative Commons Attribution-NonCommerical license, which permits the use, dissemination, and reproduction in any medium, provided the original work is properly cited, and that the use is non-commercial and otherwise in compliance with the license. See: https://creativecommons.org/licenses/by-nc/3.0/

Popular Resources



Help


SRDR Announcements



Statistics



Maintenance Schedule