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A Practical 19-Step Guideline for Conducting and Reporting Systematic Reviews Without Meta-Analysis: The Hawler Medical University Approach

Ahmed Naif Ali
Department Nursing, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Muzhda Qasim Qader
Department of Public Health, College of Health Sciences, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Bashdar Mahmud Hussen
Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Zahra Abdulqader Amin
Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Sewgil Saaduldeen Anwer
Department of Clinical Biochemistry, College of Health Sciences, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Abduljaleel Azad Samad
Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Dara Abdulla Qadir Al-Banna
Department Nursing, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Sherzad Abdulahad Shabu Hakim
Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Kazhan Ibrahim Mahmood
Department Nursing, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Karwan Mohammed M. Amin
Department Nursing, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq.
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Copyright (c) 2026 Ahmed Naif Ali, Muzhda Qasim Qader, Bashdar Mahmud Hussen, Zahra Abdulqader Amin, Sewgil Saaduldeen Anwer, Abduljaleel Azad Samad, Dara Abdulla Qadir Al-Banna, Sherzad Abdulahad Shabu Hakim, Kazhan Ibrahim Mahmood, Karwan Mohammed M. Amin (Author)

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Abstract

Background and objective: Approximately one-third of health systematic reviews do not employ meta-analysis, and novice reviewers may report narrative syntheses with insufficient methodological detail. Established resources such as PRISMA 2020, PRISMA-P, SWiM, the Cochrane Handbook, and GRADE provide complementary guidance but are distributed across separate documents. This guideline provides a practical, step-by-step approach for conducting and reporting systematic reviews without meta-analysis for students at Hawler Medical University.

Methods: The 19-step guideline was developed by mapping complementary recommendations from PRISMA 2020, PRISMA-P, SWiM, the Cochrane Handbook, MMAT, Garrard's matrix method, GRADE, and JBI guidance across four sections: Methods (Steps 1–9), Results (Steps 10–13), Discussion (Step 14), and Conclusion and reporting elements (Steps 15–19). Reporting standards were distinguished from methodological guidance and institutional recommendations. Each step identifies its intended location, procedure, rationale, and corresponding reporting output. A draft was circulated to a panel for feedback and revised with an audit trail.

Results: The guideline links methodological decisions to reporting outputs, including protocol development and registration, topic scoping, reproducible search design, eligibility criteria, two-stage screening, design-appropriate critical appraisal, standardized data extraction, and structured synthesis. It emphasizes reviewer calibration, transparent documentation, and selection of synthesis methods according to the review question and evidence type. Worked examples, synthesis matrices, and conceptual models are presented as optional teaching tools where appropriate rather than universal requirements.

Conclusion: This practical 19-step guideline integrates established methodological and reporting resources into a single institutional framework for systematic reviews without meta-analysis. It is intended to support novice reviewers while allowing methodological choices to vary according to the review question, study designs, and evidence type. The framework also incorporates considerations relevant to Iraq and the Kurdistan Region and should be refined through future usability and implementation evaluation.

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References

  1. De Cassai A, Dost B, Tulgar S, Boscolo A. Methodological standards for conducting high-quality systematic reviews. Biology (Basel). 2025;14(8):973. DOI: 10.3390/biology14080973
  2. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. DOI: 10.1136/bmj.n71
  3. Tawfik GM, Dila KAS, Mohamed MYF, Tam DNH, Kien ND, Ahmed AM, et al. A step by step guide for conducting a systematic review and meta-analysis with simulation data. Trop Med Health. 2019;47(1):46. DOI: 10.1186/s41182-019-0165-6
  4. Gusenbauer M, Gauster SP. How to search for literature in systematic reviews and meta-analyses: a comprehensive step-by-step guide. Technol Forecast Soc Change. 2025;212:123833. DOI: 10.1016/j.techfore.2024.123833
  5. Randles R, Finnegan A. Guidelines for writing a systematic review. Nurse Educ Today. 2023;125:105803. DOI: 10.1016/j.nedt.2023.105803
  6. Siddaway AP, Wood AM, Hedges LV. How to do a systematic review: a best practice guide for conducting and reporting narrative reviews, meta-analyses, and meta-syntheses. Annu Rev Psychol. 2019;70:747–70. DOI: 10.1146/annurev-psych-010418-102803
  7. Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ. 2020;368:l6890. DOI: 10.1136/bmj.l6890
  8. Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. 2018;34(4):285–91. DOI: 10.3233/EFI-180221
  9. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–94. DOI: 10.1016/j.jclinepi.2010.04.026
  10. Garrard J. Health sciences literature review made easy: the matrix method. 5th ed. Burlington (MA): Jones & Bartlett Learning; 2017.
  11. 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):1. DOI: 10.1186/2046-4053-4-1
  12. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI manual for evidence synthesis [Internet]. Adelaide: JBI; 2024 [cited 2026 Jan 4]. DOI: 10.46658/JBIMES-24-01
  13. Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160. DOI: 10.1136/bmj.n160
  14. Barrington MJ, D'Souza RS, Mascha EJ, Narouze S, Kelley GA. Systematic reviews and meta-analyses in regional anesthesia and pain medicine (Part I): guidelines for preparing the review protocol. Reg Anesth Pain Med. 2024;49(6):391–402. DOI: 10.1136/rapm-2023-104801
  15. Bramer WM, De Jonge GB, Rethlefsen ML, Mast F, Kleijnen J. A systematic approach to searching: an efficient and complete method to develop literature searches. J Med Libr Assoc. 2018;106(4):531–41. DOI: 10.5195/jmla.2018.283
  16. Iraqi Academic Scientific Journals (IASJ). Iraqi Academic Scientific Journals [Internet]. Iraq: IASJ; 2026 [cited 2026 Aug 17]. Available from: https://iasj.rdd.edu.iq/
  17. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74. DOI: https://doi.org/10.2307/2529310
  18. Büchter RB, Weise A, Pieper D. Development, testing and use of data extraction forms in systematic reviews: a review of methodological guidance. BMC Med Res Methodol. 2020;20(1):259. DOI: 10.1186/s12874-020-01143-3
  19. Ahmed B, Voss JG, Griggs S, Naif AA, Ruksakulpiwat S, Aldossary HM, et al. HIV in Iraq: key populations, sociodemographics, transmission modes, present realities, and urgent next steps: a systematic review. Chronic Illn. 2026;22(1):3–16. DOI: 10.1177/17423953261417151
  20. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane Handbook for Systematic Reviews of Interventions. Version 6.5 (updated August 2024) [Internet]. Cochrane; 2024. Available from: https://training.cochrane.org/handbook
  21. Ayala AP, Sikora L, Kirtley S, Labelle PR. Barriers and facilitators for early career researchers completing systematic or scoping reviews in health sciences: a scoping review [Preprint]. Open Science Framework; 2019 [cited 2026 Sep 2]. DOI: 10.31219/osf.io/gkzf2
  22. Rohwer A, Ngah V, Mavridis D, Young T, McCaul M. Building capacity for network meta-analysis in Sub-Saharan Africa: reflections and future direction. Syst Rev. 2024;13(1):7. DOI: 10.1186/s13643-023-02418-8
  23. Alfonso F, Crea F. International Committee of Medical Journal Editors recommendations: an update. Eur Heart J. 2026;47(29):3886–8. DOI: 10.1093/eurheartj/ehag290
How to Cite
Naif Ali, A. ., Qasim Qader, M. ., Mahmud Hussen, B. . ., Abdulqader Amin, Z. . ., Saaduldeen Anwer, S. . ., Azad Samad, A. ., Abdulla Qadir Al-Banna, D. . ., Abdulahad Shabu Hakim, S. . ., Ibrahim Mahmood, K. ., & Mohammed M. Amin, K. . (2026). A Practical 19-Step Guideline for Conducting and Reporting Systematic Reviews Without Meta-Analysis: The Hawler Medical University Approach. Zanco Journal of Medical Sciences (ZJMS), 831–844. https://doi.org/10.15218/zjms.2026.060

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