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In this blog interview Dr David Nunan shares with us which systematic review that he’s led or been involved in he would choose to take with him to read, if he was stranded on a desert island.

A picture of a beautiful tropical island with blue sky, turquoise sea and white sand. There are palm trees. overlaid is a picture of a woman in a seated yoga pose

Can you introduce yourself and share your role in the MSc EBHC (Systematic Reviews) programme?

Hi, David here. I’m a senior research fellow in evidence-based healthcare (EBHC) and Director of the MSc in EBHC in Teaching and Education. I’ve been teaching about, and teaching others how to teach about systematic reviews for over 12 years. I also have an interest in the methods of systematic reviews. I currently support the Complex Reviews module.

If you were stranded on a "Desert Island", which systematic review that you have led or been involved in might you take with you to read?

Hmmm. This is a hard one as I have many to choose from. But if I have only one to choose then it would be this one:

Physical activity for treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews. 2022, Issue 6. Art. No.: CD011497. DOI: 10.1002/14651858.CD011497.pub2.

 What type of review was it?

 A systematic review of intervention studies

Why did you choose this review?

Because of the personal connection I have to this review. I came up with the idea for it after the experience of my late grandmother (“nanna”) who suffered with irritable bowel syndrome (IBS) in her later years. At the time of conceiving the idea I had been involved in EBHC for around 4 years and had developed an eye for everyday opportunities for evidence-informed decision-making. When my nanna was struggling with IBS I wondered what the available treatment options were and consulted the latest clinical guidelines. When reviewing these I noted that physical activity was mentioned as a potential option to manage IBS symptoms. This interested me for another reason - my background before EBHC was in sport and exercise science and I had a research interest in exercise and physical activity. When I look at the evidence cited to support the recommendation for physical activity I noted it was from low-quality, individual studies and that a comprehensive, high-quality systematic review had not been performed on this intervention.

What did your review show?

We found that a small body of evidence suggesting that physical activity comprising of yoga, treadmill exercise or support to increase physical activity may improve symptoms but not quality of life or abdominal pain in people diagnosed with IBS but we have little confidence in these conclusions due to the very low certainty (quality) of evidence.

The numbers of reported adverse events were low and the certainty of these findings was very low for all comparisons, so we could not draw any conclusions on harms of physical activity.

We concluded that if it was deemed sufficiently important to patients and healthcare providers, higher quality research is needed to enable more certain conclusions.

What did you particularly enjoy about the review?

I enjoyed the fact that this was the first Cochrane review that I lead and that it was on a topic of personal interest to me. I particularly liked that I was able to write and communicate the findings and conclusions in a way that was as close to the principles of good epidemiological reporting and evidence-based practice as possible.

Reflecting on your review, what one learning would you offer individuals completing a systematic review for the first time?

 Ensure that the question you are seeking to address is 1. something you care about enough to want to try answering it and 2. there is a real need for it to be answered.

 Finally, If you were stranded on a "Desert Island" and about to read your review, what one food or drink treat would you bring with you?

 Japanese gyoza and (iced!) green tea

You can learn more about the MSc EBHC (Systematic Reviews) programme through the dedicated webpage or by contacting cpdhealth@conted.ox.ac.uk

Please note: the views expressed in this blog are those of the author and do not necessarily represent the views of CEBM as a group.