Over the course of two months, a multinational team used Sysrev to assess the clinical characteristics and the risk factors associated with SARS CoV2 in patients with Chronic Kidney Disease.  

Researchers from the UK and China performed a two-stage review of 476 documents, as well as a ROBINS-I Risk assessment.  EDIT: The results of this review have been published: COVID-19 and kidney transplantation: A systematic review.

This story begins in late March when we decided to fund a COVID based research project.  Around that time, I noticed that Dr. Ciara Keenan (Associate Director of Cochrane Ireland and a research fellow for Campbell UK and Ireland) had created a COVID Mapping project on Sysrev.  As I had followed Dr. Keenan for some time (check out her twitter @MetaEvidence!), I was excited to see how we may help.  After some discussion, Sysrev offered to finance a COVID-focused project of her choosing.

Within a few days, Dr. Keenan had put together a multi-national team headed by Dr. Damian Fogarty, senior nephrologist in the Belfast Health and Social Care Trust.

See Research Team


The research team screened 476 abstracts for inclusion / exclusion.  The abstracts were uploaded into Sysrev via two XMLs.  One XML consisted of entirely English abstracts, while the other contained Chinese abstracts.  As Sysrev allows users to sort based on import file, this allowed the multi-national team to focus on the publications in their primary language.

Dr. Keenan: "Setting up the project was very easy. I had deduplicated all references in my endnote library, as usual, and then was able to import the remaining references as an XML format directly to Sysrev."

Import Articles Dashboard for Project 29506

As you can see in the Project Description, the Rapid Review’s protocol had strict inclusion / exclusion guidelines.  To help guide the reviewers, Dr. Keenan constructed labels that translated the requirements into a series of Yes – No (Maybe) questions.  In this way, it is easier to visualize the logic progression and spot any errors.  

Dr. Keenan: "When creating the labels I was able to input brief explanations which the users could see if they hovered over the question mark symbol. "

Label Definitions for Project 29506

Setting the labels up in this way saved substantial time.  Only 20 of the 476 articles resulted in Conflicts – that is, the reviewers disagreed on whether the article should be included.  In the end, 31 articles were included.

Dr. Keenan "From a project management perspective, I found it invaluable that you can track reviewers progress in real time. When I have managed systematic review projects in the past, I have provided batches of references to reviewers and it just isn’t possible to tell if they have started the batch, finished the batch, or are stuck, but with SysRev I was able to check in with the reviewers as they progressed and that really helped moved the project on quickly."

Full-Text (PDF) Data Extraction (Project 29629)

To start the Data Extraction phase, Dr. Keenan once again uploaded two XML’s, one for each language.  She then uploaded full PDF documents to each article within Sysrev.  For copyright reasons, Sysrev does not render PDFs to non-project members.  

The goal of the data extraction phase was to pull out a number of study details, including study design, participant details, interventions, and outcomes.  To capture all of the intended labels, Dr. Keenan created 29 labels.  By selecting Display Options – Labels in the Articles page, you can see all of the data extracted for each document.  In the end, over 700 pieces of information were extracted.

Dr. Mahalingasivam: [Sysrev] very easy to use... the notes function was very useful and it was easy to go back and correct responses if mistakes were made.

ROBINS – I Assessment Tool (Project 30488)

As a final step, the review team conducted a ROBINS-I Risk of Bias Assessment.  To learn more about the ROBINS-I tool, check out this publication.  Dr. Keenan translated the inferences of the tool into six labels, one for each potential source of bias.  Reviewers then classified each article’s potential for that bias as Critical, Moderate, Serious or Low.

We appreciate Dr. Keenan and her team’s devotion to their work and we are proud to have supported this effort.  We look forward to seeing the resulting publications, as well as their future work.  If you have an open science project that you would benefit from funding, apply to our future Mini-Grants.  

Sysrev Mini-Grants

Sysrev supports academic research by providing a platform for free open-access projects.  In addition, Sysrev offers Mini-Grants for open science projects.  Using Sysrev's built-in compensation tool, Mini-Grant winners are able to pay their reviewers on a per-document basis.  In this way, Sysrev provides funding to the research team for their otherwise pro-bono work.  

Dr. Keenan: "The compensation feature was excellent. I was able to deposit the funds into the reviewers PayPal account as soon as they had completed the task, instant reimbursement!"

Research Team

Dr Ciara Keenan is the Associate Director of Cochrane Ireland and a research fellow for Campbell UK and Ireland.

Dr Damian Fogarty is a senior nephrologist in the Belfast Health and Social Care Trust. He has held positions in the past as senior lecturer with Queen’s University Belfast (2002-2014) and as Chairman of the United Kingdom Renal Registry (2010-2014).

Dr Viyaasan Mahalingasivam is a trainee in renal medicine at Barts Health NHS Trust, London, UK.

Dr Alison Craik is a trainee in renal medicine in Newcastle-Upon-Tyne, UK and an Epidemiology Masters student at the London School of Tropical Medicine and Hygiene.

Professor Laurie Tomlinson is an Associate Professor at the London School of Hygiene and Tropical Medicine and an Honorary Consultant Nephrologist at Brighton and Sussex University Hospitals NHS Trust.

Professor Kehu Yang is the Director for Evidence-Based Medicine Center, Lanzhou University.

Dr Long Ge is a researcher in School of Public Health, Lanzhou University.

Ms Liangying Hou is a MD candidate in School of Public Health, Lanzhou University.

Ms Qi Wang is an undergraduate student in School of Public Health, Lanzhou University.

Blog photo credit: CDC/ Alissa Eckert, MS; Dan Higgins, MAMS