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Using Systematic Reviews to Support Future Dietary Reference Intakes: A Letter Report (2023)

Chapter: 4 Decision Tree to Determine the Need for a De Novo or Update of an Existing Systematic Review

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Suggested Citation:"4 Decision Tree to Determine the Need for a De Novo or Update of an Existing Systematic Review." National Academies of Sciences, Engineering, and Medicine. 2023. Using Systematic Reviews to Support Future Dietary Reference Intakes: A Letter Report. Washington, DC: The National Academies Press. doi: 10.17226/27031.
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4

Decision Tree to Determine the Need for a De Novo or Update of an Existing Systematic Review

The Nordic Nutrition Requirements 2022 (NNR2022) developed an organizational framework of principles and methodologies for the conduct of systematic reviews. Their proposed framework is based on a system of checks and balances with the objective of minimizing the introduction of bias into the review process (Arnesen et al., 2020b). The NNR2022 served as a resource to determine the need for a de novo or update of an existing systematic review that could support a Dietary Reference Intake (DRI) study. The decision tree addresses only systematic reviews. The standing committee recognizes that umbrella reviews have a place among approaches to reviewing the evidence, however such an approach would require delineation of additional criteria, which was outside the scope of the committee’s task.

The decision tree recommended by the standing committee for determining whether a de novo or updated systematic review is needed to support a DRI study is shown in Figure 4-1. The sponsoring group that commissions the systematic review determines the specific review criteria. A DRI committee is not involved in the development of the systematic review; rather, after the systematic review has been completed a DRI committee is convened to assess the systematic review and any other evidence that it has been provided.

Suggested Citation:"4 Decision Tree to Determine the Need for a De Novo or Update of an Existing Systematic Review." National Academies of Sciences, Engineering, and Medicine. 2023. Using Systematic Reviews to Support Future Dietary Reference Intakes: A Letter Report. Washington, DC: The National Academies Press. doi: 10.17226/27031.
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Image
FIGURE 4-1. Decision tree for determining whether a de novo or updated existing systematic review is needed to support a Dietary Reference Intake study.
NOTE: PI(E)CO = population, intervention (exposure), comparator, outcome.
a A relevant DRI question would include specific DRI values to be addressed in the review such as setting a Tolerable Upper Intake Level (UL) vs. Chronic Disease Risk Reduction (CDRR) value.
b The process of setting the study questions and development of the PI(E)CO criteria falls to the group that is commissioning the systematic review.
Suggested Citation:"4 Decision Tree to Determine the Need for a De Novo or Update of an Existing Systematic Review." National Academies of Sciences, Engineering, and Medicine. 2023. Using Systematic Reviews to Support Future Dietary Reference Intakes: A Letter Report. Washington, DC: The National Academies Press. doi: 10.17226/27031.
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Page 19
Suggested Citation:"4 Decision Tree to Determine the Need for a De Novo or Update of an Existing Systematic Review." National Academies of Sciences, Engineering, and Medicine. 2023. Using Systematic Reviews to Support Future Dietary Reference Intakes: A Letter Report. Washington, DC: The National Academies Press. doi: 10.17226/27031.
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Page 20
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In response to a request from the US Department of Agriculture, the Health and Medicine Division (HMD) of the National Academies established the Standing Committee to Review the Dietary Reference Intake (DRI) Framework. The committee was asked to respond to DRI-related questions to inform the Federal DRI working group about the conduct of new DRI reviews and DRI-related issues more broadly, including their application.

This second letter report advises the Federal DRI Working Group on three questions: 1) Are de novo systematic reviews are needed in future DRI reviews or can qualified systematic reviews be used? 2) If qualified systematic reviews can be used, what are the appropriate inclusion and exclusion criteria? 3) Can previously published systematic review be updated? In response, the standing committee developed a report that includes a decision tree that addresses the need for systematic reviews to support the DRI process.

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