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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.

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.