Details have been modified to protect client confidentiality. This case study represents a composite of common research scenarios encountered by Research Gold.
A systematic review case study illustrating the complete journey from clinical question to journal acceptance. Dr. A., an internal medicine resident preparing for fellowship applications, needed a first-author publication to strengthen their academic portfolio. They had a compelling clinical question about blood pressure management in elderly patients with diabetes but no experience conducting systematic reviews or meta-analyses.
The Starting Point: A Clinical Question Without a Method
Dr. A. observed conflicting guidance in their hospital's hypertension protocols for diabetic patients over 65. Some attending physicians advocated aggressive targets (below 130/80 mmHg), while others preferred conservative management (below 140/90 mmHg), citing hypotension risks. The clinical uncertainty was genuine and well-suited to evidence synthesis.
However, Dr. A. had never:
- Registered a protocol on PROSPERO
- Developed a multi-database search strategy
- Used a screening tool like Covidence or Rayyan
- Conducted risk of bias assessment with RoB 2 online assessment calculator
- Run a meta-analysis in R or Stata
- Prepared a PRISMA-compliant manuscript
Their fellowship application deadline was 16 weeks away. The typical systematic review timeline of 67 weeks was not an option.
Week 1-2: Protocol Development and Registration
The first step was transforming the clinical observation into a structured research question using the PICO framework:
Population: Adults aged 65+ with type 2 diabetes and hypertension Intervention: Intensive blood pressure targets (below 130/80 mmHg) Comparison: Standard blood pressure targets (below 140/90 mmHg) Outcomes: All-cause mortality, cardiovascular events, serious adverse events, renal outcomes
The protocol was drafted using the PROSPERO registration formatter, specifying planned databases, search strategy outline, eligibility criteria, risk of bias tools (RoB 2 for RCTs), planned subgroup analyses (by diabetes duration, baseline blood pressure, and follow-up length), and the meta-analytic model (random-effects, DerSimonian and Laird).
PROSPERO registration was confirmed within 5 business days. This time-stamped public record established the a priori methodology, a requirement for the target Q2 cardiology journal.
Week 3-4: Comprehensive Literature Search
A systematic search strategy was developed across five databases: PubMed/MEDLINE, Embase, Cochrane CENTRAL, CINAHL, and ClinicalTrials.gov. The strategy combined MeSH terms and free-text terms for hypertension, diabetes mellitus, blood pressure targets, elderly/aged, and randomized controlled trials.
Using our search strategy builder to structure the Boolean logic, the search retrieved:
- PubMed: 1,847 records
- Embase: 2,103 records
- CENTRAL: 412 records
- CINAHL: 289 records
- ClinicalTrials.gov: 196 records
After deduplication, 2,847 unique records entered the screening phase.