A Practical 19-Step Guideline for Conducting and Reporting Systematic Reviews Without Meta-Analysis: The Hawler Medical University Approach

Abstract

Background and objective: Approximately one-third of health systematic reviews do not employ meta-analysis, and novice reviewers may report narrative syntheses with insufficient methodological detail. Established resources such as PRISMA 2020, PRISMA-P, SWiM, the Cochrane Handbook, and GRADE provide complementary guidance but are distributed across separate documents. This guideline provides a practical, step-by-step approach for conducting and reporting systematic reviews without meta-analysis for students at Hawler Medical University. Methods: The 19-step guideline was developed by mapping complementary recommendations from PRISMA 2020, PRISMA-P, SWiM, the Cochrane Handbook, MMAT, Garrard's matrix method, GRADE, and JBI guidance across four sections: Methods (Steps 1–9), Results (Steps 10–13), Discussion (Step 14), and Conclusion and reporting elements (Steps 15–19). Reporting standards were distinguished from methodological guidance and institutional recommendations. Each step identifies its intended location, procedure, rationale, and corresponding reporting output. A draft was circulated to a panel for feedback and revised with an audit trail. Results: The guideline links methodological decisions to reporting outputs, including protocol development and registration, topic scoping, reproducible search design, eligibility criteria, two-stage screening, design-appropriate critical appraisal, standardized data extraction, and structured synthesis. It emphasizes reviewer calibration, transparent documentation, and selection of synthesis methods according to the review question and evidence type. Worked examples, synthesis matrices, and conceptual models are presented as optional teaching tools where appropriate rather than universal requirements. Conclusion: This practical 19-step guideline integrates established methodological and reporting resources into a single institutional framework for systematic reviews without meta-analysis. It is intended to support novice reviewers while allowing methodological choices to vary according to the review question, study designs, and evidence type. The framework also incorporates considerations relevant to Iraq and the Kurdistan Region and should be refined through future usability and implementation evaluation.