Figure 1 shows a diagram outlining key questions to be addressed in the evidence review. The key questions help organize main issues as well as the approach to the literature search. Such a diagram is called an analytic framework.
The figure reads from left to right and connects a series of boxes indicating outcomes of interest, with arrows indicating actions that connect adjacent boxes, or dotted lines indicating associations between adjacent boxes. Above the arrows and dotted lines are numbers relating to the key questions listed in the text. The systematic review will attempt to answer key questions in order to understand each action or association.
The analytic framework begins on the left side of the figure by defining the population of interest as women and elderly adults in primary care settings. The first key question is represented by an overarching arrow 1 (labeled to refer to key question 1) that moves across the top of the figure and connects to 2 boxes on the far right. The arrow represents the action of screening, the boxes represent outcomes. Outcomes for the first box include reduced physical or mental harms including physical trauma (fractures, dislocations, brain injury, etc.); unwanted pregnancy and sexually transmitted diseases; mental trauma; social isolation and its repercussions, such as depression, anxiety, nightmares, among others. Outcomes for the second box include reduced premature death and physical and mental disability. The two boxes are connected by a dotted line, which denotes an association between the outcomes. The dotted line has no key question because the investigators did not examine the association.
Arrow 2 in the diagram corresponds to key question 2 and also indicates the action of screening. It begins with the population on the far left and connects to two rounded corner rectangular boxes. The upper box is labeled "current harm or risk for harm identified" and the lower box is labeled "current harm or risk for harm not identified."
Coming off Arrow 2 is Arrow 3, a curved line moving downward that connects to an oval labeled "adverse effects" (labeled to refer to key question 3).
Arrow 4 corresponds to key question 4 and indicates the action of intervention. It moves from the upper rounded rectangular box labeled "current harm or risk for harm identified" to the previously mentioned rectangular box labeled "reduced physical or mental harms."
Coming off Arrow 4 is Arrow 5, a curved line moving downward that connects to an oval labeled "adverse effects" (labeled to refer to key question 5).